Frequency Of Physical Therapy Research Articles

Association between physical therapy frequency and postacute care for a national cohort of patients hospitalized with pneumonia.

Annually more than 300,000 patients hospitalized for pneumonia need postacute care. Patients and systems prefer home discharge, but physical limitations often necessitate postacute care. It is unknown whether frequency of physical therapy in the hospital affects postacute care discharges. Examine the relationship between physical therapy visit frequency and disposition among a national sample of patients hospitalized with pneumonia. Observational cohort study. Acute care hospital. Adult patients with primary diagnosis of pneumonia in the Premier Data Set who received physical therapy in the hospital during a 5-day window, with therapy on at least days 1 and 5. Physical therapy visit frequency. Discharge disposition (home or postacute care). We included 18,886 patients from 595 hospitals. Just over half were discharged home (n = 9638; 51.0%) and 558 (2.95%) died. Patients getting more frequent therapy were older, non-Hispanic white, treated in small non-teaching rural hospitals in the West, Midwest, or South, and had fewer severe illness indicators. In adjusted models, patients who received physical therapy on 100% of days were 7% [(95% confidence interval, 4.3-9.7), p < .0001] more likely to go home than patients who received physical therapy on 40% of days. As a falsification test, we found that there was no relationship between physical therapy frequency and all-cause mortality. Physical therapy visit frequency was positively associated with discharge to home. Increasing visit frequency of physical therapy in hospitals might reduce the need for postacute care, but randomized controlled trials are needed to confirm the effect.

Influence of Physical Therapy Frequency on AMPAC Scores and Hospital Discharge Disposition: A Pilot Study

<h3>Research Objectives</h3> To investigate if there was an association between physical therapy (PT) frequency and discharge location for subjects who were admitted to the cardiovascular service line and had an AMPAC score between 12 and 17 at PT initial evaluation. <h3>Design</h3> This was a retrospective chart review study. Subjects were stratified by whether they remained on or transferred off CV-SL during hospitalization. Subjects were divided by frequency of PT visits: ≥0.57 or < 0.57, with the cutoff determined as 4 visits over 7 days. Statistical analysis included a Chi-square analysis to look for an association between frequency of PT visits and discharge location and paired t-tests. <h3>Setting</h3> The setting was a tertiary care hospital. <h3>Participants</h3> Ninety-nine subjects (mean age=77.33 years, 54 males) were included. Inclusion criteria included ≥18 years of age, admitted between January 1 and March 30, 2019, and an AMPAC score between 12 and 17 at PT initial evaluation. <h3>Interventions</h3> Not applicable as this was a retrospective chart review. <h3>Main Outcome Measures</h3> The main outcome measure used was the Boston University AM-PAC "6 clicks" Basic Mobility Short Form. <h3>Results</h3> Twenty-six subjects received ≥0.57 PT visits throughout their hospitalization. There was no significant association between PT visit frequency and discharge location (X2 = 3.75, p=0.29). There was a statistically significant difference in AMPAC score between PT initial evaluation and last PT visit for patients receiving ≥0.57 PT visits (t=-6.23, p=0.000) and those who received < 0.57 visits (t=-3.29, p=0.002). Subjects who received ≥0.57 PT visits had a greater increase in mean AMPAC score (3.04) compared to subjects who received < 0.57 visits (1.80). <h3>Conclusions</h3> There was not an association between frequency of PT visits and discharge location. This could be due to a small sample size, with an uneven distribution of subjects between frequency groups and discharge locations. There was a difference in AMPAC scores from PT initial evaluation to last PT visit in the positive direction, indicating functional improvement. <h3>Author(s) Disclosures</h3> I have no financial disclosures or conflicts of interest to disclose.

Optimal frequency of physical therapy in young children with cerebral palsy: a retrospective pilot study

ABSTRACT Purpose To determine the optimal frequency of physical therapy (PT) in young children with cerebral palsy (CP). Methods Twenty-three children (mean age, 47.30 ± 31.95 months) with CP who had undergone both low- and high-frequency PT in an outpatient rehabilitation clinic were analyzed retrospectively. The Gross Motor Function Measure-88 (GMFM-88) score was assessed before and after low- and high-frequency PT. Results The high-frequency PT group showed statistically significant improvements of GMFM-88 compared to the low-frequency PT group. In the high-frequency PT group, the improvement in total GMFM-88 scores was greater in children below 36 months of age than in children above 36 months of age. Moreover, the ambulatory group showed greater improvement compared to the non-ambulatory group during high-frequency PT. Conclusions High-frequency PT might benefit gross motor function in children with CP up to 36 months of age. High-frequency PT resulted in improved standing and gait function in the ambulatory group.

Association between weather and utilisation of physical therapy in patients with osteoarthritis: a case-crossover study

BackgroundDuring varied weather conditions, patients with osteoarthritis experience different severity of symptoms and signs. However, weather may also cause barriers or incentives for patients to seek medical services. These factors may result in changes in medical utilisation; however, no studies have investigated whether the probability of physical therapy utilisation among patients with osteoarthritis is associated with changes in meteorological factors.MethodBy using a secondary data of NHID in Taiwan, we conducted a population-based, retrospective study with case-crossover design for patients initially diagnosed with osteoarthritis between 2000 and 2013. The meteorological factors of months with the lowest treatment rate were used as patients’ own control periods and compared with the parameters of months with high treatment frequency. The risk of exposure to different meteorological factors, including mean temperature, daily highest temperature, daily minimum temperature, diurnal temperature range, relative humidity, and barometric pressure, was estimated and represented by odds ratios (ORs) and 95% confidence intervals (CIs).ResultsA total of 8,130 patients were recruited. Regardless of univariate or multivariable analysis, increased daily highest temperature enhanced the frequency of physical therapy (OR: 1.04; 95% CI: 1.02–1.05; p < 0.01; OR: 1.07; 95% CI: 1.04–1.10; p < 0.01). When the weather was hotter (> 23 °C), higher diurnal temperature range and humidity resulted in an increase in the utilisation of physical therapy. However, when the weather was colder (< 23 °C), reverse effects were observed.ConclusionsAn increase in temperature increases the probability of physical therapy resource use. Therefore, temperature, along with other meteorological factors, may play a key role in the utilization of physical therapy among patients with osteoarthritis.

Фізична терапія пацієнтів після кардіохірургічних втручань: аналіз опитувань фізичних терапевтів різних країн

Мета. Проаналізувати результати опитувань фізичних терапевтів різних країн щодоособливостей їх практики з кардіохірургічними пацієнтами. Методи. Аналіз та порівняннярезультатів досліджень, котрі присвячені вивченню особливостей фізичної терапії пацієнтівпісля кардіохірургічних втручань на стаціонарному етапі у формі опитувань фізичнихтерапевтів, а також аналіз обґрунтованості моделей фізичної терапії.Результати. Отримано досить великі відмінності та різноманітні підходи до передопераційногоконсультування та навчання пацієнтів елементам фізичної терапії. Частота використанняфізичної терапії для інтубованих пацієнтів також різнилася. Ключові особливості мобілізаціїпацієнтів та використання терапевтичних вправ відрізнялися у різних країнах. Кіль-кість процедур також мала широкий діапазон. Вправи з глибоким диханням були однієюз найпоширеніших технік серед респіраторної фізичної терапії. Запобіжні заходи післястернотомії та терміни їх дотримання не були однаковими. Наукова обґрунтованість практикифізичної терапії залишається сумнівною. Особистий досвід, протокол лікарні та уподобанняколег, а не результати наукових досліджень, є основою практики. Впровадження результатівнаукових досліджень у практику є складним процесом з рядом перешкод.Висновки. Подальший аналіз та розробка міжнародних рекомендацій з науковимобґрунтуванням необхідні для встановлення оптимального протоколу фізичної терапії пацієнтівпісля хірургічних втручань на серці.

Large Variability of Frequency and Type of Physical Therapy in Patients in the German Network for Systemic Sclerosis.

To determine the type and frequency of physical therapy (PT) prescribed by physicians for patients in the registry of the German Network for Systemic Sclerosis. The data for 4,252 patients were analyzed using descriptive statistics, chi-square tests, and odds ratios (ORs). Overall, 37.4% of patients (1,590 of 4,252) received PT at the end of a yearly follow-up. The most frequently used type of PT was lymphatic drainage (n = 1,061, 36.8%), followed by exercise therapy (n = 1,047, 36.3%) and heat therapy (n = 689, 23.9%). More than three-fourths of treated patients (82%) received 1 or 2 different forms of PT simultaneously. The prescription of PT was associated with the extent of skin fibrosis as measured by the modified Rodnan skin thickness score (<10 [41.8% of patients], 11-20 [55.8% of patients], and >21 [63.9% of patients]; P < 0.001). Patients with musculoskeletal involvement (e.g., arthritis, muscle weakness, joint contractures, tendon friction rubs) had a higher chance of receiving PT than patients without these symptoms, with corresponding ORs ranging from 1.96 (95% confidence interval [95% CI] 1.69-2.28) for joint contractures to 3.83 (95% CI 2.89-5.08) for arthritis. When comparing the type of PT prescription across the initial and all follow-up visits from 2003 to 2017, significant alterations with a decreasing frequency of patients receiving PT could be observed (P = 0.001). To our knowledge, this is the first study reporting the use of PT in patients with systemic sclerosis (SSc) in a large cohort. Although SSc is characterized by considerable disability and restriction of motion, <40% of patients received PT.

Change of Tolerance of Physical Load and Quality of Life using Physical Therapy in Patients after Myocardial Infarction in the Early Period of Rehabilitation

Each second a person dies from cardiovascular diseases in Lithuania. Mortality from cardiovascular diseases in 2020 will account for 37% of all deaths in the world. Movement is very important for blood circulation and cardiac work, but due to reduced blood supply to the heart physical capacity is disrupted. Physical therapy improves tolerance of physical load, reduces fatigue, dyspnoea, frequency of hospitalization and improves the quality of life. The maximum efficiency is achieved when physical therapy starts in the first week after myocardial infarction. Starting physical therapy each week later, rehabilitation period becomes a month longer. The purpose of this study was to evaluate the effects of physiotherapy on the tolerance of physical load and the quality of life changes in patients after myocardial infarction in the early period of rehabilitation. The study involved 14 people (58.1 ± 7,6) after a myocardial infarction (9 men and 5 women). In study there were two groups: 1 – control group (n = 7) with physical therapy 1 time per day, 5 days per week (n = 5), 2 – experimental group (n = 7) with physical therapy 3 times per day, 5 days per week (n = 15). Tolerance of physical load was determine using a 6 min walk test, before and after the 6 min walk test we evaluated subjective complaints using Borg scale. The quality of life was evaluated using SF – 36 questionnaire. Both groups were evaluating before physical therapy and after 5 days of physical therapy. After physical therapy the tolerance of physical load increased in control and experimental groups, it improved during the 6-minute walk distance (p &lt; 0.05), fatigue decreased (p &lt; 0.05) (there was no differences between groups (p &gt; 0.05)). The leg pain in both groups did not change (p &gt; 0.05), dyspnoea did not decrease (p &gt; 0.05). Physical therapy frequency did not influence the quality of life. Conclusion: physical therapy 3 times per day improved the tolerance of physical load – it increased in 6-minute walk distance, but the quality of life did not change significantly.Keywords: myocardial infarction, functional capacity, quality of life, physical therapy.

Frequency of physical therapy in knee osteoarthritis: a randomized controlled trial

Objectives: This study is conducted to compare the three different frequency of the physical therapy application for knee osteoarthritis in female patients. Methods: Consecutive 89 female patients with knee osteoarthritis were randomized into three groups of physical therapy as twice-daily, once-a-day and alternate day, by computerized random number generator. We used Visual Analog Scale (VAS); to determine pain level, Western Ontario McMaster Osteoarthritis Index (WOMAC); to determine osteoarthritis (OA) severity, 10-meter walking test (WD); to determine walking speed and Short Form (SF-36) questionnaire; to determine the quality of life. All groups received a total of 10 physical therapy sessions including hot pack, therapeutic ultrasound (US) and transcutaneous electrical nerve stimulation (TENS). We evaluated subjects at the beginning, at the end of treatment and at the third month control at post-treatment period. Results: Improvement was observed in all groups after treatment (p &amp;lt; 0.05). While there was no significant difference in once-a-day treatment group at 3rd month control (p &amp;gt; 0.05), alternate day group showed a significant improvement (p &amp;lt; 0.05). Conclusions: In the treatment of knee osteoarthritis, usually once-a-day physical therapy approach is preferred in daily practice. Alternatively twice a day or alternate day therapies can be applicable.

Is more frequent physical therapy associated with increased gross motor improvement in children with cerebral palsy? A national prospective cohort study

Purpose: To investigate the association between physical therapy frequency and gross motor improvement in children with cerebral palsy (CP).Materials and methods: This is a prospective cohort study of 442 children aged 2–12 years, Gross Motor Function Classification System levels I–V, from the Cerebral Palsy Follow-up Program and the Cerebral Palsy Register of Norway. Outcome was change in reference percentiles for the Gross Motor Function Measure (GMFM-66) between two subsequent assessments (N = 1056) analyzed in a linear mixed model.Results: It was a dose response association between physical therapy frequency and gross motor improvement. Mean change was 4.2 (95% CI: 1.4–7.1) percentiles larger for physical therapy 1–2 times per week and 7.1 (95% CI: 2.6–11.6) percentiles larger for physical therapy >2 times per week, compared to less frequent physical therapy when analyzed in a multivariable model including multiple child and intervention factors. The only statistically significant confounder was number of contractures which was negatively associated with gross motor improvement.Conclusions: When gross motor improvement is a goal for children with CP, more frequent physical therapy should be considered.Implications for rehabilitationIn general, the gross motor development of Norwegian children with cerebral palsy was as expected according to the reference percentiles for the GMFM-66.When gross motor improvement is a goal for children with cerebral palsy, high-frequency physical therapy should be considered.Contractures should be addressed in order to optimize gross motor improvement for children with cerebral palsy.

理学療法の治療形態・内容・頻度が脳性麻痺児一症例の運動機能に及ぼす影響

理学療法の治療形態・内容・頻度が脳性麻痺児一症例の運動機能に及ぼす影響

Effect of the frequency of therapy on the performance of activities of daily living in children with cerebral palsy.

[Purpose] This study investigated the frequency effect of physical and occupational therapy on activities of daily living performance in children with cerebral palsy. [Subjects and Methods] A total of 162 children with cerebral palsy who attended a convalescent or rehabilitation center for disabled individuals or a special school for physical disabilities in South Korea participated in this study. The Pediatric Evaluation Disability Inventory was used to collect data on activities of daily living performance according to physical therapy frequency based on neurodevelopmental therapy for 1 year. [Results] The relationships between physical therapy frequency and activities of daily living performance (mobility, social function, and total functional skill) and between occupational therapy frequency and activities of daily living performance (social function and total functional skill) were significant. There was no significant difference in activities of daily living performance according to physical therapy frequency. The difference in the activities of daily living performance according to occupational therapy frequency was significant for social function. [Conclusion] Intensive occupational therapy was more effective in improving activities of daily living performance in children with cerebral palsy. In particular, their social function further improved with intensive physical therapy.

Timing and Amount of Physical Therapy Treatment are Associated with Length of Stay in the Cardiothoracic ICU

Significant variability exists in physical therapy early mobilization practice. The frequency of physical therapy or early mobilization of patients in the cardiothoracic intensive care unit and its effect on length of stay has not been investigated. The goal of our research was to examine variables that influence physical therapy evaluation and treatment in the intensive care unit using a retrospective chart review. Patients (n = 2568) were categorized and compared based on the most common diagnoses or surgical procedures. Multivariate semi-logarithmic regression analyses were used to determine correlations. Differences among patient subgroups for all independent variables other than age and for length of stay were found. The regression model determined that time to first physical therapy evaluation, Charlson Comorbidity Index score, mean days of physical therapy treatment and mechanical ventilation were associated with increased hospital length of stay. Time to first physical therapy evaluation in the intensive care unit and the hospital, and mean days of physical therapy treatment associated with hospital length of stay. Further prospective study is required to determine whether shortening time to physical therapy evaluation and treatment in a cardiothoracic intensive care unit could influence length of stay.

Physical Therapy Dosing: Frequency and Type of Intervention in Pediatric Postacute Hospital Care.

To examine differences in physical therapy dosing frequency recommendations based on children's characteristics and to describe types of intervention recommended at postacute hospital admission. Demographic and clinical information, recommended physical therapy intervention frequency, and intervention types were collected for all admissions from April 1, 2015, to March 1, 2016. Differences across 2 groups, children with recommendations for "less" (≤3x/wk) or "more" (≥4x/wk) frequent therapy, were examined. Types of interventions recommended were described and the measure of association between frequency and type was determined. Older children, those with higher admission functional scores, and children with less dependence on medical technology were recommended for "more." Therapeutic exercise was the most common intervention recommended. Greater physical therapy frequency was associated with Functional Training and Motor Function Training. Children's age, functional level, and technology dependence influence dosing recommendations. Interventions focused on function are associated with greater physical therapy frequency.

Two Different Types of High-Frequency Physical Therapy Promote Improvements in the Balance and Mobility of Persons With Multiple Sclerosis

ObjectiveTo evaluate the mobility and postural balance improvements that could be achieved in a cohort of persons with multiple sclerosis (MS) who participated in a motor adaptation protocol and a cohort of persons with MS who participated in a therapeutic exercise protocol. DesignA cohort design, where subjects were evaluated before and after a 6-week intervention period. SettingClinical laboratory setting. ParticipantsIndividuals (N=42) with relapsing-remitting or secondary progressive MS (Expanded Disability Status Scale [EDSS] scores, 3.0–6.5) were initially screened for eligibility for participation in the study, from which those who fit the inclusion criteria (n=32) were enrolled in the study. Subjects were pseudorandomly assigned to a treatment group and matched based on EDSS scores. Fourteen individuals in the motor adaptation cohort (MAC) (mean age ± SD, 52.6±9y; mean EDSS score ± SD, 5.5±0.9) and 13 individuals in the therapeutic exercise cohort (TEC) (mean age ± SD, 54.0±9y; mean EDSS score ± SD, 5.3±0.9) completed the entire duration of their respective programs. InterventionsBoth cohorts completed their therapy twice a day, 5 days each week, for 6 weeks. Each session of the MAC program consisted of balance and gait training that encouraged new ways to adapt to challenging task demands. The TEC program was similar to a traditional exercise program. Main Outcome MeasuresThe Sensory Organization Test, 6-minute walk test, and gait spatiotemporal kinematics. ResultsCollectively, both treatment groups had improvements in postural balance (P=.001), walking endurance (P=.002), walking speed (P=.004), and step length (P<.001) after therapy. However, there were no statistical differences between the 2 treatment groups for any of the outcome variables (P values >.01). ConclusionsOur exploratory results suggest that a high frequency of physical therapy rather than a specific activity focus might be an important parameter for persons with MS.

Effect of physical therapy frequency on gross motor function in children with cerebral palsy.

[Purpose] This study attempted to investigate the effect of physical therapy frequency based on neurodevelopmental therapy on gross motor function in children with cerebral palsy. [Subjects and Methods] The study sample included 161 children with cerebral palsy who attended a convalescent or rehabilitation center for disabled individuals or a special school for children with physical disabilities in South Korea. Gross Motor Function Measure data were collected according to physical therapy frequency based on neurodevelopmental therapy for a period of 1 year. [Results] The correlation between physical therapy frequency and Gross Motor Function Measure scores for crawling and kneeling, standing, walking, running and jumping, and rolling, and the Gross Motor Function Measure total score was significant. The differences in gross motor function according to physical therapy frequency were significant for crawling, kneeling, standing, and Gross Motor Function Measure total score. The differences in gross motor function according to frequency of physical therapy were significant for standing in Gross Motor Function Classification System Level V. [Conclusion] Intensive physical therapy was more effective for improving gross motor function in children with cerebral palsy. In particular, crawling and kneeling, and standing ability showed greater increases with intensive physical therapy.

Physical Therapist Treatment of Patients in the Neurological Intensive Care Unit: Description of Practice

Although studies have established the safety and feasibility of physical therapy in the critical care setting, minimal information about physical therapist practice in the neurological intensive care unit (NICU) is available. This study describes physical therapists' treatment of people admitted to a NICU. People admitted to the NICU with a diagnosis of subarachnoid hemorrhage, subdural hematoma, intracranial hemorrhage, or trauma were retrospectively studied. Data on patient demographics, use of mechanical ventilation, and intracranial pressure (ICP) monitoring were collected. For each physical therapy session, the length of the session, the location (NICU or post-NICU setting), and the presence of mechanical ventilation or ICP monitoring were recorded. Data on safety parameters, including vital sign response, falls, and dislodgement of lines, were collected. Over 1 year, 180 people were admitted to the NICU; 86 were evaluated by a physical therapist, for a total of 293 physical therapy sessions in the NICU (n=132) or post-NICU setting (n=161). Only one session (0.3%) was stopped, secondary to an increase in ICP. The first physical therapy session occurred on NICU day 3.0 (25%-75% interquartile range=2.0-6.0). Patients received a median of 3.4 sessions per week (25%-75% interquartile range=1.8-5.9). Patients with mechanical ventilation received less frequent physical therapy sessions than those without mechanical ventilation. Patients with ICP monitoring received less frequent sessions than those without ICP monitoring. However, after multivariate analysis, only the admission Glasgow Coma Score was independently associated with physical therapy frequency in the NICU. Patients were more likely to stand, transfer, and walk in the post-NICU setting than in the NICU. The results are limited by the retrospective, single-center nature of the study. There is inherent bias of evaluating only those patients who had physical therapy, and therapists were unable to completely adjust for the severity of illness of a given patient. Physical therapy was performed safely in the NICU. Patients who required invasive support received less frequent physical therapy.

Predicting 6-minute walking distance in recipients of lung transplantation: longitudinal study of 108 patients.

Exercise capacity, muscle function, and physical activity levels remain reduced in recipients of lung transplantation. Factors associated with this deficiency in functional exercise capacity have not been studied longitudinally. The study aims were to analyze the longitudinal change in 6-minute walking distance and to identify factors contributing to this change. This was a longitudinal historical cohort study. Data from patients who received a lung transplantation between March 2003 and March 2013 were analyzed for the change in 6-minute walking distance and contributing factors at screening, discharge, and 6 and 12 months after transplantation. Linear mixed-model and logistic regression analyses were performed with data on characteristics of patients, diagnosis, waiting list time, length of hospital stay, rejection, lung function, and peripheral muscle strength. Data from 108 recipients were included. Factors predicting 6-minute walking distance were measurement moment, diagnosis, sex, quadriceps muscle and grip strength, forced expiratory volume in 1 second (percentage of predicted), and length of hospital stay. After transplantation, 6-minute walking distance increased considerably. This initial increase was not continued between 6 and 12 months. At 12 months after lung transplantation, 58.3% of recipients did not reach the cutoff point of 82% of the predicted 6-minute walking distance. Logistic regression demonstrated that discharge values for forced expiratory volume in 1 second and quadriceps or grip strength were predictive for reaching this criterion. Study limitations included lack of knowledge on the course of disease during the waiting list period, type and frequency of physical therapy after transplantation, and number of missing data points. Peripheral muscle strength predicted 6-minute walking distance; this finding suggests that quadriceps strength training should be included in physical training to increase functional exercise capacity. Attention should be paid to further increasing 6-minute walking distance between 6 and 12 months after transplantation.

The influence of physical therapy and anti-botulinum toxin antibody on the efficacy of botulinum toxin-A injections in children with spastic cerebral palsy

Objective: To identify factors associated with the efficacy of botulinum toxin-A (BoNT-A) injections. Methods: Thirty-eight children with spastic cerebral palsy (CP) received BoNT-A injections into the gastrocnemius. The baseline anti-botulinum antibodies were checked. The Static dorsiflexion range of motion (ROM), Modified Tardieu Scale (MTS) and Physician Rating Scale (PRS) were assessed at pre-injection as well as 4- and 12-week post-injection. Results: No samples contained anti-botulinum antibodies. Greater baseline MTS dynamic range was associated with greater changes in MTS dynamic ranges at 4-week post-injection. More frequent physical therapy was associated with greater changes in static dorsiflexion ROM at 4-week post-injection and greater changes in PRS at 4- and 12-week post-injection. Conclusion: The improvement in PRS at 12-week post-injection was associated with the frequency of physical therapy. Therefore, intensive physical therapy programs may be necessary to maintain the beneficial effects of BoNT-A injections in children with CP.

Changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis caused by frequency of physical therapy: a randomized controlled trial.

[Purpose] The purpose of this study was to investigate the changes in pain, dysfunction, and grip strength of patients with acute lateral epicondylitis and to suggest the appropriate treatment frequency and period. [Subjects] The subjects were divided into three: 2 days per week group (n=12), 3 days per week group (n=15), and 6 days per week group (n=13). [Methods] All groups received conventional physical therapy for 40 minutes and therapeutic exercises for 20 minutes per session during 6 weeks. The outcome measurements were the visual analogue scale (VAS), Patient-Rated Tennis Elbow Evaluation (PRTEE), and grip strength. [Results] The results of this study were as follows: at 3 weeks, there were no significant differences in VAS and PRTEE in the 3 groups, but at 6 weeks, 6 days per week group significantly decreased these two outcomes. Grip strength was significantly increased in 3 and 6 days per week groups at 6 weeks. [Conclusion] In conclusion, physical therapy is needed 3 days per week for 3 weeks in patients with acute lateral epicondylitis. After 3 weeks, 6 days per week is the most effective treatment frequency.

Relationship between corticosteroid dose and declines in physical function among allogeneic hematopoietic stem cell transplantation patients

The aim of this study was to investigate the relationship between corticosteroid dose and degree of physical function decrease in allogeneic hematopoietic stem cell transplantation (allo-HSCT) patients during the early stage of recovery. We further investigated the confounding factors affecting loss of physical function. The study included 113 patients who underwent allo-HSCT between July 2007 and April 2012 at Hyogo College of Medicine Hospital in Japan. Physical function was assessed using tests for hand-grip strength, knee-extensor strength, and the 6-min walk test (6MWT). Fatigue was measured using the Piper Fatigue Scale. Total corticosteroid dose, frequency of physical therapy, body weight, and nutritional status were also collected from medical records. Total corticosteroid dose was correlated with decrease of hand-grip and knee-extensors strength (P < 0.01) but was not correlated with 6MWT performance. Results of multivariate analysis confirmed that low physical function was associated not only with high corticosteroid dose but also with low frequency of physical therapy, increase in fatigue, and body weight loss (P < 0.05). Also, hemoglobin levels were associated with 6MWT (P < 0.05). This study showed the relationship between corticosteroid dose and declines in physical function and also showed other clinical factors affecting loss of physical function among allo-HSCT patients. Our results indicate that the effectiveness of rehabilitation may be influenced by corticosteroid treatment.