Physiotherapy Management Research Articles

The effect of physiotherapy intervention on functional outcomes among COVID-19 patients: Clinical experimental study.

COVID-19 is a highly contagious virus that causes pneumonia, which quickly progresses to acute respiratory distress. In the case of COVID-19, physiotherapy is critical in non-invasive support management, postural changes, chest physiotherapy (CPT), and bed mobility. This study aims to look into the effects of physiotherapy intervention on functional outcome levels in COVID-19 patients in the acute stage. A total of 60 severe COVID-19 patients (54 males and 6 females) with a mean age of 50years were studied. The intervention group (n=30) had two daily physiotherapy sessions that included positioning, CPT, cardio exercises, breathing exercises, and early mobility, whereas the control group (n=30) received only standard medical care. Patients were tested twice at the baseline and discharge using peripheral oxygen saturation, respiratory rate (RR) test, dyspnea rate, two-min walk test, and spirometer scores, forced vital capacity (FVC) and forced expiratory volume in one second (FEV1). The two groups improved significantly between the baseline and discharge ratings. The intervention group, on the other hand, significantly improved all outcome indicators at discharge (p-value=0.00). This study found that physiotherapy management improved oxygen saturation, RR, dyspnea, and lung function tests in COVID-19 patients except in FVC (p-value=0.402) and FEV1(p-value=0.114). Physiotherapist interventions with COVID-19 patients increase respiratory function and treatment time.

Physiotherapy management in anal cell carcinoma following laparoscopic surgery – A Case Report

Physiotherapy management in anal cell carcinoma following laparoscopic surgery – A Case Report

Effectiveness and efficiency of patient care while enrolled in an orthopedic physical therapy fellowship program

Rationale: Post-professional orthopedic manual physical therapy education programs have proliferated, in part due to increasing therapist demand. Despite the time, effort, and money required to complete these programs, there is scant research addressing their impact. We investigated whether physical therapists enrolled in an accredited manual physical therapy fellowship program achieved better outcomes, determined by patient changes in function, number of physical therapy visits, and episode of care duration while enrolled in the program. We also examined whether outcomes varied by clinician demographics, clinician life circumstances, and clinic characteristics. Methods: Forty-two therapists contributed patient data addressing functional status, number of visits, and episode of care duration. We compared data from the first 30 patients with data from the last 30 patients seen by each therapist while enrolled in the program. We also surveyed therapists regarding their demographics, life circumstances, and clinic characteristics. Results: There were no clinically meaningful or statistically significant differences in change in functional status when comparing results from the first 30 patients with the last 30 patients seen by therapists. However, there was a significant reduction in the number of visits and episode of care duration. Outcomes were influenced by entry-level degree and the presence of children at home. Conclusion: In our study, enrollment in a physical therapy fellowship program did not improve patient functional status but did reduce the number of visits and episode of care duration. Outcomes were influenced by some clinician life circumstances and clinic characteristics.

Physiotherapists' attitudes and beliefs in the management of low back pain: Protocol for a systematic review.

Low back pain (LBP) poses a significant global health burden where a biopsychosocial model of care has been recommended. Physiotherapists (PTs) play a crucial role in LBP management; however, their attitudes and beliefs towards LBP were not reviewed in detail. This systematic review aims to summarise the attitudes and beliefs of PTs towards LBP and the factors influencing them. The review protocol and methods adhere to the PRISMA-P and Meta Analyses and Systematic Reviews for Observational Studies in Epidemiology (MOOSE) guidelines. A comprehensive search of PubMed, Scopus, CINAHL, Web of Science, PEDro and Ovid databases will be conducted to search for cross-sectional studies evaluating PTs' attitudes and beliefs towards LBP. Two reviewers will independently screen the articles, conduct data extraction and assess methodological quality using the Joanna Briggs Institute's critical appraisal tool for prevalence studies. Data synthesis will involve a narrative synthesis of study characteristics, attitudes, beliefs, and methodological quality. If feasible, a meta-analysis will be performed to quantify the pooled effects. Despite the emphasis on biopsychosocial approaches for managing LBP, the adoption of such approaches in physiotherapy practice is still suboptimal, with attitudes and beliefs of PTs being considered an important factor influencing treatment practices. Our review will summarise the literature on attitudes and beliefs of PTs towards LBP. Such knowledge would inform the need for development of additional interventions addressing the attitudes and beliefs that would eventually enhance the update of the biopsychosocial model of care in physiotherapy management of LBP.

Challenges and Practical Considerations in Applying Virtual Reality among Tamil Geriatric Patients with Periarthritis Shoulder – A Qualitative Study

Background: Virtual Reality (VR) has shown promise in healthcare, especially in areas like cognitive training, pain management, and motor rehabilitation, yet adapting it for use among elderly individuals comes with specific limitations and barriers. Aims and Objectives: This study analyses the challenges and practical considerations in applying Virtual Reality (VR) to Tamil geriatric patients during physiotherapy management. Materials and Methods: This qualitative study, utilized in-depth interactive interviews through a Semi-structured interview to collect and analyse data. Participants 34 native Tamil geriatric patients aged more than 60 years (67.5 ±2.78) complaining of a painful restricted range of motion in the unilateral shoulder joint diagnosed as periarthritis shoulder were treated with fully immersive virtual reality technology for 7 days. Following the intervention, the patients were interviewed under 5 codes (“usability,” “comfort,” “satisfaction,” “technical issues,” and “practical consideration”) Results: Participants reported virtual reality was enjoyable and engaging, a positive impact and motivation. Dizziness and sweating during virtual reality sessions when it extended beyond 20 minutes was a concern. Several participants faced hardware problems, such as issues with headset fit, leading to discomfort and difficulties in using hand-held control buttons. Adjusting virtual reality settings, including boundaries and game-level setting, was mentioned as a practical challenge for some participants. Conclusion: Proper orientation, patient selection for virtual reality, and sufficient familiarization are essential for the success of virtual reality rehabilitation among the Tamil geriatric population

Current physiotherapy practice for adults with bronchiectasis: Data from the Australian bronchiectasis registry

BackgroundAlthough airway clearance techniques (ACTs) and physical exercise are recommended for adults with bronchiectasis, there is little data on current practice and limited guidance predicting clinical approach. ObjectiveThis study aimed to describe current ACT and exercise practice recorded by patients, and identify predictors of regular ACTs, ACT modalities and exercise. MethodsPhysiotherapy-specific interventions, quality of life (Quality-of-Life Bronchiectasis questionnaire, QOL-B), demographics and disease severity were extracted from the Australian Bronchiectasis Registry. Multivariate analyses were undertaken to identify predictors of undertaking ACTs or exercise. ResultsWe included 461 patients; median age of 72 years (interquartile range 64–78 years). Regular ACT use was recorded by 266 (58 %) patients; the active cycle of breathing technique (n = 175, 74 %) was the most common technique. Regular exercise use was recorded by 213 (46 %) patients, with walking the most common form of exercise. A pulmonary rehabilitation referral was made for 90 (19.5 %) of patients. Regular ACT use was associated with a higher treatment burden on QOL-B (Odds ratio (OR) = 0.97, 95 % confidence interval (CI) 0.96 to 0.99). Regular exercise was more likely amongst patients with severe bronchiectasis compared to those with mild disease (OR = 9.46, 95 % CI 1.94 to 67.83) and in those with greater physical function on the QOL-B (OR = 1.02, 95 % CI 1.01 to 1.04). ConclusionApproximately half the adults in the registry report regular ACT or exercise; QOL and disease severity predict this engagement. This knowledge may guide the tailoring of ACTs and exercise prescription to optimise physiotherapy management in adults with bronchiectasis.

What is the Status Quo of Patient-Centred Physiotherapy Management of People with Headache within a Biopsychosocial Model? - A Narrative Review.

Patient-centred care (PCC) is deemed essential in the rehabilitation of musculoskeletal pain. Integrating such care within a biopsychosocial framework, enables to address all facets of the individual pain experience, and to manage the individual instead of the condition. This narrative review describes the status quo of PCC physiotherapy management of people with headache within a biopsychosocial model. PubMed, EMBASE, Web of Science, Scopus were searched (update 07.05.2024). The search-query comprised terminology relating to "headache", "patient-centred", "biopsychosocial", "physiotherapy". Additional eligibility criteria were reviews, trials, cohort, case report, case-control studies in English, Dutch, French. Gaps are exposed in patient-centred physiotherapy management of migraine, tension-type headache, and cervicogenic headache. While a biopsychosocial approach is advised to manage migraine and tension-type headache, its use in clinical practice is not reflected by the literature. A biopsychosocial approach is not advised in cervicogenic headache. Psychosocial-lifestyle interventions are mainly delivered by health-care providers other than physiotherapists. Additionally, psychologically-informed practice is barely introduced in physiotherapy headache management. Though, managing the social context within a biopsychosocial framework is advised, the implementation by physiotherapists is unclear. Comparable conclusions apply to PCC. PCC is recommended for the physiotherapy management of primary and secondary headache. Such recommendation remains however theoretical, not reaching clinical implementation. Yet, a shift from the traditional disease-centred model of care towards PCC is ongoing and should be continued in physiotherapy management. With this implementation, clinical and economical studies are needed to evaluate its effectiveness.

Bibliometric Analysis of the Research Status and Global Trends in Behavioral and Psychological Symptoms of Dementia in Alzheimer's Disease from 2002 to 2022.

Several reviews on behavioral and psychological symptoms (BPSDs) in patients with Alzheimer's disease (AD) have summarized the current state of this field, but global trends are unclear. This study utilized CiteSpace to provide a global overview of the current state of research on AD and its BPSDs and to predict future research trends in the field. Data were retrieved from the Web of Science Core Collection. Bibliometric and cooccurrence analyses were performed using CiteSpace software. In total, 787 valid publications were included in the analysis. Publications on AD and BPSD have shown an increasing trend since 2002. The United States and the University of Toronto were the countries and institutions with the highest total number of publications, respectively. Japan and China were the second and third most influential in the field. Clive Ballard was the top author in terms of the number of publications. Journal of Alzheimer's Disease had the highest number of publications on this topic. Co-occurrence analysis showed that AD, behavioral symptoms, cognitive impairment, and early markers are hot topics in this area. Non-drug management of BPSDs, pharmacological treatment, and physiotherapy will be a hot topic in this field in the future. Our study visualized the relevant articles over the past 21 years to detect global hotspots and trends. Our findings may help researchers to identify research hotspots in this field and will help in the selection of appropriate research topics, while possibly leading to cross-regional cooperation.

Physical Therapy Management for a Patient with Hallux Rigidus in a Baseball Player.

Hallux rigidus is a common condition affecting the foot. There is a paucity of evidence describing the management of patients with hallux rigidus with manual physical therapy consisting of hands-on manual therapy techniques and movement reinforcing exercise. This case highlights the management of a patient with hallux rigidus by a physical therapist. The patient was a 60-year-old male baseball player with pain, loss of metatarsophalangeal joint motion, and radiographically visible degenerative changes suggesting a diagnosis of hallux rigidus. Treatment involved non-thrust joint manual distraction mobilization to the 1st metatarsophalangeal joint. Improvements were noted immediately in the patient's ability to run with decreased symptoms. I carefully instructed the patient to perform the manual distraction techniques at home. After 4 clinical visits, the patient returned to baseball the following spring. Outcomes were maintained 8 years after initial evaluation.

Towards novel classification of infants’ movement patterns supported by computerized video analysis

BackgroundPositional preferences, asymmetry of body position and movements potentially indicate abnormal clinical conditions in infants. However, a lack of standardized nomenclature hinders accurate assessment and documentation of these preferences over time. Video tools offer a safe and reproducible method to analyze and describe infant movement patterns, aiding in physiotherapy management and goal planning. The study aimed to develop an objective classification system for infant movement patterns with particular emphasis on the specific distribution of muscle tension, using methods of computer analysis of video recordings to enhance accuracy and reproducibility in assessments.MethodsThe study involved the recording of videos of 51 infants between 6 and 15 weeks of age, born at term, with an Apgar score of at least 8 points. Based on observations of a recording of infant spontaneous movements in the supine position, experts identified postural-motor patterns: symmetry and typical asymmetry linked to the asymmetrical tonic neck reflex. Deviations from the typical postural-motor system were indicated, and subcategories of atypical patterns were distinguished. A computer-based inference system was developed to automatically classify individual patterns.ResultsThe following division of motor patterns was used: (1) normal patterns, including (a) typical (symmetrical, asymmetrical: variants 1 and 2); and (b) atypical (variants: 1 to 4), (2) positional preference, and (3) abnormal patterns. The proposed automatic classification method achieved an expert decision mapping accuracy of 84%. For atypical patterns, the high reproducibility of the system’s results was confirmed. Lower reproducibility, not exceeding 70%, was achieved with typical patterns.ConclusionsBased on the observation of infant spontaneous movements, it is possible to identify movement patterns divided into typical and atypical patterns. Computer-based analysis of infant movement patterns makes it possible to objectify and satisfactorily reproduce diagnostic decisions.

A Bibliometric Analysis Study on Sport Sciences: Trends and Recommendation for Athletes’ Performance

Background: Sports science is responsible for locating, approving, developing, and perfecting various strategies to improve athletic performance. New methods for assessing an athlete’s technical and physical prowess are being created daily, and fresh training concepts are evolving impressively swiftly. If coaches had access to the most up-to-date techniques and knowledge to create the most effective training plans, athletes would gain significantly. This study aims to find patterns and make recommendations to stakeholders to enhance athlete performance. Method: A literature review of documents was conducted from 2018 to 2022, specifically focusing on “sports science” in 2023. 408 English-language documents in the area of medicine were identified using the Scopus database. Scopus search analysis and VOSviewer software were employed to analyze the bibliometric data. Result: The top three keywords’ trends found in this study were health (1.41%), physical (1.15%), and sports (0.89%). The top results revealed a positive correlation between overall sports sciences scores on physical and activity (Pearson correlation score ± 0.74 - 0.73, P0.50). Sports injury, types of sport, physical, epidemiology, basic science study, and physiotherapy are the six clusters our study on sports sciences has discovered. The trends analyzed in this study were sports sciences, sports performance, and sports injury. This study recommends enhancing the physical training performance of athletes for the sports they are playing. Conclusion: A sports science approach to evidence-based practice could effectively prevent athlete injuries and physiotherapy management. The coaches should be concerned about the health and safety of their athletes. The practice of sports medicine can improve sports science and athlete performance.

Innovative Physiotherapy Approaches in Managing Patellar Tendinopathy (Jumper’s Knee): An Updated Literature Review

Introduction: Patellar tendinopathy (jumper's knee) is an overuse injury that usually has a gradual onset of pain. This condition is common in jumping athletes, characterized by local pain at the attachment of the proximal tendon to the bone and dysfunction of the patellar tendon during jumping and landing. Patellar tendinopathy clinically results from high loads on the tendon, such as jumping and changing direction. Patellar tendinopathy can affect health and quality of life by limiting participation in sports and activities for athletes. Objective: This study aims to summarize secondary data related to physiotherapy management of patellar tendinopathy. Methods: The research method used is a literature study using secondary data in the form of journals related to the topic of patellar tendinopathy (jumper's knee) obtained through Google Scholar, Science Direct, and PubMed. Results: From five recent journal articles obtained with various physiotherapy intervention protocols, the results were able to reduce symptoms in patients with patellar tendinopathy. Conclusion: Physiotherapeutic interventions such as progressive tendon-loading exercises (PTLE), Eccentric exercise programmes, Kinesio-tape® and isometric exercises are effective in reducing symptoms in patients with patellar tendinopathy. Keyword: patellar tendinopathy, jumper's knee, physiotherapy

Revolutionizing Care: Unleashing the Potential of Digital Health Technology in Physiotherapy Management for People With Cystic Fibrosis.

This viewpoint paper explores the dynamic intersection of physiotherapy and digital health technologies (DHTs) in enhancing the care of people with cystic fibrosis (CF), in the context of advancements such as highly effective modulator therapies that are enhancing life expectancy and altering physiotherapy needs. The role of DHTs, including telehealth, surveillance, home monitoring, and activity promotion, has expanded, becoming crucial in overcoming geographical barriers and accelerated by the recent pandemic. Physiotherapy, integral to CF care since 1946, has shifted toward patient-centered approaches, emphasizing exercise training and a physically active lifestyle. The reduction in inpatient admissions due to highly effective modulator therapies has led to increased home care and online or electronic consultations, and DHTs have revolutionized service delivery, offering flexibility, self-management, and personalized care options; however, there is a need to comprehensively understand user experiences from both people with CF and physiotherapists. This paper highlights the essential exploration of user experiences to facilitate clinician adaptation to the digital requirements of modern clinical management, ensuring equitable care in the "future hospitals" arena. Identifying research gaps, this paper emphasizes the need for a thorough evaluation of DHT use in CF physiotherapy education, training, and self-monitoring, as well as the experiences of people with CF with online or electronic consultations, self-monitoring, and remote interventions. Online group exercise platforms address historical challenges relating to infection control but necessitate comprehensive evaluations of user experiences and preferences. Future-proofing DHTs within the physiotherapy management of CF demands a shift toward full integration, considering stakeholder opinions and addressing barriers. While DHTs have the potential to extend physiotherapy beyond the hospital, this paper stresses the importance of understanding user experiences, addressing digital poverty, and working toward more equitable health care access. A flexible approach in the "future hospital" is advocated, emphasizing the need for a nuanced understanding of user preferences and experiences to optimize the integration of DHTs in CF care.

Operative management of chronic isolated rectus femoris rupture with semitendinosus graft and biofiber: A case report

Rectus femoris tear is rare and often overlooked in emergencies. The majority of quadriceps muscle belly injuries can be successfully treated conservatively and for less active, older populations Non-operative management is reasonable. A case report of a 19-year-old male Kabbaddi player who sustained an injury to his rectus femoris muscle belly while playing 5 months back. This young patient did not recover the functional outcome required to get back to running and participating in kabaddi despite 5 months of physiotherapy and non-operative management and had complaints of Pain over midthigh and weakness in quadriceps during hip flexion and knee extension. This leads to Hindrances in Jumping, running, and kicking movements. Tenderness over the midthigh and palpable defect with Pain upon resisted hip flexion or extension was seen.3/5 quadriceps power was noted. Ultrasound and MRI were done to confirm the clinical diagnosis. Operative treatment using the semitendinosus allograft with bio fiber reconstruction system to augment rectus femoris repair allowed immediate full passive flexion of the knee and an early graduated physiotherapy program leading to a return to running and his previous level of sport without any restrictions. Surgical treatment of rectus femoris tear seems to be a good option for Chronic tears.

Symposium extended abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th-6th July

Symposium extended abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th-6th July

Conference abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th–6th July.

Conference abstracts from IFOMPT 24, the 12th world conference of musculoskeletal and manual physical therapy. Celebrating 50 years. Basel, Switzerland 4th–6th July.

Manual Therapy Versus Exercise Therapy in Patients with Osteoarthritis of Knee -A Comparative Study

AIM OF THE STUDY: The aim of the study to compare the effectiveness of manual therapy versus exercise therapy in patients with knee osteoarthritis in terms of decreasing pain HYPOTHESIS • Null Hypothesis: There may be no significant difference in the effectiveness of manual therapy and exercise therapy in patients with knee osteoarthritis • Alternate Hypothesis: There may be significant difference in the effectiveness of manual therapy and exercise therapy in patients with knee osteoarthritis INTERVENTION Group A: MANUAL THERAPY Manual physiotherapy protocol consisted of Treatment is done for two sessions per week for four weeks. Knee Mandatory interventions: 1. Knee flexion, non-thrust Antero-posterior directed force to the tibia, 2. Tibio-femoral joint ,non-thrust 3. Knee extension, non-thrust Postero-anterior directed force to the tibia 4. Tibio-femoral joint, non-thrust 5. Patellar gliding force, non-thrust 6. Manual stretch to quadriceps, hamstring, triceps surae muscle groups 7. Soft tissue manipulation ,quadriceps and Peripatellar connective tissue, hamstring, hip adductor and triceps surae muscles groups Treatment is done for two sessions per week for four weeks. Group B: EXERCISE THERAPY This group performed a closely supervised standardized knee exercise program at twice a week for four weeks at eight treatment sessions. This program consists of active range of motion exercise for knee, muscle strengthening exercise for hip and knee, muscle stretching for lower limbs and riding a stationary bike. Aerobic exercises • Up to 10 minutes stationary bicycle or walk. Stretching exercises: • Standing calf stretch – 3 repetitions with 30 sec hold • Supine hamstring stretch -3 repetitions with 30 sec hold • Prone quadriceps stretch –3 repetitions with 30 sec hold Range of motion exercises: • In long sitting position, • Knee mid flexion to end range extension – two 30 sec bouts with 3 sec hold at end range • In long sitting position, knee mid flexion to end range flexion – two sec bouts with 3 sec hold at end range Strengthening exercises: • Static quad sets in knee extension –one set of 10 repetitions with 6 sec hold,10 sec rest between repetitions. • Short arc terminal extension exercises for the knee joint. • Quadriceps non-weight bearing progressive resistance exercises with weighted cuffs. • Supine Straight Leg Rise (SLR) Neuro muscular control exercises: Closed chain progression: • Seated leg press – one 30 sec bout • Standing weight –shifting exercises • Side- stepping • Step ups • Forward-backward and shuttle – walking drills RESULTS: Knee function of all patients increased significantly after the 4-week intervention program in both the groups of MANUAL THERAPY and EXERCISE THERAPY but Group A Manual therapy improved more significantly when compared to Group B Exercise therapy. CONCLUSION: Treatment effect was more in the patients received Manual therapy when compared to Exercise therapy. This finding suggest that Manual therapy can be useful intervention supplement in patients with osteoarthritis of knee.

Penatalaksanaan Fisioterapi Pada Kondisi Drop Foot Bilateral dengan Modalitas Infra Red, TENS dan Terapi Latihan

Drop Foot is someone who is unable to lift the front foot when walking. This incident is reported to be around 19 per 100,000 people or 1% to 2% of all diagnosed sufferers. The aim of this research is to determine the management of physiotherapy with pain problems, limited range of motion of joints and decreased muscle strength. These problems are the reason researchers use selected modalities such as Infra Red, TENS and exercise therapy in the form of an ankle pump from February to March at the Bagas Waras Regional Hospital, Klaten. Collecting case study data on physiotherapy treatment using Infra Red modalities, TENS and exercise therapy in the form of an Ankle pump which resulted in reducing pressure pain in the 6th therapy (T6) to 1 from 4 (T0), increasing the range of joint movement by 5° at each meeting on the left side, as well as increasing muscle strength at the 6th therapy (T6) to a value of 3 from 1 (T0). Researchers advise the public to reduce activities such as lifting heavy weights in order to reduce the occurrence of spondylosis so that the number of Drop Foot cases does not continue to increase.

Penatalaksanaan Fisioterapi Pada kasus Post ORIF Metacarpal IV Sinistra dengan modalitas Infra Red(IR) dan Terapi Latihan

Based on 2018 Riskesdas data, an average of 92,976 fractures occurred, totaling 5,144 people. A single trauma and sudden excess force can cause a fracture. Orif installation is carried out if the use of close reduction/plaster fails, Orif is installed on the right fracture fragment. In solving problems in post-orif cases, physiotherapy plays a role in restoring movement and function using infrared modalities and exercise therapy. The energy produced by IR can be absorbed by superficial tissue with a warm feeling, thereby reducing pain. Exercise therapy using active and passive body movements can increase the range of motion of joints, increase muscle strength values ​​to restore functional ability. This research method uses a case study of physiotherapy management in Post Orif Metacarpal IV cases with Infra Red (IR) and Exercise Therapy. Results were obtained such as pressure pain from T0:3 decreased to T6:1, movement pain T0:5 decreased to T6:1. The muscle strength value of left wrist flexor T0:3 increased to T6:5, extensor T0: 3 increased to T6: 5 in left wrist flexor T0: 3 increased to T6: 5, extensor T0: 3 increased to T6:4. Left wrist joint range of motion from T0 (S: 20°-0°-15°) increases to T6 (S: 50°-0°-50°) at T0 left mcp (S: 10°-0°-20°) increases to T6:(S:45°-0°-40°), functional activity from T0:(severe dependence) increases to T6:(light dependence). Being more careful in activities and not pushing your abilities can reduce the incidence of fractures.

Effect of Proper Use of Cane and Physical Therapy Management to Reverse Hamstrings Tightness and Abductors Weakness Due to Improper Use in Knee and Hip OA Patients

Effect of Proper Use of Cane and Physical Therapy Management to Reverse Hamstrings Tightness and Abductors Weakness Due to Improper Use in Knee and Hip OA Patients