Physical Therapy Clinic Research Articles

Abstract TP396: Effects of low-intensity pulsed focal ultrasound-mediated delivery of endothelial progenitor-derived exosomes in MCAo stroke

Exosomes have been used for therapeutic purposes to target stroke and other disorders. Repeated administration of mesenchymal stem cell (MSC)-derived exosomes in rats showed improved functionality and reduced stroke injury. However, exosomes from endothelial progenitor cells (EPCs) have not been tested in any stroke model, and in vivo bio-distribution study is lacking. Targeted delivery of IV-administered exosomes has been a great challenge. Modifying the exosomal surface to carry different ligands or peptides has been tried to increase delivery to target tissues. However, the overall results are not encouraging. Delivery of exosomes to the brain is a daunting task, and a blood-brain barrier(BBB)-penetrable peptide is being considered. However, a method that can deliver naïve (unmodified) exosomes to the site of stroke without destroying host tissues, disrupting BBB, or the membranes of the delivery vehicles (such as exosomes) will be a breakthrough. Low-intensity pulsed ultrasound (LIPUS) is approved for clinical use in musculoskeletal and physiotherapy clinics. The use of focused LIPUS to deliver exosomes has yet to be explored in stroke. The objectives of the proposed studies were to determine whether LIPUS-mediated increased delivery of EPC exosomes enhances stroke recovery and functional improvement in mice with tMCAo stroke. In this study, we used EPC-derived exosomes for stroke treatment. To enhance exosome delivery to the stroke area, we utilized focused LIPUS, which temporarily disrupts BBB. We evaluated stroke volume with MRI at different time points. We also conducted behavioral studies in parallel to MRI to determine the recovery. In the end, we studied the brain tissue with immunohistochemistry studies to evaluate the extent of stroke and tissue regeneration. In vivo, imaging showed a higher accumulation of EPC exosomes following focused LIPUS without any damage to the underlying brain tissues. Four groups (Vehicle, LIPUS only, EPC-exosomes only, and LIPUS+EPC-exosomes) of aged animals were enrolled in the studies. The focused LIPUS + EPC exosomes group showed a decreased stroke volume (p=0.08) on day 7, decreased FluoroJade+ cells, and significantly higher numbers of neovascularization in and around the stroke areas although rCBF was not increased compared to that of other groups. There were no differences in the white matter tract volumes, ventricular volumes, astrogliosis, or neurobehavioral functions among the treated groups.

Hippotherapy practice and safety patterns for adult clients in the United States

Abstract Objective: Hippotherapy is a treatment strategy used by occupational therapy, speech-language, and physical therapy clinicians to influence client outcomes through the movement of a horse. While hippotherapy has been widely researched among pediatric populations with neuromuscular disorders, limited evidence exists regarding hippotherapy for adult populations. This study describes the practice patterns, safety patterns, and changes in these trends over time for clinicians who incorporate hippotherapy into treatment plans for adult populations in the United States (USA). Design: A survey was distributed via email listserv to American Hippotherapy Association, Inc. (AHA, Inc.) and Professional Association of Therapeutic Horsemanship, International (PATH, Intl.) members for 5 consecutive years. Clinicians were included in the study if they worked with adults (ages 18–64), practiced in the USA and were licensed physical therapists, physical therapy assistants, occupational therapists, occupational therapy assistants, speech-language pathologists, and speech-language pathologist assistants. Descriptive analyses were performed using Microsoft Excel. Results: The majority of the clinicians were physical therapists (2019 n = 8; 2020 n = 21; 2021 n = 26; 2022 n = 20; 2023 n = 20) working with clients who had cerebral palsy, autism spectrum disorder, or attention deficit disorder aged 18–26 and addressing neuromuscular client factors. Across the five years, <0.001–0.012 out of every one session included an emergency dismount, <0.001–0.003 out of every one session resulted in a safety occurrence that required on-site first aid, and <0.001–0.01 out of every one session resulted in an injury that required off-site first aid. Conclusions: The study findings describe consistent practice and safety patterns across time for adult clients with low numbers of adverse events. As the population ages, hippotherapy should be considered more often for adult clients. Clinicians can educate referring providers to advertise hippotherapy as adult-inclusive or age-friendly as appropriate. Researchers should examine the efficacy of hippotherapy for specific adult populations to guide the practice of clinicians incorporating hippotherapy into treatment plans for adult clients. Educators in accredited therapy programs and the AHA, Inc. should consider expanding their curriculum to include more adult-specific information for hippotherapy and draw attention to how and why the treatment strategy should be used with this population.

Ataxia telangiectasia in a Bahraini child treated with intensive physiotherapy: A case report

Ataxia telangiectasia (AT) is a rare neurodegenerative condition with a prevalence of 1 in 40,000 to 1 in 300,000 worldwide. It involves a genetic mutation of chromosome 11q.26. The condition is inherited in an autosomal recessive manner causing atrophy of the cerebellum due to loss of Purkinje fibres. AT presents early in childhood and the clinical features depend on the type of mutation. The study is a case report of a rare genetic disorder of a 9-year-old female who came to the physiotherapy clinic with a diagnosis of AT. The patient was presented with progressively worsening gait problems with frequent falls, with complete dependence on assistance and impaired balance and coordination. The treatment program was 12 months divided into an intense physiotherapy program for two months followed by 10 months of two times per week of physiotherapy sessions. The program was divided into four elements which are: (1) Lifestyle changes, (2) Strengthening exercises, (3) Coordination exercises, and (4) Balance training exercises. The result showed a positive outcome in increasing the patient’s independence, increased muscle strength, reduced ataxia symptoms intensity, and the patient can carry out complex activities with the help of accessory orthosis devices.

Protocol for alleviating alcohol-induced conditioned place preference in mice using alternating bilateral sensory stimulation.

Alternating bilateral sensory stimulation (ABS) is a clinical physical therapy technique effective in treating post-traumatic stress disorder (PTSD). However, its utilization in treating conditions beyond PTSD remains limited. Here, we present a protocol to reduce ethanol-induced conditioned place preference (CPP) using 4Hz ABS. We describe steps for the assembly of ABS apparatus, CPP training, and ABS treatment. This protocol has been validated in male mice and can be used to explore the mechanism behind the therapeutic effect of ABS. For complete details on the use and execution of this protocol, please refer to Lei etal.1.

Neuromuscular Response to High-Velocity, Low-Amplitude Spinal Manipulation—An Overview

The clinical use of spinal manipulation to treat musculoskeletal conditions has nearly tripled in the United States since 1980, and it is currently recommended by most global clinical guidelines as a conservative treatment for musculoskeletal pain, despite a lack of knowledge concerning its mechanisms of action. This overview highlights evidence of direct neuromuscular responses to high-velocity, low-amplitude spinal manipulation (HVLA-SM) as delivered by chiropractic, osteopathic, and physical therapy clinicians, with an intent to foster greater interprofessional dialogue and collaborative research to better address current gaps in mechanistic knowledge of the neuromuscular response to HVLA-SM. Three databases (PubMed, CINAHL Ultimate (EBSCO), EMBASE (Elsevier)) were searched from 2000 to December 2024 with specific search terms related to thrust HVLA-SM and the neuromuscular response. To focus strictly on neuromuscular responses related to HVLA-SM, this literature overview excluded articles using non-HVLA-SM manual therapy techniques (i.e., massage, non-thrust joint mobilization, and/or combined HVLA-SM with other forms of treatment such as exercise or non-thrust joint mobilization) and studies in which patient-centered outcomes (i.e., pain scores) were the primary outcomes of the HVLA-SM interventions. Pediatric studies, animal studies, and studies in languages other than English were also excluded. One-hundred and thirty six articles were identified and included in this overview. Neuromuscular findings related to HVLA-SM in the areas of electromyography (EMG), muscle thickness, muscle strength, reflexes, electroencephalogram (EEG), and evoked potential were often mixed; however, evidence is beginning to accumulate either in favor of or opposed to particular neuromuscular responses to HVLA-SM as larger and more scientifically rigorous studies are being performed. Recurrent limitations of many HVLA-SM-related studies are small sample sizes, leading to a lack of generalizability, and the non-standardization of HVLA-SM delivery, which has prevented researchers from arriving at definitive conclusions regarding neuromuscular responses to HVLA-SM. Discussions of future neuromuscular research needs related to HVLA-SM are included for clinicians and researchers inside and outside of the field of manual therapy, to advance this field.

ATHLETIC RUNNER’S QUALITY OF LIFE WITH GROIN STRAIN- A CROSS-SECTIONAL STUDY

Background: Groin pain is a common and debilitating issue among athletes, particularly those engaged in high-intensity sports involving kicking, sprinting, and rapid directional changes. It accounts for approximately 6% of all athletic injuries, with prevalence increasing to 13% in specific sports like soccer. The condition often leads to impaired mobility, reduced quality of life, and suboptimal athletic performance. Despite its impact, there is limited evidence regarding its prevalence and effects on athletic runners. Objective: To evaluate the prevalence of hip pain and assess the quality of life in athletic runners with groin strain using validated measurement tools. Methods: This cross-sectional study was conducted using non-probability convenience sampling. A total of 150 athletes aged 18-35 years with groin strain were recruited from various sports physiotherapy clinics. Participants were evaluated using the Visual Analog Scale (VAS), the Copenhagen Hip and Groin Outcome Score (HAGOS), and the Lower Extremity Functional Scale (LEFS) to assess hip pain and quality of life. Data were analyzed using SPSS version 24, and correlations were determined with a significance level of p < 0.05. Results: Of the participants, 64.7% were male, and 35.3% were female, with a mean age of 25 ± 4.6 years. The prevalence of hip pain was 88%. Pain intensity levels included no pain (12%), mild pain (38.7%), moderate pain (31.3%), and severe pain (18%). Functional impairment was evident, with 38.1% scoring less than 40 on LEFS. A significant negative correlation (p < 0.05) was observed between hip pain and quality of life, indicating the adverse impact of groin strain on athletic performance. Conclusion: Groin strain significantly impairs quality of life in athletic runners, reducing physical function, general well-being, and athletic performance. Early diagnosis and tailored rehabilitation protocols are essential to mitigate these effects.

VIRTUAL REALITY REHABILITATION VERSUS TASK-ORIENTED TRAINING FOR IMPROVING DYNAMIC BALANCE AND GAIT AMONG PARKINSON’S DISEASE PATIENTS

Background: Gait and balance are significant complained in patients with Parkinson’s disease (PD) which decrease their movement capability and life quality. Two innovative therapeutic modalities reported to provide better functioning in PD are virtual reality (VR) and task-oriented training (TOT). Objective : To determine effect of virtual reality rehabilitation versus task-oriented training for improving dynamic balance and gait among parkinsons disease patients Material and methods : This was comparative randomized controlled trial . Allied hospital Civil hospital Faisalabad Moeen physiotherapy clinic were utilized as study setting .Diagnosed PD patients (Hoehn and Yahr stages 2–3) aged 50–70 years were included. Exclusion criteria was patients with severe dementia or other neurological abnormalities. Sample Size was 28. Group A undergo VR-based sessions vs Group B participants were given task-oriented training Berg Balance Scale (BBS) and Timed Up and Go Test and Functional Gait Assessment (FGA) used as assessment tools. Statistical analysis performed by SPSS version 21. Results : Demonstrated BBS Score was 48.9 ± 2.9 with p score 0.03 FGA Score 23.3 ± 2.1 with p score 0.04 and 12.0 ± 1.4 TUG score with p value 0.02 among group A and group B revealed BBS Score was 46.3 ± 3.0 FGA Score was 21.7 ± 2.4 12.9 ± 1.6 was TUG score. Group A revealed more significant results as compared to group B. Conclusion: Both intervention groups revealed significant improvement after treatment but virtual reality training group showed more improvement on balance and gait among parkinsonism patients as compared to task oriented group.

Enhancing Patient Choice Through the Development of Physical Therapist Online Biographies.

Provider web profiles are becoming popular locations for patients to seek information before their visits. This industry insight assesses patients' utilization of a physical therapy clinic's website to determine the impact the addition of physical therapist biographies had on patient perceptions and physical therapist selection. Forty-six percent of first-time patients (n = 786) indicated visiting the clinic's website prior to their visit. After biographies were added, these website visitors rated the website as more helpful, and indicated a greater perception of certainty regarding the services the clinic provides. A greater percentage of website visitors made a purposeful selection of therapist after therapist biographies were posted online than prior to biographies being posted. These findings indicate that improvements to a clinic's website can positively impact patient empowerment in making personal healthcare decisions. Simply adding biographies of physical therapists to clinics' websites can have significant effects on reducing first-time patients' uncertainty, as well as providing a greater level of patient-centered care by offering information to empower patients to be more active participants in their healthcare choices.

Effectiveness of a physiotherapist-led triage and treatment service on WAITing time for adults with musculoskeletal pain referred to Australian public hospital physiotherapy clinics: a protocol for the WAIT-less trial

IntroductionMusculoskeletal pain is the second leading cause of disease burden in Australia, and there is a need to investigate new models of care to cope with the increasing demand for...

The effect of physiotherapy on anxiety, depression, and stress in chronic low back pain

Background: Chronic low back pain has an impact on the patient’s life socially,financially, and psychologically, and little data is dealing with the effect of physiotherapy on improving this psychological burden. Objectives: to assess the effect of physiotherapy on depression, anxiety, and stress in those patients. Method: cross-sectional study was conducted at many of the neurology and physiotherapy clinics in Erbil (Iraq), with 40 patients who met the criteria of low back pain depending on the Back Pain Functional Scale, and for each patient, we determined the socio demographic characteristics and clinical ones. The anxiety, depression, andstress were assessed by the Depression, anxiety, and Stress Scale before and afterphysiotherapy. Results: of the 40 patients, there were 10 males (25 %), 19 were unemployed (47.5%), and 19 were uneducated (47.5%). There were 13 patients with another joint deformity (32.5%), and 34 patients were married. There was a significant improvement of depression (p=0.002) and improvement of anxiety (p=0.023), and the most significant was with improvement of stress (p=0.0001). Conclusion:physiotherapy can lead to the improvement of depression,anxiety,and stress in low back pain patients. Keywords:physiotherapy; anxiety; depression; stress; low back pain

Investigation of the use of gabapentinoid drugs in pain management

Objectives: This study aimed to investigate the kind of painful conditions and preferred drug doses for which gabapentinoids were used for pain management for the musculoskeletal and nervous systems. Materials and Methods: The study included 364 patients over the age of 18 who applied to the physical therapy and rehabilitation outpatient clinic with complaints of musculoskeletal and nervous system pain. Demographic characteristics of the patients including age, gender, body mass index, smoking, disease diagnoses, preferred gabapentinoid drug, and dosage were recorded. Moreover, the estimation of the severity of pain by the Visual Analog Scale (VAS) before and 6 months after the treatments was collected from medical records. Results: The mean age of the patients was 59.54 ± 11.59 years and 82.1% were female and 17.9% were male. The diseases preferred for drug use were lumbar disc herniation (39.3%), cervical disc herniation (13.7%), spondylolisthesis (11.3%), diabetic neuropathy (11%), frozen shoulder (10.7%), gonarthrosis (10.4%), psoriatic arthritis (8.5%), spondylosis (8%), fibromyalgia (4.9%), carpal tunnel syndrome (4.7%), complex regional pain syndrome (2.7%), restless leg syndrome (1.1%), coxarthrosis (0.8%), postherpetic neuralgia (0.8%), and hemiplegia (0.5%), respectively. There was significant female gender superiority in both pregabalin and gabapentin groups (P < 0.001). In whole chronic pain conditions, the VAS scores before and after 6 months of treatment were significantly reduced in both groups, except for restless legs syndrome (P = 0.066). According to the results of the study, it was determined that the indication for gabapentinoid use was mainly related to neuropathic pain and gabapentinoid doses were below the recommended amounts. Conclusion: Originally developed as anticonvulsants, gabapentin, and pregabalin are increasingly used in the treatment of various types of pain, including neuropathic and musculoskeletal pain. Although they raise concerns about addiction, it should not be overlooked that gabapentinoids are useful in the treatment of chronic painful conditions when used in the correct indications and doses.

Effect of acetic acid shockwave phonophoresis on spur morphology, foot pain and function in patients with calcaneal spur: A randomised controlled trial.

To investigate the effect of acetic acid shockwave phonophoresis on spur morphology, foot pain, and function in patients with calcaneal spurs. A double-blinded, randomised clinical trial. Outpatients physical therapy clinics. One hundred forty-seven patients with calcaneal spurs, 18-65 years old, were randomly allocated to three equal groups. The study group (A) received acetic acid shockwave phonophoresis plus conventional physical therapy. The study group (B) received shockwave therapy plus conventional physical therapy. The control group received conventional physical therapy programme only. Interventions were applied twice a week for 3 weeks. Calcaneal spur width, calcaneal spur length, pain intensity level, pain pressure threshold and foot and ankle ability measure activities of daily living subscale were measured at baseline, after 3 weeks of interventions and after 4 weeks of follow-up with no intervention. Between-group differences were observed for calcaneal spur width and length, pain intensity, pain pressure threshold and function after 3 weeks favouring Group A (p < 0.001). Mean differences (95% CI) between study groups were -1.11 mm (-1.46, -0.77) for spur width; -1.34 mm (-1.67, -1.01) for spur length; -20.71 mm (-24.66, -16.77) for pain; 1.45 kg/cm2 (1.05, 1.85) for pain pressure threshold; and 12.16 points (9.24, 15.09) for function after 3 weeks. Acetic acid shockwave phonophoresis combined with exercise clinically and statistically improves calcaneal spur width, length, pain intensity, pain pressure threshold and foot function more than shockwave therapy alone or conventional physical therapy. This method might be considered an effective, feasible, safe, non-invasive and locally applicable treatment for heel spurs.

Stroke survivors’ perceptions of living with disability in urban Ghana- a qualitative study

BackgroundStroke prevalence is one of the most pressing issues in many sub-Saharan African countries. Stroke survivors often face disabilities, mental health problems, and experience stigma. Research on post-stroke experiences and interventions is limited, particularly in low and middle-income countries, including Ghana. This study aims to contribute to this gap by investigating experiences of everyday life following a stroke in urban Ghana.MethodA qualitative in-depth study involving 14 interviews with stroke survivors who attended physiotherapy at Accra Physiotherapy and Sports Injury Clinic. Qualitative analysis was conducted to analyse the data.ResultsData analysis generated four themes; [1] Mobility limitations; [2] Psychosocial burden [3] Employment Limitations [4] Financial burden.ConclusionStroke survivors with disabilities perceive themselves as non-functional members of society, which limits their options for a normal life and undermines their well-being. A more in-depth understanding of these issues can contribute to strategies, interventions, and policies that address these problems.

What do patients with lumbar spinal stenosis think is physical therapy’s best card? A survey of perceived message strength

ABSTRACT Objectives Rising surgical rates for lumbar spinal stenosis (LSS) and underutilization of physical therapist services for this condition may increase patient risks and healthcare costs. Patient beliefs may also contribute to this problem. Therefore, our objective was to determine which messages about physical therapy were perceived as strongest by patients with LSS and whether those messages were influenced by patient factors. Methods The study used a cross-sectional survey design, and participants were patients of outpatient physical therapy clinics with imaging or clinical evidence of LSS. Participants completed an electronic survey containing different messages about physical therapist services for LSS. Messages were designed using the health belief model. Perceived message strength was scored using the perceived argument strength scale (PASS). Pain catastrophizing and pain self-efficacy were measured to determine whether they influenced participant perceptions. Occurrence of magnetic resonance imaging and surgical consultations were also measured. Results Of 189 potential participants, 101 were included in the study. The message perceived as strongest emphasized physical therapists as listeners who would customize a plan (PASS 36.1 [5.0]) Similar scores were seen for messages that emphasized benefits of education and self-management and de-emphasized severity. The message that emphasized research findings was rated the least strong. Participants who had high levels of pain catastrophizing were more likely to have had imaging and perceived arguments as less strong. Discussion/Conclusion Results of the current study suggested patients with LSS preferred a message that emphasized physical therapists as listeners who would customize a plan. The message about research outcomes was perceived as the least strong. Therefore, awareness campaigns intended to influence the beliefs or behavior of patients with LSS should emphasize the individualized nature of physical therapy more than research evidence.

Comparison of the treatment efficacy of suprascapular nerve block and intra‐articular shoulder injection techniques in patients diagnosed with adhesive capsulitis

AbstractBackgroundAdhesive capsulitis (AC) is a common cause of shoulder disability. Interventional procedures are used along with many other treatment methods. There are insufficient studies directly comparing the superiority of suprascapular nerve block (SSNB) and intra‐articular shoulder injection (IAI) techniques, which are frequently used interventional methods in treatment.ObjectiveTo compare the efficacy of ultrasonography‐guided SSNB and IAI techniques in terms of pain and functional status in the treatment of AC.DesignA single‐center, double‐blind randomized study.SettingThe study was conducted at the Physical Therapy and Rehabilitation outpatient clinic of Antalya Training and Research Hospital between March and October 2022.ParticipantsEighty‐four participants aged 15 to 75 years with a clinical diagnosis of AC were screened for the study, and 60 participants were included in the study after excluding participants who did not meet the criteria.InterventionsParticipants were randomized into two groups with 30 participants in each group. Both groups received an injection of 1 mL of 40 mg of triamcinolone acetonide and 9 mL of 0.5% bupivacaine hydrochloride under ultrasonographic guidance.Main Outcome MeasuresThe patients' Shoulder Pain and Disability Index (SPADI) scores, shoulder active and passive range of motions (ROM), and visual analog scale (VAS) scores were evaluated before and after the injection in the 1st week, 4th week, and 12th week.ResultsOur study found no significant difference in SPADI and ROM between the two groups when comparing pre‐injection and post‐injection results in 1st week, 4th week, and 12th week. When pre‐injection and 1st week, 1st week and 4th week, 4th week and 12th‐week measurements were compared, improvement in SPADI‐Disability scores, SPADI‐Total scores, active flexion, passive flexion, active abduction, passive abduction, and active extension ROM values continued until the 12th week in both groups. In both groups, improvement in SPADI‐Pain scores, active external rotation, and passive external rotation ROM values continued until the 4th week. In terms of VAS scores, passive extension, active internal rotation, and passive internal rotation ROM values, there was a statistically significant improvement in both groups after the injection compared to pre‐injection.ConclusionThe efficacy of SSNB and IAI techniques in the treatment of adhesive capsulitis was found to be similar. In both methods, significant improvements were observed in SPADI, ROM, and VAS measurements compared to baseline.

Use of machine learning to identify prognostic variables for outcomes in chronic low back pain treatment: a retrospective analysis

ABSTRACT Objectives Most patients seen in physical therapy (PT) clinics for low back pain (LBP) are treated for chronic low back pain (CLBP), yet PT interventions suggest minimal effectiveness. The Cochrane Back Review Group proposed ‘Holy Grail’ questions, one being: ‘What are the most important (preventable) predictors of chronicity’ for patients with LBP? Subsequently, prognostic factors influencing outcomes for CLBP have been described, however results remain conflicting due to methodological weaknesses. Methods This retrospective observational cohort study examined prognostic risk factors for PT outcomes in CLBP treatment using a sub-type of AI. Bootstrap random forest supervised machine learning analysis was employed to identify the outcomes-associated variables. Results The top variables identified as predictive were: FOTO™ predicted functional status (FS) change score; FOTO™ predicted number of visits; initial FS score, age; history of jogging/walking, obesity, and previous treatments; provider education level; medication use; gender. Conclusion This article presents how AI can be used to predict risk prognostic factors in healthcare research. Improving predictive accuracy helps clinicians predict outcomes and determine most appropriate plans of care and may impact research attrition rates.

FEITOS E PERFIL POPULACIONAL DE IDOSOS NA PRÁTICA DE ATIVIDADES FÍSICAS EM PORTO VELHO – RONDÔNIA

The elderly population has been growing significantly over the years, and with this, there has also been a growing concern about ensuring that these individuals have an active and healthy life. Physical activity is one of the main ways to promote health and quality of life in old age, as it can prevent and treat various health conditions, in addition to improving physical and cognitive function. Based on this, this article aims to analyze the importance of physical activity for health and the benefits that the activity provides to the elderly. The study is descriptive and quantitative in nature and was carried out in the city of Porto Velho, Rondônia, at the Physiotherapy Clinic of the São Lucas Educational Center and SESC/RO Social Service of Commerce Rondônia. It is important to note that the study included male and female elderly people, aged 60 years and older. In addition, two questionnaires were used to produce the data: one about general information based on daily habits and a description of physical exercises and the benefits achieved. Complementary data information about risk factors, weight, height and lifestyle changes. It is worth noting that a sociodemographic questionnaire was applied, along with a functional test scale to assess the physical fitness of the elderly, the Berg Balance Scale and the Modified Baecke Questionnaire for the Elderly. And the guardians signed the free and informed consent form (ICF). The data were collected through the evaluation instruments that were tabulated in the Microsoft Excel program for statistical analysis. The research evaluated 60 participants, predominantly women (93.3%), aged between 60 and 90 years, most living in the urban area. In terms of health, 31 of the participants reported regular perception and 62% had 2 to 3 comorbidities. The majority did not smoke (58 participants) and did not consume alcohol (52 of the 60 participants). Regarding Covid-19, 31 had been infected, but only 1 required intubation. On the Berg Scale, 98.3% of the elderly demonstrated good balance when standing for 2 minutes without support, and 44 of 60 were able to pick up objects from the floor independently. However, 60% suffered two or more falls and 40% reported moderate or extreme fear of falling, while 30% had difficulty standing on one leg for 3 seconds or more. These data reveal a predominance of good functional capacities, but with significant limitations in relation to falls and comorbidities. The completion of this study contributed to a greater understanding of the importance of physical activity in the lives of the elderly, considering that physical activity is an element that can contribute to the promotion of health, physical and mental well-being and functional capacity of the elderly, demonstrating that regular exercise not only improves muscle strength and balance, but also significantly reduces the risk of falls, one of the main challenges faced by this population. The data obtained highlight the need for interventions that encourage physical activity, since many elderly people consider themselves active, but only a minority performs exercises regularly. Therefore, the implementation of physical exercise programs is essential to prevent chronic diseases, improve quality of life and promote functional independence among the elderly, contributing to healthy and active aging.

Effectiveness of McKenzie exercises plus stabilization exercises versus McKenzie exercises alone on disability, pain, and range of motion in patients with nonspecific chronic neck pain: A randomized clinical trial.

Chronic nonspecific neck pain is a common disorder that causes disability and reduced quality of life. Effective conservative treatment options are needed to manage this condition. This randomized trial compared the efficacy of McKenzie exercises alone versus McKenzie plus cervical and scapulothoracic stabilization training for patients with chronic nonspecific neck pain. A randomized controlled trial was conducted in an outpatient physical therapy clinic. 76 patients with chronic (> 3 months) neck pain were randomized to 6 weeks of either McKenzie exercises alone (n= 38) or McKenzie plus stabilization exercise (n= 38). The McKenzie protocol included posture correction, range of motion exercises, and lateral neck stretches. The stabilization program added targeted exercises for the neck and scapula. The combination of McKenzie plus stabilization exercises resulted in significantly greater reduction in current neck pain intensity compared to McKenzie alone at 6 weeks (mean difference: -1.2 points on 0-10 scale, 95% CI -1.8 to -0.6; p< 0.001). Neck disability improved in both groups. Cervical range of motion also improved more with the addition of stabilization, except for extension. Adding specific cervical and scapulothoracic stabilization exercises to a standard McKenzie protocol led to clinically meaningful reductions in neck pain compared to McKenzie therapy alone in patients with chronic nonspecific neck pain. This combined approach can improve outcomes.

The Oswestry Disability Index is not a good measure for low back pain in adolescents: A Rasch analysis of data from 200 people

Objective To evaluate the psychometric properties of the modified Oswestry Disability Index in adolescents with low back pain through Rasch analysis. Design This is a psychometric study. Setting Physical therapy clinics of a large pediatric hospital in Columbus, Ohio (United States). Subjects Two hundred adolescent patients with low back pain (112 female, 15.4 ± 1.9 years old). Main measure The modified Oswestry Disability Index. Results The mean modified Oswestry Disability Index score was 17.1 ± 12.1, with scores ranging from 0 to 56 on the 100-point scale. The Rasch person reliability for the Oswestry Disability Index was 0.70, representing minimal acceptable person reliability. The Oswestry Disability Index demonstrated poor item spacing, hierarchy, and targeting of the adolescents’ disability level (>1 logit between person mean and item mean). A significant misfit was observed in three of 10 items. There were significant issues with the functioning of responses on all items of the Oswestry Disability Index. Principal component analysis of residuals revealed a ratio of 5.3:1, demonstrating acceptable unidimensionality. Conclusion Due to multiple psychometric issues, the Oswestry Disability should not be used to assess disability in adolescents with low back pain. The Oswestry Disability Index significantly mistargets adolescent ability and only provides an acceptable assessment of the most disabled adolescents.

Pain during prolonged sitting in subjects with patellofemoral pain in Dutch physical therapy clinics: an online questionnaire-based analysis

ObjectivesThis study aimed to describe (1) differences between subjects with patellofemoral pain (PFP) with and without pain during prolonged sitting (PDPS), (2) minimum knee flexion angle and time to onset/disappearance...