Physiotherapy Department Research Articles

Effectiveness of functional electrical stimulation machine in managing neurological diseases - A retrospective study.

Cerebrovascular Accident (CVA) or stroke, Spinal Cord injury can lead to neurological diseases resulting in major loss in motor function causing hemiplegia or tetraplegia. In 2019, according to The Global Burden of Diseases (GBD) CVA/Stroke is the second leading cause of death and the third leading cause of death and disability combined, globally. Its prevalence vary drastically among South Asian countries. The objective of this study was to determine the effectiveness of Functional Electrical Stimulation (FES) machine on neurologically impaired patients at the Physical Therapy department at IHHN, Karachi, Pakistan. In this retrospective study data was extracted from August 2016 to February 2022 on patients with neurological symptoms i.e. hemiplegia or paraplegia with muscle power of two or less on Manual Muscle Testing (MMT). The parameters for evaluating patients progress pre and post treatment were MMT results and their mobility status. The number of sessions ranged between 40 to 100 sessions of Functional Electrical Stimulation (FES) provided on alternate days according to the patient's need. Data of 51 patients who had completed their treatment were extracted and analyzed. The mean age of patients who completed treatment was 49.62 ± 17.26 years. Out of 51(100%), 30 (58.8%) were male and 21 (41.2%) were female. Pre- and post-treatment median (IQR) showed remarkable improvement in MMT of upper limb muscle (from 1.0 to 4.0) and lower limb muscle (from 2.0 to 4.0). FES cycling is an effective treatment for patients with neurological impairments, as it resulted in improvement in both upper and lower limb muscle strength, along with mobility status.

Effects of Low-Level Laser Therapy on Shoulder Pain, Functional Disability and Range of Motion in Patients with Type II Slap Tear

BACKGROUND: Low-level lasers may occasionally replace surgery or medications without adverse effects, so studying them stands to reason. It heals, regenerates tissue, reduces inflammation, discomfort, and boosts immunity. Research is continuing. It may help physical therapy, healthcare, and the community by being cost-efficient, simple, and successful. OBJECTIVE: To compare the effects of low-level laser therapy and routine physical therapy on shoulder pain, functional disability, and range of motion in patients with Type II SLAP tear. METHODS: It was a Randomized Controlled Trial conducted at Physical therapy department, Sialkot Medical and Physiotherapy Center Branches Pasroor and Sambrail. The estimated sample size is 52, and adjusting for an expected 20% dropouts, the sample size was 62, allocated 31 in each group. Both male and female patients with Age between 50-70 years having Type II SLAP tear, Visual analogue scale (VAS) score above 3 and the patients diagnosed by physician, orthopedic physician or surgeon or rheumatologist were included. The included patients were allocated in group A, routine physical therapy, and Group B low level laser. All the patients were assessed at baseline, at 4th week of Treatment and at 8th week of Treatment for pain, shoulder pain and disability index and shoulder ranges. RESULTS: The results regarding age showed mean and standard deviation to be 1.8387±.77875 in routine physical therapy group while 1.8065±.79244 in low level laser therapy group. The comparison of mean SPADI total score at 8th week of assessment it was found to be respectively 58.3226±4.57083 and 50.3871±4.85577 with a significant mean difference of 7.935 in favor of low-level laser therapy as shown by p value 0.000. Other outcome measures including pain and shoulder ranges were also significantly improved in low level laser therapy group, p value < 0.05. CONCUSSION: The findings of the study concluded that low level plays the therapy is significantly more effective improving pain disability and shoulder range of motions in patients with slap tear, except for abduction range of motion which was improved equally in both groups. Moreover, within routine physical therapy and low-level laser therapy group showed significant improvement at pre and post level of assessment except that of total shoulder and pain disability index score which was not improved significantly in routine physical therapy group without combination of low-level laser therapy.

Improving the Format, Content, and Writing Process of Outpatient Clinic Letters Within a Musculoskeletal Therapy Department.

Outpatient clinic letters are recognized as an important component of patient care. This project aimed to coproduce clinic letters that have meaning and relevance for key stakeholders. This health care improvement project was conducted in one musculoskeletal therapy (physiotherapy and osteopathy) department in southern England using a Lean Six Sigma Define, Measure, Analyze, Improve, and Control-inspired framework. The views and experiences of key stakeholders, including therapists, general practitioners, and patients, were explored using surveys and group meeting methods. New letter designs were coproduced with stakeholders, including patient partners and personalized care lead staff, and were refined through a pilot phase. Qualitative data were analyzed thematically, and quantitative data were analyzed descriptively. Overall, patients and therapists found the clinic letters an important and meaningful part of care. However, therapists reported that they often did not write the letters, and time was identified as the main barrier. The main theme identified from patient feedback was that patients wanted to write the letters in collaboration with the clinician. The pilot phase demonstrated that, on average, the new letters took less time to write. This project has coproduced new clinic letters and operational processes centered on the needs of key stakeholders. This article will help other outpatient departments reflect on their own clinic letters and consider their meaning and relevance for their stakeholders.

물리치료 전공 학생의 자아존중감과 인권 의식이 인권 태도 미치는 영향

The purpose of the study is a descriptive research study to investigate the impact of physical therapy students' self-esteem and human rights awareness on human rights attitudes. A total of 153 students enrolled in the Department of Physical Therapy were analyzed. The research tool was a total of 60 questions including self-esteem, human rights awareness, and human rights attitude. Statistical analysis was performed using SPSS 24.0, using descriptive statistics, correlation analysis, and multiple regression analysis methods. The results showed that in the correlation analysis, there was a positive correlation between self-esteem and cognitive human rights attitude, and between human rights awareness and emotional human rights attitude. As an influencing factor, self-esteem influenced cognitive human rights attitude, and human rights awareness, presence of university human rights education, and presence of human rights defender role were observed. etc. were confirmed to have an impact on emotional human rights attitudes, and the explanatory power of each was at the level of 41%. Based on the above results, we would like to emphasize the need to increase the diversity of educational contents that can increase human rights attitudes in the university curriculum for health and medical personnel to grow as professionals.

Benefits of a 12-week pulmonary rehabilitation programme in interstitial lung diseases: 1 year post completions

Objectives Evidence on the efficacy of Pulmonary Rehabilitation in the management of ILD is growing. Despite studies reporting benefits, few studies have investigated the long-term effects in such patients, resulting in a call for such research. Therefore, this study aimed to evaluate the effectiveness of a 12-week PR programme on exercise tolerance, quality of life and physical activity, 6- and 12-months post completion. Design An observational, prospective, quasi experimental type of study. Setting Out-Patient Physiotherapy Department. Participants 60 participants diagnosed with Interstitial Lung Disease. Intervention A 12week PR programme was delivered with outcome measures assessed throughout the programme and at the 28th and 52nd week. Main Outcome Measures 6-min walking distance test, Dyspnoea Borg Scale, St George’s Respiratory Questionnaire and Hospital Anxiety and Depression Score were measured. Results Maintenance of effects was noted in SGRQ scores p = 0.005 on completion of the 12week programme, depression scores (p = 0.038 at week 28 and p = 0.008 at week 52) and BODE index resulting in a statistically significant improvement at the 52nd week (p = 0.017). Benefits of in the 6MWT were maintained at 28week but had a statistically significant decline at 52weeks post completion (p = 0.013). Dyspnoea scores increased post completion of the 12week PR programme at both the 28th week (p = 0.008) and 52nd week (p = 0.005). Conclusion Improvements were maintained up to 1 year post completion in most outcome measures or else showed benefits till the 52week.

Retrospective Evaluation of Neurosurgery Outpatient Services in 3 Different Tertiary Care Hospitals in Turkey

IntroductionCascading of referrals to health institutions aims to increase the balanced distribution and quality of health services provided. Although health institutions in Turkey are divided into steps in terms of scope, there is no mandatory referral system for patient application. MethodPatients admitted to the neurosurgery outpatient clinic of three different hospitals in the first week of September 2023 were analysed. The patients complaints, the reasons for referral to the outpatient clinic, by whom or by which system, the department to which they should have applied and the necessity of the operation were examined to evaluate. Results671 applications were made to the neurosurgery outpatient clinic in 3 different health institutions. The average examination time per patient was 6 minutes. Surgical treatment was planned for only 14.8% of the patients. Most patients were referred to physical therapy and neurology departments from neurosurgery. Only 59% of the patients came to the examination by making an appointment, while 41% were examined without an appointment. The ratio of inappropriate admissions to total admissions in these three health institutions was 85.1%. ConlusionOnly a minority of patients admitted to the neurosurgery outpatient clinic at a public health institution in Turkey were found to require surgery, while the majority were referred to other outpatient clinics. This study underscores the significance of the referral chain in delivering high-quality healthcare services, particularly in the field of neurosurgery.

Effect of Physiotherapy Management of the Post-Traumatic Stiff Elbow: A Case Report

23 years old female who is a student by occupation had a history of a direct fall on her right elbow and injury takes place on her left elbow. After the injury, an orthopedic surgeon and the patient wastreated conservatively. The patient came to the physiotherapy department with a chief complaint of left elbow pain with difficulty in moving the left elbow. On examination, restriction in elbow flexion and extension assortment of motion and tightness of left biceps brachii were seen. The intervention was carried out for 6 sessions per week for 6 weeks. The patient was treated with electrotherapy and exercise therapy. After 6 weeks of intervention pain was reduced (VAS score from 7 to 3), elbow extension range of motion was improved and OES was 20 to 39. This case report results suggest that physiotherapy treatment is important in reducing pain and increasing range of motion and functional ability.

Effects of progressive functional ankle exercises in spastic cerebral palsy, plantarflexors versus dorsiflexors: a randomized trial.

Children with cerebral palsy (CP), even those who have very mild impairment, have lower muscle strength than their typically developing peers. The ankle dorsiflexors (DFs) and plantarflexors (PFs) of children with CP are especially weak. Weakness in the ankle muscles causes problems in functional skills, mobility, and balance in spastic CP (SCP). The aim of this study was to investigate the effects of progressive functional exercises (PFEs) on the DF, PF, or dorsi-plantar flexor (DPF) muscles in children with SCP, specifically, the functional mobility, balance, and maximum voluntary contraction (MVC), and compare the effects of strengthening these muscles individually or combined. This randomized trial was conducted between December 1st, 2018, and May 15th, 2019, at Gazi University, Department of Physiotherapy and Rehabilitation. Randomly assigned into groups were 27 independently ambulant patients with unilateral/bilateral SCP, where PFEs were applied to the DF, PF, or DPF muscles. Muscle tone, balance, and functional mobility were assessed. The MVC was evaluated by surface electromyography. PFEs were performed 4 times a week, for 6 weeks. The spasticity of the PF muscles decreased in all of the groups. PFE of the DF muscles led to an increase in ankle joint range of motion (ROM) and improved functional mobility (p < 0.05). PFE of the PF muscles resulted in improvements in balance and functional mobility (p < 0.05). PFE of the DPF muscles brought about improvements in balance but not in functional mobility (p < 0.05). No significant difference in the MVC was observed in any of the groups (p > 0.05). Gains are obtained according to the function of a muscle group. By training the DF muscles, it is possible to improve function and ROM. Furthermore, training the PF muscles led to improvements in balance and functional mobility, indicating that it is possible to bring about positive changes in spastic muscles. This study showed that muscle groups must be exercised according to the intended goal.

Efficacy of upper limb training on grip strength and muscle activity in individuals with type 2 diabetes: a feasibility study

Abstract The upper limb (UL) is one of the important target for musculoskeletal complications in patients with diabetes. The objective of this trial was to measure the feasibility and clinical effectiveness of upper limb training on grip strength and muscle activity in individuals with Type 2 Diabetes mellitus (T2DM). A parallel three-arm randomised controlled trial (RCT) was employed. Fifty-seven patients with T2DM aged between 35 to 60 years were recruited based on eligibility criteria and asked to visit the outpatient department (OPD) of physiotherapy. They were randomly allocated into 3 groups; resistance training (RT) group; sensorimotor training (SMT) group; and control group with the help of a computer-generated random number table. Primary outcome measures were recruitment rate, outcome measure, retention rate, adherence, and acceptability of the intervention to assess trial feasibility. The efficacy of training on grip strength and on activation of deltoid, bicep and triceps brachii after 6 weeks was measured using a JAMAR hand dynamometer and S4-channel Neurostim EMG/NCV/EP system, respectively. The feasibility of recruitment rate of participants was 72.15%, outcome measures feasibility was 81%, retention rate of participants was 81% and intervention adherence was 91.34% for RT group &amp; 87.41% for SMT group. Most of the participants were satisfied with the given intervention as the acceptance rate was high. Between and within-group analysis of muscular activity and strength shows a significant difference as the P-value was &lt; 0.05. RT group shows maximum improvement in both outcome measures. This study was feasible and well accepted by participants. Therefore, it is possible to perform a fully powered RCT and to use upper limb training in the future for good clinical management in type 2 diabetic population. This trial was registered under the Clinical Trial Registry of India (CTRI) with registration no. CTRI/2021/06/034188.

Comparison of Conventional Physical Therapy with and Without Maitland Thoracic Manipulation in Shoulder Impingement Syndrome Patients. A Randomized Controlled Trial (RCT)

The most typical cause of shoulder or sub acromial pain was impingement syndrome. Between 6.7 and 66.7% of people reported having shoulder pain at some point in their lives, and this frequency increases with age, reaching its peak around 50. The most frequent causes of shoulder pain were rotator cuff disease and adhesive capsulitis, both of which may present with the same signs but differ in the results and consequences of particular therapeutic approaches. Various therapies, such as joint mobilization and therapeutic exercises targeted at particular shoulder tissues, were employed in current practice to treat shoulder pain, but their efficacy was limited.The Mayo hospital in Lahore's OPD physiotherapy department hosted this blinded, controlled trial. In this study, two groups of 40 participants were randomly chosen. Static conservative exercise treatment was used to treat the subjects in Group A. The individuals in Group B received Maitland Thoracic Manipulation as part of a conservative exercise therapy regimen. Each patient signed a Performa, and informed consent was obtained from them all. The Neer Impingement test and a self-made and peer-reviewed questionnaire were both utilized to collect data and determine the prevalence of shoulder impingement syndrome.The findings of this study demonstrated that Maitland manipulation was more successful for treating Shoulder Impingement syndrome than conservative therapy alone.Impingement syndrome was the most common cause of shoulder or sub acromial pain. The incidence of shoulder pain was ranging from 6.7 to 66.7% which increase in frequency as age progresses, peaking at 50 years of age. Rotator cuff pathology and adhesive capsulitis were the most common causes of shoulder pain, may exhibit same findings but with variety of outcomes and effects to specific treatment strategies. In current practice, different interventions were used for treating shoulder pain, such as joint mobilization and therapeutic exercises, directed at specific tissues of the shoulder, but the effectiveness of these treatment options were limited.According to the study, conservative physical therapy combined with Maitland Mobilization and Manipulation is more effective at treating shoulder impingement discomfort and produces greater results than conservative physical therapy alone.

Comparison of Effectiveness of Maitland’s Mobilizations at End-Range Versus Within Pain-Free Joint Range of Movement in Treatment of Patients with Frozen Shoulder RCT

Maitland’s mobilizations are an important treatment option for treating patients with Frozen shoulder or Adhesive capsulitis of shoulder joint. In this study we compared the efficacy of Maitland’s mobilization at end-range of tissue resistance with high intensity glides i.e. High Grade with low intensity glides i.e. Low grade within pain free range of joint movement. The study was conducted at OPD of Department of Physical Therapy, Mayo Hospital, Lahore. In this study total of 57 patients were taken and only 36 patients were selected after assessing on inclusion criteria. Those 36 patients were divided into 3 groups with 12 patients in individual group. With the joint close to its neutral position, translation and distraction techniques were used to begin mobilization techniques in the fundamental starting positions. Numeric Pain Rating Scale (NPRS) and SPADI scales were used for measuring pain and disability index. ROMs were measured before, during and after treatment course i.e. at Day 1, after 2 weeks and after 4 weeks respectively. Statistical analysis was done on SPSS using ANOVA. When the ranges were compared by using ANOVA on SPSS it was evident that Group A patients showed better treatment outcomes as compared to other two groups. P-value (0.000) less than 0.05 is considered significant for group A patient. Mean of demographic data also support the fact that AC is more common in women than man. As a result of this study we can conclude that all treatment options gave good results in enhancing range of motion (ROM) and decreasing pain in shoulder joint but high-grade mobilization techniques applied at end range gave a significant treatment outcome on Ranges when compared. Numeric Pain Rating Scale (NPRS) and SPADI scales

Comparing the Effects of Post Facilitation Stretching and Active Release Technique on Pain, Pain Pressure Threshold and Patients Satisfaction in Upper Trapezius Trigger Points

Purpose: Trigger points are localized, hyperirritable areas term as “Knots” and are palpable in taut band of muscle fibers, tendon or a ligament. To compare the effects on Post facilitation stretching and Active release technique on pain, pain pressure threshold and level of patients’ satisfaction in upper trapezius trigger points.&#x0D; Methodology: It was a quasi-experimental study with sample size of 30 and convenient sampling was used. Inclusion criteria of study were females and males of age 25 to 40 years, positive jump sign and persistent pain for more than 4 months. Study setting was the physical therapy departments of private hospitals of Faisalabad and Lahore. Study duration was 6 months. Out of 30 patients 15 were enrolled in group-A (baseline therapy and Post facilitation stretching) and remaining 15 were enrolled in group-B (baseline therapy and Active release technique). Pain pressure threshold was measured by algometer, Intensity of pain was assessed by NPRS before and after the treatment of one week and patient satisfaction was measure by PSQ-18 after the treatment. Data was analyzed by software SPSS 24. Demographic data and test statistics was presented in form of tables.&#x0D; Findings: Out of 30 patients, 33.3% were male and 66.7% were females. Wilcoxon Signed-Rank Test for within-group analysis revealed a significance difference (p≤0.05) in NPRS and PPT before and after the treatment in both groups. Mann-Whitney U test for between-group analyses showed the p&gt;0.05, which means that no significant differences was observed in results produced by Post facilitation stretching in group A and Active release technique in group B.&#x0D; Recommendations: A significantly reduction in the pain intensity and enhancement in pain pressure threshold was observed in both groups. Both Post facilitation stretching and active release techniques were equally effective in reducing intensity of pain, improving pain pressure threshold in upper trapezius trigger points and patients of both groups showed equally satisfaction level after the treatment. Informed by targeted intervention theories, the study utilized rigorous research methodologies for validation. Practitioners are advised to undergo specialized training for PFS and ART application, ensuring a tailored approach per individual needs. Policymakers should set stringent licensing standards and promote continued research to bolster the techniques' efficacy and widespread adoption.

Relationship between personality traits and hazard perception in the clinical setting: a study of male university students in the Department of Physical Therapy

Relationship between personality traits and hazard perception in the clinical setting: a study of male university students in the Department of Physical Therapy

Hip Flexors Shortening among Patients with Low Back Pain

Purpose: Determine the hip flexors shortening in individuals with low back pain.&#x0D; Methodology: It was descriptive cross-sectional study. A total of 255 participants were included according to the selection criteria. Non-probability sampling technique was used to select participants. Inclusion criteria of the study were the patients of age between 18 to 65 years having low back pain from a period of 3 months or more. Exclusion criteria were the individuals with history of spinal trauma, joint dysfunction in past 3 months, any congenital deformity in hip or lumbar region, any history of fracture in related joints in previous 6 months and history of abdominal, hip or lumbar surgery in previous 3 months. Study settings include OPD of DHQ hospital, Gujranwala and Physical therapy department of Gondal hospital, Gujranwala. Study was completed within 4 month. Thomas test was used to assess hip flexors shortening. A structured questionnaire was used to collect participants’ relevant data. Data was analysed by SPSS version 20.&#x0D; Findings: Mean age of the patients was 40.10±12.31 and mean body mass index was 27.44±6.10. Out of 255 patients, 35.7% were male and 64.3% were females. 64.3% participants were housewife, 20.8% were labour and 14.9% were worker. Thomas test was found to be positive in 63.5% patients of low back pain and negative in 36.5% patients. Chi square shows that (p&gt;0.05) there was no significant association between participants’ gender and the results of Thomas test. But a statistically significant association was found between gender and occupation (p&lt;0.05).&#x0D; Recommendations: In conclusion, hip flexor shortening was prevalent in patients of low back pain. The prevalence of hip flexor muscles shortening was found to be 63.5%. There was no statistical significant association of participants’ gender with hip flexor shortening. However, statistical significant association was found between gender and occupation of the participant with low back pain. The relationship of hip flexor shortening with various conditions should be evaluated in future research with a bigger sample size, diverse populations, and different age groups. It is suggested that future research look at the prevalence of hip flexor shortening in those without LBP. To stop people's muscles from shortening in general, several awareness programmes for posture advice and muscle stretching practices should be set up.

Effects of positional release technique on myofascial trigger points of the upper trapezius in computer users having forward head posture

Background: Forward head posture is associated with the upper trapezius myofascial trigger points and cause pain, restricted range of motion, and referred pain in the arm. The positional release technique is likely to focus on evaluating the efficacy of this manual therapy approach. Objective: To determine the effects of positional release technique for myofascial trigger points of the upper trapezius with forward head posture Method: A randomized control trial study was conducted in the Physiotherapy Department of THQ Hospital Wazirabad, Pakistan, from February 2021 to June 2021 with a sample size of n=32 male participants. Participants were recruited with pain intensity of at least 3 points on the Visual Analogue Scale at baseline, at least one active TrP in the upper trapezius that was diagnosed using the method described by Travel and Simon, and computer users who spend at least 6 hours per day in a sitting posture and are between the ages of 18 and 45. All subjects were randomly and equally allocated into the Positional Release Therapy (PRT) group and a conventional Physical Therapy group. A total 12 treatment sessions were given with 3 days a week for consecutive 4 weeks. The data was collected at the baseline and after the 12th session. The outcome measures for trigger point sensitivity were pain pressure threshold (PPT), visual analogue scale (VAS), active contra lateral flexion (ACLF), cranio-vertebral angle (CVA), and neck disability index (NDI). Data analysis was done through SPSS version-27. Results: The mean age of 34.3±6.57 years. The positional release therapy post-intervention results showed more significant improvement (p≤0.05) in all outcomes PPT, VAS, ACLF, CVA, and NDI between the groups with large effect size. Conclusion: Positional release therapy (PRT) is superior to conventional therapy in decreasing pain intensity and threshold with disability in patients of upper trapezius trigger points Keywords: cranio-vertebral angle; forward head posture; neck disability index; pain pressure threshold; positional release therapy; trigger points; upper trapezius; visual analogue scale.

Evaluation of the factors affecting the learning process of the physiotherapy and rehabilitation department students' continuing education and training in the hybrid education model from the student's perspective

Amaç: Bu çalışmanın amacı, sağlık eğitimi alanında giderek yaygınlaşan hibrit eğitim modeli ile eğitime devam eden fizyoterapi ve rehabilitasyon bölümü öğrencilerinin öğrenme sürecini etkileyen faktörleri kendi bakış açıları ile değerlendirmektir.&#x0D; &#x0D; Yöntemler: Çalışmaya 18-25 yaş aralığında, Fizyoterapi ve Rehabilitasyon bölümünde, hibrit eğitim modeli ile eğitim öğretime devam eden ve çalışmaya katılmaya gönüllü olan öğrenciler dahil edildi. Öğrenme sürecini etkileyen faktörleri değerlendirmek amacıyla yazarlar tarafından hazırlanan 28 sorudan oluşan anket formu kullanıldı. &#x0D; &#x0D; Bulgular: Çalışmaya 12 farklı üniversitede Fizyoterapi ve Rehabilitasyon eğitimine devam eden 388 (%80,66) kadın, 93 (%19,33) erkek olmak üzere toplam 481 öğrenci katıldı. Öğrencilerin 127’si (%26,4) 1. sınıf, 60’ı (%12,5) 2. sınıf, 132’si (%27,4) 3. sınıf ve 162’si (%33,7) 4. sınıfta eğitim öğretime devam ediyordu. Öğrencilerin, yüz yüze derslerde, online derslere göre hiç bilmedikleri konuları daha kolay ve kalıcı şekilde öğrendikleri, videolar ile yaptıkları sık ve bol tekrarların öğrenme üzerinde kalıcılık yarattığı belirlendi. Yüz yüze yapılan uygulamalı derslerde, öğretim elemanı tarafından zamanında sağlanan geribildirimlerin öğrenme üzerinde kolaylaştırıcı etki sağladığı görüldü. Arkadaşları ile birlikte oluşturdukları sosyal ortamların öğrenme sürecini desteklediği, derslere katılım zorunluluğu bulunmamasının öğrenme sürecinde kolaylaştırıcı etkiye sebep olduğu görüldü. Ders sırasında kullanılan görsel materyallerin yanı sıra, online dersler sırasında dersi anlatan öğretim elemanının kamerasının açık, sesinin net olmasının ve pozitif ifade ile dersi anlatmasının öğrencilerin konuyu öğrenmeleri üzerinde olumlu katkısı olduğu belirlendi. &#x0D; &#x0D; Sonuç: Bu çalışmanın sonucunda, hibrit eğitim modelinin öğrencilerin öğrenme süreci üzerinde kolaylaştırıcı pek çok faktörü bünyesinde barındırdığı, sağlık bilimleri alanında kullanılmasının öğrenme sürecine olumlu katkılar sağladığı görülmektedir. Öğrencilerin bakış açılarına göre öğrenme sürecine olumlu yönde katkı veren yaklaşımların benimsenerek, mevcut uygulamalarda gerekli stratejilerin geliştirilerek, ilerleyen dönemlerde bu stratejilerin etkinliğini araştıran çalışmaların planlanmasının önemli olduğu düşünülmektedir.

Department of Physical Medicine and Rehabilitation-A New Horizon in Saidu Group of Teaching Hospital Swat KPK

Rehabilitation is a term which is generally perceived to be linked into physical therapy, geriatrics, drug addiction, mental disorders or care of individuals with chronic illnesses. The core concept of rehabilitation is poorly understood among the general public and also in medical professionals. In Pakistan, the general perception about rehabilitation is “physiotherapy” because the department previously named the physiotherapy department were now converted to rehabilitation medicine department after availability of FCPS qualified rehabilitationmedicine consultants.

Effects of Virtual Reality Exercises on Chronic Low Back Pain: Quasi-Experimental Study.

Low back pain is a common health problem globally. Based on the duration of pain, it is classified as acute, subacute, or chronic low back pain. Different treatment strategies are available to reduce chronic low back pain. Virtual reality (VR) is a novel approach in back pain rehabilitation. This study aimed to compare the effects of VR games on chronic low back pain. This quasi-experimental study was conducted among 40 patients with chronic low back pain. The data were collected using a nonprobability, convenient sampling technique. Patients visiting the Department of Physiotherapy, Government Services Hospital, Lahore, Pakistan, were recruited and equally divided into 4 groups. Group A received the Reflex Ridge game; group B received the Body Ball game; group C combined the 2 games without back-strengthening exercises; and group D combined the 2 games with back-strengthening exercises. The participants received 8 treatment sessions, with 3 sessions/wk. The outcomes were pre- and posttest measurements of pain intensity, low back disability, and lumbar range of motion. The repeated measurement ANOVA was used for inter- and intragroup comparison, with significance at P≤.05. The study comprised a sample of 40 patients with low back pain; 12 (40%) were female and 28 (60%) were male, with a mean age of 37.85 (SD 12.15) years. The pre- and posttest mean pain scores were 7.60 (SD 1.84) and 4.20 (SD 1.62) in group A, 6.60 (SD 1.776) and 5.90 (SD 1.73) in group B, 6.90 (SD 1.73) and 5.40 (SD 1.07) in group C, and 7.10 (SD 1.53) and 3.60 (SD 0.97) in group D, respectively. The mean pain score differences of group D (combining the Reflex Ridge and Body Ball games with back-strengthening exercises) compared to groups A, B, and C were -.60 (P=.76), -2.30 (P<.001), and -1.80 (P=.03), respectively. Regarding the range of motion, the forward lumbar flexion mean differences of group D compared to groups A, B, and C were 3.80 (P=.21), 4.80 (P=.07), and 7.40 (P<.001), respectively. Similarly, the right lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P=.04), 5.20 (P<.001), and 4.80 (P<.001), respectively. The left lateral lumbar flexion mean differences of group D compared to groups A, B, and C were 2.80 (P<.001), 4.80 (P=.02), and 2.20 (P<.001). respectively, showing significant pre- and posttreatment effects. VR exercises had statistically significant effects on improving pain, low back disability, and range of motion in all groups, but the combination of Reflex Ridge and Body Ball games with back-strengthening exercises had dominant effects compared to the other groups. Iranian Registry of Clinical Trial IRCT20200330046895N1; https://en.irct.ir/trial/46916.

183 Pathfinder emergency response to urgent urinary catheter issues in older adults; a service profile

Abstract Background Older adults are frequent attendees at the Emergency Department (ED) and experience high rates of adverse outcomes following ED presentation. There is growing evidence for alternative care pathways at the time of a low acuity Emergency Medical Services (EMS) call. The Pathfinder service is a collaboration between the National Ambulance Service and acute hospital Occupational Therapy and Physiotherapy Departments. The service responds to low acuity 999/112 calls for people aged 365 years within the hospitals catchment area, including low acuity calls for blocked or dislodged indwelling urinary catheters. Methods A retrospective analysis of the service’s database was completed (1/1/22–26/5/23). All of the patients seen where the reason for 999 call was recorded as ‘blocked catheter’, ‘dislodged catheter’ or ‘urinary issues’, were identified and analysed. Results One hundred patients were identified, with urinary catheter related issues. Of these patients, 70% were male. The average age was 81 years. The average Clinical Frailty Scale score was 7 (severely frail). Ninety One percent of these patients remained at home as a result of the services’ intervention at the time of the 999 call. Of these 91 patients, 54% were classified as ‘treat and discharge’ (no further input or onward referral required), and 37% were ‘treat and refer’ (with onward referral to other services including Hospital Urodynamics Team, Public Health Nursing, GP). Seventy five percent remained at home without representation at 24 hours; 90% at 7 days and 75% at 28 days. Conclusion The Pathfinder service is safely and effectively managing urgent indwelling catheter issues, at the time of a 999 call, in older peoples’ homes instead of the ED. This upskilling project was made possible by excellent cross-organisational collaboration with the Hospital Urology and Urodynamics Department. The next phase of upskilling will focus on the management of urgent suprapubic catheter related issues.

Comparison of Neuromuscular Joint Facilitation and Quadriceps Strengthening Exercise in Knee Osteoarthritis: a Randomized Controlled Trial.

To compare the effect of neuromuscular joint facilitation (NJF) and quadriceps strengthening exercises on pain, physical function, static posture, and balance control in subjects with knee osteoarthritis. Randomized controlled trial. Department of Physiotherapy, Manipal Hospitals, Bangalore. Subjects diagnosed with knee osteoarthritis according to the American College of Sports Medicine criteria. The mean age of subjects in the control group was 63.12 ± 8.08 years; in the experimental group was 61.77 ± 8.46 years. The intervention group received NJF treatment twice a week for six weeks, and the control group received quadriceps strengthening exercises. Standard knee exercises were given as a home program to both groups. Numeric Pain Rating Scale (NPRS), 30-second chair stand (30s-CST), and single leg stance (SLS) were used to assess physical function, static posture, and balance control, respectively, at the end of the sixth week. Sixty subjects were randomly allocated to intervention and control groups. The experimental and control group showed a mean difference of 3.89 and 4.17 in NPRS, 4.19 and 4.17 in 30s-CST, 6.81 and 5.71 in SLS at the end of six weeks. This change was significant within both groups (p value .000) and not significant between groups (NPRS p value .303; 30s-CST p value .09; SLS p value .525) at the end of six weeks. NJF and quadriceps strengthening exercises effectively reduced pain and improved physical function, static posture, and balance control in subjects with knee osteoarthritis. Both groups had the same effect on all clinical variables at six weeks of follow-up. Hence, further studies with long term follow-up are warranted.