Physiotherapy Department Research Articles

A Case Report of Limb Dystonia Management in a Nigerian Hospital: Physiotherapy Perspective

Background: Dystonia is a common movement disorder characterized by abnormal postures of the affected body part. The disabilities associated with dystonia are socially disabling and disfiguring, ranging from pain, loss of muscle strength and activities of daily living, poor quality of sleep and even depression. This article presents a case report of physiotherapy approach in the management of a patient with limb dystonia with major focus on pain management, balance control and functional independence. Case Presentation and Treatment Outcome: A case report of the management of a 48-year old female patient with limb dystonia. Patient was referred from the neurology unit, department of Internal Medicine, University of Port Harcourt Teaching Hospital (UPTH) to the neurology unit of the physiotherapy department, UPTH as a case of lower limb dystonia with an unknown cause. Appropriate physiotherapy intervention was given for a period of 12 weeks after a thorough assessment of the patient. The Numerical Pain Rating Scale (NPRS) was used to assess the level of pain in the affect limbs. The Berge Balance Scale (BBS) was used to assess the patient’s balance while Barthel Index (BI) was used to assess the functional independence of the patient. The case report was presented in line with CAse REport (CARE) guideline for case reports. All ethical procedures were followed. Treatment Outcome revealed that the score on Berg Balance Scale increased from 25 to 45 while that of Barthel Index scale increased from 13 to 18 after 12 weeks of intervention. Pain level on Range of Motion (ROM) based on the Numerical Pain Rating Scale (NPRS) reduced from 4/10 to 0/10 on the upper limb and from 9/10 to 1/10 on the lower limbs. Conclusion: Physiotherapy is effective in the management limb dystonia. Early referral to Physiotherapy is key to pain management, balance control and overall functional independence of the patients.

Physiotherapy Management of Vocal Cord Paralysis in a Nigerian Hospital: A Case Report

Background: Vocal cord paralysis is disabling and can lead to morbidities such as dysphagia, dysphonia and aspiration. It can also lead to loss of quality of lives and productivity in sufferers. An appropriate understanding of etiologies, signs and symptoms, diagnosis and management are essential in offering patients appropriate treatments. This article discussed a case report of the physiotherapy assessment and management of a patient with vocal cord paralysis. Case Presentation and Treatment Outcome: A case report of the assessment and management of a 38-year old male patient with vocal cord paralysis. Patient was referred from Ear, Nose and Throat (ENT) department to the physiotherapy department after an emergency tracheostomy done 2 months prior to referral. He was given appropriate physiotherapy intervention after a thorough assessment. Voice Handicap Index Score (VHIS) was used to assess voice projection of the patient. The Numerical Pain Rating Scale (NPRS) was used to assess the level of pain while tape measure was used to measure chest excursion. The CARE: CAse REport guideline for case reports was followed. All ethical procedures were followed as well. Treatment outcome revealed full AROM of the neck, increased chest excursion (from 2cm to 3.5cm), no hoarseness, no choking during deglutition and a Voice Handicap Index score of 25 after 10 treatment sessions. Pain level on Numerical Pain Rating Scale (NPRS) was reduced from 8/10 to 2/10. Conclusion: Physiotherapy is effective in the management of vocal cord paralysis. Early referral to Physiotherapy is advised for good prognosis. Adequate teamwork and proper communication pathways should be encouraged in hospitals for good treatment outcome.

The Impact of Physiotherapy in the Management of Non-Operated Gonarthrosis in Mali

Introduction: According to the WHO, osteoarthritis is the result of mechanical and biological phenomena that destabilise the balance between the synthesis and degradation of cartilage and subchondral bone. Gonarthrosis is a genuine public health problem in developed countries due to its high frequency, the functional impotence it causes and its socio-economic impact [2, 3]. Its prevalence is estimated at between 7% and 17% in people aged over 45 [4]. This incidence has continued to increase over the last few decades due to the industrialisation of the world and the sedentary lifestyle of human beings. In the absence of any study on the role of physiotherapy in the management of gonarthrosis in Mali. We deemed it necessary to undertake a study whose aim was to evaluate the impact of physiotherapy in the management of non-operated gonarthrosis in the physiotherapy department of the Centre National d'Appareillage Orthopédique du Mali (C.N.A.O.M). Methods and Patients: This was a descriptive cross-sectional study over a period of one month. All patients seen in consultation with gonarthrosis and consenting were included. Results: In total, out of 561 patients seen in consultation at the C.N.A.O.M, we included 10 patients, i.e. 1.78%. Females accounted for 86%, with an average age of 55 years. Gonarthrosis was unilateral in 28.6% and bilateral in 71.4%. With the exception of one patient, all the other patients were overweight or obese. Apart from one patient, physiotherapy improved the symptoms in all our patients. Conclusion: Gonarthrosis is a very disabling condition. Our results are similar to those in the literature, i.e. it mainly affects obese adult women. Management is multidisciplinary. Physiotherapy plays a key role in the management of gonarthrosis. It significantly improves the clinical signs and quality of life of patients. A multicentre case-control study would be useful to assess the efficacy of physiotherapy alone in the management of gonarthrosis.

Effect of Exercise Training on Functional Capacity Head and Neck Cancer Patients Receiving Various Anticancer Therapies: An Interventional Study.

Anticancer therapies causes decreased respiratory function, quality of life and functional capacity in head and neck cancer patients. Patients receiving these cancer therapies suffer from fatigue which causes decrease in functional capacity and quality of life. The objective of this present study was to determine and compare the effect of exercise training on fatigue, functional capacity and quality of life in head and neck cancer patients receiving various anticancer therapies. A total of 45 subjects were included based on inclusion and exclusion criteria. 6-minute walk test, brief fatigue inventory (BFI) and functional assessment of cancer therapy- general (FACT-G) was used to measure the functional capacity, fatigue and quality of life respectively at baseline and post intervention. Participants received exercise intervention for six weeks (three days a week) for 40 min. Exercise intervention is delivered by a qualified physiotherapist from the Department of Physiotherapy. The result of this study shows that there was highly significant improvement in six-minute walk distance pre and post intervention in chemotherapy (33.75+21.55, p=0.000), radiation therapy (39.69+25.46, p=0.000) and chemoradiotherapy (32.06+16.49, p=0.000) within the group. Similarly, significant improvement was also seen in quality of life within the groups, chemotherapy (2.92+2.43, p=0.002), radiation therapy (6.06+3.13, p=0.000) and chemo radiotherapy (5.65+6.93, p=0.004). There was significant reduction in fatigue in chemotherapy (6.92+11.07, p=0.045), radiation therapy (12.38+7.28, p=0.000) and chemo radiotherapy (11.47+8.89, p=0.000). No significant improvement was noted between the groups for six- minute walk distance (p=0.784), quality of life (p= 0.058) and reduction in fatigue (p=0.065). This study concluded that exercise training is effective in improving functional capacity, quality of life and reducing fatigue in head and neck cancer patients receiving various anticancer therapies.

Investigating the Effects of Retro Walking on Pain, Physical Function, and Flexibility in Chronic Non-specific Low Back Pain

Objectives: Chronic non-specific low back pain (CNSLBP) is described as pain whose pathoanatomical cause cannot be determined. The current study aims to evaluate the impact of retro-walking on pain, flexibility, and physical functions in patients with CNSLBP. Methods: A randomized controlled trial was conducted in the Physical Therapy Department of District Head Quarter Hospital Nankana Sahib, Punjab, Pakistan from September 2021 to March 2022. The trial was conducted on 36 patients, randomly divided into 2 groups of 18 patients. Conventional treatment and retro-walking were given to the experimental group and the conventional treatment alone was provided to the control group for 1 month with 3 sessions per week. The outcome variables were pain, the flexibility of hamstrings and lumbar region, and physical function assessed by numeric pain rating scale, sit and reach test, modified Schober test, and modified Oswestry disability index, respectively. The data were assessed at pre-treatment after the sixth and twelfth sessions. Results: This study showed a significant difference in the numeric pain rating scale, sit-and-reach test, and modified Oswestry disability index with a P<0.05 in both groups after intervention. However, in the group comparison, these variables showed better results in the retro-walking group compared to others with a P<0.001 after both the sixth and twelfth sessions. Discussion: The current study suggested that when added up to conventional treatment, retro-walking was more beneficial in reducing pain and enhancing the flexibility and physical function in patients with CNSLBP when compared to conventional treatment alone; therefore, it should be added to the treatment protocol for chronic non-specific pain in the lower back.

The Effect of Combined Treatment with Passive Therapy, Physical Exercises, Lumbar Traction, and Walking Program on Chronic Low Back Pain

Chronic low back pain (CLBP) is one of the most common musculoskeletal disorders worldwide with far-reaching implications for social, economic, and public health. The study aimed to compare the effect of combined physiotherapy treatment in patients with CLBP. This observational retrospective randomized controlled study involved reviewing medical records of patients who were treated during a period of 6 weeks in the physiotherapy department of the Special Hospital for General Rehabilitation “Banja e Kllokotit,” Kllokot, Republic of Kosovo. The observational research was conducted for 60 patients, divided into two groups: Group 1: experimental group (n=30), with mean age of 41.7 years, average height of 1.68 cm, and average body mass index (BMI) of 71.7 for both sexes; Group 2: control group (n=30) with mean age of 43.1 years, average height of 1.66 cm, and average body mass index (BMI) of 71.5 for both sexes. In Group 1, combined treatment with passive therapy [thermotherapy and transcutaneous electrical nerve stimulation (TENS)], physical exercises, lumbar traction, and walking program was applied, while in Group 2, passive therapy like thermotherapy and TENS was applied. Outcome measurements included pain intensity, lumbar flexibility, revised Oswestry disability index (ODI), and self-confidence, which were assessed pre-treatment, at 3 weeks, and after 6 weeks of clinical treatment. The results showed significant improvement in both groups. However, the improvement was greater and with a significant difference only after 6 weeks in Group 1 compared to Group 2. The differences were observed in various outcome measures, including the visual analog scale for pain (VAS; p<0.0001), fingertip-to-floor distance (FTF; p<0.0001), ODI (p<0.0001), and Rosenberg self-esteem scale (RSE; p=0.0002). According to our data, combined treatment with thermotherapy, therapeutic exercises, lumbar traction, TENS, and walking program was more effective and can be considered as a treatment protocol for patients with CLBP. However, further research is recommended on the efficacy of combined physiotherapy treatment, especially lumbar traction for longer periods.

Feasibility and Efficacy of Craniosacral Therapy on Sleep Quality in Fibromyalgia Syndrome: a Pre-Post Pilot Trial.

Sleep disturbance is one of the key symptoms of fibromyalgia syndrome (FMS), which negatively affects the participants' quality of life. Craniosacral therapy (CST) is a gentle manual technique found to have significant effects on pain and function in chronic pain participants. However, limited evidence exists on its effectiveness on sleep quality in FMS participants. To evaluate the feasibility and effectiveness of CST on sleep quality in FMS participants. Outpatient physiotherapy department of a hospital in Bangalore. Participants diagnosed with FMS. A pre/post pilot trial. Once weekly, 45-minute sessions of CST for 12 weeks. The participants continued the standard medical care prescribed by the physician. The sleep quality was evaluated using Pittsburgh Sleep Quality Index (PSQI) at baseline and 12 weeks. The data analysis was carried out using paired t test. 9 out of 10 included participants completed the treatment and were included for analysis. The results of the paired t test showed significant improvement in the global PSQI score (p = .001, mean difference = 5.44±3.28, 95% CI = 2.92-7.97), as well as the 5 components of PSQI (p < .05). CST was feasible to deliver with high retention, acceptability, and minimal adverse events. It significantly improved sleep quality in FMS participants along with standard medical care. However, future studies with larger sample sizes and appropriate control groups are required to confirm the findings.

Proactive outcome monitoring and standardisation of physiotherapy stroke rehabilitation- A retrospective functional outcomes analysis of Accelerated Stroke Ambulation Programme (ASAP).

A clinical quality improvement programme named Accelerated Stroke Ambulation Programme (ASAP) was piloted in Physiotherapy Department of Tai Po Hospital from 1st October 2019 to 30th September 2020 and executed as a standard practice afterwards. The goal of ASAP was to facilitate early maximal walking ability of stroke patients in early rehabilitation phase. ASAP featured (1) proactive outcome monitoring and standardised process compliance monitoring by a patient database - Stroke Registry; (2) standardised mobility prediction by Reference Modified Rivermead Mobility Index (MRMI) Gain and (3) standardised intervention database - Stroke Treatment Library. To investigate the effectiveness of ASAP in an inpatient rehabilitation setting for stroke patients in terms of functional outcomes. The design was a retrospective comparative study to analyse the difference in functional outcomes of Pre-ASAP Group (1st October 2018 - 30th September 2019) and Post-ASAP Group (1st October 2020-30th September 2021). The primary outcome measures were MRMI, Berg's Balance Scale (BBS), Modified Barthel Index (MBI), MRMI Gain, BBS Gain, MBI Gain, MRMI Efficiency, BBS Efficiency and MBI Efficiency. There 348 subjects in Pre-ASAP Group and 281 subjects in Post-ASAP Group. Both groups had highly significant within-group improvement in MRMI, BBS and MBI (). The MRMI Gain of Pre-ASAP Group and Post-ASAP Group was 6.32 and 7.42, respectively; and the difference was significant (). The BBS Gain of Pre-ASAP Group and Post-ASAP Group was 8.17 and 9.70, respectively; and the difference was in margin of significance (). The MBI Gain of Pre-ASAP Group and Post-ASAP Group was 10.69 and 11.96, respectively; but the difference was non-significant (). The MRMI Efficiency, BBS Efficiency and MBI Efficiency of Post-ASAP Group were higher than Pre-ASAP Group but the difference was non-significant. The results of this study reflected that stroke rehabilitation programme with proactive outcome monitoring, standardised process compliance monitoring, standardised mobility prediction and standardised intervention database was practical in real clinical practice with better functional outcomes than traditional physiotherapy practice which were dominated by personal preference and experience of therapists. Proactive outcome monitoring, standardised process compliance monitoring, standardised mobility prediction and standardised intervention database may enhance the effectiveness in terms of functional outcomes of stroke rehabilitation programme.

Effectiveness of Maitland Mobilization Technique in Comparison with Mulligan Mobilization Technique in Management of Frozen Shoulder

Background: Frozen shoulder refers to a common shoulder condition characterized by a general limitation of shoulder range of motion in the capsule model. The capsular pattern of the shoulder is characterized by the greatest limitation of passive lateral rotation and abduction. Physiotherapy is the most important part of the conservative treatment of frozen shoulder. Aim: To find the role of Maitland mobilization technique in treatment of frozen shoulder with Mulligan’s mobilization techniques and its possible effects in early gaining of ROM and pain management. Methods: This was a comparative study conducted at the Department of Physical Therapy and Orthopedic Surgery I, King Edward Medical College/Mayo Hospital, Lahore. Subjects were conveniently divided into her two groups, each group containing her 40 patients. In group A, patients were treated with Maitland manipulative therapy. In group B, patients were treated with mulligan mobilization and movement techniques. Patients in both groups were followed for up to 6 weeks and improvements in motor parameters were recorded at each patient's follow-up visit. SPSS was used for data entry and analysis. Result: A total of 50 patients participated in this study. The mean age of patients in group A was 46.23 years and the mean age of group B was 45.23 years at the onset of the disease at 6 weeks, 11 patients at 10 weeks, and 2 patients at 12-year intervals. Patients had an onset duration of 6 weeks, 10 patients had an onset duration of 10 weeks, and 6 patients had an onset duration of 12 weeks. Abduction was observed to be significantly improved in patients treated with the Mulligan method compared with those treated with the Maitland mobilization method. Practical implication: More specifically, the study will be focused on the examining the shoulder active and passive ROMs and pain reduction before and after the treatment. All measured characteristics of FS patients will be compared with those of the subjects with asymptomatic shoulders. Conclusion: In comparison with Mulligan mobilization technique, Maitland mobilization technique is more effective in the management of frozen shoulder. Keywords: Adhesive capsulitis /Frozen shoulder, Mulligan mobilization technique, Maitland mobilization technique.

Comparison of Repeated Task Oriented Training for the improvement of motor function with mirror Therapy and Conventional Treatment On upper limb in patients with stroke - A Randomized Controlled Trial (RCT)

Background: This study's goal is to illustrate how mirror treatment can be used with someone who has upper-extremity hemiparesis three months after suffering a cerebrovascular accident (stroke). These patients frequently fail to use their affected upper extremity to its full extent, possibly as a result of the "learned nonuse phenomenon. On each weekday of the 9-day intervention period, the patient performed tasks with the paretic upper extremity for 6 hours while being closely watched. Methods: Study population was patients from Mayo hospital Lahore. Study design was Randomized Controlled Trial. RCT:. 34 patients who met the requirements for inclusion were examined in this study. Before beginning any physical examination, each participant in this study gave their written, informed consent. Patients were divided equally into two groups. The Wolf Motor Function Test and the Numeric Pain Scale were used to measure pain and motor function on the first day. Group A received treatment using mirror therapy, whereas Group B received traditional care. Results: Mirror therapy was significantly effective in lowering pain and boosting functional activity in stroke patients, as evidenced by the comparison of the pre- and post-treatment scores on the NPRS and WMFT for groups A and B. Practical Implication: Stroke leads to multiple dysfunctions depending upon severity of lesion. It may decrease the range of motion and leads to functional dependency or disability. Physical therapy is important in the management of stroke including Strengthening, Stretching, ROMs and Manipulation and Mirror Therapy. This study provided an opportunity to share my personal experience with community. This study was conducted purely in clinical setting of Physiotherapy Department Mayo Hospital, Lahore. Conclusion: The study has proved that mirror therapy is more effective when combined with conventional treatment in management of stroke as compared to only use of conventional treatment. Keywords: Task oriented training, Motor function, Mirror therapy, conventional therapy, stroke, RCT

Role of virtual reality distraction technique to improve chest burns with acute respiratory distress syndrome (ARDS) following smoke inhalation in middle-aged adults – A randomized controlled study

BackgroundBurns of the chest region constitute a common burn and develops skin contractures around the thorax region. Inhalation of toxic gases and chemical irritants during the fire leads to Acute Respiratory Distress Syndrome (ARDS). Breathing exercises are painful but are needed to help counteract contractures and increase lung capacity. These patients are usually in pain and extremely anxious about chest physiotherapy. Virtual reality distraction is one such technique that is gaining immense popularity when compared to other pain distraction techniques. However, studies examining the efficacy of the virtual reality distraction technique in this population are lacking. ObjectivesTo find and compare the effects of the virtual reality distraction technique as a pain alleviation tool for reducing pain during chest physiotherapy in chest burns patients with ARDS in middle-aged adults. MethodsA randomized controlled study was conducted at the physiotherapy department between 1st Sep 2020 and 30th Dec 2022. The eligible sixty subjects were randomized into two groups: The virtual reality distraction group (n = 30) received virtual reality distraction technique and the control group (n = 30) received progressive relaxation technique before chest physiotherapy as a pain distraction technique. All the participants received chest physiotherapy as a common treatment (treatment as usual). Primary (Visual Analogue Scale – VAS) and secondary (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), residual volume (RV), functional residual capacity (FRC), total lung capacity (TLC), RV/TLC, and diffusing capacity for carbon monoxide of the lungs (DLCO) outcome measures were measured at baseline, after four weeks, eight weeks and at six months follow up. The effects between the two groups were analyzed using the independent t-test and chi-square test. The intra-group effect was analyzed with a repeated measure ANOVA test. ResultsBaseline demographic characters and study variables show homogenous distribution between the groups (p > 0.05). Four weeks following two different training protocols virtual reality distraction group shows more significant changes in pain intensity, FVC, FEV1, FEV1/FVC, PEF, RV, FRC, TLC, RV/TLC, and DLCO (p = 0.001) but not in RV (p = 0.541). The similar improvements were noted in the 8 weeks and 6 months follow up. ConclusionThe reports of the study concluded that virtual reality distraction is an effective and useful technique in reducing pain and increasing lung capacity in chest burn patient with ARDS following smoke inhalation in community-dwelling middle-aged adults. In the virtual reality distraction group, the patients reported significantly less pain and clinically meaningful changes in pulmonary functions as compared to the control group (physiotherapy + relaxation).

Exploring the Barriers and Enablers to High Quality Clinical Placements in Physiotherapy at a Metropolitan Teaching Hospital Using an Implementation Science Approach

Background: Indicators of quality in physiotherapy clinical placements offer opportunity to assess current practise. The Consolidated Framework for Implementation Research (CFIR) provides a framework to identify barriers and enablers to guide tailored strategies for improvement. Aims: The aims of this study were to explore adherence to indicators of quality in a single physiotherapy department at a metropolitan teaching hospital, and to conceptualise the barriers and enablers to achieving quality in clinical placements in this context using the CFIR. Methods: A mixed-methods sequential explanatory study design was undertaken at a metropolitan hospital in Queensland, Australia. Stakeholder’s perceptions of enablers and barriers to meeting quality indicators in relation to current practise were assessed using a standardised survey (n=28), followed by focus groups and semi-structured interviews (n=19). Results: Three main themes were identified: (i) training in clinical education skills is essential but currently focuses on assessment, (ii) the clinical educator (CE) role is perceived as having low value, and (iii) opportunities identified to develop existing supports for CEs. Conclusion: Findings from this study have informed strategies implemented at the facility under study, which focus on increasing the perceived value of the CE role, engaging CEs in training as educators, and collaboration with university coordinators.

Association Between Subscapularis Trigger Point and Frozen Shoulder: A Cross Sectional Study

Background: Uncertainty surrounds the relationship between subscapularis trigger sites and the development of frozen shoulder syndrome. Objectives: The purpose of this study was to investigate the relationship between subscapularis trigger points and immobilized shoulder in patients from the Outpatient Physical Therapy Department at NMC Hyderabad. Methods: This cross-sectional study was conducted from September 2022 to February 2023 and included 71 patients diagnosed with grade 1 or 2 frozen shoulder based on Codman's criteria and aged 35 or older. Using an axillary approach, subscapularis trigger points were identified manually, and their presence was evaluated on both the affected and unaffected sides. Using the Chi-square test in SPSS version 22, the relationship between subscapularis trigger points and immobilized shoulder was analyzed. Results: 33 (46.5%) of the 71 participants were male, while 38 (53.5%) were female, with a mean age of 53.32 years. On the affected side, there was a significant association between frozen shoulder and subscapularis trigger points (p =.001). Intriguingly, a statistically significant difference was also observed in the unaffected shoulder joint (p =.001). Practical Implications: It highlighted the importance of diagnosing and treating subscapularis trigger points in patients with frozen shoulder, potentially guiding new therapeutic strategies to improve shoulder mobility and reduce pain in these individuals. Conclusion: Our findings indicate a considerable association between subscapularis triggers points and frozen shoulder, making these trigger points possible therapeutic targets. To investigate the underlying mechanisms and validate these results in larger populationss, additional research is required. Keywords: Frozen shoulder syndrome; Orthopedics; Subscapularis trigger points; Surgery

How Stories Help Us See Ourselves: The Power of Storytelling by Physical Therapists.

Journal Article Accepted manuscript How Stories Help Us See Ourselves: The Power of Storytelling by Physical Therapists. Get access Oro Valley Oro Valley Department of Physical Therapy, Arizona School of Health Sciences, A.T. Still University, Mesa, AZ, USA Address correspondence to Dr Peterson at: srpeterson01@atsu.edu; @drsethpt Search for other works by this author on: Oxford Academic Google Scholar Physical Therapy, pzad046, https://doi.org/10.1093/ptj/pzad046 Published: 04 May 2023 Article history Received: 17 January 2023 Accepted: 30 April 2023 Published: 04 May 2023

CycLing and EducATion (CLEAT): protocol for a single centre randomised controlled trial of a cycling and education intervention versus standard physiotherapy care for the treatment of hip osteoarthritis

BackgroundOsteoarthritis (OA) is a chronic degenerative joint disorder for which there is no known cure. Non-surgical management for people with mild-to-moderate hip OA focuses mainly on alleviating pain and maximising function via the National Institute for Health and Care Excellence (NICE) recommended combination of education and advice, exercise, and, where appropriate, weight loss. The CHAIN (Cycling against Hip pAIN) intervention is a group cycling and education intervention conceived as a way of implementing the NICE guidance.MethodsCycLing and EducATion (CLEAT) is a pragmatic, two parallel arm, randomised controlled trial comparing CHAIN with standard physiotherapy care for the treatment of mild-to-moderate hip OA. We will recruit 256 participants referred to the local NHS physiotherapy department over a 24-month recruitment period. Participants diagnosed with hip OA according to NICE guidance and meeting the criteria for GP exercise referral will be eligible to participate. Primary outcome is the difference in Hip Disability and Osteoarthritis Outcome Score (HOOS) function, daily living subscale between those receiving CHAIN and standard physiotherapy care. Secondary outcomes include performance-based functional measures (40 m walking, 30s chair stand and stair climb tests), ability for patient to self-care (patient activation measure) and self-reported health-related resource use including primary and secondary care contacts. The primary economic endpoint is the number of quality adjusted life years (QALYs) at 24 weeks follow-up. The study is funded by the National Institute for Health Research, Research for Patient Benefit PB-PG-0816-20033.DiscussionThe literature identifies a lack of high-quality trials which inform on the content and design of education and exercise in the treatment of patients with hip OA and explore cost-effectiveness. CLEAT is a pragmatic trial which seeks to build further evidence of the clinical benefits of the CHAIN intervention compared to standard physiotherapy care within a randomised, controlled trial setting, and examine its cost-effectiveness.Trial registration numberISRCTN19778222. Protocol v4.1, 24th October 2022.

Pain, kinesiophobia, functional status, and physical activity among patients with knee osteoarthritis

Aims: The present study attempted to investigate the relationship between pain, kinesiophobia, functionality, and physical activity among patients with knee osteoarthritis (OA). Methods: We recruited 88 patients aged 40-70 years with OA, 21 males and 67 females, who applied to Gebze Fatih State Hospital, Department of Physical Therapy and Orthopedic Clinic between February 2022 and January 2023. We evaluated the patients’ pain status with the Visual Pain Scale (VAS), their functional status with the WOMAC Osteoarthritis Index (WOMAC), their kinesiophobia with the TAMPA Scale for Kinesiophobia (TKS), and their physical activity levels with the International Physical Activity Questionnaire-Short Form (IPAQ-SF). We performed all statistical analyses using SPSS 25.0 (SPSS Inc., Chicago, IL, ABD) and p-value &lt; 0.05 was accepted as statistically significant. Results: The majority of the participants were females (76.1%, n=67), and the mean body mass index (BMI) was found to be 30.33. The findings revealed low positive correlations between the patients’ BMI and their VAS (p=0.029) and WOMAC scores (p=0.017). While we found a moderate positive relationship between the patients’ VAS and WOMAC scores (p=0.001), it was low between their TAMPA and WOMAC scores (p=0.001). Conclusion: As a result of the study, the relationship between pain, kinesiophobia, functional status and physical activity levels of individuals with knee OA was revealed; The necessity of planning applications to increase the physical activity level of these individuals and to reduce their body mass index has been underlined.

Problems and ways of development of the sports and recreation industry in the context of international sanctions

The article actualizes the problems of development of the commercial and public sector of the sports and recreation industry in the context of international sanctions. In a situation of budgetary funding cuts, it is proposed to solve the problems of sports and recreational work with young people, in which local authorities play an important role. In particular, in the direction of the work of regional authorities for physical culture and sports on social advertising of a healthy lifestyle, as well as on explaining the methodological foundations regarding self–study in innovative non– traditional types of health–improving physical culture for online training. The article also discusses the problems of developing commercial fitness/wellness clubs, outlines aspects of a marketing strategy aimed at customers in the economy class segment and expanding the network of small format fitness studios. The positive and negative aspects of the pension reform of the Russian Federation, the health care reform of the Russian Federation are analyzed, the consequences are identified, and some conceptual proposals are formed. From the author’s point of view, in order to increase the working capacity and productivity of workers of pre–retirement age, it is necessary to focus on free services of restorative rehabilitation medicine by resuming the work of physiotherapy departments in city clinics and on providing pre–pensioners with free sanatorium– and spa–treatment.

Promotion of physical activity by health professionals in a sample of six public hospitals: A cross sectional study.

Despite strong evidence of physical and mental health benefits from physical activity, participation is low. Physical activity promotion by health professionals can effectively increase physical activity participation. This study aimed to explore the frequency of physical activity promotion by health professionals in public hospitals with a focus on community-based structured exercise; and facilitators and barriers to such promotion. We surveyed health professionals (n = 100) from physiotherapy, rheumatology and rehabilitation departments at six public hospitals in Sydney, Australia. Most common respondent characteristics were physiotherapist (84%), female (68%), aged 25-34 years (45%) and treating older adults (45%). Almost all health professionals (94%) considered themselves physical activity role-models. Half (53%) reported promoting physical activity frequently/often to their clients. Those working with children with a physical disability (23%) were more likely to promote physical activity (Relative Risk 1.69, 95% CI 1.13-2.51, p = .03), than those working with adults or older adults. Half the physiotherapists (52%) reported providing tailored advice about increasing physical activity frequently/often, but only 20% provided advice about structured physical activity. Barriers reported by physiotherapists were lack of time (51%) and client's access to transport (61%). Only half the health professionals surveyed offered tailored physical activity advice to clients, and advice on structured physical activity was less common. SO WHAT?: Some promotion of physical activity by health professionals is occurring in hospital settings but more work is needed to embed this within clinical care.

IMPROVING THE METHODOLOGY OF PHYSICAL THERAPY IN ATHLETES WITH INJURIES OF THE KNEE JOINT CONNECTIVE APPARATUS

Description and results of the action developed programs of kinesiotherapy with a combination of kinesiotape to restore impaired locomotor functions of the knee joint and the possibility of continuation playing sports after arthroscopic operations for damage to the ligamentous apparatus.&#x0D; Injuries of the musculoskeletal system (MS) are quite common, especially in athletes. According to statistics, up to 50-70% of all ORA injuries occur in the knee joint. Most often, this type of injury is received by athletes, representatives of complex coordination sports and martial arts. Among injuries to the knee joint, injuries to the ligaments, which later cause post-traumatic instability, take second place after damage to the menisci.&#x0D; 35 patients with injuries of the ligamentous apparatus of the CS (12 women and 23 men) who underwent arthroscopic surgery took part in our study. The patients were active athletes in various sports, in particular game sports. Patients were divided into two groups (the main group and the comparison group) depending on the kind of restorative treatment program. The main group included 23 people whose average age was (24.3±3.0) years. Patients of this group received a rehabilitation program in the conditions of an educational and scientific center Department of Physical Therapy, Occupational Therapy of PNU named after Vasyl Stefanyk. The comparison group (CP) consisted of 12 people, the average age of which was (23.8±3.1) years, who underwent rehabilitation in the polyclinic department of the 1st city polyclinic.&#x0D; The individual program of physical therapy for OG patients included kinesiotherapy and massage muscles of the lower limb, physiotherapeutic procedures and the use of kinesiotape. Kinesiotherapy included therapeutic gymnastics of independent classes, massage for the prevention of contracture of the CS and atrophy of the thigh muscles. Various types of massage were used - classic manual massage with passive movements in the joints, self-massage and hydro massage. Physiotherapy procedures were aimed at reducing swelling and pain, preventing the development of the inflammatory process. Patients were prescribed electrophoresis of painkillers, UV irradiation, and UHF or laser therapy, applications of ozokerite or paraffin. These procedures contribute to the stimulation of lymph and blood circulation, trophic processes in the joints, increasing the amplitude of movements and restoring the strength of the muscles of the limb.&#x0D; In order to objectify the results of the restorative treatment, the functional ability of the lower limb was assessed using the Lovett muscle test (six-point assessment of muscle strength), the amplitude of movements in the knee joint (goniometry) and the visual analog pain scale (VAS) on the 14th day, 1.5 months, 3 and 5 months after the operation. This part of the study showed the advantages of the developed rehabilitation program using elements of kinesiotaping, as only a few patients with functional disorders were found in OG while in the comparison group their number was up to 20%. Improvement of joint function and normalization of muscle strength and goniometry indicators occurred earlier in OG patients by 2 weeks, compared to patients who underwent restorative treatment according to the traditional method of the city polyclinic.&#x0D; A special place in the assessment of results is given to determining the quality of life using the SF-36 questionnaire. The dynamics of quality of life indicators showed a gradual and likely improvement of all components of quality of life at the entire stage of post-hospital rehabilitation. We proved that the proposed rehabilitation program is more effective compared to the traditional methods of restorative treatment of a medical institution and allows achieving better results in restoring the functions of the knee joint in the shortest possible time after the injury and can be recommended for wide use.

Commentary on "Barriers and Facilitators to the Acceptance of eHealth Interventions by Dutch Pediatric Physical Therapists in Times of the COVID-19 Pandemic: A Mixed-Methods Approach".

Department of Physical Therapy, University of Delaware, Newark, Delaware Center for Disabilities Studies, University of Delaware, Newark, Delaware The authors declare no conflicts of interest.