Physical Therapy Program Research Articles

New Non‐Invasive Approach for a Woman With Dyssynergic Defecation Associated With Dyspareunia: A Case Report

ABSTRACTBackgroundThe pelvic floor muscles are a complicated muscular structure with three major functions: defecation, urination, and sexual function. Constipated patients rarely have sexual or urinary complaints. The objective of this case is to provide a new and successful therapy strategy for a patient with dyssynergic defection and dyspareunia.Study DesignThe case study below discusses physical therapy rehabilitation and the consequences for both current and future physical therapy programs of constipation caused by PFM dyssynergia and dyspareunia.Case DescriptionA 22‐year‐old married nulliparous woman was referred by her urogynecologist for the management of PFM tightness, with the main complaints being pain during intercourse and chronic constipation. The diagnosis had been confirmed by MR defecography, which revealed puborectalis and external anal muscle tightness. Neuromuscular reeducation employing electromyography biofeedback, improved rectal sensation, intravagival massage, the application of an intermittent pneumatic compression belt on the abdominiopelvic region, and suprapubic water bag ultrasound therapy were among the pelvic floor rehabitation strategies.ConclusionThe intermittent pneumatic compression belt and water bag ultrasound approach, combined with standard program rehabitation, was successfully used in patients with defection dyssynergia and dyspareunia. After 3 weeks, stool frequency decreased from once every 10 days to one bowel movement per week; a condition reported less bloating and stomach pain, as well as a pain rating of 5/10 during sexual activity and 0/10 immediately afterward; and FSFI increased from 15.1 to 19.1. After 12 weeks, stool frequency is three bowel movements per week, a condition has less bloating and stomach discomfort and rates pain as 1/10 during sexual activity and 0/10 immediately, and FSFI has risen from 15.1 to 25.1.

Effect of Radial Extracorporeal Shockwave Therapy on Pain Intensity Level in Patient with Calcaneal Spur

Background: Heel pain is a common musculoskeletal issue that significantly impacts patient daily activities and, consequently, their quality of life. This clinical study aims to evaluate the effectiveness of radial extracorporeal shockwave therapy in reducing pain intensity in patients with calcaneal spurs.Objective: To investigate the effects of radial extracorporeal shockwave therapy on pain intensity in patient with calcaneal spur.Methods: A total of 60 patients diagnosed with calcaneal spurs based on clinical examination and lateral radiography between September 2022 and June 2023 were included in this study. Participants were randomly assigned to two groups: Group A (radial extracorporeal shockwave therapy) and Group B (traditional physical therapy). All participants followed an exercise program; however, those in Group A received six sessions of radial extracorporeal shockwave therapy (10 Hz, 2000 pulses, at 2.4 bar). The Visual Analog Scale (VAS) was used to assess pain intensity both before and after treatment in all participants.Results: No significant differences were observed between Group A and Group B regarding gender, affected side, condition distribution, age, weight, height, or BMI (p > 0.05). Both groups experienced significant reductions in VAS scores post-treatment (p < 0.001); however, Group A demonstrated a greater improvement, with a percentage reduction in pain of -50.65%, compared to -28.17% in Group B. Additionally, post-treatment VAS scores were significantly lower in Group A than in Group B (p = 0.003), indicating that shockwave therapy yielded a more substantial reduction in painConclusions: Both radial extracorporeal shockwave therapy and traditional physical therapy programs significantly reduced pain intensity in patients with calcaneal spurs, with a favorable effect observed for radial extracorporeal shockwave therapy. These methods can be considered effective, safe, and conservative treatment options for managing calcaneal spurs.

Prognostic Factors in Patients Undergoing Physiotherapy for Chronic Low Back Pain: A Level I Systematic Review

Background: Low back pain is common. For patients with mechanic or non-specific chronic LBP (cLBP), the current guidelines suggest conservative, nonpharmacologic treatment as a first-line treatment. Among the available strategies, physiotherapy represents a common option offered to patients presenting with cLBP. The present systematic review investigates the prognostic factors of patients with mechanic or non-specific cLBP undergoing physiotherapy. Methods: In September 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which evaluated the efficacy of a physiotherapy programme in patients with LBP were accessed. All studies evaluating non-specific or mechanical LBP were included. Data concerning the following PROMs were collected: the pain scale, Roland Morris Disability Questionnaire (RMQ), and Oswestry Disability Index (ODI). A multiple linear model regression analysis was conducted using the Pearson Product–Moment Correlation Coefficient. Results: Data from 2773 patients were retrieved. The mean length of symptoms before the treatment was 61.2 months. Conclusions: Age and BMI might exert a limited influence on the outcomes of the physiotherapeutic management of cLBP. Pain and disability at baseline might represent important predictors of health-related quality of life at the six-month follow-up. Further studies on a larger population with a longer follow-up are required to validate these results.

COMPLEX PHYSICAL THERAPY OF PATIENTS WITH ADHESIVE CAPSULITIS

Adhesive capsulitis is predominantly an idiopathic condition and is more common in patients with metabolic disorders. PS contracture can be of varying degrees of severity, depending on the pathology of the PS with which we are dealing. This condition greatly aff ects work capacity and quality of life due to the presence of pain, discomfort and limitation of daily life activities. Prolonged pain syndrome can provoke sleep disorders and depression. Disruption of normal sleep, pain and depression form a pathological closed circle and contribute to the maintenance of the pathological process in the locus morbi.The development of a comprehensive program of physical therapy for patients with adhesive capsulitis with the use of modern means of recovery, which will reduce the risk of the disease re-emerging, and will also contribute to the faster recovery of the functional capacity of the musculoskeletal system of the patients.The objective of the study. The develop and practically substantiate a comprehensive program of therapy for patients with adhesive capsulitis using physical therapy.Materials and Research Methods. The study is based on a comprehensive therapeutic approach for 36 patients diagnosed with adhesive capsulitis in the acute phase of the condition. The assessed parameters included X-ray and computed tomography results, evaluation of range of motion in the shoulder joint, joint- muscle apparatus, and analysis of pain intensity indicators.Conclusions. To improve the condition of patients and optimize the process of treatment and rehabilitation of patients with adhesive capsulitis of the shoulder joint in the acute period, it is advisable to use with the diff erentiation of means of therapeutic intervention according to the diagnosis of the international classifi cation of functioning, optimization of physiotherapeutic means and special means of physical therapy allowed to shorten the terms of treatment and recovery of patients with adhesive capsulitis. It was determined that the best combination of means of therapeutic intervention for patients with adhesive capsulitis is the use of a complex of ideomotor exercises to create the patient’s idea of correct movement; correct positioning of the limb during sleep, everyday and professional activity; passive exercises to increase the volume of painless movements (bending, external rotation); restorationof the pattern of typical motor actions and optimization of physiotherapeutic means due to the use of shock wave and TENS therapy signifi cantly improved the eff ectiveness of their recovery in the short-term and long-term stages of the acute period of rehabilitation.

First Nations Peoples' perspectives on telehealth physiotherapy: a qualitative study focused on the therapeutic relationship.

Relationships are the core of Indigenous Peoples' spiritual and cultural identities, and therapeutic relationships are an integral part of the physical rehabilitation process, directly influencing health outcomes. However, participating in therapeutic relationships can be difficult for First Nations Peoples, particularly in the virtual landscape. There is limited understanding of First Nations Peoples' perspectives on this issue, and this understanding is crucial to developing culturally safe and effective telehealth physiotherapy programs. Therefore, the purpose of this study is to explore the perspectives of First Nations Peoples from British Columbia, Canada, on telehealth physiotherapy, with an emphasis on the virtual therapeutic relationship. A narrative qualitative study that utilized one-on-one, semistructured interviews was conducted with 19 First Nations adults from remote and rural First Nations communities in north-central British Columbia, Canada. Interviews were recorded, transcribed verbatim, and analyzed using an inductive approach to reflexive thematic analysis. Three themes emerged from data analysis. 'Therapist's attitude and rapport' captures participants' perceptions of what matters the most in how physiotherapists relate to First Nations Peoples and carry out their work. 'Remote nature of virtual care' encompasses the main challenges of virtual care visits, particularly how these were perceived to impact establishing and maintaining solid therapeutic relationships. 'Fostering culturally appropriate and safe telehealth physiotherapy' focuses on what is needed to advance telehealth physiotherapy in a manner that respects and reflects First Nations cultures, equipping all involved parties to provide comprehensive and sensitive services. Our findings advocate a hybrid model that combines in-person and telehealth visits to address communication barriers and the absence of physical interaction. Bridging the digital health literacy gap through training and collaboration with local support staff is crucial (as it is to bridge the possible cultural literary gap of therapists), and the incorporation of cultural elements holds promise for enhancing the engagement and effectiveness of telehealth services in these communities. The pursuit of equitable health care for First Nations communities demands not only increased access but also a thoughtful, culturally safe, trauma-informed, and holistic approach. This approach must be tailored to the unique needs of First Nations Peoples, emphasizing the integration of cultural elements and community support. A hybrid model combining in-person and telehealth visits is recommended to address logistical challenges and enhance the therapeutic relationship, ensuring that care is both effective and respectful of cultural values and practices.

PHYSICAL REHABILITATION FOR YOUNG MEN WITH GRADE I AND II OBESITY

The goal of this study is to study the role of exercise and dietary modification in the treatment of obesity in young men. Materials and methods. A study was conducted with 10 young men aged 25 to 30 who had a body mass index (BMI) exceeding 30 kg/m², indicative of obesity. The primary intervention combined diet therapy with increased physical activity. Most participants also had obesity-related comorbidities, including arterial hypertension, autonomic-vascular dystonia, type II diabetes, and spinal osteochondrosis. Patient motivation was considered crucial in program development, and thus only individuals with a high motivation level were selected for participation. Results and discussion. Based on data from dynamic observations, we can state that the physical therapy program studied has a positive effect on body weight reduction in cases of mild forms of alimentary obesity. After three months of participation, an average weight loss of 8.5% was observed, which represents a very favorable outcome. The results indicate that physical exercises combined with dietary adjustments positively influence weight loss dynamics in young men with grade 1 alimentary obesity. Weight loss occurred most rapidly during the first month of the program. Conclusion. The physical therapy program for grade 1 obesity involves a comprehensive approach, combining physical exercises conducted in a medical rehabilitation department with a specially designed dietary plan. This program is recommended for individuals with mild forms of alimentary obesity and a body mass index (BMI) up to 35 kg/m². After three months of implementing this approach, participants showed an average reduction in excess body weight of 8.5%. This physical therapy program may be effectively used for managing grade I obesity.

HE ROLE OF PHYSICAL THERAPY IN MANAGING SYMPTOMS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION SECONDARY TO OSTEOARTHRITIS

The purpose of the study is to evaluate the effectiveness of the physical therapy in managing symptoms of temporomandibular joint dysfunction in patients with osteoarthritis. Materials and methods. 48 people with diagnosis of osteoarthritis of the temporomandibular joints were examined. In Group 1 (23 participants), correction involved wearing customized relieving splints. In addition to splint therapy, Group 2 received a course of physical therapy, which included therapeutic exercises targeting the masticatory muscles, facial muscles, tongue, and anterior neck muscles, as well as a course of transcutaneous electrical nerve stimulation (TENS) using the unipolar method on the masticatory and temporal muscles. The correction period for both groups was 1 month. Outcomes were evaluated using the Hamburg Test, the Helkimo Index, and the Jaw Functional Limitation Scale. Results. After the application of relaxing splints and the implementation of the physical therapy program, the total score of the "Hamburg test" decreased by 39.6% in group 1, and by 59.4% in group 2 (p<0.05). The positive dynamics of the Helkimo index was 34.5% in group 1, 48.6% in group 2 (р<0.05), passing within the parameters of moderate temporomandibular joint dysfunction. When re-evaluating the functional state of the temporomandibular region according to the Jaw Functional Limitation Scale, the improvement of chewing in group 1 was 28.8%, in group 2 – 62.3%, the mobility of the lower jaw was 21.9% and 44.3%, respectively, verbal and emotional communication – 26% and 41.7%, the total score – by 26.2% and 49.6%. The developed program of physical therapy against the background of wearing individual relief splints demonstrated a statistically significantly better effect (p<0.05) on all the studied indicators of the functioning of the orofacial zone compared to the initial data and the results of the group that corrected the dysfunction of the temporomandibular joint with talc splints. Conclusion. Use the means of physical therapy can be recommended to increase the effectiveness of dental orthopedic correction in patients with osteoarthritis of the temporomandibular joint.

Interprofessional Education in Neurology Intensive Care Unit: Learning Activity for Students Completing Clerkships and Field Experiences.

Teaching learners the benefits and challenges of interprofessional collaborative practice (IPCP) in acute care is best done in the context of authentic patient care rather than classroom settings. Yet differing clinical schedules of students and faculty as well as structured, controlled environments of intensive care units are not conducive to bringing multiple interprofessional learners to the bedside. We developed a 2.5-hour interprofessional education (IPE) activity based around neurology intensive care unit patients that was implemented using team-based learning (TBL) methodologies, including individual/team readiness assessments (iRAT/tRAT) and application activities comprising interprofessional student-led care conferences in which authentic patients and their unique, deidentified clinical parameters were discussed. Students represented medicine, nursing, chaplain, physician assistant, social work, respiratory therapy, pharmacy, physical therapy, and law programs. Two hundred ninety-three students participated online during the first year. Mean tRAT scores were 14.9 points higher than iRAT scores (39.5 vs. 24.6 of 44 possible). There was strong agreement from students that the session met educational objectives (all >4.0 on a 5-point Likert scale). Individualized feedback was provided to learners using a rubric; 276 students shared personal reflections of knowledge learned through interactions with other health professional students/faculty. IPE activities that use authentic patient chart data as the basis for student application exercises are useful learning tools since students must teach and learn from each other, interpret data, and propose care plans based upon their collaborations. This enables students to experience acute care IPCP in a low-stakes environment.

The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans

ObjectiveTo examine retention and compliance to a novel Physical Therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD-). DesignThis study was a preplanned secondary analysis of an ongoing randomized controlled trial. SettingOutpatient PT at VA Boston Healthcare System (VABHS). ParticipantsSeventy-two community-dwelling middle-aged and older Veterans (mean age 72, (range 51-91); 87% male) with gait speed between 0.5 and 1.0 m/s were recruited from primary care practices. InterventionsEight-week moderate to vigorous intensity PT program. Main outcome measureVeterans’ baseline mobility, retention (dropouts), and treatment compliance and post-treatment exercise compliance to 8-week PT treatment were evaluated based on their baseline EFD status. ResultsOf the 72 participants, 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility performance (Short Physical Performance Battery (SPPB), 7.7 vs. 9.5, p<0.001) and patient-reported mobility (Activity Measure for Post-Acute Care (AM-PAC), 57.6 vs. 62.2, p<0.01) after adjusting for age, gender, number of comorbidities, depressive symptoms, and pain interference. Dropout rates for EFD+ and EFD- were 44% and 25%, respectively (p>0.05). In multivariable logistic regression modeling, pain interference, depressive symptoms, mobility, and living alone but not EFD status were associated with dropping out. There was no evidence of significant differences in treatment compliance or post-treatment exercise compliance, measured by the number of attended sessions and the number of post-treatment exercise days by EFD status. ConclusionEFD+ was associated with poor baseline mobility. While the dropout rate was higher among Veterans with EFD+, we were unable to conclude whether EFD status impacts retention or compliance due to the small sample size. Further investigation is needed to determine whether EFD status may identify individuals who need additional support during and/or after rehabilitation treatment.

Effect of cognitive training on selected gait parameters in patients with stroke

Background. Not only may early cognitive rehabilitation help stroke patients with their cognitive impairment, but it can also help patients restore their capabilities to do everyday activities. There isn’t much data on how cognitive training affects spatiotemporal gait variables in stroke survivors. Objective. To examine the impact of cognitive training on selected gait parameters in stroke patients. Subjects and Methods. Forty male and female patients with mild ischemic chronic stroke, ranging in age from 45 to 60 years, were recruited and distributed into two equal groups at random (G1 and G2). The Montreal Cognitive Assessment Scale (MOCA) and the Rehacom system were utilized to evaluate the patient’s cognitive function. The Biodex gait trainer device was utilized to measure several gait variables for all patients. Rehacom cognitive training and a selected physiotherapy program were administered to the study group (G1). The similar selected physiotherapy program utilized for the G1 was applied to the control group (G2). For eight weeks, the treatment was administrated three sessions each week, day after day. All variables were evaluated before- and after-intervention. Results. The step length and walking speed, as well as the MOCA scale score of G1, were significantly higher after treatment than those of G2 (p = 0.001). The correlation between step length and median reaction time (MRT) was moderate negative significant correlation (r = – 0.698, p = 0.001). Conclusion. Cognitive training has a beneficial impact on improving the selected spatiotemporal gait parameters in stroke patients.

Examining the effects of non-immersive virtual reality game-based training on knee hyperextension control and balance in chronic stroke patients: a single-blind randomized controlled study.

Post-stroke hemiparesis can lead to decreased mobility, gait disturbances, impaired balance, postural instability, limitations in activities of daily living (ADL), and long-term disability. The aim of this study was to examine the effect of non-immersive virtual reality game-based training (nIVRGT) in addition to conventional rehabilitation in stroke patients on dynamic balance, knee hyperextension control, and ADL. Twenty-five chronic stroke patients aged between 51 and 70 were included in the study. Stroke patients were randomized to a control group (n = 12) and a study group (n = 13). Individuals in control group participated conventional physiotherapy and rehabilitation program for 60min, 3 days a week for 6 weeks. individuals in the study group received 40min of conventional physiotherapy and rehabilitation program plus 20min nIVRGT. Functional Reach Test, Timed Up and Go Test, Computerized Gait Evaluation System and Barthel Index were used in the evaluation. The study group improved significantly in dynamic balance, knee control, and ADL (p < 0.05). In the control group, significant improvements were observed in dynamic balance and knee control (p < 0.05), except ADL (p > 0.05). The study group improved in dynamic balance compared with the control group (p < 0.05). Knee control and ADL improved similarly in both groups (p > 0.05). Our results showed that conventional and additional nIVRGT rehabilitation improved dynamic balance and knee hyperextension control in chronic stroke. However, it was observed that the non-immersive virtual reality (nIVR) approach was more effective in improving dynamic balance in stroke patients than conventional rehabilitation alone. NCT05907473.

The Effects of Physiotherapy Programmes, Aided by Virtual Reality Solutions, on Balance in Older Women: A Randomised Controlled Trial.

Background: Modern technologies are being applied to maintain and improve the functional performance of older adults. Fully immersive virtual reality (VR) combined with a scope of dual-task (DT) activities may effectively complement conventional physiotherapy programmes for seniors. The study aimed to compare the effectiveness of a fully immersive virtual reality (VR) environment combined with a scope of dual-task activities regarding balance in older women. Methods: Eighty women were recruited to the study protocol and, following randomisation, allocated to two equally sized groups, one pursuing conventional OTAGO exercises, the other one the VR-solutions-aided exercise programme combined with a scope of DT activities. Physiotherapy sessions spanned 6 weeks, each one lasting 60 min, three times a week, in both groups. Results: Homogeneity analysis of both study groups indicated no statistically significant differences at the first measurement point. After the intervention, both study groups achieved significantly improved scores on all tests. The VR + DT group obtained better results in dual-task gait and single-leg standing, whereas the greatest difference was observed during SLS CL (1.52 s vs. 2.33 s-difference 0.81 s 53.2% change, p = 0.001). The OTAGO group performed better in the TUG single-task gait (11.35 s vs. 12.60 s, p < 0.001) and in the Berg balance scale. Conclusions: The VR + DT training is effective in improving individual balance as well as in reducing fall risks. VR-assisted physiotherapy should complement conventional physiotherapy programmes (e.g., OTAGO). The benefits of applying VR solutions indicate that older women might well use this form of activity regularly under the guidance of a therapist or a family member.

The Effect of Postural Rehabilitation on Pain, Balance, Mandibular Movement, and Posture in Temporomandibular Disorder Patients: A Comparison Between Posterior Edentulous and Dentate Groups.

Objective: Posterior edentulism reduces occlusal support, thus increasing the risk and symptoms of temporomandibular disorder. No previous study has explored its effect on the treatment of temporomandibular disorders. This study aimed to examine the relationship between neck posture, balance, and posterior edentulism in patients with temporomandibular disorder and compare the effectiveness of physical therapy. Methods: In a quasi-experimental controlled trial, 26 patients with temporomandibular disorder were divided into 13 in the partly edentulous group and 13 in the dentate group. Both groups received manual therapy, postural exercises, deep neck flexor stabilization, and Kinesio tapping for 6 weeks. Each participant completed 12 physiotherapy sessions, administered twice weekly, with a minimum interval of 48 hours between sessions. Outcomes were assessed at baseline and after the 6-week program, including pain, mandibular movement, posture, and balance. Results: The physical therapy program significantly improved all measured outcomes (P < .05). Furthermore, the partially edentulous group showed more remarkable improvement in pain and balance compared to the dentate group (P < .05). Conclusions: Postural exercises effectively alleviate symptoms in patients with temporomandibular disorder, with more significant improvements observed in the partially edentulous group than in the dentate group.

Experience-based co-design to develop innovative telehealth physiotherapy interventions and resources for children and young people with asthma and dysfunctional breathing

Introduction Healthcare requires new technologies to deliver hybrid services. Before embedding health-delivery transformations including physiotherapy in asthma clinics, it is essential to give young people and their carers a voice to facilitate co-designing of services. Objective To co-design hybrid telehealth physiotherapy services and online resources for, and in partnership with, young people with asthma and dysfunctional breathing, and their families. Methods Experience based co-design study undertaken at a specialist paediatric difficult asthma clinic, including online service user focus groups and electronic questionnaires for service providers. Eight children aged between 11 and 17 years and their families and 11 members of the multi-disciplinary team (MDT) managing children with difficult asthma were recruited purposively. Results A series of seven online videos were created, topics included: how to support a breathless child, education on how we breathe, breathing patterns, symptom differentiation, breathlessness, rescue breathing techniques, and exercise. Each video has downloadable resources. Five children and four parents wrote blogs to share their experiences. A live online 12-week physiotherapy program was developed on a web-based platform www.beamfeelgood.com called Asthma Kids. Conclusion Co-design enabled partnership working to develop hybrid telehealth physiotherapy services and prototype interventions to support home practice for children with asthma and dysfunctional breathing.

Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study.

Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments. This study aims to identify the capabilities required to use TM in physiotherapy treatment. An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings. Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the "digital health technologies, systems, and policies" domain, 7 capabilities in the "clinical practice and application" domain, and 5 capabilities in the "data analysis and knowledge creation" domain. No capabilities were identified in the "system and technology implementation" domain. The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists.

Dynamics of the functional state of the cardiovascular system in individuals after cholecystectomy under the influence of a rehabilitation program in sanatorium-resort conditions.

The article discusses the dynamics of the functional state of the cardiovascular system (CVS) in individuals after laparoscopic cholecystectomy (LCС) under the influence of a rehabilitation program in SANATORIUM-RESORT CONDITIONS. The study involved 79 individuals after LCC aged 45 to 59 years. The individuals were divided into 2 groups: group A (n=39) and group B (n=40). Individuals in group A received rehabilitation services according to the clinical protocol (diet, hydrotherapy, mineral or coniferous baths, and physical therapy, etc.) In group B, individual rehabilitation programs were formed depending on the existing dysfunctions and the tolerance of the CVS to physical activity. In group B, the rehabilitation intervention to increase the function of endurance and physical performance was applied Nordic walking (NW). The initial examination in both groups revealed an increase in resting heart rate (RHR), diastolic (DBP) and systolic (SBP) blood pressure, a decrease in the performance of a 6- minute walk test and the presence of a feeling of shortness of breath during the test. The implementation of a physical rehabilitation (physical therapy) program in group B, which used Nordic walking to increase physical activity, tolerance to physical activity, and improve cardiovascular function, was effective. The use of NW in sanatorium-resort conditions of rehabilitation (lasting at least 18 days) has a positive effect and leads to a statistically significant decrease in RHR, SBP, DBP, an increase in walking distance in 6 minutes and a decrease in the feeling of shortness of breath when walking, compared to the control group. It was established that diet therapy, hydrotherapy, mineral or coniferous baths, and other water procedures, classical abdominal and back massage, group daily therapeutic gymnastics in group A did not have a positive effect on increasing the level of physical activity tolerance, CVS functioning in patients after LCC.

Academic Coaching in Entry-level Doctor of Physical Therapy Education.

Learners face a variety of academic and personal challenges that may impact performance in Doctor of Physical Therapy (DPT) programs. Academic coaching has emerged as a student support model within undergraduate medical education but has not yet been evaluated in DPT education. The purpose of this method/model presentation was to describe the development, implementation, and evaluation of 2 coaching programs. Two hybrid DPT programs implemented a coaching approach to support students. The coaching framework was centered around an individualized relationship between the learner and faculty coach to promote reflection, growth, agency, and persistence in educational and professional development. Faculty members were prepared and supported to serve as coaches. Coaches met with their assigned students at regular intervals throughout the program, including clinical experiences. The coaching programs were assessed through program exit surveys and an alumni survey. Graduates from both programs reported that the coaching program was effective and supported a sense of belonging or connectedness within their DPT program. They reported several specific activities that were part of the coaching program structure that supported its effectiveness, including group-based orientation activities and 1:1 meetings with their coach. Graduates also provided suggestions for program improvement including increased structure and more opportunities to connect with their peers and coaches in a nonacademic setting. Two DPT programs successfully implemented coaching as their student support model. With appropriate preparation, planning, and support, coaching programs have the potential to provide individualized and meaningful support for DPT students.

IMPROVEMENT OF THE QUALITY OF LIFE OF PATIENTS WITH CONCUSSION BY MEANS OF PHYSICAL THERAPY

Brain concussion from blast waves is one of the most common injuries in combat. This injury is three times more common than wounds. Blast wave brain concussion has significant consequences and impairs the quality of life for an indefinite period of time, so the use of physical therapy to improve the quality of life of patients with its consequences is an urgent issue. Purpose to prove the effectiveness of physical therapy in improving the quality of life of patients after blast concussion. Methods. To achieve the aim of the study, the scientific literature was analyzed and information was systematised using electronic databases such as PubMed, Google Scholar and others. To assess: sleep function, the Insomnia Severity Index (ISI) was used; pain perception, the Visual Analogue Scale (VAS) and the Verbal Rating Scale were used; changes in emotional functions, the Wessman-Ricks Emotional State Self-Assessment (WESA) was used; and quality of life, the Health Survey (SF-36 v2) was used. Research results. The initial treatment of concussion is of great importance and includes a number of important aspects that can be performed by a first responder. Since concussion leads to partial or complete disability and largely results in disability, which leads to other problems at different levels, the prerequisites for developing a physical therapy programme aimed at improving the quality of life of patients were the selection of ICF components appropriate to the patients' condition. The physical therapy programme was individualised, tailored to each patient individually, taking into account their condition and wishes, with special attention paid to the primary tasks of pain relief and normalisation of sleep function, which is key to reducing all other consequences of concussion and improving the quality of life. After the implementation of the proposed physical therapy programme, patients in the main group improved their sleep, decreased their pain levels and improved their emotional state. All indicators at the end of the study were better in the main group than in the control group, although at the beginning of the study the indicators in both groups did not differ significantly. Comparison of the results of the SF-36 v2 Health Survey proves the effectiveness of the developed physical therapy programme in combination with conventional treatment of blast injury. Conclusions. The results of the study proved the positive impact of the physical therapy programme for patients with blast concussion, which took into account the patient's condition and wishes, and whose primary objectives were to stop the manifestation of pain and normalise sleep function, actively involve the patient in the rehabilitation process through Pilates, Yoga, Nordic walking and an obstacle course with a sports focus. Motivation for action and normalisation of the emotional state are important during the rehabilitation period. The combination of active activities with massage therapy, namely Thai traditional massage, Thai foot massage, Tibetan singing bowl massage and Rebozo massage, contributed to general relaxation, reducing the effects of stress, muscle and emotional stress, harmonising the emotional state, improving blood circulation and restoring all body systems.

DYNAMICS OF ANTHROPOMETRIC AND PHYSICAL MARKERS OF SARCOPENIC OBESITY IN ELDERLY PERSONS WITH OSTEOARTHRITIS OF THE HIP IN THE PROCESS OF PHYSICAL THERAPY

Purpose: to determine the effect of a physical therapy program on anthropometric and physical indicators of elderly people with osteoarthritis of the hip, which occurs against the background of sarcopenic obesity. Material. 68 elderly people with osteoarthritis of the hip and sarcopenic obesity and 36 of their healthy peers (control group) were examined. Representatives of the comparison group (33 persons) corrected the signs of osteoarthritis according to the clinical guideline "Osteoarthrosis". Representatives of the main group (35 persons) were engaged in a physical therapy program for six months. Its goal was: reduction of pain and discomfort in the hip; improvement of the amplitude of movements in the hip, joints of the lower limbs, spine; optimization of general mobility and motor stereotype; decrease of body weight; facilitating activities of daily living; improvement of geriatric status. The physical therapy was implemented in rehabilitation center and in the form of telerehabilitation. It included kinesitherapy, Proprioceptive Neuromuscular Facilitation of the lower limbs and lower back; massage, kinesiological taping of the hip, thigh and lower back muscles; a course of shock wave therapy of the hip, nutritional correction, education of patients and their family members. The effectiveness of the program was evaluated by the dynamics of anthropometry (mass, body mass index, waist and hip circumferences and their ratio), body composition (fat content, muscle tissue, visceral fat), sarcopenia markers (hand dynamometry, Short Physical Performance Battery). Results. Application of the physical therapy program led to a decrease in body weight in patients of the main group: in men by 5.4 kg, in women by 4.51 kg, p&lt;0.05. Corresponding changes occurred in body mass index, and the women of the main group reached the level of overweight. The dynamics of the abdominal nature of obesity also changed: the decrease in waist circumference in men was 8.3 cm, in women - 5.9 cm, which had a favorable effect on the ratio of waist and hip circumferences. A decrease in the severity of the signs of sarcopenia in main group persons was confirmed by the results of a statistically significant increase in the content of muscle tissue both in men (from 22.17±1.30% to 28.12±1.09%) and in women (from 19, 01±1.20% to 23.44±1.15%). The content of visceral fat in the subjects of the main group decreased by almost 25%. The content of adipose tissue in the whole body decreased in men from 42.29±1.73% to 34.50±1.22%, in women – from 46.53±1.19% to 40.57±1.57%. The increase in hand dynamometry results in women was from 13.48±1.14 kg to 17.22±0.56 kg, in men - from 19.80±1.07 kg to 26.15±1.01 kg. The complex nature of the physical therapy program contributed to the improvement of performance of all Short Physical Performance Battery subtests in the main group, and the improvement of its total score was 35.5% (from 6.49±0.53 points to 10.07±0.44 points, p&lt;0, 05). Patients of the comparison group, who underwent rehabilitation according to the standard program for the correction of osteoarthritis, did not show improvement in the studied indicators of anthropometry and markers of sarcopenia (p&gt;0.05). Conclusions. Elderly patients with osteoarthritis of the hip and sarcopenic obesity require the development of physical therapy programs taking into account and correcting the specifics of each condition, which will increase the overall effectiveness of rehabilitation measures.

FAMILY-ORIENTED PHYSICAL THERAPY PROGRAM FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

Family-centered physical therapy programs for children with autism involve the child, family members, and professionals working together. They aim to provide support, education, and resources that enable the family to understand and cope with the special needs associated with the rehabilitation of a child with autism. By involving the entire family in the therapy process, such programs help improve communication, enhance the quality of life for the entire family, help the child develop skills to participate in various activities with peers, strengthen family ties and provide a more holistic approach to child care. Aim. To substantiate the structure and program of family-oriented physical therapy for preschool children with autism spectrum disorders (ASD). Materials and methods. Analysis of literature sources, including clinical guidelines and recommendations, as well as scientific research on the rehabilitation of patients with autism spectrum disorders; systematic analysis and synthesis, methods of analogy, abstraction and generalization. The experience of rehabilitation and physical therapy of children with ASD, gained by the NGO Agape, which is engaged in the rehabilitation and habilitation of children with disabilities in Khmelnytskyi, was also taken into account. Results. A child's atypical development and disabilities affect the entire family. Caregivers and family members may develop feelings of vulnerability and guilt, or they may feel unable to care for their child. In addition, the patient-centered and biopsychosocial approach assumes that decisions about therapy are made by caregivers, as they are the best experts on their needs and abilities. There has also been a shift in emphasis from impairment of body structures and functions to the child's participation in family life and activities with the family, as well as from what the child cannot do to what the child can do. Supporting the child and family through this complex process of rehabilitation and physical therapy with this in mind, and recognizing the family's interests and values, is crucial and helps families feel stronger and more confident as they face daily challenges. Family-centered physical therapy takes all of these approaches into account. Family-centered physical therapy is a set of activities aimed at involving the family and the family environment in the child's physical therapy process to provide support, necessary skills and resources to both the patient and the family at each stage of therapy, ensuring the best possible results. All phases of physical therapy involve the child and family members in the evaluation, goal and objective setting, education, implementation of the planned intervention program, counseling and monitoring, and adjustment of the goal, objectives and physical therapy program. Conclusions. Family-centered service programs encourage therapists to move from focusing on an isolated impairment and the needs of the child alone to understanding disability within the social model of services and the context of the family and community. A family-centered physical therapy program for children with ASD involves close collaboration between physical therapists, the child, and parents and other family members. This ensures an individualized approach to therapy, increased effectiveness of the sessions, and improved quality of life for the child and the entire family. Active involvement of parents and providing them with the knowledge and skills to conduct sessions at home helps to achieve sustainable results in the child's development and strengthens family ties, increasing the overall level of satisfaction.