Physical Therapy Program Research Articles

Physiotherapeutic Interventions for Patients With Rare Genetic Muscle-Wasting Disorders: A Systematic Review andMeta-Analysis.

Patients with rare genetic muscle-wasting disorders (MWDs) often experience significant motor function impairments, making effective management strategies crucial for improving their quality of life. This systematic review and meta-analysis aimed to evaluate the impact of physiotherapeutic interventions on motor outcomes in this patient population. A comprehensive literature search was conducted to identify randomized controlled trials (RCTs) and cohort-based studies that assessed physiotherapeutic interventions in patients with rare genetic MWDs. The primary outcome measure was the 6-minute walk test (6MWT). A random effects model was employed to calculate the mean difference (MD) and 95% confidence interval(CI). Nine studies were selected for inclusion, and most demonstrated observable improvement in different facets of individuals with MWDs using physiotherapy. The meta-analysis of RCTs showed that physiotherapy statistically improved 6MWT performance (MD: -35.25 meters; 95% CI: -54.14 to -16.37) with low heterogeneity (Tau² = 0.00; Chi² = 0.48, df = 2, P = 0.79; I² = 0%). Similarly, the cohort-based studies demonstrated an overall MD (MD: -10.00; 95% CI: -11.07 to -8.93), with low heterogeneity (Tau² = 0.00; Chi² = 0.01, df = 1, P = 0.94; I² = 0%). Both analyses indicated significant improvements in 6MWT performance (RCTs: Z = 3.66, P = 0.0003; cohort-based: Z = 18.26, P < 0.00001). Physiotherapeutic interventions significantly enhanced motor function in patients with rare genetic MWDs, as evidenced by improved 6MWT performance. Exercise and intensive physiotherapy programs were particularly effective, although the benefits varied depending on the specific intervention and patient population. These findings support incorporating tailored physiotherapeutic strategies in MWD management to improve motor outcomes and overall quality of life.

PHYSIOTHERAPY MANAGEMENT OF AIDP GUILLAIN-BARRÉ SYNDROME VARIANT IN A TERTIARY HOSPITAL IN SOUTH-WEST NIGERIA: A CASE REPORT

Guillain-Barré Syndrome (GBS) is an acute neurological condition marked by swift muscular weakening, with the most prevalent form being the Acute Inflammatory Demyelinating Polyradiculoneuropathy (AIDP) variety. This case report provides a comprehensive account of the physiotherapy treatment of a 35-year-old patient diagnosed with Acute Inflammatory Demyelinating Polyneuropathy (AIDP) in a tertiary hospital in South-West Nigeria. After contracting a gastrointestinal infection, the patient developed a gradual loss of strength in their limbs and paralysis of the facial muscles on both sides of the face. The diagnostic assessments verified Acute Inflammatory Demyelinating Polyneuropathy (AIDP), and the treatment consisted of intravenous immunoglobulin (IVIg), plasmapheresis, and a planned physiotherapy program. During a period of four weeks, the patient demonstrated notable enhancements in muscle strength, functional autonomy, and pain levels. This case emphasizes the significance of initiating physiotherapy early and maintaining a consistent approach. It also demonstrates the potential of customized rehabilitation programs to improve recovery in settings with limited resources.

Mental health content in the physiotherapy undergraduate curriculum in South Africa.

Knowledge about mental health in physiotherapy practice is essential as mental health can impact physical health. Little is known about the mental health content in the South African physiotherapy undergraduate programme. Our study explored the mental health content in the undergraduate physiotherapy programme at eight universities and the perceptions of academic staff at an identified training institution in South Africa and stakeholders about the relevance of mental health in the undergraduate physiotherapy programme. Our study employed a concurrent-mixed method design, which consisted of: (1) the administration of a survey to academic leaders or lecturers undertaking mental health teaching at universities and (2) an online interview that included stakeholders and a focus group to gauge perceptions of academic staff at an identified institution in South Africa. Seven of eight universities participated in our study. All the universities had a psychology module and agreed that it is crucial to have mental health content in the curriculum. There is diversity in the mental health content between the universities. There is a need for consistency in the mental health content at all universities to ensure that all students receive the same skill set to have an impact on the quality of care. There is a need to include mental health content at universities offering theoretical and practical undergraduate programmes.

A home-based tele-rehabilitation exercise system for patients after knee replacement surgery

BackgroundKnee arthritis is a destructive disorder that affects the knee joints and causes pain and reduced mobility. Drug treatments, weight loss, and exercise control the symptoms of the disease, but these methods only delay the disease process and eventually, knee joint replacement surgery will be needed. After surgery, with the help of a proper physiotherapy program, full recovery takes an average of 6–12 months. However, currently, there is no similar tool to facilitate this process in Iran.ObjectiveThe purpose of this research is to design and develop the prototype of a rehabilitation system for patients after knee replacement surgery, which provides patients with information and appropriate physiotherapy programs.MethodsThis study was development-applied and was done in three stages. In the first stage, the needs and content of education and therapeutic exercises were prepared in the form of a checklist, and then the necessity of each item was checked in the evaluation sessions. In the second stage, the prototype of the system was developed using Adobe XD software and based on the requirements approved from the previous stage. In the third stage, the usability of the program was analyzed from the point of view of experts using the exploratory evaluation method with Nielsen’s 13 principles of usability.ResultsAt first, the system requirements were extracted and prepared in two checklists of content (51 exercises) and capabilities (60 items). Then after a survey of experts based on the Delphi technique, content information (43 exercises) and functional and non-functional requirements (53 items) were obtained. A survey of experts helped to finalize the information elements, categorize them, and prepare the final version of the checklists. Based on this, the system requirements were classified into 11 categories, and the training content was classified into 3 training periods. Finally, the design and development of the system was done. This system has admin, physician, and patient user interfaces. The result of usability showed that this system is efficient and there are only a few problems in the feature of helping users to detect and recover from errors.ConclusionIt seems necessary to develop a system based on the principles of usability by therapists and rehabilitation specialists to train and monitor the remote rehabilitation process of patients after knee joint replacement at home. And the importance of involving stakeholders in the design and development of remote rehabilitation systems is not hidden from anyone. Kara system has all of the above.

Physical therapy of persons after acute cerebrovascular accident in a long-term rehabilitation period

Purpose: to study the dynamics of recovery of walking, balance and quality of life of persons after acute cerebrovascular accident in a long-term rehabilitation period. Material and methods: patients were randomly divided into a main group (MG), which included 35 patients (n=35), and a comparison group (CG), which included 38 patients (n=38). The groups received rehabilitation intervention in accordance with the concept of the International Classification of Functioning, Disability, and Health (ICF). A categorical profile was created for each person and SMART goals were set. A physical therapy (PT) program was developed for MG after acute cerebrovascular accident (ACVA) in the long-term rehabilitation period. Short- and long-term goals were set in the SMART format, which included the use of therapeutic exercises. Functional capabilities and quality of life were assessed before and after the rehabilitation intervention using the ten-meter walk test, the Tinetty balance and fall risk scale, the modified Renkin functional independence scale and quality of life. Results: the dynamics of the ten-meter walking test during the PT program among patients in the MG is reflected in a decrease in the test completion time, which amounted to 23,6 s, and in the CG – 7 s. By the time of the final examination, the range of the obtained values was limited to 8 and 15 s in the MG, and among the CG, the extreme values were found at the levels of 12 and 160 s. By the time of the final examination, the "balance" item on the Tinetty balance and risk of falls scale in the MG was 13,8 ± 1,69 points out of a possible 16 points; the Me (25%; 75%) indicators were 14 (13; 15) points. In the CG, the indicator was slightly lower and was 12,3 ± 2,61 points; the Me (25%; 75%) indicators were 13 (10; 15) points. The difference between the groups by the end of the study for this indicator was significant (p&lt;0.05). As for the increase, it was 4.7 points in the MG and 3.1 points in the CG. The average statistical results of the assessment of the “Risk of Falls” section in the MG were 9.2±1.59 points out of a possible 12; the Me (25%; 75%) indicators were 9 (8; 11) points. In the CG patients, the indicator was slightly lower and was 5,2±1,99 points; the Me (25%; 75%) indicators were 6 (4; 6.3) points. The difference between the groups by the end of the study for this indicator was significant. (р&lt;0,01). As for the increase, it was 5 points in MG and 1,4 points in CG. The intermediate results on the Renkin scale were 1,83±0,62 and 2,13±0,74 points in MG and CG with Me (25%; 75%) – 2 (2; 2) and 2 (2; 3), respectively. At this stage, there was no statistical difference between the groups (p&gt;0,05), but both groups showed a reliable improvement compared to the initial result (p&lt;0,01). During the final examination, the results in MG patients improved and were 1,11±0,62 points, where the Me (25%; 75%) indicators were found at the level of 1 (1; 2) point. Among the CG patients, the final result was worse (p&lt;0.01) and was found at the level of 1,55±0,72 points with Me (25%; 75%) 1 (1; 2) point. Conclusions: Analysis of the dynamics of walking, balance and quality of life indicators after acute cerebrovascular accident in a long-term rehabilitation period confirmed the advantages of the developed physical therapy program for individuals from the MG.

Personalized rehabilitation approach for reaching movement using reinforcement learning

Musculoskeletal disorders challenge significantly the performance of many daily life activities, thus impacting the quality of life. The efficiency of the traditional physical therapy programs is limited by ecological parameters such as intervention duration and frequency, number of caregivers, geographic accessibility, as well as by subjective factors such as patient’s motivation and perseverance in training. The implementation of VR rehabilitation systems may address these limitations, but the technology still needs to be improved and clinically validated. Furthermore, current applications generally lack flexibility and personalization. A VR rehabilitation game simulation is developed, which focuses on the upper-limb movement of reaching, an essential movement involved in numerous daily life activities. Its novelty consists in the integration of a machine learning algorithm, enabling highly adaptive and patient-customized therapeutic intervention. An immersive VR system for the rehabilitation of reaching movement using a bubble popping game is proposed. In the virtual space, the patient is presented with bubbles appearing at different locations and is asked to reach the bubble with the injured limb and pop it. The implementation of a Q-learning algorithm enables the game to adjust the location of the next bubble according to the performance of the patient, represented by his kinematic characteristics. Two test cases simulate the performance of the patient during a training program of 10 days/sessions, in order to validate the effectiveness of the algorithm, demonstrated by the spatial and temporal distribution of the bubbles in each evolving scenario. The results show that the algorithm learns the patient’s capabilities and successfully adapts to them, following the reward policy dictated by the therapist; moreover, the algorithm is highly responsive to kinematic features’ variation, while demanding a reasonable number of iterations. A novel approach for upper limb rehabilitation is presented, making use of immersive VR and reinforcement learning. The simulation suggests that the algorithm offers adaptive capabilities and high flexibility, needed in the comprehensive personalization of a rehabilitation process. Future work will demonstrate the concept in clinical trials.

Rehabilitation program and challenges in managing hospitalized COVID-19 patients: a case series from Egypt

BackgroundThe COVID-19 pandemic urged all healthcare providers to collaborate to defeat this mortal infection. SARS-CoV-2 almost hits the respiratory system and may have subsequent serious complications like pulmonary embolism and multi-organ damage.ObjectiveTo illustrate the rehabilitation program challenges encountered by physiotherapists in clinically managing hospitalized COVID-19 patients. The goal was to preclude the need for invasive mechanical ventilation and to improve the patient’s oxygen saturation and general health.MethodsIn this retrospective case-series study, we described the physiotherapy strategies implemented for 14 COVID-19 patients during the hospitalization period at an Egyptian governmental quarantine hospital.ResultsThe rehabilitation program was customized by physiotherapists to accommodate the specific circumstances, conditions, and acquired complications of individual patients. Patients were under the care of physiotherapists in both the COVID ward and ICU. Overcoming challenges such as patient reluctance, co-morbidities, and the effects of aging was a task faced by these healthcare professionals. Consequently, the program had to be modified to suit the unique needs of each patient. These tailored programs encompassed techniques such as percussion, positioning, range of motion, circulatory exercises, and respiratory exercises. The patients exhibited positive responses to their designated physical therapy program, experiencing improvements on various levels based on the progression of their individual cases.ConclusionPhysiotherapy has a major role in improving patient complications after being infected with COVID-19. In this desperate pandemic era, physiotherapists gave hospitalized patients support both psychologically and physically.

APPLICATION OF ANALYTICAL EXERCISES AFTER ANTERIOR CRUCIATE LIGAMENT RECONSTRUCTION FOR STATIC, DYNAMIC BALANCE AND POSTURAL CONTROL IMPROVEMENT

Purpose: to assess the recovery of static, dynamic balance and postural control while overcoming muscle imbalance after an anterior cruciate ligament reconstruction by applying analytical exercises. Material and methods: Material: 15 men (mean age 25.16) were observed in the span of 14 weeks (three and a half months) after anterior cruciate ligament reconstruction. They underwent physiotherapy, including analytical kinetic chain exercises in hospital, ambulatory and at home conditions. Research, measurement, and evaluation methods include range of motion in the knee joint, manual muscle testing (MMT), static and dynamic balance tests, and postural control tests. Statistical methods include statistical data grouping, Cronbach’s test, descriptive method, testing of statistical hypotheses, and correlation analysis. The data was processed with SPSS v.24.0 for Windows. Results: The results show a change in the static postural control with a 1/4-point deviation from the standard. This requires the inclusion of additional sensorimotor exercises in combination with other specific and general strengthening exercises. Conclusion: From the performed observation and the obtained results, compared to those of 20 healthy men, the following conclusion has been drawn: the analytical exercises for lower extremities lead to the overcoming of dysfunction and increased stability in the extremities. The physiotherapy programme should include sensory stimulation exercises tailored for strengthening the weakened muscles and should contribute to the overcoming of muscle imbalance.

The impact of simulation-based learning on the knowledge, attitude and performance of physiotherapy students on practice placement

BackgroundPractice placement is a crucial part of pre-registration physiotherapy education worldwide. However, educators face challenges in finding practice sites for students to undertake placement. The use of simulation-based (SBL) learning has the potential to replace some traditional placement, thereby increasing placement capacity, but the benefits have not been fully explored. This study aimed to assess the impact of SBL placement on students’ knowledge, attitude, and performance during practice placements with external providers.MethodsThis study utilised an exploratory qualitative research design using a semi-structured interview to collect data from Year 2 students of a 2-year MSc pre-registration physiotherapy programme in the UK. To be eligible to be included in the study, students must have participated in the 4-week simulation placement and have completed all their practice placements with external providers. All the interviews were conducted virtually in a 1:1 setting and recorded. The interviews lasted an average of 45 min. An inductive thematic analysis based on Braun and Clarke’s approach was utilised in this study.ResultsTwelve students consented to participate in this study. The 56 codes generated from the data were categorised into 5 themes; [1] Working together, [2] Working with Service Users, [3] Professionalism, [4] Profession-specific practical skills and [5] Generic practical skills. Participants unanimously expressed a positive view on working in groups, and they believe that engaging with service users who acted as patients enhanced the authenticity of the simulation placement. Subjective and objective assessments were considered important profession-specific skills gained during the simulation. Despite the benefits derived from the simulation placement, some participants felt that the learning experience would have been enriched by periodically changing the groups they were working in and having the opportunity for more 1:1 feedback throughout the four weeks.ConclusionsSBL has the potential to be a valuable educational experience for physiotherapy students. It may assist in better preparing students for successful integration into the dynamic healthcare environment. To enhance and improve the authenticity of this type of placementour recommendations include recruiting more service users, incorporating and encouraging more intervention-based elements, and increasing the practice educators’ and students’ contact time.

Systemic Inflammatory Changes in Spinal Cord Injured Patients after Adding Aquatic Therapy to Standard Physiotherapy Treatment.

Spinal cord injury (SCI) is a severe medical condition resulting in substantial physiological and functional consequences for the individual. People with SCI are characterised by a chronic, low-grade systemic inflammatory state, which contributes to further undesirable secondary injuries. This study aimed to evaluate the effect of adding aquatic therapy to the standard physiotherapy treatment, implemented in two different schedules, on systemic inflammation in SCI patients. Additionally, the relationship between cytokine blood levels and changes in functionality (measured with the 6MWT, 10MWT, WISCI, BBS, and TUG tests) throughout the study was assessed. A quantitative multiplexed antibody assay was performed to measure the expression level of 20 pro- and anti-inflammatory cytokines in blood samples from SCI patients at three time points: baseline, week 6, and immediately post-intervention (week 12). This study identified a complex signature of five cytokines (IL-12p70, IL-8, MCP-1, IL-1α, and IP10) associated with the time course of the two physiotherapy programs. Two other cytokines (IL-4 and TNF-α) were also associated with the functional recovery of patients. These could be important indicators for SCI prognosis and provide a basis for developing novel targeted therapies.

How Integrating the 5 Pillars of Community Practice Can Transform Physical Therapist Education and Reduce Health Disparities.

Patient history assists clinicians in determining the most appropriate tests to identify the symptoms' source and select appropriate interventions. Therefore, a subjective history is an essential component of patient management. When physical therapist practitioners transition into academia, they must understand how the history of the education system may affect learners. Health disparities are related to the lack of workforce diversity and skills in cultural responsiveness, and the education system is critical in addressing the impact of future providers on health disparities. Developing a doctor of physical therapy program to address health disparities requires an analysis of the historical context of the US educational and health care systems, along with traditional components of physical therapist education. This country's education system was built upon a 2-tiered system, where minoritized individuals struggled to overcome barriers imposed by legislation and societal beliefs. Jim Crow laws continued this unequal access to education, and the recent Supreme Court ruling to deny race-based affirmative action continues these inequities. This historical context informed the construction of the College of Saint Mary Doctor of Physical Therapy Program. The program's mission led to using less traditional educational approaches; thus, the pillars of practice took form. The 5 pillars evolved to include social determinants, inclusive faculty and student recruitment and retention practices, equitable grading, culturally responsive pedagogy, and community development. The purpose of this paper is to present a historical overview of the US education system and its influence on physical therapist education. Furthermore, it will illustrate how this historical context inspired the 5 Pillars of Community Practice from College of Saint Mary and discuss the challenges and interventions related to these pillars. There are tremendous disparities in educational outcomes and patient services in the United States. Disparities are most significant in those with historically marginalized identities. If those disparities are to improve, a change is required in the people providing care to patients. The best way to accomplish this is by transforming how future providers are educated.

Lumbar spine fusion surgery versus best conservative care for patients with severe, persistent low back pain.

People with severe, persistent low back pain (LBP) may be offered lumbar spine fusion surgery if they have had insufficient benefit from recommended non-surgical treatments. However, National Institute for Health and Care Excellence (NICE) 2016 guidelines recommended not offering spinal fusion surgery for adults with LBP, except as part of a randomized clinical trial. This survey aims to describe UK clinicians' views about the suitability of patients for such a future trial, along with their views regarding equipoise for randomizing patients in a future clinical trial comparing lumbar spine fusion surgery to best conservative care (BCC; the FORENSIC-UK trial). An online cross-sectional survey was piloted by the multidisciplinary research team, then shared with clinical professional groups in the UK who are involved in the management of adults with severe, persistent LBP. The survey had seven sections that covered the demographic details of the clinician, five hypothetical case vignettes of patients with varying presentations, a series of questions regarding the preferred management, and whether or not each clinician would be willing to recruit the example patients into future clinical trials. There were 72 respondents, with a response rate of 9.0%. They comprised 39 orthopaedic spine surgeons, 17 neurosurgeons, one pain specialist, and 15 allied health professionals. Most respondents (n = 61,84.7%) chose conservative care as their first-choice management option for all five case vignettes. Over 50% of respondents reported willingness to randomize three of the five cases to either surgery or BCC, indicating a willingness to participate in the future randomized trial. From the respondents, transforaminal interbody fusion was the preferred approach for spinal fusion (n = 19, 36.4%), and the preferred method of BCC was a combined programme of physical and psychological therapy (n = 35, 48.5%). This survey demonstrates that there is uncertainty about the role of lumbar spine fusion surgery and BCC for a range of example patients with severe, persistent LBP in the UK.

Burnout, Exhaustion, Experiences of Discrimination, and Stress Among Underrepresented and First-Generation College Students in Graduate Health Profession Education.

Mental health disorders are increasing among health profession students. Compounding this, students from underrepresented backgrounds may face additional stressors and challenges. The aims of this study were to: (1) assess the extent to which burnout, exhaustion, experiences of discrimination, and stress exist among students in dentistry, nursing, occupational therapy, pharmacy, and physical therapist professional education programs; (2) determine if there are significant differences by key demographic characteristics (those who are first-generation college students [FGCSs], a member of an underrepresented minority [URM] group, or both); and (3) highlight strategies and solutions to alleviate these challenges identified by students. Cross-sectional survey using a mix of question types of a sample of graduate students from dentistry, nursing, occupational therapy, pharmacy, and physical therapy programs from February to June 2020. Utilizing the Maslach Burnout Inventory Student Survey and campus climate and stress survey, mean subscale scores were calculated for the following outcomes of interest: MBI-SS burnout, dimensions of stress, and observed racism. Logistic regressions examined student factors that may help explain these outcomes. Content analysis examined participants' responses to open-ended questions. There were 611 individuals who completed all survey questions. FGCSs were significantly more likely than non-FGCSs to report exhaustion (adjusted odds ratio [aOR]: 1.50; 95% CI = 1.04-2.16), family stress (aOR: 3.11; 95% CI = 2.13-4.55), and financial stress (aOR: 1.74; 95% CI = 1.21-2.50). URM students reported not feeling supported in their program and mentioned needing additional support, particularly for well-being, from staff and faculty. Findings from this study are consistent with literature that FGCSs experience additional stressors that may lead to burnout and exhaustion. URM students reported not feeling supported in their programs. This study's findings point to the need for leadership and faculty of health professional schools to implement or strengthen current policies, practices, and strategies that support URM students and FGCSs. Research demonstrates that a diverse student body and faculty enhances the educational experience for health professional students, and that diversity strengthens the learning environment and improves learning outcomes, preparing students to care for an increasingly diverse population. However, this study finds that students from underrepresented backgrounds may still experience more burnout, exhaustion, discrimination, and stress than their peers. Programs and policies to support URM students and FGCSs throughout their academic careers can help improve graduation and retention rates, leading to improved workforce diversity.

Attitudes towards research in graduate-entry Australian physiotherapy students: a survey

Purpose: To assess the attitudes towards research in a two-year, graduate-entry Master of Physiotherapy course. Methodology: All students starting (T0) and ending (T1) their degrees in 2020 and 2021 were invited to complete the revised Attitudes Towards Research Questionnaire. This is a three-factor instrument with 13 statements assessing Research Usefulness (four statements, scores ranging from 4 to 28), Research Anxiety (five statements, scores ranging from 5 to 35), and Positive Research Predispositions (four statements, scores ranging from 4 to 28). Each statement was scored using a seven-item Likert scale ranging from ‘Strongly Agree’ (1) to ‘Strongly Disagree’ (7). Student responses between T1 and T0 for factor scores were compared using independent samples t-tests and summarised using mean differences (95% CIs). We defined the minimally important difference as 15% of the scale range. Findings: Ninety-seven percent (n=124/129) of students completed the survey at T0 and 57% (n=79/125) at T1. We found no difference between T0 and T1 in research anxiety (0.2 points, 95% CI: –1.5 to 2.0) and research usefulness (–0.9 points, 95% CI: –1.8 to 0.1), but a significant (although not meaningful) decrease in positive research predispositions between T0 and T1 (–1.7 points, 95% CI –3.2 to –0.2). Research implications: Qualitative research could complement these quantitative findings and provide in-depth reasons for student scores. Practical implications: Educators need more active strategies to improve attitudes and engagement in research-focused subjects to further engage students. Originality/value: This is the first study to document attitudes towards research in an Australian graduate-entry Master of Physiotherapy program. Limitations: There is likely bias (unclear in which direction) at T1 given that 57% of students completed the survey. Surveys were not linked, so group differences were assessed independently. Keywords: Evidence-based practice; research methods; Master of Physiotherapy, UTS Physiotherapy Student surveys (PHYSS) study

The Impact of Graduate Record Exam Threshold Scores in Disqualifying Underrepresented Ethnic-Racial Minority Applicants for Admission to a Doctor of Physical Therapy Program.

A growing number of graduate-level health professions education programs in the United States are discontinuing the use of the Graduate Record Exam (GRE) in their admissions requirements amidst concerns that its use puts Underrepresented Racial Minority (URRM) applicants at a disadvantage. This retrospective cross-sectional study analyzes the association between ethnic-racial selection and the reasons for disqualification among applicants to a public Doctor of Physical Therapy (DPT) program that used a minimum grade point average (GPA), and Analytic Writing and Quantitative Reasoning GRE minimum threshold scores to qualify applicants. There is evidence across the health professions literature that both GRE scores and GPA are associated with success on licensure examinations and academic performance. However, these variables also tend to disadvantage URRM applicants in gaining admissions to postgraduate health care fields, including physical therapy. All applicants (N = 4,797) to a single DPT program from a 9-year period were included. Racial and ethnic self-selections, GRE scores, and prerequisite GPA were coded for each applicant and classified for meeting qualifying criteria. The URRM applicants were disqualified based on GRE scores alone (P < .001) and in combination of GRE and GPA at a statistically significantly (P < .001) higher rate than Overrepresented Racial Group (ORRG) applicants, although the associations were negligible or weak. Compared with ORRG applicants, URRM applicants were at a statistically significant disadvantage because of the GRE threshold scores requirement. Furthermore, this study demonstrated that use of GRE minimum threshold scores disproportionately reduced URRM applicants in the qualified applicant pool. This investigation can be used as a model to inform holistic admission decisions regarding the use of academic variables to achieve the diversity and success goals of the program.

ОСОБЛИВОСТІ ФІЗИЧНОЇ ТЕРАПІЇ У ПРОЦЕСІ РЕАБІЛІТАЦІЇ ОСІБ ПОХИЛОГО ВІКУ З ПОРУШЕННЯМ ФУНЦІЙ ХРЕБТА

According to literary sources, osteochondrosis of the cervical and thoracic spine is one of the most common diseases. This disease affects 22% of the world's population and ranks first in the group of diseases of the musculoskeletal system. The main goal of restorative treatment of elderly patients with cervical and thoracic osteochondrosis is to reduce muscle spasticity, decrease the level of heart rate, arterial systolic and diastolic pressure, reduce pain, facilitate the performance of household tasks, etc. In the program of physical therapy, we included therapeutic physical culture, therapeutic massage, and physiotherapeutic means. Therefore, the purpose of the study was to study of the peculiarities of physical therapy in the rehabilitation process of elderly people with osteochondrosis. Research methods. 28 people (12 men and 16 women) with osteochondrosis of the cervical-thoracic spine took part in the study. The average age of the patients was 64.5 years. The pedagogical experiment was aimed at determining the effectiveness of the program of physical therapy developed by us for elderly people with osteochondrosis on indicators of mobility in the cervical spine, intensity of pain sensations. Results and conclusions. The results of the conducted research indicate the positive impact of classes in the complex program of physical therapy for the elderly with cervicothoracic osteochondrosis. Thus, after the completion of the formative study, we established an improvement in the functional state of the cervical spine in elderly persons with cervical-thoracic osteochondrosis. The average group value of the pain intensity index in patients at the end of the study corresponded to the assessment of «very mild pain», while at the beginning of the study it corresponded to the assessment of «pain above average».

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

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

Occurrence of Body Posture Abnormalities in Overweight and Obese Children Aged 5-6 Years-Pilot Study.

The study aimed to assess the occurrence of body posture disorders and their changes under the influence of a physioprophylactic program in children depending on body weight. In the examined children, the general and segmental body composition and body posture were determined using a physiotherapeutic assessment based on the Kasperczyk method. Mass, overall, and segmental body composition were determined using the bioelectrical impedance method using a TANITA body composition analyzer. The study group of 76 children was divided due to body weight disorders into Group I (n = 51), in which BMI and fat mass values were within the normative limits for age and gender, and Group II (n = 19), comprising children whose body weight exceeded the norm and/or fat mass exceeded normative values. The examined children underwent a physioprophylactic. The program was conducted by qualified physiotherapists for 12 weeks, once a week for 30 min. The therapeutic program was focused on physioprevention of being overweight and the correction of body posture. A distal distribution of fat mass was observed in the examined group. Asymmetry in the sagittal plane was found in 35% of children. No statistically significant differences were found in the presence of asymmetry in the sagittal plane between the groups. No statistically significant differences were found in the occurrence of posture irregularities between the groups. There were no changes in the weight and body posture of the examined children under the influence of the physiotherapy program. The lack of correlation in the examined group between body weight and posture irregularities in 5-6-year-olds may suggest the acquisition of posture defects as a consequence of the persistence of overweight or obesity.

Effect of aquatic versus conventional physical therapy program on ankle sprain grade III in elite athletes: randomized controlled trial

IntroductionAnkle sprains are the second most common sports injury after knee injuries, with about 85% of them affecting the lateral ankle ligaments. These injuries are particularly prevalent in sports like basketball and volleyball.PurposeTo investigate the effect of Aquatic therapy as an early rehabilitation protocol for elite athletes with acute lateral ankle sprain grade III on back-to-sport time, dynamic balance, pain, Athletic performance, and muscle power compared to land-based exercise training.MethodsThirty elite athletes have ankle sprain grade III with sprain onset from 1 to 7 days, their age ranges from 18–30 years old were recruited. All participants are professional athletes; mainly participating in above-head sports such as volleyball and basketball. The patients were randomly allocated into two treatment groups: Group I (control group): 15 patients received a conventional physical therapy program of structured therapeutic exercise program, manual therapy and land-based exercises, in addition to external support, and Group II (Aquatic therapy group): 15 patients received aquatic training. Visual Analog Scale (VAS) was used to measure the pain intensity, while the dynamic balance was measured by the Star Excursion Balance Test. Athletic performance was measured by HOP Tests (Single, Triple, 6-m, and Cross-over hops) aided by the Agility T-Test (ATT) and Illinois Agility Test (IAT). Muscle power was tested by a Single Leg Press. Finally, back to sports time was recorded for each participant in both groups.ResultsThere was a significant interaction effect of Aquatic therapy and time for VAS (p < 0.001), single hop (p < 0.001), triple hop (p < 0.001), cross-over hop (p < 0.001), IAT (p = 0.019) and ATT (p < 0.001) of both affected and nonaffected. There was no significant interaction effect of Aquatic therapy and time for 6-MHT of affected (p = 0.923), and nonaffected (p = 0.140). There was a significant main effect of time for all dependent variables (p < 0.001) except for 6-MHT of affected (p = 0.939), nonaffected (p = 0.109), and IAT (p = 0.099). The Star excursion dynamic balance test (SEBT) and Single leg press revealed a significant difference between groups on affected and non-affected sides (p < 0.001*). Lastly and most importantly the back-to-sport time revealed a significant difference in the return-to-sport time in favor of the Aquatic therapy group who returned faster than the control group (p < 0.001*).ConclusionAquatic therapy is more effective than traditional protocols regarding early rehabilitation of acute ankle sprain grade III in Elite professional athletes for reducing pain intensity, improving dynamic balance and athletic performance and power and accelerating their return to sports time. Because aquatic therapy produces better outcomes, it is advised to be included in the rehabilitation programs of athletic patients with acute ankle sprains grade III.

Altruistic values among students of Nursing, Midwifery, Physiotherapy, and Health Psychology: a cross-sectional study

Aim – to study the altruistic values of o group of nursing, midwifery, and physiotherapy students, and how these values evolved throughout academic years and across study programs. The study used a descriptive correlational design. The data were collected from students in the bachelor’s degree programs in nursing, midwifery, and physiotherapy, and in the master's degree program in health psychology (students in this program have completed bachelor’s degrees in nursing, midwifery, or physiotherapy). The Faculty of Natural Sciences at the University of Shkodra “Luigi Gurakuqi”, Albania offers bachelor’s degree programs in nursing, midwifery, physio­therapy and a professional master's degree in health psychology. During the academic year 2022-2023, the number of active students was 756. A total of 457 students participated in this study: 175 from the nursing program, 130 from the midwifery program, 107 from the physiotherapy program, and 45 from master program. Data were collected from December 1, 2022, through January 31, 2023, with an online questionnaire. Two tools were used in this study: a demographic questionnaire and the Altruism Scale used by Űmmet and colleagues. The mean score on the Altruism Scale was 2.9±0.78. A one-way ANOVA revealed that there was a difference in mean altruism score between at least two groups (F (3, 452) = [3.232], p=0.02). Tukey’s HSD Test for multiple comparisons found out that the mean value of altruism was different between the bachelor students in nursing and bachelor students in physiotherapy (p=0.011, 95% CI = [0.0498, 0.5448]). Compared to others, bachelor students in nursing had higher level of altruism and bachelor students in physiotherapy had lower level of altruism. Conclusions: The results showed that it is precisely the feeling of altruism that people have, which made them choose nursing as a profession. Since altruism is so important for the nursing profession, topics related to altruism should be included in nursing curricula.