Efficacy Of Physiotherapy Research Articles

Urinary incontinence in postmenopausal women - causes, symptoms, treatment.

Urinary incontinence (UI) is an important social problem that affects more than 50% of postmenopausal women. The number of patients increases from year to year. According to recent data, UI affects women twice as often as men. This condition occurs in about 20-30% of young women, 30-40% in middle age and up to 50% of women in old age. There are five types of urinary incontinence. The etiology of the problem of incontinence is not fully understood, because the problem can affect men and women of all ages and can be due to many changes in the human body. International Continence Society Guidelines indicate that treatment of urinary incontinence should begin with conservative treatment. Surgical treatment should be used when conservative treatment will not bring positive results. According to guidelines, conservative treatment should include pharmacotherapy, physiotherapy, and behavioral therapy. Numerous scientific reports indicate efficacy of physiotherapy in the treatment of urinary incontinence. Most recent reports indicate that physiotherapy gives a positive result in up to 80% of patients with stage I or stress urinary incontinence (SUI) and mixed form, and in 50% of patients with stage II SUI. Urinary incontinence is an interdisciplinary problem because in addition to the sphere directly related to medicine, it also concerns the economic and social spheres. The latest data show that incontinence in postmenopausal women occurs more often than other civilization diseases such as diabetes, hypertension or depression.

Physiotherapy informed by Acceptance and Commitment Therapy (PACT) for people with chronic low back pain: a randomised controlled trial

Purpose: Chronic low back pain (CLBP) is the greatest cause of years lived with disability worldwide thus debilitating for patients, challenging for health care systems and costly for societies. Physiotherapy is moderately effective but might be improved by incorporating psychological models and techniques. Acceptance and Commitment Therapy (ACT), a form of cognitive-behavioural therapy, is effective for people with chronic pain when delivered by psychologists but is uncommon in physiotherapy. This trial aimed to test the efficacy of physiotherapy informed by ACT (PACT) against usual care (UC) physiotherapy for CLBP.

The TeMPO trial (treatment of meniscal tears in osteoarthritis): rationale and design features for a four arm randomized controlled clinical trial

BackgroundMeniscal tears often accompany knee osteoarthritis, a disabling condition affecting 14 million individuals in the United States. While several randomized controlled trials have compared physical therapy to surgery for individuals with knee pain, meniscal tear, and osteoarthritic changes (determined via radiographs or magnetic resonance imaging), no trial has evaluated the efficacy of physical therapy alone in these subjects.MethodsThe Treatment of Meniscal Tear in Osteoarthritis (TeMPO) Trial is a four-arm multi-center randomized controlled clinical trial designed to establish the comparative efficacy of two in-clinic physical therapy interventions (one focused on strengthening and one containing placebo) and two protocolized home exercise programs.DiscussionThe goal of this paper is to present the rationale behind TeMPO and describe the study design and implementation strategies, focusing on methodologic and clinical challenges.Trial registrationThe TeMPO Trial was first registered at clinicaltrials.gov with registration No. NCT03059004. on February 14, 2017.

The management of shoulder impingement and related disorders: A systematic review on diagnostic accuracy of physical tests and manual therapy efficacy

BackgroundDiagnostic accuracy of physical tests and effectiveness of musculoskeletal rehabilitation of shoulder disorders are still debated. ObjectivesTo investigate diagnostic accuracy of physical tests, efficacy of physiotherapy and coherence between target of assessment and intervention for shoulder impingement and related disorders like bursitis, rotator cuff and long head biceps tendinopathy and labral lesions. MethodsA systematic search of four databases was conducted, including RCTs and cross-sectional studies. Cochrane Risk of Bias and QUADAS-2 were adopted for critical appraisal and a narrative synthesis was undertaken. Results6 RCTs and 2 cross-sectional studies were appraised. Studies presented low to moderate risk of bias. There is a lack of evidence to support the mechanical construct guiding the choice of physical tests for diagnosis of impingement. Manual techniques appear to yield better results than placebo and ultrasounds, but not better than exercise therapy alone. Discrepancy between the goal of assessment strategies and the relative proposed treatments were present together with high heterogeneity in terms of selection of patients, type of endpoints and follow-ups. ConclusionsMusculoskeletal physiotherapy seems to be an effective treatment for patients with shoulder pain although it is still based on weak diagnostic clinical instruments. The adoption of more functional and prognostic assessment strategies is advisable to improve coherence between evaluation and treatment.

Efficacy of Physiotherapy in Improving the Range of Motion of Elbow after the Treatment of Pediatric Supracondylar Humeral Fracture

Introduction: Temporary stiffness of elbow range of motion (ROM) after treatment of supracondylar humeral fracture in children is often a parental concern.Objectives: We examined the role of physiotherapy in improving the elbow ROM in management of supracondylar humeral fracture in children.Methodology: Sixty-four patients were randomly divided into intervention and control groups. Then intervention group patients received regular physiotherapy sessions while control group patients were not sent for physiotherapy. We assessed the outcome according to Flynn criteria during their follow-ups at two, six and 12 weeks, after removal of cast/k-wires.Results: In intervention group, 77.4% children had excellent outcome, and in control group, 80.6% children had excellent outcome. However, we did not find any statistically significant association between physiotherapy and outcome at 12 weeks, after controlling for baseline characteristics in multivariable regression model.Conclusion: Children managed by close reduction for uncomplicated supracondylar humeral fracture with immobilization for three weeks regain their functional ROM within 12 weeks of mobilization by themselves, with no added benefit from physiotherapy.BJHS 2018;3(2)6: 432-436.

Exploring well-being and satisfaction with physiotherapy efficacy: an Italian study of cancer patients

Several studies have shown that rehabilitation can alleviate post-treatment side effects, maintain quality of life, and improve survival. However, information on the experience of physiotherapy care among patients with cancer is scarce. This study aimed to explore well-being and satisfaction with and perceptions of efficacy of physiotherapy care among patients diagnosed with cancer. The participants were 100 subjects in rehabilitation therapy after surgery for cancer (mean age = 57.1 years, 87.1% women). The study collected quantitative data through a questionnaire on well-being and satisfaction with and efficacy of physiotherapy treatment. The results showed that participants had good levels of well-being, and compared to a control population, these participants showed significant differences in environmental mastery, personal growth and positive relationships with others. Participants in this study had higher levels of satisfaction with and perceptions of the efficacy of their physiotherapy care. Correlation analyses indicated that there is a moderate positive correlation between global satisfaction and the dimensions of treatment efficacy. The results are discussed in relation to the need to give attention to well-being and rehabilitation treatment in cancer patients.

Recent advances in musculoskeletal physiotherapy for haemophilia.

Physiotherapy is directed towards the movement needs and potential of individuals, providing treatment and rehabilitation to develop, maintain and restore maximum movement and functional ability throughout the lifespan. Recent systematic reviews and randomized controlled trials have extended evidence for the clinical efficacy of physiotherapy interventions and rehabilitation for people with haemophilia. This narrative review synthesizes recent evidence to discuss; differentiating musculoskeletal bleeding and haemophilic arthropathy, efficacy of physiotherapy and rehabilitation for acute musculoskeletal bleeding and arthropathy, as well as monitoring musculoskeletal health. Whilst robust evidence is emerging, there is a need for more well designed randomized clinical studies with larger numbers and homogeneity of participants and collaboration of all researchers and clinicians to identify a core set of outcome measures that can be used to monitor musculoskeletal health.

Physiotherapy and Occupational Therapy in Acute Neurology

AbstractTherapy of neurological patients comprises, beyond medical treatment, the treatment of functional deficits which result from a neurological disease such as stroke. Physiotherapy aims at enabling bedridden neurological patients to become mobile again using training of movement and coordination. In cooperation with occupational therapists, patients are trained to become able to perform activities of daily living again. In addition, multimodal activating/assisting exercises are mandatory to counteract the deficit-related development of joint contractures. The rationale for these exercises are neurophysiological findings about postlesional cerebral plasticity. Moreover, parametric scales have been developed to assess neurological disturbances and to monitor their resolution in an observer-independent fashion. This allows communication across institutions and to assess the efficacy of physiotherapy and occupational therapy.

The combined effect of cranial-nerve non-invasive neuromodulation with high-intensity physiotherapy on gait and balance in a patient with cerebellar degeneration: a case report

BackgroundCranial-nerve non-invasive neuromodulation (CN-NINM) using the portable neuromodulation stimulator (PoNS™) device has been proposed as a novel adjuvant intervention to improve efficacy of gait and balance. This device modulates input and output signals during motor tasks which prompts neuroplastic changes. In this study, we investigated the efficacy of physiotherapy using the PoNS™ in a case with cerebellar degeneration.Case presentationThe PoNS™ was used during a high-intensity physiotherapy programme delivered over 2 weeks (2 × 1.5 h sessions daily). Clinical and instrumented gait and balance tests were applied pre- and post-intervention.ResultsThe patient improved in all tests without any adverse effects.ConclusionThis study showed the efficacy and feasibility of combined high-intensity physiotherapy and CN-NINM for gait and balance rehabilitation. Further studies should explore CN-NINM effects in larger and more diverse samples of neurological patients.

Effectiveness of physiotherapy in elderly patients with dementia: a prospective, comparative analysis

Background: The aim of this study was to assess the efficacy of physiotherapy in nursing home patients with comorbid dementia.Materials and methods: The study group consisted of 88 patients, including 48 people with dementia and 40 people without dementia. Before and after physiotherapy, the Mini Mental State Examination and Barthel Index were used.Results: Elderly patients without dementia achieved a greater improvement in functional status. The level of cognitive functioning at the time of admission to a nursing home, but not the patient’s functional status, had a significant impact on physiotherapy efficacy.Conclusion: Understanding the role of dementia in the rehabilitation process is important for care planning. More research is required to ascertain the efficacy of physiotherapy in people with moderate to severe dementia, including the best strategies to improve their functional status.Implications for RehabilitationThe level of cognitive function is important in the rehabilitation process, and it influences effectiveness of physiotherapy.Physiotherapy efficacy in the group of patients with coexisting dementia is lower than that in patients without dementia.Regular physiotherapy can also improve functional status in patients with coexisting dementia.The results of the study may have utilitarian implications, leading to a change in therapy regimens at physiotherapy centres treating disabled chronically ill people with coexisting dementia.

Vaskülitik nöropatiye bağlı düşük ayak gelişen olguda fizyoterapinin etkinliği

Vaskülitik nöropatiye bağlı düşük ayak gelişen olguda fizyoterapinin etkinliği

Wpływ sposobu kwalifikacji na efekty fizjoterapii chorych na POChP

Objective. The study was aimed at the assessment of qualification of COPD patients participating in the pulmonary rehabilitation program covering models A, B, C, D and E. Materials and methods. 174 COPD patients treated were included in the study. Exercise tolerance was assessed in all patients, based on a treadmill test or 6-minute walk test. The physiotherapy program was based on efficiency trainings of intensity determined individually for each patient. A result of the exercise test constituted a basis for qualification for an appropriate rehabilitation model and for individual selection of intensity level. The exercise test was repeated three weeks later, after the end of the physiotherapy program. Results. Results of pre- and post-rehabilitation tests in both groups were statistically analysed. Intra-group assessments used t-Student test for dependent samples. Mean values of individual indexes, standard deviations and mean growth of all indexes were calculated. A chart frame area plot of all variables was used for the analysis of test results. Conclusions. 1. A significant improvement of exercise tolerance was observed after a physiotherapy program both in patients assessed using the modified Brice's protocol and in those assessed using the 6-minute walk test 2. The study demonstrated that the assessment of exercise tolerance is a basis for selection of exercise intensity level. 3. Efficacy of physiotherapy of COPD patients participating in pulmonary rehabilitation programs was demonstrated.

The general surgeon\u2019s perspective of rectus diastasis. A systematic review of treatment options

BackgroundDiastasis of the rectus abdominis muscles (DRAM) is characterised by thinning and widening of the linea alba, combined with laxity of the ventral abdominal musculature. This causes the midline to “bulge” when intra-abdominal pressure is increased. Plastic surgery treatment for DRAM has been thoroughly evaluated, though general surgical treatments and the efficacy of physiotherapy remain elusive. The aim of this systematic literature review is to evaluate both general surgical and physiotherapeutic treatment options for restoring DRAM in terms of postoperative complications, patient satisfaction, and recurrence rates.MethodMEDLINE®, Embase, PubMed, PubMed Central®, The cochrane central registry of controlled trials (CENTRAL), Google Scholar, and the Physiotherapy Evidence Database (PEDro) were searched using the following terms: ‘rectus diastasis’, ‘diastasis recti’, ‘midline’, and ‘abdominal wall’. All clinical studies concerning general surgical or physiotherapeutic treatment of DRAM were eligible for inclusion.ResultTwenty articles describing 1.691 patients (1.591 surgery/100 physiotherapy) were included. Surgical interventions were classified as plication techniques (313 patients; 254 open/59 laparoscopic), modified hernia repair techniques (68 patients, all open), and combined hernia & DRAM techniques (1.210 patients; 1.149 open/40 hybrid). The overall methodological quality was low. Plication techniques with interrupted sutures and mesh reinforcement were applied most frequently for DRAM repair. Open repairs were performed in 85% of patients. There was no difference in postoperative complications or recurrence rate after laparoscopic or open procedures, or between plication and modified hernia repair techniques. Physiotherapy programmes were unable to reduce IRD in a relaxed state. Though reduction of IRD during muscle contraction was described.ConclusionBoth plication-based methods and hernia repair methods are used for DRAM repair. Based on the current literature, no clear distinction in recurrence rate, postoperative complications, or patient reported outcomes can be made. Complete resolution of DRAM, measured in a relaxed state, following a physiotherapy training programme is not described in current literature. Physiotherapy can achieve a limited reduction in IRD during muscle contraction, though the impact of this finding on patient satisfaction, cosmesis, or function outcome is unclear.

Results of Physiotherapy Treatments in Exacerbations of Chronic Obstructive Pulmonary Disease: A Systematic Review.

Purpose: The objective of this study was to review clinical trials of the effectiveness of physiotherapy compared with standard care, focused mainly on the functional status of patients hospitalized for acute exacerbation of chronic obstructive pulmonary disease (AECOPD). Methods: Search strategies were developed for each of the databases (PubMed, Scopus, and Web of Science). The study eligibility criteria were as follows: (1) The objective was to assess the effect and efficacy of physiotherapy compared with standard care (which included only medical and pharmacological treatment); (2) adults subjects had AECOPD; (3) one of the outcome measures was functional status, defined as an individual's ability to perform the normal daily activities required to meet basic needs, fulfill usual roles, and maintain health and well-being; (4) it was a clinical trial; (5) it was written in English; (6) it was published between January 2009 and February 2016; and (7) the full-text article was available. Results: The review revealed that for patients hospitalized for AECOPD, exercise, neuromuscular electrical stimulation, breathing exercises, and chest therapy significantly improved their functional status compared with standard care. Conclusions: A variety of physiotherapy modalities have been shown to improve functional status compared with standard care among patients hospitalized for AECOPD; other outcome measures also showed improvements.

Physiotherapy and behavior therapy for the treatment of overactive bladder syndrome: a prospective cohort study.

To determine the efficacy of physiotherapy and behavior therapy and to find specific subgroups of women with overactive bladder syndrome that might gain increased benefit from this therapy. Women with ≥10 micturitions per 24-h period were included. Six to nine therapy sessions were held within a 14-day interval. Efficacy end point was a reduction in micturitions and in episodes of nocturia. Secondary outcomes included ICIQ-OAB, ICIQ-OABqol and visual analog scales. Follow-up was 6months. Levene test, Student's t test, Pearson´s and Spearman's correlations were utilized as well as the Friedman test and a multivariable-multilevel model. 32 women were included. Mean age was 51 ± 15.9 (years ± standard deviation, sd). Mean body mass index (BMI) was 24.4 ± 4.8 (kg/m2 ± sd). There was a 22.9% reduction in the number of micturitions per 24h (11.7 ± 1.6 vs. 9.0 ± 1.3 p < 0.001), a 21.3% reduction during the day (10.3 ± 1.4 vs. 8.1 ± 1.1 p < 0.001) and a 34.7% reduction in episodes of nocturia (1.5 ± 1.0 vs. 1.0 ± 0.8 p = 0.026). Both ICIQ-OAB (8.7 ± 2.3 vs. 5.8 ± 2.7 vs. 6.3 ± 3.3 p < 0.001) and ICIQ-OABqol (73.4 ± 25.9 vs. 47.5 ± 14.5 vs. 47.7 ± 18.6 p < 0.001) questionnaires as well as VAS (7.5 ± 1.4 vs. 4.1 ± 2.4 vs. 4.2 ± 2.7 p < 0.001) showed significant improvement persisting in the 6-month follow-up. In addition, in a multivariable model controlling for age, women who were overactive bladder syndrome therapy naïve responded significantly better than those who had already been under therapy (p < 0.001). This study shows the efficacy of physiotherapy and behavior therapy in women with overactive bladder syndrome with a post-therapy effect especially for women with no prior treatment.

Physical activity for knee osteoarthritis.

Elder populations have been increasing in Japan and estimated 24 million people have knee osteoarthritis(OA). Recently, people have diverse sociological background and demand for participating sports has been growing. People may participate sports to prevent some diseases such as locomotive syndrome. According to the recent studies, excessive high impact sports increase the risk of OA, while daily life exercise decrease the risk. Epidemiological approach demonstrated that reduced knee extension muscle strength increases the risk of OA. We reviewed and discussed the recent topics including efficacy of physical therapy for knee OA and how much sports activities could be beneficial after knee surgery.

Access, delivery and perceived efficacy of physiotherapy and use of complementary and alternative therapies by people with progressive multiple sclerosis in the United Kingdom: An online survey

IntroductionAll people with progressive MS in the United Kingdom should have access to physiotherapy through the National Health Service (NHS). However levels of access and delivery are unknown. Furthermore there is no research on perceived efficacy of physiotherapy or the use of complementary and alternative medicine in people with progressive MS in the United Kingdom. MethodsAn online survey was carried out via the UK MS Register. Inclusion criteria were diagnosis of progressive MS, a member of UK MS Register and 18 years or older. The survey asked participants regarding access and delivery of physiotherapy; perceived efficacy of physiotherapy and interventions received; barriers to accessing physiotherapy and use of complementary and alternative medicine. The following additional data were supplied from the UK MS Register: demographics, EQ5D, MSIS-29 physical and psychological sub-scales and geographical data. ResultsTotal number of respondents was 1,298 from an identified 2,538 potential registrants: 87% could access physiotherapy services, 77% received physiotherapy from the NHS and 32% were currently receiving physiotherapy. The most common interventions received were home exercise programme (86%), exercises with a physiotherapist (74%) and advice/education (67%). 40% had recently used complementary and alternative medicine.Perceived efficacy of physiotherapy was high with 70% reporting it to be either ‘beneficial’ or ‘very beneficial’. Main barriers to accessing physiotherapy were mobility, fatigue, continence, transport issues, requiring someone to go with them and pain. DiscussionAccess to physiotherapy was high with most people reporting it as beneficial. However 13% reported not having access indicating a gap in accessibility. Considering some of the barriers reported may allow physiotherapy services to address this gap in accessibility.

Is Physical Therapy Beneficial for Low Back Pain

Evidence supporting the efficacy of physical therapy (PT) for low back pain (LBP) is mixed. In this observational study, researchers used data from a

The Effect of Depressive Emotional State on the Efficacy of Physical Therapy in Patients with Low Back Pain

Objective: The aim was to investigate the effect of depressive emotional state on the efficacy of physical therapy in patients with chronic mechanical low back pain (LBP). Methods: Sixty patients with chronic LBP were included in the study. The patients were evaluated by a psychiatrist according to the Hamilton Depression Rating Scale (HAM-D) and separated into 2 groups regarding the cut off score. Group 1 consisted of 31 patients without depressive emotion while group 2 included 29 patients with depressive emotion. An exercise program consisting of lumbar dynamic stabilization exercises was instructed to all of the patients for 8 weeks. Infrared, ultrasound and TENS were applied to both groups for 15 seans. The pain was evaluated by visual analog scale (VAS), disabilite and quality of life was evaluated by Oswestry disability index and the Short-Form 36(SF-36) at baseline and 3rd and 8th weeks. Results: Improvement at pain severity during ADL, rest and sitting position was found to be significantly higher in group 2 compared to group 1 patients at the 8th week (p 0.05), but improvement of some SF-36 subscale scores (pain, emotional role functioning, mental health) of groups significantly lower in group 2 compared to group 1 at the 8th weeks (p<0.05). Conclusions: Patients with chronic LBP and a depressive emotional state are inclined to have more disability and poorer quality of life, while physical therapy and exercises yield to less improvement in scores of pain and some subscales of the SF-36 in these patients than those without depressive affect.

Bodily symptoms in patients with post traumatic stress disorder: A comparative study of traumatized refugees, Danish war veterans, and healthy controls

Post traumatic stress disorder (PTSD) is associated with increased general health symptoms and patients suffer from numerous bodily complaints such as increased pain, increased muscular tension, and restricted breathing. This study applied the Body Awareness Movement Quality and Experience scale (BAS MQ-E) in assessing and comparing bodily symptoms, including movement function, in traumatized refugees (N=14) and Danish war veterans with PTSD (N=19) and healthy controls (N=20). Patients with PTSD had significantly poorer stability, balance, flexibility and coordination in movement, had more muscular tension, more complaints of pain, more restricted breathing, and more limitation in function of daily life than healthy controls. The BAS MQ-E was found to be an applicable and useful measure of bodily symptoms in patients with PTSD. Further research may add to the validity of BAS MQ-E and might be considered in future studies evaluating the efficacy of physiotherapy for patients with PTSD.