Effect Of Physical Therapy Treatment Research Articles

Exploring how common factors influence experience and outcomes in painful musculoskeletal conditions: a qualitative study

Background/Aims In studies exploring the effectiveness of physical therapy treatment for painful musculoskeletal conditions, interventions appear to improve patient-reported outcomes. The interventions adopt different approaches, but there is a lack of agreement about which approach is most effective. Thus, research is needed to look at the potential influence of other variables present, such as common factors. Common factors are elements present across different treatments, which are necessary conditions for forming a therapeutic alliance and providing patient-centred care. While there is a positive relationship between common factors and patient outcomes noted in physical therapy, the mechanism through which these factors influence patient outcomes is less understood. The aim of this study was to explore participants' perceptions of the influence of common factors on physical therapy outcomes. Methods Interviews were undertaken with seven individuals participating in physical therapy. The contextual model provided the framework to move beyond defining common factors to discussing how these elements contribute to the therapeutic changes seen in physical therapy. Results Participants discussed how the therapeutic relationship is influenced by perceived trust and credibility, enhanced by goal setting, and individualised care. When these common factors are present, the potential for engaging in the work of physical therapy and enacting healthy behaviours and actions by patients were enhanced. Conclusions By understanding common factors in physical therapy, a more complete view of the effects of interventions may be possible. Implications for practice This study sheds light on the clinical impact of common factors in physical therapy, highlighting the pivotal role of therapeutic relationships built on trust, credibility, and individualized care. Recognizing and integrating these common factors into practice may enhance patient engagement and foster better therapeutic outcomes in musculoskeletal conditions.

Effect of Physical Therapy Treatment in Knee Osteoarthritis with and without Wedge Insole: Randomized Controlled Trial

The purpose of this study was to determine the effects of physical therapy treatment in knee osteoarthritis with and without wedge support.Methods: This randomized controlled trail was conducted at Outpatient Department of Physical Therapy, Mayo Hospital, Lahore and Mid City Hospital, Lahore. Eighty patients with knee osteoarthritis were selected using a predefined inclusion and exclusion criteria and randomly allocated in two treatment groups; Group A (Routine physiotherapy treatment) and Group B (Routine physiotherapy with wedge insole). Outcome were recorded at the start and at the end of treatment at 3 weeks in terms of pain and disability as recorded on Numeric Pain Rating Scale (NPRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively. The collected data was entered and analyzed using SPSS v25 with p value < 0.05 as significant.Results: At the end of the third week, there was a statistically significant difference between the two treatment groups in terms of VAS (Mean Difference 1.55; p value 0.05) and WOMAC (Mean Difference 5.53; p value 0.0001). A statistically significant difference in before and after treatment VAS and WOMAC score was also noted within each group with p value <0.0001.Conclusion: In comparison to conventional physical therapy alone, adding wedge insoles to the routine physical therapy treatment of Knee Osteoarthritis results in better pain relief and function improvement.

Effect of Physical Therapy Treatment in Knee Osteoarthritis with and without Wedge Insole: Randomized Controlled Trial

The purpose of this study was to determine the effects of physical therapy treatment in knee osteoarthritis with and without wedge support.Methods: This randomized controlled trail was conducted at Outpatient Department of Physical Therapy, Mayo Hospital, Lahore and Mid City Hospital, Lahore. Eighty patients with knee osteoarthritis were selected using a predefined inclusion and exclusion criteria and randomly allocated in two treatment groups; Group A (Routine physiotherapy treatment) and Group B (Routine physiotherapy with wedge insole). Outcome were recorded at the start and at the end of treatment at 3 weeks in terms of pain and disability as recorded on Numeric Pain Rating Scale (NPRS) and Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) respectively. The collected data was entered and analyzed using SPSS v25 with p value < 0.05 as significant.Results: At the end of the third week, there was a statistically significant difference between the two treatment groups in terms of VAS (Mean Difference 1.55; p value 0.05) and WOMAC (Mean Difference 5.53; p value 0.0001). A statistically significant difference in before and after treatment VAS and WOMAC score was also noted within each group with p value <0.0001.Conclusion: In comparison to conventional physical therapy alone, adding wedge insoles to the routine physical therapy treatment of Knee Osteoarthritis results in better pain relief and function improvement.

046 Feasibility, Acceptability and Effects of Physical Therapy Treatment for Gynecological Cancer Survivors with Dyspareunia

Dyspareunia affects more than half of gynecological cancer survivors. These women are confronted with this serious health issue as well as relationship difficulties and psychological distress. Despite the impact on their quality of life, the available treatments remain limited and poorly studied. Physical therapy (PT) has been shown to be highly effective to treat dyspareunia in younger populations with no history of cancer. However, no study has investigated PT in gynecological cancer survivors with dyspareunia.

Effectiveness of physical therapy treatment in addition to usual podiatry management of plantar heel pain: a randomized clinical trial

BackgroundMany patients will seek care from a podiatrist for plantar heel pain (PHP), while few of these patients will also be seen by a physical therapist. Physical therapists can provide treatment that is not a part of routine podiatric care for PHP and may provide additional improvement. Therefore, the purpose of this study was to examine the effects of interdisciplinary care for PHP that incorporated physical therapy treatment after initiating podiatric treatment.MethodsEligible individuals with PHP that presented to a podiatrist were randomized to receive usual podiatric care (uPOD) or usual podiatric care plus physical therapy treatment (uPOD+PT). The primary outcome was change in foot and ankle ability measure (FAAM) at 6-months. Secondary outcomes included change in numeric pain rating scale (NPRS), patient-reported success, and 6-week and 1-year endpoints. Patient-reported success was defined as the top two global rating of change scale rankings. Primary analysis was intention-to-treat (ITT) using analysis by covariance adjusted to baseline scores, and a secondary per-protocol (PP) analysis was performed analyzing only those who completed treatment.ResultsNinety-five individuals participated and were included in the ITT analysis, and 79 were included in the PP analysis. For the primary outcome of FAAM change from baseline to 6-months, both groups improved significantly (uPOD+PT: 26.8 [95% CI 21.6, 31.9]; uPOD: (20 [15.6, 24.4]), but there was no between-group difference (4.3 [− 1, 9.6]). For secondary outcomes, the uPOD+PT group demonstrated greater improvement in NPRS at 6 weeks (0.9 [0.3, 1.4]) and 1 year (1.5 [0.6, 2.5]) in the ITT analysis. In the PP analysis, the uPOD+PT group demonstrated greater improvement in FAAM at 6 months (7.7 [2.1, 13.3]) and 1 year (5.5 [0.1, 10.8]), NPRS at 6 weeks (0.9 [0.2, 1.6]), 6 months (1.3 [0.6, 2.1]) and 1 year (1.3 [0.6, 2.1]), and in patient-reported success (relative risk [95% CI]) at 6 weeks (2.8 [1.1, 7.1]), 6 months (1.5 [1.1, 2.1]), and 1 year (1.5 [1.1, 1.9]).ConclusionsThere was no significant benefit of uPOD+PT in the primary outcome of FAAM change at 6 months. Secondary outcomes and PP analysis indicated additional benefit of uPOD+PT, mostly observed in individuals who completed treatment.Trial registrationProspectively registered May 24, 2013 at www.clinicaltrials.gov (NCT01865734).

Wednesday, September 26, 2018 7:35 AM–9:00 AM ePosters: P60. The effect of physical therapy on gait and balance in patients follow lumbar artificial disc replacement: a preliminary study

BACKGROUND CONTEXT Lumbar disc replacement (LDR) is used primarily to treat lumbar degenerative disc disease (DDD) resulting with back pain and/or leg pain in the absence of nerve root compression due to its advantages over fusion, including reduction of adjacent segment disease and reoperations as well as spinal motion preservation. A key factor of clinical success is rehabilitation. Physical therapy (PT) is often used to improve flexibility, strength and stability as well as balance and coordination, areas commonly deficient after surgery. Studies on PT and LDR are scarce. The impact of PT intervention on the neuromuscular, biomechanical, and self-reported outcomes of LDR patients’ gait and balance have not yet been explored. PURPOSE To evaluate the effect of PT on the biomechanics of the lower extremities and spine during gait and balance in patients with DDD after LDR surgical intervention. STUDY DESIGN/SETTING A prospective concurrent control cohort study. PATIENT SAMPLE Eight LDR patients. OUTCOME MEASURES Gait spatiotemporal parameters and center of mass (COM) and head sway during functional balance test along with VAS and ODI. METHODS After LDR surgery, gait and functional balance analyses were performed the week before PT (pre) and after completion of 6-8 weeks PT (post). PT consisted of manual therapy, therapeutic exercises and activities as well as neuromuscular education per LDR protocol, which focused on improved mobility, stability and strength as well as balance in accordance with appropriate precautions or restrictions. No modalities, except for cold packs, were used. Spatiotemporal parameters (ie, gait speed, cadence, stride length, width and time, etc.) were calculated during the gait evaluation. The functional balance test was similar to a Romberg's test. COM and head displacements in the sagittal and coronal planes and total sway amount were calculated. ODI and VAS were collected on the day of each testing. RESULTS ODI score was reduced from 29.3±22.8 to 15.5±2.5. VAS leg (pre: 3.3±2.3vs. post: 0.6±0.5), and lower back (pre: 3.6±2.9vs. post: 1.4±0.3) scores were reduce as well. Patients presented with less COM say in the forward–backward direction (pre: 1.27±1.11vs. post: 0.21±0.87 cm), less external oblique muscle (pre: 0.028±0.020vs. post: 0.009±0.003 mV) but more rectus femoris (pre: 0.009±0.004vs. post: 0.012±0.005 mV) and tibialis anterior (pre: 0.009±0.002vs. post: 0.012±0.001 mV) muscle activity after completion of PT in comparison to their pre-PT state. Gait spatiotemporal parameters did not significantly change completion of PT. This may be due to the small sample size we have. CONCLUSIONS This is the first study to explore the effect of PT treatment on function in patients with DDD after LDR surgery. Minimal information is available on the effect of PT and LDR. PT after LDR surgery may positively affect the COM sway and improved muscle recruitment of the tibialis anterior and rectus femoris during balance resulting with a more stable, efficient, and normal balance pattern. Gait appears intact after LDR. More research and standardization of PT care is needed for optimal LDR benefits.

Noisy galvanic vestibular stimulation: an emerging treatment option for bilateral vestibulopathy.

Patients with bilateral vestibulopathy (BVP) suffer from persistent imbalance during standing and walking as well as an impaired gaze stabilization during head movements. Disabilities associated with BVP severely compromise patients' daily activities and are often linked to an increased risk of falls. Currently, the only established treatment option in BVP is physical therapy. However, treatment effects of physical therapy in BVP are most often limited and many patients do not adequately recover performance. Therefore, a number of technical therapeutic approaches are being explored that either try to substitute lost vestibular sensation with a congruent stimulation of other sense modalities or to artificially mimic vestibular function by means of an implantable vestibular prosthesis. Besides, attempts have recently been made to augment and optimize residual vestibular function in patients with BVP using an imperceptible noisy galvanic vestibular stimulation (nGVS). This approach is based on the natural phenomenon of stochastic resonance, wherein the signal processing in sensory systems can be improved by adding an appropriate level of noise to the system. Promising first study outcomes of nGVS treatment in patients with BVP indicate the feasibility of a future non-invasive sensory prosthetic device for BVP rehabilitation. This paper gives an overview about recent research on nGVS treatment in patients with BVP and discusses future research perspectives in this field.

Physiotherapy of Operative of Myocardial Revascularization Post-Surgery

Introduction: Myocardial infarction (MI) is defined by total interruption of coronary flow, resulting in ischemia and myocardial necrosis. In MI, diastolic function of the left ventricle is immediately altered, since part of the diastole is an energy-dependent procedure. Objective: To analyze, through a systematized review, the effect of physical therapy treatment in the postoperative period of myocardial revascularization. Methodology: The tool used to analyze the selected articles was the list of PRISMA recommendations. We analyzed original researches published in English and Portuguese in the last ten years, using the SCIELO, PUBMED, BIREME, MEDLINE databases. Results: 100 articles were selected, with inclusion and exclusion criteria, being chosen only 20 articles, 10 of Portuguese language and 10 of foreign language. Conclusion: Cardiac rehabilitation protocols, involving the association of conventional physiotherapy with stimulators and other techniques, such as PEEP, TENS, CPAP, muscle training, deep breathing exercises, provide a satisfactory and immediate result to individuals.

Effectiveness of physical therapy treatment of clearly defined subacromial pain: a systematic review of randomised controlled trials

AimTo summarise the current evidence regarding the effectiveness of physical therapy on pain, function and range of motion in individuals with subacromial pain syndrome (SAPS).DesignSystematic review.Data sourcesPubMed, Web of Science,...

Mobility and Ambulation for Patients with Pulmonary Artery Catheters: A Retrospective Descriptive Study.

The purposes of this retrospective study are to: 1) describe the amount and type of documented mobility activity for patients with an indwelling Pulmonary Artery Catheter (PAC) and 2) document the frequency and type of complications that occur with an indwelling PAC during patient participation in these activities. This study is a single-center, retrospective, descriptive study including all patients (>18 years) between June 2010 and October 2012 with an indwelling PAC in the Cardiology Intensive Care Unit (CICU). Data was extracted on all documented mobility activity each of these patients performed with nursing or during skilled treatments provided by a physical therapist (PT), or occupational therapist (OT). Any notation of PAC-related complications while the PAC was in place was recorded. In the CICU over a 29-month period, 366 patients with indwelling PACs performed bed mobility, transfers, ambulation and climbed stairs with no reports of PAC complications during or in relation to participation in mobility activity. The data suggests that participation in mobility activities does not place patients with an indwelling PAC at increased risk of PAC related complications. This data further supports the involvement of rehabilitation specialists in the CICU. Future prospective research is necessary to measure the effects of physical therapy treatment on patients with indwelling PAC.

Effect of Physical Therapy Training on Gait Initiation in Patients with Moderate Parkinson's Disease

The present study investigated the effects of physical therapy treatment on gait initiation in patients with Parkinson's disease (PD). Thirteen patients with PD were randomized into a treatment (n = 7) and control (n = 6) group. Participants were assessed for their severity level, using the Modified Hoehn and Yahr scale, and motor evaluation, using the Unified Parkinson's Disease Rating Scale (UPDRS), items III and IV. At pre- and post-assessments, gait initiation was assessed using a gait mat, synchronized with a video camera. The treatment group received a physical therapy training program based on the TrainingBIG™ technique and task-specific concepts, three times per week for four weeks. The control group received no physical therapy treatment. From analysis of the pre- and post-assessment variables, only the treatment group showed a significant decrease in preparatory phase time (p = 0.043) and increase in step length (p = 0.018). In addition, the treatment group had a significant increase in step length (p = .022) at post-assessment when compared to the control group. The present findings demonstrated that physical therapy treatment would be beneficial for patients with PD experiencing gait initiation problems.

Effect of early treatment with transcutaneous electrical diaphragmatic stimulation (TEDS) on pulmonary inflammation induced by bleomycin

BackgroundBleomycin (B) is an antineoplastic drug that has pulmonary fibrosis as a side effect. There are few experimental studies about the effects of physical therapy treatment in this case.ObjectiveThe objective was to study rat lungs treated with B and precocious intervention by transcutaneous electrical diaphragmatic stimulation (TEDS).MethodWistar rats were divided into 4 groups (n=5): a control group (C); a stimulated group (TEDS); a group treated with a single dose of B (intratracheally, 2.5 mg/kg) (B); and a group treated with B and electric stimulation (B + TEDS). After the B instillation, the electrical stimulation was applied for 7 days, for a duration of 20 minutes. Lung fragments were histologically processed with hematoxylin and eosin (HE) and 8-isoprostane-PGF2α (8-iso-PGF2α). The density of the alveolar area was determined by planimetry, the inflammatory profile was defined by the number of cells, and the level of oxidative stress in the pulmonary tissue was evaluated by 8-iso-PGF2α. For statistical analysis of the data, the Shapiro-Wilk test was used, followed by a one-way ANOVA with the post-hoc Bonferroni test (p≤0.05).ResultsThe B group exhibited a significant reduction in the area density, and the acute treatment with B + TEDS prevented this reduction. There were increased numbers of fibroblasts, leukocytes, and macrophages in the B group, as well as increased lipid peroxidation, which was observed only in this group.ConclusionB promoted a reduction in the alveolar density area, thereby inducing the inflammatory process and increasing the production of free radicals. These effects were minimized by the application of TEDS at the initial treatment stage.

Physical therapy treatment in incontinent women provided by a Public Health Service

INTRODUCTION: Urinary incontinence affects more than 50 million people worldwide, it has a great impact on quality of life by affecting social, domestic, occupational and sex life, regardless of age. Objective: The objective of this study was to analyze the effectiveness of physical therapy treatment in women attending the Urogynecology service of Hospital and Maternity Leonor Mendes de Barros. METHOD: We retrospectively assessed 65 records of patients with diagnosis of urinary incontinence treated between November 2005 and November 2006. In order to have their data analyzed, patients were divided into two groups; group MF, which underwent medical treatment and physiotherapy, and group M, which had only medical treatment. In order to compare both groups' quantitative data, the analysis was performed in Statistica® software using Mann Whitney's non-parametric test. The analysis of association between the quantitative variables was performed through the Chi-Square test at 5% (p > 0.05) significance level. RESULTS: We observed that 60.6% of patients who underwent physical therapy treatment and medical treatment had the urinary incontinence symptoms decreased or completely cured, while 80% of women belonging to the medical treatmen only-group underwent surgery. CONCLUSION: Thus, we conclude that physical therapy is essential in treatment protocols of urinary incontinence outpatient clinics and to prevent surgery.

Efeito do treinamento funcional do assoalho pélvico associado ou não à eletroestimulação na incontinência urinária após prostatectomia radical

Effect of functional training for the pelvic floor muscles with or without electrical stimulation in cases of urinary incontinence following radical prostatectomy Introduction: Literature on physical therapy for the pelvic floor muscles to treat urinary incontinence following radical prostatectomy is scarce, with descriptions of differing techniques for physical therapy treatment. Objective: To evaluate the effect of physical therapy treatment for recovering urinary continence among patients who had undergone radical prostatectomy, by using functional training of the pelvic floor muscles with or without electrical stimulation. Method: Twenty patients with urinary incontinence following radical prostatectomy were selected. The patients were randomly allocated to a control or to an experimental group. The experimental group was composed of ten patients who received physical therapy treatment consisting of functional training of the pelvic floor muscles and electrical stimulation. The control group was composed of ten patients who received physical therapy treatment consisting only of functional training of the pelvic floor. All of the patients were re- evaluated three, six and twelve months after beginning treatment, by using the pad test, visual analog scale (VAS) for incontinence, VAS for the problem and counting the number of diapers (nappies) used. Results: There was a statistically significant decrease between the initial and 12 th month evaluations of the pad test, VAS for incontinence, VAS for the problem and numbers of diapers of the control group and experimental group. However, no statistically significant difference was found when the same variable was compared between the two groups. Conclusion: There was no additional improvement from treatment with functional training of the pelvic floor muscles associated with electrical stimulation, in relation to treatment only using functional pelvic floor training. However, there was a significant improvement in urinary incontinence in both groups.

A patient-oriented health status measure in outpatient rehabilitation.

The purpose of this study was to assess the utility of a patient-centered health status measurement tool in multiple outpatient rehabilitation clinics and to characterize health status before and after an outpatient physical therapy intervention as part of that assessment. Six outpatient rehabilitation clinics voluntarily agreed to incorporate a standardized patient-centered health status questionnaire into everyday practice. Patients completed the SF-36 health status questionnaire before initiating treatment and again at discharge. Only nonsurgical patients without comorbidities were enrolled. Voluntary application of the SF-36 on a small scale was achieved over a period of 3-4 mo. All health concepts improved except general health perceptions. The results suggest that (1) a standard patient-oriented health status questionnaire can be incorporated into outpatient rehabilitation clinics, and useful information can be derived regarding outcomes; (2) careful administrative coordination is necessary to optimize follow-up and decrease burden on both patients and clinicians; (3) although improvements in health status were demonstrated, small sample sizes and the lack of control groups prevents conclusions regarding the effectiveness of physical therapy treatment; and (4) the magnitude of effect sizes suggests that controlled studies could be performed by clinicians partnering with researchers to improve outpatient rehabilitation.