Conventional Physiotherapy Research Articles

THE EFFECT OF LOWER EXTREMITY CLOSED KINEMATICS CHAIN EXERCISE ON POLYCYSTIC OVARIAN SYNDROME WITH MENORRHEA

Aim:This study investigated the effect of lower extremity closed kinematics chain exercise on polycystic ovarian syndrome with menorrhea. Method:A total of 35 subject young women with polycystic ovarian syndrome between the age of 18 to 30 years, were recruited over 6 months and randomly allocated to an intervention group(n=35), participated in this observational experimental study. In this study menorrhea flow were measured at baseline prior to enrolment after 6 months of participation. In an intention-to-treat analysis, we experiment the closed kinematics chain exercise is effective in polycystic ovarian syndrome with menorrhea. Result: Result of this study were analysed in terms effect of lower extremity closed kinematics chain exercise on menorrhea with polycystic ovarian syndrome patient the population of 35 subjects [all females] were served for effect of lower extremity of closed kinematics exercise on patients with menorrhea in polycystic ovarian syndrome in age group of 18 to 30 yrs. Out of 35 patients Pads count are compared between pre and post result and same in result is seen in Menorrhea outcome questionnaire score. The study states that pads count and menorrhea outcome questionnaire score for menorrhea in polycystic ovarian syndrome patient is showed that improve after lower extremities closed kinematics chain exercise. Conclusion: The study concluded that conventional physiotherapy with lower extremity closed kinematics chain exercises are effective in reducing menorrhea in patient with polycystic ovarian syndrome.

Comparison of the efficacy of auricular vagus nerve stimulation and conventional low back rehabilitation in patients with chronic low back pain

BackgroundIn recent years, human and animal studies have provided increasing evidence that vagus nerve stimulation (VNS) can produce analgesic effects as well as alleviating resistant epilepsy and depression. Our study was designed to compare the efficacy of transcutaneous auricular vagus nerve stimulation with conventional low back rehabilitation in patients with chronic low back pain (CLBP). MethodsSixty patients with LBP were randomly divided into two groups. Group 1 received conventional rehabilitation and home exercise, and Group 2 received transcutaneous auricular VNS and home exercise. Both groups received treatment five days a week for three weeks. Trunk mobility (Modified Schober test, fingertip-to-floor test), muscle strength (CSMI-Cybex Humac-Norm isokinetic dynamometer and Lafayette manual muscle strength measuring device), trunk endurance, balance tests, Visual Analog Scale, Beck Depression Scale, Pittsburgh Sleep Quality Index, Oswestry Disability Index were evaluated. ResultsAt the end of three weeks, within-group assessment results showed positive effects on mobility, functional status, depression and sleep in all groups (p < 0.05). Pain level, endurance time and flexion trunk muscle strength results showed more improvement in Group 2 (p < 0.05). Some parameters of isokinetic lower extremity quadriceps muscle strength and fall risk scores showed a significant improvement in Group 1 (p < 0.05). DiscussionVNS has been observed to be more effective on pain, trunk muscle strength and endurance duration and sleep status. Auricular VNS may be included in the treatment of patients with CLBP in whom conventional physical therapy is inadequate or not applicable.

Effect of Spinal and Lower limb Re-alignment Protocol on Bilateral Medial Compartment Osteoarthritis of Knee in Postmenopausal Women

The alignment of spine-pelvis-lower extremity axis is significantly influenced by knee osteoarthritis. Joint alignment is the main bio-mechanical risk factor for progression of knee osteoarthritis. The purpose of this study was to find out the effect of spinal and lower limb realignment protocol on bilateral medial compartment knee osteoarthritis in postmenopausal women and to compare it with the conventional method of treatment for osteoarthritis of knee. A study sample of 128 post-menopausal subjects within age group 50-70 and BMI between 25-35 kg/m2 having bilateral knee osteoarthritis with medial compartment involvement were selected and equally divided into two groups as the control group and the experimental group. Assessment of pain, knee range of motion, quadriceps and hip abductor strength, and posture for spinal and lower limb malalignment was taken before and after giving the treatment regime to both the groups. Comparison was carried out between the results of the two groups.The results showed how significantly the mal-aligned structures were re-aligned after giving 8 weeks of realignment protocol and how significantly this resulted in better reduction of pain intensity and improvement in knee range of motion and strength of quadriceps and hip abductor muscles in experimental group as compared to the control group. Re-aligning the spinal and lower limb malalignment present in postmenopausal women with bilateral medial compartment knee osteoarthritis results in pain reduction associated with knee joint and improved knee range of motion and strength of quadriceps and hip abductor muscles in these individuals as compared to the ones receiving conventional physiotherapy.

The effectiveness of partial body weight support treadmill training on walking in people with cerebral palsy

Background: People with Cerebral Palsy (CP) face daily motor, sensory, and cognitive impairments that significantly impact their quality of life. This systematic review aimed to investigate RCTs regarding the effectiveness of treadmill walking with partial body weight support (PBWSTT) in individuals with CP. Methods: A search was performed in PubMed, Scopus and Research Gate. The study selection process was conducted by two separate reviewers. The quality of the final studies included in the systematic review was assessed using the PEDro scale. Results: Out of the 673 studies initially identified, 6 studies were included. The results showed that (PBWSTT) leads to an increase in scores on the GMFM scale, as well as improvement in walking pattern, speed, endurance, and rhythm. The method of PBWSTT in comparison to conventional physiοtherapy did not show better results, as the included studies in this review showed conflicting results. Conclusion: The effect of therapeutic exercise with partial body weight support has a positive impact on improving the gross motor function of patients with Cerebral Palsy. However, the question of whether PBWSTT is more effective than conventional physiotherapy and over-ground walking exercise cannot be conclusively answered yet, highlighting the importance of conducting further research in this field.

Possibilities of backward walking application in the rehabilitation of patients with gonarthrosis: review

INTRODUCTION. Osteoarthritis of the knee joint or gonarthrosis (GA) is one of the most common joint pathologies. The medical and social significance of GA is associated with its high prevalence and a significant percentage of premature disability and a significant deterioration in the quality of life due to persistent pain syndrome. Modern treatment of patients with GA includes a combination of pharmacological and non-pharmacological methods; physical therapy is the leading method of non-drug therapy. By now, a number of studies have been conducted to research the effectiveness of backward walking (BW) in people with GA. AIM. Analysis of scientific data on the possibilities of using BW in the rehabilitation of patients with GA. MATERIALS AND METHODS. A systematic search of literary sources by keywords was carried out: “backward walking”, “gonarthrosis”, “knee osteoarthritis”, “knee joint”, “rehabilitation”, “physical therapy”. DISCUSSION. Recently, backward locomotion is increasingly used in medicine. Kinetic and kinematic analysis during BW showed a number of advantages over the usual method of movement, which can be successfully used for rehabilitation of patients with GA. BW is associated with less overload on knee joints. It is also one of the few natural ways of strengthening the quadriceps. It prevents excessive stretching of the anterior cruciate ligament and improves the stability of the knee joint. BW leads to a more cardiovascular and respiratory load and a more significant aerobic and anaerobic capacity of the organism compared with forward walking at similar parameters of physical activity. CONCLUSION. There is evidence that adding BW to conventional physiotherapy treatment may further reduce pain, functional disability and improve the strength of the quadriceps muscles.

The effects of aromatherapy massage in menopausal women with knee osteoarthritis: A randomized controlled study

ObjectiveKnee Osteoarthritis (OA)’s prevalence increases during menopause. Aromatherapy massage with different oils is applied in the treatment of knee OA. The aim of this study was to determine the effects of aromatherapy massage with Bergamot essential oil (BEO) on pain, functionality, sleep quality and menopausal symptoms in menopausal women with knee OA. Materials and methodsThis study included 60 menopausal participants diagnosed with grade II-III OA. Participants were randomly divided into three groups: BEO (n=20), placebo (n=20) and control (n=20). The participants in the BEO group, received aromatherapy massage with BEO, in the placebo group aromatherapy massage with sweet almond oil was applied twice a week for 4 weeks. All participants underwent conventional physiotherapy. Visual Analog Scale was used to assess the severity of pain, Osteoarthritis Index to assess functionality, Pittsburgh Sleep Quality Index to assess sleep quality and Menopausal Symptoms Rating Scale to assess menopausal symptoms. All measurements were performed before and after the study. ResultsThe results of the study showed that all three groups were effective on pain, functionality, sleep quality and menopausal symptoms (p<0.001). The results of the study showed that, aromatherapy massage with BEO was found to be more effective on functionality (p<0.001), pain (p<0.001) and menopausal symptoms (somatic and psychological symptoms) (p<0.001) compared to the control and placebo groups. It was determined that aromatherapy massage with BEO did not create a significant difference between the sleep quality scale scores in the control group and the placebo group (p=0.454). ConclusionThis study found that aromatherapy massage with BEO improved functionality, reduced pain and menopausal symptoms, and did not affect sleep quality. We consider that its application in addition to routine treatment may be useful to reduce symptoms.

EFFECTIVENESS OF SACRAL RELEASE TECHNIQUE COMBINED WITH CONVENTIONAL PHYSIOTHERAPY FOR MANAGING DYSMENORRHEA: A CASE STUDY

Background: Dysmenorrhea (menstrual cramps) is a common gynecological condition with painful menstruation as its main symptom. It negatively influences women’s quality of life and hampers their productivity and activities. While the exact etiology is unknown, increased prostaglandin levels and myofascial trigger points are thought to play a role. This study investigated the effectiveness of combining sacral release technique, a myofascial release therapy, with conventional physiotherapy for treating dysmenorrhea symptoms. Methods: A 23-year-old woman with clinically diagnosed primary dysmenorrhea was treated with a rehabilitation protocol consisting of sacral release technique, deep breathing exercises, and static stretching over the course of her menstrual period. Outcomes were measured pre- and post-intervention using the Numerical Pain Rating Scale (NPRS) and Menstrual Distress Questionnaire (MEDI-Q). Results: Subsequently after the intervention all outcome indices indicated significant improvement for the patient. NPRS scores reduced from 6 to 4 indicating less pain intensity while broad MEDI-Q total score went down from 64 to 39 signifying improved menstrual symptoms along with distress due to periods in addition to over-all quality regarding daily living associated with menses. Conclusion: In Conclusion, combining sacral release technique, and traditional physiotherapy methods of deep breathing and stretching were effective in alleviating symptoms of woman during menstrual flow, reducing pain and improving quality of life for the mentioned patient. These findings indicate that having a sacral release along with other modalities may become another intervention in treating dysmenorrhea. Keywords: Dysmenorrhea, sacral release technique, Pain Management, conventional physiotherapy, case study.

Effect of Dynamic Balance Training on Physical Function and Proprioception in Individuals with Knee Osteoarthritis

Background: Osteoarthritis (OA) is a prevalent joint disorder affecting synovial joints, particularly the knee. It leads to degeneration of cartilage, causing pain and reduced physical function. Effective treatment strategies are essential for managing symptoms and improving quality of life. Objective: To determine the effect of dynamic balance training on physical function and proprioception in individuals with knee osteoarthritis. Methods: This quasi-experimental trial was conducted at Riphah International University Lahore, Aziz Medical Clinic, and Ali Hospital, Mughal Pura Lahore. A total of 48 patients with anterior knee pain were recruited and divided into two groups: one receiving dynamic balance training and the other receiving conventional physical therapy (control). Non-probability convenience sampling was used. Outcomes were measured using NPRS, a goniometer, the Community Balance and Mobility Scale (CB&amp;M), and the Western Ontario and McMaster Universities Arthritis Index (WOMAC). Knee proprioception was assessed by joint position sense using a universal goniometer, with the average of three angles taken for the final reading. Data were analyzed using SPSS version 25. Results: Significant differences were observed in joint proprioception between weight-bearing (WB) and non-weight-bearing (NWB) procedures. The mean difference for WB was -3.07 compared to -2.18 for NWB, with a higher relative error in WB (p &lt; 0.05). Dynamic balance training resulted in greater reductions in NPRS scores and improvements in WOMAC scores compared to conventional physical therapy (p &lt; 0.05). Conclusion: Dynamic balance training was more effective than conventional physical therapy in improving physical function and proprioception in individuals with knee osteoarthritis.

Effects of robot-assisted walking training on balance, motor function, and ADL depending on severity levels in stroke patients.

Despite the explosive increase in interest regarding Robot-Assisted Walking Training (RAWT) for stroke patients, very few studies have divided groups according to the severity levels of patients and conducted studies on the effects of RAWT. The purpose of this study was to present a definite basis for physical therapy using the robot-assisted walking device through a more detailed comparison and analysis and to select the optimal target of RAWT. This study was designed as a prospective and randomized controlled trial to investigate the effect of RAWT on balance, motor function, and Activities of Daily Living (ADL) depending on severity levels in stroke patients. 100 participants were randomly divided into study and control groups in equal numbers. The study group was 49 and the control group was 47. One from the study group and three from the control group were eliminated. The study period is four weeks in total, and RAWT is performed five times a week for 40 minutes only for study group. During the same period, all group members had 30 minutes of Conventional Physiotherapy (CP) five times a week. The results of this study clearly confirmed that RAWT combined with CP produces more significant improvement in patients with stroke than the CP alone. And they indicated that RAWT had a more considerable effect in the poor or fair trunk control group for trunk balance and in the high fall risk group for balance. In motor function, RAWT showed its value in the severe and marked motor impairment group. The total or severe dependence group in ADL experienced more improvements for RAWT. This study can be concluded that the lower the level of physical functions, the more effective it responds to RAWT. As demonstrated in the results of this study, the potential of current robotic technology appears to be greatest at very low functional levels of stroke patients. Patients with low functional levels among stroke patients may benefit from robot rehabilitation.

Effect of Maitland mobilization versus deep cervical flexors muscles training on proprioception in adults with chronic mechanical neck pain: a randomized controlled trial

ObjectiveTo examine the effect of adding Maitland mobilization (MM) versus deep cervical flexors muscles training (DCFMT) to conventional physical therapy (CPT) on proprioception in adults with chronic mechanical neck pain (CMNP).Materials and methodsA randomized controlled study was carried out at the outpatient clinics of physical therapy at Cairo and Suez universities. Sixty participants (27 males, 33 females) with CMNP were randomized into 3 equivalent groups. Group I received MM plus CPT, group II received DCFMT in addition to CPT, and group III received CPT only. All individuals were given three sessions a week for 4 weeks. The primary outcomes were proprioception (CROM), and pain (VAS). The secondary outcomes were cranio-vertebral angle (CVA), and upper cervical angle (C0–C2). Outcomes were evaluated at baseline and following 4 weeks of treatment.ResultsFollowing 4 weeks of treatment, the DCFMT group showed statistically significant improvement to the MM group as well as the CPT group in all outcome measures (p > 0.05). Also, the MM group was remarkably better than the CPT group in all measured outcomes (p > 0.05). The mean signed difference (M±SD) post-treatment within the group of VAS were 6.87 ± 1.26, 7.15 ± 1.38, and 7.20 ± 1.39 cm for MM, DCFMT, and CPT groups respectively. The (M±SD) of CVA were 42.61 ± 4.36, 42.24 ± 3.64, and 42.32 ± 4.81 degrees for MM, DCFMT, and CPT groups respectively. The (M±SD) of C0–C2 were 24.25 ± 2.98, 23.37 ± 1.94, and 24.95 ± 3.01 degrees for MM, DCFMT, and CPT groups respectively. The (M±SD) of flexion JPE to target were 3.62 ± 0.91, 2.86 ± 0.77, and 4.35 ± 0.91 degrees for MM, DCFMT, and CPT groups respectively. The (M±SD) of flexion JPE to neutral were 3.96 ± 0.78, 2.66 ± 1.03, and 5.23 ± 1.52 degrees for MM, DCFMT, and CPT groups respectively.ConclusionAdding MM and DCFMT to CPT revealed significant enhancement, favoring DCFMT, on proprioception, pain, cranio-vertebral angle (CVA), upper cervical angle (C0–C2), and intensity than CPT alone in adults with CMNP.Trial registrationPan African Clinical Trails Registry with a registration No. PACTR202211651838599 on the 3rd of November 2022.

Evaluating the Impact of Flossing Band Integration in Conventional Physiotherapy for Patellofemoral Pain Syndrome.

Background/Objectives: Patellofemoral Pain Syndrome (PFPS) is prevalent among physically active individuals, highlighting the need for innovative treatment strategies beyond conventional physiotherapy. This study investigates the effectiveness of integrating flossing band therapy with standard physiotherapy, anticipating improved outcomes in pain reduction, functional ability, and patient satisfaction. Methods: A double-blinded randomized controlled trial involved 50 PFPS-diagnosed participants. They were divided into two groups: Standard Physiotherapy Group (SPG) and Flossing Band and Physiotherapy Group (FBPG), each undergoing an 8-week intervention focusing on resistance training supplemented by respective therapies. Assessment metrics included pain (VAS), strength (Dynamometry), lower limb function (LEFS), and PFPS function (AKPS) measured before and after the intervention. Results: Significant enhancements in all outcome measures were noted for both groups, yet the FBPG exhibited notably superior improvements in pain, knee functionality, muscle strength, and lower extremity function. The FBPG demonstrated statistically significant greater efficacy in pain alleviation and strength enhancement. Conclusions: The addition of flossing band therapy to conventional physiotherapy presents a more effective treatment modality for PFPS, suggesting its potential to redefine therapeutic standards. Future studies should delve into the long-term impacts and mechanistic underpinnings of floss band therapy in PFPS management.

Effects of robot-assisted gait training using the Welwalk on gait independence for individuals with hemiparetic stroke: an assessor-blinded, multicenter randomized controlled trial

BackgroundGait disorder remains a major challenge for individuals with stroke, affecting their quality of life and increasing the risk of secondary complications. Robot-assisted gait training (RAGT) has emerged as a promising approach for improving gait independence in individuals with stroke. This study aimed to evaluate the effect of RAGT in individuals with subacute hemiparetic stroke using a one-leg assisted gait robot called Welwalk WW-1000.MethodsAn assessor-blinded, multicenter randomized controlled trial was conducted in the convalescent rehabilitation wards of eight hospitals in Japan. Participants with first-ever hemiparetic stroke who could not walk at pre-intervention assessment were randomized to either the Welwalk group, which underwent RAGT with conventional physical therapy, or the control group, which underwent conventional physical therapy alone. Both groups received 80 min of physical therapy per day, 7 days per week, while the Welwalk group received 40 min of RAGT per day, 6 days per week, as part of their physical therapy. The primary outcome was gait independence, as assessed using the Functional Independence Measure Walk Score.ResultsA total of 91 participants were enrolled, 85 of whom completed the intervention. As a result, 91 participants, as a full analysis set, and 85, as a per-protocol set, were analyzed. The primary outcome, the cumulative incidence of gait-independent events, was not significantly different between the groups. Subgroup analysis revealed that the interaction between the intervention group and stroke type did not yield significant differences in either the full analysis or per-protocol set. However, although not statistically significant, a discernible trend toward improvement with Welwalk was observed in cases of cerebral infarction for the full analysis and per-protocol sets (HR 4.167 [95%CI 0.914–18.995], p = 0.065, HR 4.443 [95%CI 0.973–20.279], p = 0.054, respectively).ConclusionsThe combination of RAGT using Welwalk and conventional physical therapy was not significantly more effective than conventional physical therapy alone in promoting gait independence in individuals with subacute hemiparetic stroke, although a trend toward earlier gait independence was observed in individuals with cerebral infarction.Trial registrationThis study was registered with the Japan Registry of Clinical Trials (https://jrct.niph.go.jp; jRCT 042180078) on March 3, 2019.

Effectiveness of Mindfulness Based Cognitive Therapy Verses Conventional Physiotherapy on Kinesiophobia in Patients with Frozen Shoulder: A Comparative Study

Background: Frozen Shoulder is defined as a clinical syndrome characterized by painful restriction of both active and passive shoulder movements (1) . there is high degree of kinesiophobia among patients having shoulder pain(2). Mindfulness based cognitive therapy (MBCT) may be an effective intervention for the treatment of active depression in a population with chronic pain (3) . The treatment goal of MBCT program, is to find ways of managing the pain and the adverse consequences on mental health and quality of life (4). considering that in patients with frozen shoulder treatment of pain alone was not enough to reduce fear of movement , Hence this study aimed to find the effect of MBCT on pain and kinesiophobia in patients with frozen shoulder. Objective: To find the effect of mindfulness based cognitive therapy on pain and kinesiophobia in patients with frozen shoulder. Methodology: After designing the study Institutional Ethical Approval was taken. Consent was obtained from all the participants. 30 samples were screened based on eligibility criteria, 2 were excluded and 28 were further divided into Group A (experimental group) received MBCT and conventional therapy and Group B (control group) received conventional therapy. Pre-assessment was by Tampa scale for kinesiophobia and VAS scale for pain done at Week 0. The experimental group received the MBCT and regular exercise program for 8 sessions 2 hours per day for 8 weeks. The control group received regular exercise program. Post-assessment was done at week 8. Result: The (INSTAT) was used for comparison of mean of group A and group B. One participant from the experimental group and one from the control group did not complete the study. The comparison of mean post intervention scores for group A and B of TSK Scores was found to be Extremely significant which was calculated using un-paired t test with t value t= 3.922, p value p= &lt;0.0006. Comparison of mean post intervention scores for group A and B of VAS Scores was found to be Not significant which was calculated using un-paired t test with t value t= 0.4583, p value p= 0.6505. Conclusion: The study concludes that MBCT along with conventional physiotherapy is effective in reducing kinesiophobia in patients with frozen shoulder.

Virtual reality-based interventions, a neoteric approach for management and rehabilitation in patients with breast cancer.

Breast cancer (BC) patients and survivors can experience immense emotional and psychosocial trauma. Treatment modalities for BC, including surgery, chemotherapy and radiotherapy are associated with certain displeasing and undesirable effects, including physical restrictions as well as mental stress. However, it has been ascertained that appropriate supportive and rehabilitative strategies can significantly help to alleviate the distress. Along with several conventional physical therapy options, the novel Virtual Reality (VR) tool has opened a new gateway in rehabilitative approaches in patients with BC. We reviewed the role of VR based management for BC-related incapacitations and found that its efficacy is comparable to that of contemporary therapy options. It has the additional benefits of modulating pain perceptions, improving mobility, and overall enhancing the quality of life of BC survivors.

Effect of early weight bearing program with conventional physiotherapy on functional outcomes in surgically treated proximal tibia fracture: a pilot randomized controlled trial.

Patients are often instructed to avoid weight bearing on the proximal tibia for 6 - 12 weeks post-surgery to avoid fracture fixation failure. However, delayed weight bearing leads to delayed mobility, causing difficulties in daily activities; problems such as pain, limited knee ROM, reduced quadriceps muscle strength, and impaired functional outcomes are reported in long-term follow-up. This study primarily aimed to evaluate the feasibility and explore the effect size. The secondary aim was to determine the effectiveness of early weight bearing along with conventional physiotherapy on functional outcomes. A single-blinded pilot randomized controlled trial with 30 participants with proximal tibia type I, II, and III fractures were included; they were randomized using computer-based software. Seven patients were lost to follow-up. Group I received early weight bearing along with conventional physiotherapy whereas Group II received restricted weight bearing along with conventional physiotherapy. Assessments were made on post-operative day 3 (POD-03), at discharge, at 6 weeks, and at 12 weeks. Radiographs were recorded immediately after the operation, at discharge, and at 12 weeks. A full-scale RCT is feasible with an effect size between 0.3 - 0.7. A statistically significant difference (p < 0.05) was found within both groups 12 weeks post-surgery in all outcome measures; the difference was more prominent in the intervention group. A statistically significant difference (p < 0.05) was found between both the groups post-12 weeks in all outcome measures except quadriceps isometric muscle strength. A full-scale RCT for early weight bearing along with conventional physiotherapy for patients operated for Type I, II, and III proximal tibia fracture is feasible. Early weight bearing along with conventional physiotherapy could have a positive effect on reducing patient's pain perception and increasing knee joint mobility, quadriceps isometric muscle strength, knee function, and quality of life without any adverse effects. ClinicalTrialsRegistry.gov (CTRI/2022/10/046797).

Effect of Structured Cardio-Respiratory Fitness Protocol on Physical Function and Performance in Geriatric Patients: A Quasi Experimental Study

Background: Exercise interventions have emerged as a promising avenue for mitigating age-related declines, particularly in the context of physiological changes such as sarcopenia and muscle strength loss. A recent study utilizing the International Classification of Functioning, Disability, and Health (ICF) framework underscored declines in physical functioning among older adults. Geriatric individuals commonly undergo cardio-respiratory changes and experience a decrease in physical fitness. This study seeks to compare the effects of a structured cardio-respiratory fitness protocol with a conventional exercise program on physical function and performance in geriatric patients, with a specific focus on the impact of cardio-respiratory fitness on overall physical function. Methods: Employing a quasi-experimental pre-test post-test design spanning six months, two groups of participants aged 50 to 70, encompassing both genders and with a BMI between 20 and 30, was included. The experimental group adhered to the structured cardio-respiratory fitness protocol, while the control group received conventional physiotherapy. Measured parameters included heart rate (HR), respiratory rate (RR), peak expiratory flow rate (PEFR), and Borg scale ratings. Pre and post-treatment data underwent statistical analysis. Results: Both groups demonstrated improvements in HR, RR, PEFR, and Borg scale ratings post-intervention. Notably, the experimental group exhibited significantly greater improvements in these parameters compared to the control group (p &lt; 0.05). Conclusion: The structured cardio-respiratory fitness protocol yielded a significant enhancement in physical function and performance among geriatric patients. Recommendations for future research involve incorporating larger sample sizes, extended intervention durations, and personalized approaches to maximize effectiveness. This study contributes valuable insights into the potential benefits of structured cardio-respiratory fitness interventions for augmenting geriatric physical function and overall quality of life.

Acceptance and adoption of tele-rehabilitation by physiotherapists from Nigeria, a low resource setting: a mixed-method study

BackgroundAdoption of tele-rehabilitation among physiotherapists in developed countries has risen exponentially to complement conventional physical contact physiotherapy. However, many low- and middle-income countries like Nigeria where barriers to utilization of tele-physiotherapy were earlier identified still demonstrates limited evidence on its acceptance and adoption till date.MethodThis was a mixed-method design of quantitative and qualitative study, aimed at investigating acceptance and adoption of tele-rehabilitation among physiotherapists in Nigeria. Respondents comprised 331 physiotherapists practising in Nigeria and registered with the Medical Rehabilitation Therapists (Registration) Board of Nigeria (MRTB). Quantitative approach involved completion of a 33-item structured questionnaire shared as Google Forms to respondents’ WhatsApp and emails. Qualitative aspect involved in-depth interview with 12 physiotherapists at the clinics, using a 10-item semi-structured interview guide, and recorded with a voice recorder. Quantitative data was analysed using descriptive and inferential statistics at p < 0.05 alpha level. Qualitative data was analysed using thematic content analysis.ResultsRespondents comprised 172 males and 159 females. Their mean age and years of experience were 33.42 ± 8.95 and 8.86 ± 8.037 years, respectively. Pre-lockdown, only 62 (18.7%) respondents offered tele-physiotherapy. During the 35-day total lockdown, 114 (34.4%) offered tele-physiotherapy. Majority (155 (46.8%)) used smartphone apps. Fifty-seven (17.2%) respondents were confident that tele-rehabilitation can complement conventional physiotherapy, while 72 (21.8%) kept offering post-lockdown. Use of digital technology was highest for patient education (97 (29.3%)), especially for musculoskeletal conditions (85 (25.7%)). There were significant associations between pre-lockdown duties (p = 0.036), post-lockdown duties (p = 0.005) and use of digital health technology (p = 0.001) with respondents’ age. Significant associations also existed between respondents’ years of practice and each of post-lockdown duties (p = 0.017) and use of digital health technology (p = 0.001). Qualitative approach revealed that facilitators to adoption and acceptance of tele-rehabilitation included patient education, training of physiotherapists, availability of evidence-based guidelines and tele-health software and hardware systems. Barriers were lack of or limited technological infrastructures, finances, hospital management support, and knowledge of information and communication technology.ConclusionsPhysiotherapists in Nigeria demonstrated moderate acceptance but low adoption of tele-rehabilitation, in varied comparison with clinicians and physiotherapists in other climes. Training of physiotherapists in tele-rehabilitation and provision of enabling technological environment by regulatory bodies and policy makers are recommended.

Inspiratory Muscle Training in Patients Living With Chronic Kidney Disease and Receiving Hemodialysis: Meta-Analysis of Randomized Controlled Trials.

People living with chronic kidney disease (CKD) and receiving hemodialysis (HD) have impaired respiratory muscle strength and endurance. The objective of this study was to systematically review the effects of inspiratory muscle training (IMT) on respiratory muscle strength, functional capacity, lung function, quality of life, endothelial function, and oxidative stress in people living with CKD and receiving HD. An electronic search was conducted from inception to June 2023. Randomized controlled trials that evaluated the effects of IMT on respiratory muscle strength, functional capacity, lung function, endothelial function, quality of life, or oxidative stress in adults living with CKD and receiving HD, compared with control, placebo IMT, or conventional physical therapy, were included. Eight studies were included, totaling 246 people. The meta-analysis showed that IMT increased the maximum inspiratory pressure (MIP) by 22.53cm H2O, the maximum expiratory pressure (MEP) by 19.54cm H2O, and the distance covered in the 6-minute walk test by 77.63m. Changes in lung function and quality of life were not observed. It was not possible to quantitatively analyze data on endothelial function and oxidative stress. IMT improves MIP, MEP, and functional capacity in people living with CKD and receiving HD. IMT did not demonstrate significant results for lung function and quality of life. Effects on endothelial function and oxidative capacity remain uncertain. Inspiratory muscle training improves MIP, MEP, and functional capacity in people living with CKD and receiving HD, compared with conventional physical therapy or controls or placebo intervention. Increases in functional capacity in this population are extremely important because of the relationship with the survival of these people.

The effect of instrument-assisted soft tissue mobilization in lumbar disc herniation: A randomized controlled trial

AimTo investigate the effect of instrument-assisted soft tissue mobilization technique on pain, joint range of motion, functionality and quality of life in patients with lumbar disc herniation. MethodsThis is a double blinded, randomized controlled trial. A total of 60 patients were randomly allocated to either an experimental group [n = 30, age = 46.33 ± 12.96 years] or a control group [n = 30, age = 57.03 ± 9.64 years]. The experimental group received instrument-assisted soft tissue mobilization [3 consecutive days a week for 4 weeks] in addition to conventional physiotherapy [five days a week for 4 weeks]. The control group only received the conventional physiotherapy [five days a week for 4 weeks]. Pain intensity, range of motion of the lumbar spine (flexion, extension, lateral flexion), functional disability related to low back pain and quality of life were assessed at the beginning and end of the study. ResultsThe experimental group showed statistically significant improvements in the range of motion in lumbar area (flexion, extension and lateral flexion values) compared to that shown in the control group (p < 0.05). The mean differences in Oswestry disability index were significantly better in experimental group than in the control group (p < 0.05). There were no significant differences between the two groups in terms of pain and quality of life (p > 0.05). ConclusionsInstrument-assisted soft tissue mobilization, in addition to conservative treatment, can improve range of motion in lumbar area and reduce functional disability in patients with Lumbar Region Disc Herniations.

Dual-Task Specific Training or Conventional Physiotherapeutic Interventions, Which one is more Effective?

Background: Physiotherapeutic interventions play a crucial role in motor re-learning and functional recovery for stroke patients with upper and lower limb motor impairments. Among these interventions, dual-task training (DTT) has demonstrated significant effectiveness in enhancing the functional recovery of stroke patients. Objective: This study aims to compare the effectiveness of DTT and conventional physical therapy in ambulating right-hemiplegic stroke patients.Material and Methods: A randomized control trial (RCT) was conducted at the Department of Rehabilitation Medicine, Saidu group of Teaching Hospital, 2nd March 2020 to 3rd August 2020. Chronic right-hemiplegic stroke patients meeting set inclusion criteria were randomly assigned to two groups: the treatment group (TG) receiving DTT and the control group (CG) undergoing conventional physical therapy. DTT interventions included walking forward, backward, and sideways on a smooth surface while holding an 80-gram sandbag. The CG received conventional physiotherapy involving mat activities, strengthening, stretching exercises, and ambulation/gait training. Pre- and post-tests collected clinical data analyzed on SPSS 22 included spatial and temporal variables, 10-Meter Walk Test (10MWT), Time Up &amp; Go Test (TUG), step length, cadence, cycle time, and stride length. Results: Out of 18 patients, each group had 50%, comprising 5 males (28%) and 4 females (22%). The mean age in CG was 57.20± 5.20, and in TG, it was 57.27± 6.10 years. Baseline clinical parameters were nearly identical between groups (P&gt;0.05). Post-test scores revealed significant improvements in spatial and temporal gait variables, 10MWT score, cadence, step length, stride, and cycle time in TG compared to CG (P&lt;0.05). Conclusion: Dual-task training and conventional physical therapy both significantly enhance the functional ability of right-hemiplegic patients across all gait temporal and spatial parameters. Keywords: Conventional physical therapy, Dual task training, Gait &amp; ambulation, Stroke.