Impact Of Physiotherapy Research Articles

Impact of Phyiotherapy on the Motor Development of Infants of Different Gender and Getational Age

Research background. It is very important to recognize children whose motor development deviates from the normal, and it is affected or exposed to risk factors. The biggest attention should be paid on early diagnosis of motor development delay, and abilitation. This would let avoid severe impairments of motor development and complications. The aim of the study was to evaluate the impact of physiotherapy on motor development of infants of different gender, gestational age, height, weight, growing in infant home,. Research methods. Were analyzed motor development of 20 randomly selected infants (age 15.7 ± 10.25 weeks), growing in Klaipėda infant home. Subjects received physiotherapy with duration of 3 months. Munich functional developmental diagnostics scale was used to assess the development of three gross motor functions: crawling, sitting and walking. Research results. Before physiotherapy motor coefficient of about twenty percent of infants’ was rated < 50. Physiotherapy significantly (p < 0.05) improved infants’ gross motor functions: crawling, sitting and walking, and motor coefficient of the large majority of subjects after physiotherapy was rated as normal, i. e. > 70. There were no significant differences in motor coefficients between girls and boys. After physiotherapy motor coefficient of walking in full-term babies was significantly higher compared to preterm born babies (p < 0.05). Motor coefficient of sitting and walking in normal weight babies after physiotherapy was significantly higher (p < 0.05) compared to low weight babies. After physiotherapy motor coefficient of infants with different height improved significantly, but in taller babies it improved significantly more (p < 0.05) than in shorter babies. Conclusions. Applied physiotherapy significantly improved motor development of infants of different birth age, height and weight, growing in infant home. No significant differences in motor coefficients between girls and boys were identified. Birth age, height and weight are important for motor development.Keywords: physiotherapy, motor coefficient, birth, age, height, weight.

Impact of Physiotherapy on Physical Capacity of 7–11-Year-Old Children with Autism Disorder

Research background. Autism is one of the most difficult wide spectrum developmental disorders. Recently, striking increase in the number of autistic children is observed. Physical activation is important for the development and physical fitness of children with autism disorder. Research object – children’s balance, muscle strength and endurance. The aim was to evaluate physical capacity and impact of physiotherapy on balance, muscle strength and endurance in 7–11-yearold children with autism disorder. Methods. The study group consisted of 10 children with autism disorder (8 boys and 2 girls), the control group consisted of 18 healthy children (15 boys and 3 girls). The average age of the study group was 8.90 ± 1.4 years; in the control group 8.94 ± 1.0 years. Balance of children was assessed by Berg Balance Scale, hand grip – by dynamometry, leg muscle strength – by long jump test and squat test, and endurance of abdominal muscle – by sit up test. The results showed that physical condition of children with autism disorder was significantly poorer compared to healthy children: the balance – 43.9 ± 7.82 v. s. 55.4 ± 0.9 points; right hand muscle strength of 5.9 ± 2.06 kg v. s. 12.2 ± 3.43 kg; left – 5.3 ± 1.87 kg v. s 12.1 ± 3.43; long jump 43.0 ± 25.25 cm v. s 132.6 ± 31.87 cm; endurance of abdominal muscles 7.3 ± 2.01 v. s 19.6 ± 4.06 times per 30 s; squats 9.1 ± 4.36 v. s 27.6 ± 7.07 times per 30 s. After applying physical therapy results of all performed tests in children with autism improved significantly: balance to 49.9 ± by 5.45 points, right hand muscle strength to 7.9 ± 2.49 kg, left – 7.5 ± 2.31 kg, long jump to 79.2 ± 39.87 cm, crunches to 11.8 ± 4.54 times, squats to 14.8 ± 4.83 times, but they did not reach the results of healthy children. Conclusion. Balance, muscle strength and endurance of children with autism disorder were significantly lower than those in healthy children. Physical therapy significantly improved physical capacity of autistic children, but the level of healthy children was not reached.Keywords: autism, children, physiotherapy.

Impact of Physiotherapy Treatment in Children with Cerebral Palsy Aged Between 6 Months to 5 Years

Background: Cerebral Palsy has various structural and functional impairments which can lead to inability to walk, move independently which impairs their overall growth and development physiotherapy treatment in these subjects is a routine practice. Its applicability and outcomes is still an upcoming research area. This treatment has a longer duration of application for better outcomes. It is a big challenge for parents to do so due to many reasons. The impact of physiotherapy should be found out for all the age groups irrespective of their pathology and presentations. This study is an effort to do so. Objective: 1. To study the types of cerebral palsy. 2. To assess the children with cerebral palsy. 3. To study the impact of physiotherapy on levels of gross motor function in children with cerebral palsy. Method: Ethical Clearance was obtained from the Institutional ethical committee. 64 cerebral palsy children were selected aged between 6 months to 5 years divided in 3 groups according to their age both girls and boys were selected. They were assessed using Gross Motor Function Classification System scale which was recorded for a duration of 3 months. According to which conclusion was derived with appropriate statistical method. Result: Group A shows maximum in level IV,Group B shows maximum in level I and II and Group C shows maximum in level III. Conclusion: We found that level of Gross Motor Function was improved in the age group of 2 to 4 years and above when compared with age below 2 years after receiving physiotherapy treatment.

The Impact of Physiotherapy in the Water Assisted by Dolphins for Motor Skills of Patient after Haemorrhagic Stroke (Case Analysis)

Background. Stroke is one of the leading causes of morbidity, mortality and long-term disability worldwide. In terms of innovative technologies which help to recover from stroke one of the newest and least researched methods is physiotherapy in the water assisted by dolphins. Such an innovative case study was conducted in Lithuania. A great variety of scientifc literature on animal assisted therapies and interventions can be found worldwide, however, concerning research on human-animal interaction mechanisms a scientifc gap is still existing as presented in various journals of different felds (Beetz et al., 2012). The aim of the study was to determine the effectiveness of healing exercises in the water assisted by dolphins for motor skills of patients with haemorrhagic stroke. Methods. The study was carried out at the Dolphin Therapy Centre of the Lithuanian Sea Museum. The study lasted two weeks. The sample was a man diagnosed with a haemorrhagic stroke. The research data was collected on motor skills in the water, leg muscle strength, coordination, balance and gait. The patient participated in ten therapeutic activities in the water, assisted by dolphins (length of one activity – 30 minutes). The physiotherapist working with the patient applied balance and coordination exercises in the water. The status of the patient was evaluated four times: before activities with dolphins, after fve activities with dolphins, after ten activities with dolphins, and follow up in three weeks after ending the activities with dolphins. Results. The muscle strength of legs increased signifcantly in the foot group and slightly in the lower limb muscle group. The greatest result in balance was registered after ten therapeutic activities with dolphins in the water. The greatest improvement in coordination and walking occurred later. Assessing motor skills in the water, a signifcant positive change in equilibrium was observed. Conclusions. The results of the study showed that physiotherapy exercises in the water assisted by dolphins might help to achieve improvements in motor skills.Keywords: haemorrhagic stroke, motor skills in the water, balance, gait, therapeutic activities for assisting dolphins, physiotherapy in water.

The Importance of Physiotherapy in Promoting Bone Health for Children Supported by VAD: Early Mobilisation and Weight Bearing Guidelines

Purpose Critically ill children are at risk of bone loss due to a multitude of factors including immobility. For children who require cardiac transplantation, with or without ventricular assist device (VAD) support, reduced mobility is particularly evident. This is due in part to the severity of the child's condition and environmental limitations. Bone loss is known to be a significant risk factor for fractures which can perpetuate immobility. We reviewed patients who developed bone fractures at our institution and aimed to describe the impact of physiotherapy on their care. Methods Patients listed or within 6 months of cardiac transplant were identified from the physiotherapy transplant/VAD database. We performed a retrospective case series analysis identifying risk factors for the development of bone fractures and analysed the physiotherapy programmes. We subsequently carried out a literature review looking at factors in physiotherapy management which impact outcomes and provided guidelines for patient management. Results Between 2015 to 2017 3 of 45 cardiac transplant patients developed an atraumatic femoral bone fracture: two whilst supported on VAD and one immediately post discharge after transplantation. The children on VAD were 18 weeks and 19months old. Diagnosis was dilated DCM and late presentation ALCAPA. Both children required long tern ventilation support via tracheostomy . The third child was 37 months with a failing Fontan circulation supported medically in our PICU before transplant. All 3 received prolonged unfractionated heparin. All three children had daily physiotherapy as per our standard protocol. Conclusion Physical activity, complete nutrition and exposure to sunlight are known key elements of optimal bone health and all of these are severely limited in a young child on VAD support. Physiotherapy is a key factor in improving physical activity in children on VAD support but there are currently no published recommendations for the prevention of bone fractures while on VAD. We believe aggressive physiotherapy using protocols similar to those used for children not on VAD support with a focus on weight bearing are needed for these patients. We present a mobilisation protocol including weight bearing guidelines, as part of a comprehensive bone health strategy.

EFFECTS OF PHYSIOTHERAPY ON ADOLESCENT IDIOPATHIC SCOLIOSIS. A SYSTEMATIC REVIEW

Introduction: Scoliosis is a three-dimensional deformative abnormality of the spine, defined by the Cobb's angle of spine curvature in the coronal plane, and is often accompanied by vertebral rotation in the transverse plane and hypokyphosis in the sagittal plane. Based on the age of presentation, scoliosis is further categorized as infantile, juvenile or adolescent idiopathic. Adolescent idiopathic scoliosis (AIS) has the highest prevalence of the three categories. This type of scoliosis is present at age ten and lasts till the end of growth. Its prevalence is dependent on the curvature of the spine and gender of the patient. Objective: The purpose of this review is to evaluate the role of physiotherapy in reducing curve progression and pain, postponing or avoiding invasive treatment and improve the quality of life in adolescents with AIS. Methodology: The study is a Systematic Review, meta-analytic type, consisting of 5 studies (RCT) of the last ten years, which focus on the impact of physiotherapy in AIS. Studies include 210 patients evaluated and treated by physiotherapist, divided into 2 groups: experimental and control group. The measurement and rehabilitation includes Cobb angle, pain and quality of life. Data was extracted from medical websites and scientific journals. The evaluation was realized with the PEDro scale, which shows the validity of each study. Results: The literature used in the study claimed that physiotherapist in AIS reduces pain and Cobb angle and improve QoL (p<0.05). The 5 studies had an average PEDro score of 5.6/10. Conclusions: Evidence suggests that physiotherapy is good at reducing the Cobb angle, pain and improving the quality of life in patients with AIS. Scientific research on this topic is limited, so it is suggested to increase research, especially now that AIS incidence is higher. Keywords: physiotherapy, scoliosis, Schroth, Adolescent Idiopathic Scoliosis.

Impact of physiotherapy over chronic fatigue in men with multiple sclerosis

Impact of physiotherapy over chronic fatigue in men with multiple sclerosis

The development of an evidenced based case study database to demonstrate the value and impact of physiotherapy

The development of an evidenced based case study database to demonstrate the value and impact of physiotherapy

The impact of physiotherapy led education on time taken to mobilise in low risk patients following hepatobilary surgery

ERAS protocols promote early mobilisation reducing risk of post-operative complication [1, 2]. The Southampton Physiotherapy Post-Operative Screening Tool (SPPOST) was introduced onto specialist surgical wards, with physiotherapy withdrawn for low risk patients. An audit concluded that mobility in this patient group was safely led by nurses, with no patients re-referred with pulmonary or mobility compromise. However, patients were not meeting their specific targets of walking >30 m by day 3 in line with the ERAS protocols.

Impact of physiotherapy on neuromotor development of premature newborns

Introduction The population of children born prematurely has increased in line with improving the quality of perinatal care. It is essential to ensure to these children a healthy development. Objective We evaluate the neuromotor development of a group of preterm infants regularly assisted by a physiotherapy service in comparison to full-term newborns, checking, so the impact of the service. Materials and methods We randomly assigned preterm and full-term infants that formed two distinct groups. The group of preterm infants was inserted into a monitoring program of physiotherapy while the other infants were taken as a control group not receiving any assistance in physiotherapy. The groups were compared using the Alberta Infant Motor Scale (AIMS) at forty-week, four and six months of corrected gestational age and the scores were compared using Student's t-test, assuming a significance level of 5% (p &lt; 0.05). Results The preterm group had significantly lower scores at 40th week compared to the control group, but subsequent scores showed no significant differences between the two groups. Conclusion The timely and adequate stimulation was efficient to promote the motor development of premature infants included in a follow up clinic.

Testing a path-analytic mediation model of how motivational enhancement physiotherapy improves physical functioning in pain patients.

Pain is a complex phenomenon not easily discerned from psychological, social, and environmental characteristics and is an oft cited barrier to return to work for people experiencing low back pain (LBP). The purpose of this study was to evaluate a path-analytic mediation model to examine how motivational enhancement physiotherapy, which incorporates tenets of motivational interviewing, improves physical functioning of patients with chronic LBP. Seventy-six patients with chronic LBP were recruited from the outpatient physiotherapy department of a government hospital in Hong Kong. The re-specified path-analytic model fit the data very well, χ (2)(3, N = 76) = 3.86, p = .57; comparative fit index = 1.00; and the root mean square error of approximation = 0.00. Specifically, results indicated that (a) using motivational interviewing techniques in physiotherapy was associated with increased working alliance with patients, (b) working alliance increased patients' outcome expectancy and (c) greater outcome expectancy resulted in a reduction of subjective pain intensity and improvement in physical functioning. Change in pain intensity also directly influenced improvement in physical functioning. The effect of motivational enhancement therapy on physical functioning can be explained by social-cognitive factors such as motivation, outcome expectancy, and working alliance. The use of motivational interviewing techniques to increase outcome expectancy of patients and improve working alliance could further strengthen the impact of physiotherapy on rehabilitation outcomes of patients with chronic LBP.

Impact of physiotherapy on patients with advanced lung cancer

Patients with lung cancer have high mortality and high morbidity. Lung cancer-related symptoms and problems such as dyspnea, fatigue, pain, and cachexia that begin in the early phase later result in poor physical functioning, psychosocial, and quality of life status. In addition, advancing age is associated with significant comorbidity. These patients may benefit from multidisciplinary therapy to reduce the perceived severity of dyspnea and fatigue and increase physical functioning and quality of life. Based on management of symptoms and problems such as dyspnea, physical inactivity, cancer-related fatigue, respiratory secretions, pain, and anxiety-depression of these patients, it is thought that physiotherapy techniques can be used on advanced lung cancer patients following a comprehensive evaluation. However, well-designed, prospective, and randomized-controlled trials are needed to prove the efficacy of physiotherapy and pulmonary rehabilitation in general for patients with advanced lung cancer.

Impact of physiotherapy in the treatment of chronic constipation at Cotonou

Impact of physiotherapy in the treatment of chronic constipation at Cotonou

Acid and non‐acid reflux during physiotherapy in young children with cystic fibrosis

Gastro-esophageal reflux (GOR) may contribute to lung disease in children with cystic fibrosis (CF). There is conflicting evidence regarding the effect of chest physiotherapy (CPT) in the head-down position on GOR. Furthermore, there is currently no evidence on the impact of physiotherapy on GOR as assessed by pH-multichannel intraluminal impedance (pH-MII). (1) To characterize GOR in young children with CF. (2) To determine whether the head-down position during physiotherapy exacerbates GOR. Children were studied using pH-MII monitoring over 24-hr, during which they received two 20-min sessions of CPT. One session was performed in "modified" drainage positions with no head-down tilt and the alternate session in "gravity-assisted" drainage positions, which included 20° head-down tilt. Twenty children with CF (8 males), median age 12 months (range 8-34) were recruited. A total of 1,374 reflux episodes were detected in all children, of which 869 (63%) were acid and 505 (37%) were non-acid. Seventy-two percent of the episodes migrated proximally. During CPT, there was no significant difference between total number of reflux episodes in the modified or gravity-assisted positions, median [inter-quartile range (IQR)] 1 (0-2.5) compared to 1 (0.75-3) episode, respectively, P = 0.63. There was also no significant difference between the number of reflux episodes which migrated proximally, median (IQR) 1 (0-2) compared to 0 (0-2) episodes, respectively, P = 0.75. In young children with CF, GOR is primarily acidic and proximal migration is common. Physiotherapy in the head-down position does not appear to exacerbate GOR. The impact of GOR on lung disease remains to be elucidated.

Chest physiotherapy and outcomes in ICU

Sir: Thank you for the opportunity to reply to correspondents Beraldo and Timenetsky, who raise concerns regarding our use of statistics and suggest that we should have used ventilator-free days, as suggested by Schoenfeld and Bernard, as an alternative to the standard Kaplan–Meier analyses [1]. We considered the use of ventilator-free days as a new approach to analysing data. We had a number of reservations. Firstly, it is a new technique which has not been evaluated other than by those who suggested it. Secondly, the concept of ventilator-free days is not as tangible as the median time to become ventilator-free, which is generally clearer; however our main concern, which we raised at the initial presentation of the data at the European Society of Intensive Care meeting in Barcelona, was that it was an arbitrary calculation. Like Kaplan–Meier it effectively censures death, but the choice of 28 days is arbitrary. For example, at the meeting we demonstrated that the null hypothesis was rejected variably depending on the arbitrary cut-off point, the significance reducing progressively if the cut-off point increased from 10 to 35 days. The majority of our patients were discharged from intensive care by the second week; thus, a cut-off point of 28 days made no sense since the end point of the study had long passed. Mortality was separately analysed. Consequently, we opted to use conventional methodology. A second concern was the possible influence of the non-significantly higher APACHE II ICU day-1 risk of death among the physiotherapy group, which might have biased the results adversely. We propose that the groups had similar risks of death and actual mortality rates, suggesting equipoise rather than bias. It is well known that acuity-score-based probability of death estimates have considerable intrinsic error particularly with small populations of heterogeneous patients, such as in our study. Perhaps the correspondents are suggesting that such was the impact of physiotherapy that it improved outcome among the “sicker” physiotherapy group and matched the non-physiotherapy patients. This would have been an over-interpretation, and unlikely given that few critical care interventions on small study groups of heterogeneous patients, such as ours, have been demonstrated to improve outcome. Furthermore, the correspondents should bear in mind that the median statistic based on the Kaplan–Meier curve looks at the first 50% of patients in each group, whereas the statistic for APACHE II risk of death was based on all the patients in each group. Secondly, APACHE II reflects acuity on day 1. These patients were recruited after 48 h, and for this reason SOFA scores were included to indicate acuity at the time of recruitment; again, these were non-significantly different. The correspondents suggest that the greater number of neurosurgical patients in the physiotherapy group might have introduced bias against the physiotherapy group. We disagree. Neurosurgical patients invariably had a tracheotomy and had the advantage of meeting an easier ventilator-free end point, namely spontaneous ventilation on a CPAP circuit through a tracheotomy determined a priori. By contrast, the control group had fewer tracheotomies and had to achieve the more difficult ventilator-free end point of breathing spontaneously on a face mask.

Views of survivors of stroke on benefits of physiotherapy.

To describe the components of physiotherapy valued by survivors of a stroke. Qualitative study using in-depth interviews. Two adjacent districts in North East Thames Regional Health Authority. 82 survivors of stroke taken consecutively from a stroke register when they reached the tenth month after their stroke, 40 of whom agreed to be interviewed. Content analysis of interviews. Patients who agreed to the interview were significantly less likely to be disabled 12 months after stroke than those who did not. Twenty four patients had received physiotherapy, and these were more disabled than those who had not. Patients appreciated physiotherapy. It was believed to bring about functional improvement; the exercise component was valued because it was perceived to keep them active and busy and exercise programmes to follow at home were also valued for the structure they gave to each day; and therapists were considered a source of advice and information and a source of faith and hope. Many of the positive aspects of caring which patients described in the context of physiotherapy could be incorporated into the mainstream of rehabilitation care and training. However, health professionals need to be careful not to promote false expectations about recovery. The outcome of treatment is of critical importance to patients and should become a central dimension of patient satisfaction questionnaires. The impact of physiotherapy is not confined to reducing physical disability but may also affect wellbeing. The choice of outcome measures in rehabilitation research should reflect this situation.