Physical Therapy Exercise Program Research Articles

Effect of hip abductors training on pelvic drop and knee valgus in runners with medial tibial stress syndrome: a randomized controlled trial

BackgroundMedial tibial stress syndrome (MTSS) is a prevalent running-related injury that could impact athletic performance and quality of life. The purpose of the study was to investigate the effectiveness of functional hip abductor strength training on reducing contralateral pelvic drop angle (hip frontal plane projection angle), and dynamic knee valgus (knee frontal plane projection angle) in runners with medial tibial stress syndrome (MTSS).MethodsForty male and female recreational runners were diagnosed with MTSS for at least one month. The age ranged from 25 to 35 years old, and the body mass index (BMI) ranged between (18.5 and 25 kg/m2) participated in this study. This was a single-blind, randomized controlled trial. Participants were randomized into two groups: a control group (Group A, n = 20) received a selected physical therapy exercise program, and an experimental group (Group B, n = 20) received the same program plus functional hip abductor strength training. Dynamic knee valgus (frontal plane projection angle) and contralateral pelvic drop angle were measured using 2D video and analyzed by Kinovea software at baseline and after 8 weeks. Mixed-effect multifactor analysis of variance (MANOVA) was conducted to compare within and between groups effects on FPPA and pelvic drop angle.ResultsAfter 8 weeks, Group B exhibited a significantly decreased frontal plane projection and pelvic drop angles compared to Group A (p < 0.05). Group A also demonstrated a reduced pelvic drop angle, but to a lesser extent, and their frontal plane projection angle increased.ConclusionsThis study demonstrates that 8 weeks of functional hip abductor strength training, combined with traditional physical therapy, effectively improves lower extremity kinematics in runners with MTSS by reducing dynamic knee valgus and contralateral pelvic drop. This targeted approach likely addresses underlying muscle weakness and movement dysfunction, offering hope for potentially reducing MTSS recurrence.Trial registration: clinicaltrials.gov. NO: NCT05637476. Date: December 1, 2022.

Outcomes of a consultant physiotherapy upper limb clinic: reducing the patient journey through early access to specialist care

Background: Many patients referred into secondary care for a ‘surgical opinion’ do not have a surgical target. Aims: An intermediate care consultant physiotherapy upper limb clinic was set up to reduce the patient journey and deliver the right advice/treatment at the first point of assessment. Method: A clinic was set up to: enable an expert clinical assessment; deliver education to the patient regarding diagnosis, treatment options and likely outcomes; arrange appropriate imaging; and deliver care on the day (advice, specialist physiotherapy, injection or splinting). This creates a proactive approach to waiting list management and ensures early management for patients. Results: Complete data from the first 173 patients seen are presented. A total of 99.5% had treatment delivered on the day. Waiting times were reduced by a mean of 3.5 months for appointment, and 27 weeks for physiotherapy input. All received on-the-day expert physiotherapy advice, exercise programmes and progression advice. Oxford Shoulder Score improved by 17.5 (mean). QuickDASH scores improved by 34.72 (mean). Patient satisfaction was extremely positive. Conclusion: The clinic has been successful at shortening the patient journey, reducing the burden on secondary care and delivering best care in a timely manner.

Comparative Effects of Core Neuromuscular Training versus Conservative Physical Therapy to Reduce Pain and Improve Functional Performance in Patients with Patellofemoral Pain Syndrome

Running, stair climbing, jumping and squatting represent a few of the activities that can cause patellofemoral pain syndrome. Patellofemoral pain syndrome (PFPS) is one of the most typical causes of anterior knee discomfort in teenagers and persons below Sixty. Objective: To contrast the results of conservative physical treatment plus core neuromuscular training and conservative physical therapy alone. Methods: It was a quasi-experimental study in which patients suffering from patellofemoral pain syndrome were selected on the basis of convenience sampling from Government hospitals of Faisalabad after meeting the inclusion and exclusion criteria. Twenty patients with patellofemoral pain syndrome were divided into Group A and Group B at random. Participants of Group A performed neuromuscular core training plus conservative physical therapy exercise program for 4 weeks while participants of group B performed conservative physical therapy exercise alone for 4 weeks. Data were analyzed by SPSS version 27.0. Results: Following therapy, the pain level was substantially reduced in both of the groups (P &lt; 0.05) with Intervention group showing better results. Similarly, there was improvement in scores of Kujala questionnaire in both groups after treatment (P&lt; 0.05) but the results of Intervention group were comparatively better. Conclusions: There is significant effect of core neuromuscular training plus conservative physical therapy as compared to conservative physical therapy alone.

What are the effects of aquatic physiotherapy exercises on speed and complex gait-related activities in individuals with Parkinson's disease?

Parkinson's disease (PD) is a central nervous system disease that results in deficits in motor activities such as walking. Gait speed and step length are frequently reduced. Aquatic physiotherapy serves as a form of complementary treatment to promote improvements in the disease's motor symptoms. The purpose of this study was to examine the effect of an aquatic physiotherapy training program on gait in individuals with PD. This is an interventional clinical study in which a group of participants with PD participated in an assessment on the ground of their usual and maximum gait speed using the 10-m Walk Test and complex activities related to gait using the Dynamic Gait Index (DGI) at baseline and 12 weeks of an aquatic physiotherapy intervention, twice a week for 50 min. For statistical analysis, the paired t-test and the Wilcoxon test were used. The study included 10 individuals with PD, in the intermediate stage of PD - H&Y 2 (60%) and 3 (40%), of both sexes with a mean age of 65.8 ± 13.69 years. There was a significant increase in usual gait speed (p = 0.001) and in the DGI score (p = 0.05), but there was no improvement in maximum gait speed (p = 0.119). The aquatic physiotherapy exercise program improved habitual gait speed and the performance of complex activities related to gait in this group individuals with PD.

Exercises Program in Breast Cancer Patient with Chemotherapy Induced Peripheral Neuropathy: A Case Study

Background: Breast cancer is one of the most common cancers in women worldwide, accounting for approximately 570,000 deaths in 2015. Over 1.5 million women (25% of all women with cancer) are diagnosed with breast cancer every year throughout the world. One of the most common complications after breast cancer surgery is functional limitation of the upper body. Up to 67% of breast cancer patients experience arm or shoulder impairment, including pain, numbness, loss of strength, and reduced ROM, after surgery. Breast cancer patients are presenting with chemo-induced peripheral neuropathy (CIPN) that is impacting their balance, quality of life, and overall participation, as a side effect of chemotherapy treatment. Study Design: This case study was used to highlight the role of physical therapy interventions in the management of Breast cancer patient after surgery with chemo-induced peripheral neuropathy. Case Description: A 55-years-old Saudi female, known case of diabetes mellitus on insulin, hypertension and history of DVT 27 years back on anticoagulant. She came to the combined clinic breast clinic and all workup and investigations were done and showed invasive ductal carcinoma. Referred to physical therapy department by breast and endocrine clinic for left shoulder limited range of motion, impaired mobility and managing the symptoms. PT Management and Outcome: The patient received 2 phases of rehabilitations, phase 1 the patient was seen once a week for 4 weeks, phase 2 the patient was seen 3 times per week for 6 weeks. Exercise program of patient education, therapeutic exercise of low- to - moderate intensity resistance exercise for UE and LE. Aerobic Exercise; Cardio bike progressive training for UE and LE and balance exercise. By the end of phase 1 patient’s ROM and pain improved significantly, and by the end of phase 2 of the rehabilitation program, patient’s balance (using BBS), functional ability and QOL using (FACT-B) improved. Discussion: This case study showed that physical therapy exercise program including therapeutic exercises, low- to moderate- intensity resistance exercise, aerobic exercise, balance exercise is an effective program for breast cancer patients as it improves CIPN, minimize dependency and improved QOL.

Effect of Aerobic Exercise Versus Vestibular Stimulation on Lipid Profile in Premenstrual Syndrome

Objective: To determine the effect of aerobic exercise versus vestibular stimulation on lipid profile in premenstrual syndrome. Subjects and Methods: Sixty patients with premenstrual syndrome had regular menstrual cycles were participated in this study. Their ages were ranged between 23-30 year. Their body mass index did not exceed 30 kg/ m2. They were not participating in physical therapy exercise program at the last 3 months. Patients with cardiovascular problems, pulmonary problems and endometriosis are excluded from the study. All patients were divided randomly into two equal groups (A&amp;B). Group A: It consisted of thirty patients with premenstrual syndrome. They were treated by aerobic exercises in the form of treadmill training at moderate intensity of 60- 70% of the maximum heart rate, 3 times per week for 2 months. Group B: It consisted of thirty patients with premenstrual syndrome. They were treated by vestibular stimulation, 3 times per week for 2 months. Outcome measures: Total cholesterol level, HDL, LDL, triglycerides were assessed for all patients before and after treatment in both groups (A&amp;B). Premenstrual syndrome scale was used to confirm the diagnosis of PMS before study and to evaluate the severity of PMS symptoms for all patients in both groups (A&amp;B) before and after treatment. Results: Results revealed that, between groups; pretreatment, there was no significant difference between both groups A and B in total cholesterol, triglycerides, HDL, LDL and premenstrual syndrome scale. While post treatment, there was significant difference between both groups A and B in total cholesterol, triglycerides, HDL, LDL and premenstrual syndrome scale (with favour of group A; more decrease in total cholesterol, triglycerides, LDL and premenstrual syndrome scale and more increase in HDL). Conclusion: Aerobic exercise was found to be effective more than vestibular stimulation on lipid profile in premenstrual syndrome, in relieving stress and symptoms of PMS.

Edukasi Program Latihan Fisioterapi Pada Penderita Stroke Di Posyandu Lansia Desa Sanggung

One of the health problems is stroke. Stroke is a disease affecting the body's movement and functional systems which is the main factor in neurological disorders. Stroke is the second highest cause of death and the third leading cause of disability at world level. Stroke can affect the whole body such as paralysis, impaired cognitive function, difficulty speaking, emotional difficulties, pain and problems in daily life activities. Posyandu Ngudi Saras is one of the posyandu for the elderly in Sanggung Village. There is a shortage of physiotherapists in this place, which is one of the obstacles faced by residents in Sanggung Village. Apart from that, there is a lack of education about physiotherapy exercise programs, especially for stroke sufferers. This can be seen from the patient not continuing the exercise program at home so that his condition worsens and when carrying out activities he depends on other people. Based on these problems, we offer a solution by providing education about physiotherapy exercise programs from sitting to standing and from standing to walking to patients and families. This physiotherapy exercise program is useful for increasing the patient's independence in carrying out activities, especially when walking and standing. Activities are carried out door to door in the homes of stroke sufferers and with an interpersonal approach. Community service through this form of educational activity has been carried out and can increase the knowledge of stroke sufferers and their families.

194 Weekend warrior: a structured self-directed physiotherapy exercise programme that enhances weekend exercise in older persons inpatient rehabilitation

Abstract Background Strength and mobility exercise improve functional recovery in older persons rehabilitation. Internal audits and patient feedback show that exercise levels are lower on weekends where no physiotherapy service is available. Weekend physiotherapy intervention reduces length of stay in older persons rehabilitation. Additional interventions may be cost-effective, improve function and quality of life on discharge. This quality improvement project investigates the effect of a structured, self-directed weekend exercise programme on perceived exercise levels and satisfaction with weekend exercise levels. This project also investigates the workload of the programme for ward staff. Methods Surveys were completed after patients’ first weekend of admission. Patients self-reported time spent exercising at the weekend and their satisfaction. Weekend Warrior programmes (WWP) were given on week two of admission. Programmes matched manual handling guidelines with a traffic light system (seated = red, standing independently = amber, walking independently = green). Patients completed follow-up surveys after completing 3–4 weeks of WWP. Surveys were given to healthcare assistants to assess WWP workload burden. Results Before completing WWP, patients’ (n = 23) self-assessed exercise times were: 0-10mins exercise n = 8;10-20mins n = 7; 20-30mins n = 6 and &amp;gt; 40mins n = 2. N = 9 reported satisfactory exercise levels on weekends. After completing WWP, patients (n = 17) self-assessed exercise times were: 0-10mins n = 1; 10-20mins n = 11 and 20-30mins n = 5. N = 11 reported satisfactory exercise levels on weekends. N = 14 patients enjoyed participating in WWP. All staff (n = 6) reported that WWP did not significantly increase workload burden and supported the programme’s continuation. No adverse events were reported. Conclusion Weekend Warrior structured, self-directed exercise programme is safe and feasible in this setting. Patients reported enjoying WWP. This programme did not additional workload burden for ward staff.

Paper 66: Short-Term Outcomes in Hip Arthroscopy Patients Participating in Formal Physical Therapy vs a Home Exercise Program: A Prospectively Enrolled Cohort Analysis

Objectives: The treatment of femoroacetabular impingement (FAI) has evolved over the last two decades, transitioning from an open hip dislocation to a more minimally invasive arthroscopic approach as the gold standard for treatment. The non-surgical management of FAI has evolved as well, and a key mainstay of the treatment paradigm for FAI has become physical therapy, both in the preoperative and postoperative periods. Previous research has demonstrated the importance of physical therapy in reducing pain and improving function in patients with FAI. As FAI treatment has changed, the delivery of patient physical therapy and rehabilitation has similarly changed, specifically with the introduction of home exercise programs that are patient-driven methods of postoperative rehabilitation. While other areas of orthopaedic surgery, such as shoulder and knee arthroplasty, have demonstrated similar results when comparing formal physical therapy programs with home-based programs, a comparable study has yet to be conducted specifically in the hip arthroscopy patient population. Given this lack of investigation, the purpose of this study was to compare the short-term outcomes of a formal physical therapy program or a home exercise program (HEP) in FAI patients treated with hip arthroscopy. Our hypothesis was that individuals in both groups would report similar outcomes at short- term follow up and would be significantly improved from their preoperative baselines. Methods: Patients undergoing hip arthroscopy for the treatment of FAI at a single center from October 2020 to October 2021 were prospectively enrolled. Inclusion criteria were 1) completion of a preoperative survey, 2) age greater than 18 years at time of surgery, and 3) lack of previous hip surgery. Patients were allowed to self-select to a formal physical therapy (FPT) program, which consisted of a traditional physical therapy course, or a home exercise program (HEP). Patients were administered a survey preoperatively and at 1 month, 3 months, 6 months, and 12 months postoperatively. Included in the survey was a single assessment numeric evaluation (SANE), visual analogue scale (VAS) pain scores, the International Hip Outcome Tool-12 (iHOT-12), the Patient-Reported Outcomes Measurement Information System Physical Function (PROMIS PF), and patient satisfaction of physical therapy and their overall care. Demographic characteristics were collected from the electronic medical record. Statistical analysis was conducted using descriptive statistics, unpaired and paired t-tests, and Chi Square and Fisher’s Exact tests for categorical variable comparisons. A p-value of &lt; 0.05 was used to indicate statistical significance. Results: A total of 147 patients were included in this study, with 61 in the FPT group and 86 in the HEP group. There were no significant differences regarding patient sex (p = 0.675) and body mass index (p = 0.188), though the HEP group was slightly older than the FPT group (33.6 ± 9.5 years vs 30.1 ± 11.4 years; p = 0.048). At 12 months postoperative, no significant differences were reported between the FPT and HEP groups regarding hip function rated as a percent of normal (p = 0.576), VAS pain scores at rest (p = 0.262) or during activities of daily living (p = 0.214) or during sport (p = 0.066), PROMIS PF scores (p = 0.426), and iHOT-12 scores (p = 0.421). Furthermore, no differences were reported in patient satisfaction (p &gt; 0.05). Outcome scores at 12 months postoperative were significantly improved from the preoperative baseline across all measures in both groups (p &gt; 0.05). Conclusions: For patients undergoing hip arthroscopy for the treatment of FAI, formal physical therapy and home exercise programs are similarly efficacious in terms of patient-reported outcomes of hip function, with both rehabilitation options resulting in significant patient improvement at short term follow-up from their preoperative baseline. [Table: see text][Table: see text]

Proximal to distal posture correction protocol for IT band friction syndrome in female amateur runners

Iliotibial band friction syndrome is an overuse knee injury that is more common in runners. In IT band syndrome, pain, and tenderness are present over the lateral aspect of the knee. It is more common in females because of physiological and anatomical factors. The objective of this research was to determine and compare the effect of proximal to distal postural correction protocol with conventional physiotherapy program for IT band friction syndrome in female amateur runners. This study included 150 female amateur runners with IT band friction syndrome based on inclusion and exclusion criteria. Then the subjects were randomly allocated into group A and group B by simple random sampling method. Group A was given proximal to distal postural correction protocol and for group B conventional physiotherapy exercise program was given. Outcome measures used were a visual analog scale, postural assessment, tenderness assessment by palpation and Ober’s test. Pre and post-assessment of the above measures was taken to conform the results. The results showed a statistically significant effect of the proximal to distal postural correction protocol as compared to a conventional exercise program for IT band friction syndrome in female amateur runners. There was a significant reduction in pain (&amp;lt;0.0001) in individuals in group A than the group B. Postural abnormalities in IT band friction syndrome were also significantly (&amp;lt;0.0001) resolved and the Ober’s test came as 76% negative out of 100%positive patients. Based on results, it was concluded that the proximal to distal postural correction protocol is effective in female amateur runners.

CAN SMART PHONE VIDEO-BASED POSE ESTIMATION ACCURATELY CLASSIFY LOW BACK PHYSIOTHERAPY EXERCISES VIA MACHINE LEARNING?

Access to health care, including physiotherapy, is increasingly occurring through virtual formats. At-home adherence to physical therapy programs is often poor and few tools exist to objectively measure low back physiotherapy exercise participation without the direct supervision of a medical professional. The aim of this study was to develop and evaluate the potential for performing automatic, unsupervised video-based monitoring of at-home low back physiotherapy exercises using a single mobile phone camera.24 healthy adult subjects performed seven exercises based on the McKenzie low back physiotherapy program while being filmed with two smartphone cameras. Joint locations were automatically extracted using an open-source pose estimation framework. Engineered features were extracted from the joint location time series and used to train a support vector machine classifier (SVC). A convolutional neural network (CNN) was trained directly on the joint location time series data to classify exercises based on a recording from a single camera. The models were evaluated using a 5-fold cross validation approach, stratified by subject, with the class-balanced accuracy used as the performance metric.Optimal performance was achieved when using a total of 12 pose estimation landmarks from the upper and lower body, with the SVC model achieving a classification accuracy of 96±4% and the CNN model an accuracy of 97±2%.This study demonstrates the feasibility of using a smartphone camera and a supervised machine learning model to effectively assess at-home low back physiotherapy adherence. This approach could provide a low-cost, scalable method for tracking adherence to physical therapy exercise programs in a variety of settings.

Effect of Multicomponent Exercise Program on Temporomandibular Joint Dysfunction in Oral Cancer Survivors

Introduction: Cancer is the second most cause of mortality among which oral cancer is the most prevalent form. In temporomandibular joint dysfunction (TMJD), patients present with pain, restricted mouth opening, poor posture, facial asymmetry, diminished strength, altered breathing patterns, decreased deglutition, and poor eating habits The objective of this research was to determine and compare the effect of a multicomponent exercise program with conventional physiotherapy program for TMJD in oral cancer survivors. Materials and Methods: This study included 100 participants with TMJD based on inclusion and exclusion criteria. Then, the subjects were randomly allocated into Group A and Group B by a simple random sampling method. Group A was given a conventional physiotherapy exercise program and for Group B multicomponent exercise program was given. Outcome measures used were a Visual Analog Scale, assessment of range of motion (ROM) and manual muscle testing (MMT) and the American Academy of Orofacial Pain questionnaire. Pre- and post-assessment of the above measures was taken to confirm the results. Results: The results showed a statistically significant effect of the multicomponent exercise program as compared to a conventional exercise program for TMJD in oral cancer survivors. There was a significant reduction in pain (&lt;0.0001) in individuals in Group B than in Group A. Restriction in the ROM and improvement in MMT were also significantly (P &lt; 0.0001) resolved and the facial symmetry, breathing patterns as well as swallowing difficulty were also improved. Conclusion: On the basis of the results, it can be concluded that the Group B who followed the multicomponent exercise program showed better improvement in pain intensity, ROM, facial symmetry, muscle strength, breathing pattern and in swallowing as compared to Group A. Similarly utilizing a multifaceted patient-centered approach has been proven to be effective and lead to successful recovery of the temporomandibular joint function in oral cancer survivors.

Physiotherapy Exercise Classification with Single-Camera Pose Detection and Machine Learning.

Access to healthcare, including physiotherapy, is increasingly occurring through virtual formats. At-home adherence to physical therapy programs is often poor and few tools exist to objectively measure participation. The aim of this study was to develop and evaluate the potential for performing automatic, unsupervised video-based monitoring of at-home low-back and shoulder physiotherapy exercises using a mobile phone camera. Joint locations were extracted from the videos of healthy subjects performing low-back and shoulder physiotherapy exercises using an open source pose detection framework. A convolutional neural network was trained to classify physiotherapy exercises based on the segments of keypoint time series data. The model's performance as a function of input keypoint combinations was studied in addition to its robustness to variation in the camera angle. The CNN model achieved optimal performance using a total of 12 pose estimation landmarks from the upper and lower body (low-back exercise classification: 0.995 ± 0.009; shoulder exercise classification: 0.963 ± 0.020). Training the CNN on a variety of angles was found to be effective in making the model robust to variations in video filming angle. This study demonstrates the feasibility of using a smartphone camera and a supervised machine learning model to effectively classify at-home physiotherapy participation and could provide a low-cost, scalable method for tracking adherence to physical therapy exercise programs in a variety of settings.

A six-week physical therapy exercise program delivered via home-based telerehabilitation is comparable to in-person programs for patients with burn injuries: A randomized, controlled, non-inferiority clinical pilot trial

BackgroundExercise programmes are essential for burn rehabilitation, however patients often have barriers accessing these services. Home-based telerehabilitation (HBT) may be an alternative. This study aimed to determine if exercise programs delivered via HBT were as effective as in-person (IP) programs with respect to clinical outcomes and participant and therapist satisfaction. MethodsA single center, randomized, controlled, non-inferiority pilot trial with blinded assessment was undertaken. Forty-five adults with ≤ 25% total body surface area (TBSA) burns were randomized to receive a 6-week exercise program delivered either by HBT or IP. The primary outcome was burn-specific quality of life (Burn Specific Health Scale – Brief). Secondary outcomes included health-related quality of life, burn scar-specific outcomes, exercise self-efficacy, pain severity, muscle strength and range of motion (ROM). Participant and therapist satisfaction, technical disruptions and adverse events were also recorded. ResultsWe found no significant within- or between-group differences for any outcome measures except ROM. Achievement of full ROM was significantly different between groups at Week 12 (IP=100% vs HBT=70%, p = 0.005). Non-inferiority was inconclusive. Participant satisfaction was high (median ≥ 9.8/10), with no significant between-group differences. Therapist satisfaction was high (median ≥ 8.9/10), major technical disruptions low (8%) and no adverse events reported. ConclusionHBT is a safe, effective option to deliver exercise programs for patients with burn injuries ≤ 25% TBSA with comparable clinical outcomes to in-person programmes. Ongoing research is required to further analyze ROM and investigate the effectiveness of HBT for patients with larger burns.

Effect of adding a supervised physical therapy exercise program to photobiomodulation therapy in the treatment of cervicogenic somatosensory tinnitus: A randomized controlled study.

Objectives:To evaluate the effectiveness of adding a supervised physical therapy exercise program to photobiomodulation therapy (PBMT) in the treatment of cervicogenic somatosensory tinnitus (CST).Methods:Forty patients suffering from CST with age 45–55 years were included in the study. They were assigned randomly into 2 groups, 20 per each. (Study group) Group (A) received a supervised physical therapy exercise program in addition to 20 minutes PBMT with a 650-nanometer wavelength and a 5 milliWatt power output, spot size of 1 cm2, and energy density of 6 Joules, 3 sessions per week for 8 consecutive weeks, plus traditional medical treatment. While (control group), group (B) received the same PBMT protocol, 3 sessions per week for 8 consecutive weeks in addition to the traditional medical treatment. Tinnitus visual analog scaling (VAS), tinnitus handicap inventory (THI), and cervical range of motion (ROM) were measured at baseline and after 8 weeks.Results:Mixed MANOVA showed a statistically significant reduction in tinnitus VAS, THI, and a significant improvement in cervical ROM (flexion, extension, right bending, left bending, right rotation, and left rotation) in favor of Group A (P < .05). There was a significant decrease in posttreatment VAS treatment (P > .001) MD [−2.05(−2.68:−1.41)], and THI relative to pretreatment mean difference [−5.35(−8.51: −2.19)] and a significant increase in posttreatment neck ROM in Groups A and B relative to pretreatment neck ROM (P > .001). Flexion range posttreatment MD[3.65(1.64:5.65)], Extension MD [6.55(1.35:11.75)], right bending MD[3.8(2.51:5.08)], left bending MD[1.75(0.19:3.3)], right rotation MD [3.5(1.28:5.71)] and left rotation [2.75(0.67:4.82)].Conclusions:Adding a supervised physical therapy exercise program to PBMT showed positive and beneficial effects in the treatment of CST using VAS, THI, and Cervical ROM assessment tools.

A-03 Physical Therapy Compared to a Home Exercise Program for Protracted Pediatric Sport-Related Concussion Rehabilitation

Abstract Purpose: The purpose of this study was to compare the recovery time in days between protracted recovery (greater than or equal to 28 days since injury) patients who were prescribed physical therapy and those who were prescribed a home exercise program. We hypothesized that physical therapy would be associated with shorter recovery times relative to the home exercise program. Methods: The 159 participants (aged 8–18) were drawn from an ongoing study. This study was a retrospective cohort design of sports-related concussion patients with a protracted recovery who presented to an outpatient specialty concussion clinic between 2018 and 2021, with data collected from electronic medical records. Both prescribed physical therapy (PPT) and home exercise program (HEP) patients were provided vestibular/ocular motor rehabilitation exercises to be completed at home three times per day. PPT participants must have completed at least three PPT sessions, or they were excluded from the study. Multi-variable zero-truncated negative binomial regressions were used to evaluate associations between groups. Results: Among the 48 (30.2%) PPT and 111 (69.8%) HEP participants, the majority were female (57.9%), age was 15.3 ± 1.4 (PPT) and 14.2 ± 2.8 (HEP), and days to clinic was a median 6.0 (IQR = 3.0–27.0; PPT) and 7.0 (IQR = 3.0–23.0; HEP). After adjusting for demographic (age, sex) and clinical measures (concussion history, convergence, VOMS score, and days to clinic), PPT was associated with an additional 1.21 days (95% CI: 1.06, 1.39) than HEP. Conclusions: We unexpectedly found that PPT was not associated with a shorter recovery time relative to HEP. Future research should explore this hypothesis while aiming to evaluate the effect of PPT versus HEP using a randomized design.

Caregiver Perspectives on Physiotherapy Treatment for Paediatric Burns in the United Arab Emirates.

BackgroundPhysiotherapy is an essential component of paediatric burn treatment. Children are admitted to the paediatric burn unit with their caregivers who play a vital role in supporting the child’s post-burn physiotherapy management.ObjectiveThe objective of the study is to determine caregivers’ attitudes on physiotherapy treatment for children with burns in the UAE. This study focused on the caregiver’s perspective on five important domains: caregiver’s knowledge, burden, attitude, adherence to physiotherapy exercise program, and caregiver’s satisfaction.MethodsA descriptive cross-sectional study was conducted using self-administered questionnaire. Fifty caregivers were eligible to participate in the study. The analyses of the survey responses were done using SPSS software. Descriptive analysis and correlation statistics were used to present the data.ResultsThe caregiver participants in the study reported to have reasonably good knowledge about the paediatric burns care (13.62 ± 3.49) and had a positive attitude towards the physiotherapy treatment provided to the children with the burn injuries (9.41 ± 1.56). The adherence to the prescribed exercise regimen of physiotherapy sessions was found to be good (11.88 ± 1.50) but were overburdened with the caregiving tasks (21.42 ± 11.62). The study demonstrated very high levels of satisfaction among the caregivers with the physiotherapy treatment sessions provided to the children (13.4 ± 1.83).ConclusionCaregiver attitude regarding physiotherapy management was overall positive; caregivers were well aware of the importance of physiotherapy and have reported high levels of satisfaction with the paediatric burn physiotherapy management.

Effectiveness of Physiotherapy in Patients with Ankylosing Spondylitis: A Systematic Review and Meta-Analysis.

This study aimed to evaluate the safety and effectiveness of non-pharmacological interventions supervised by a physiotherapist in patients with Ankylosing Spondylitis, PROSPERO Protocol number CRD42020209453. Five databases (PubMed, PEDro, Scopus, Web of Science Core, and EMBASE) and reference lists with relevant articles were searched. Randomised controlled trials (RCTs) on the effectiveness of non-pharmacological interventions supervised by a physiotherapist were compared with usual care or home-based exercise programmes. Two investigators independently screened eligible studies. A total of 12 RCTs satisfied eligible criteria. The risk of bias ranged between medium and high. The meta-analysis results indicated that between supervised physiotherapy and usual care, the former was significantly associated with improvement in disease activity (standardised mean difference = −0.37, 95% CI, −0.64; −0.11; p < 0.001, I2 = 71.25%, n = 629), and functional capacity (standardised mean difference = −0.36, 95% CI, −0.61; −0.12, p < 0.05; n = 629). No statistically significant differences emerged when interventions were compared with home-based exercise programmes. Supervised physiotherapy is more effective than usual care in improving disease activity, functional capacity, and pain in patients with ankylosing spondylitis. No significant improvements emerged when supervised physiotherapy and home-based exercise programmes were compared. Further investigation and RCTs with larger samples are needed.

Prognosis in the Functional Status of Children with Duchenne Muscular Dystrophy with Physiotherapy and Yoga Exercise Protocols – A Randomized Controlled Trial

Context: Duchenne muscular dystrophy (DMD) is a progressive neuromuscular disease leading to destruction of the skeletal muscles, causing limitations in the activities of daily living, and ambulation at a later stage. Aims: The present study intended to identify the effect of add-on yoga with physiotherapy intervention compared to physiotherapy exercise program on the functional status of children with DMD. Settings and Design: A randomized controlled study was conducted at the physiotherapy center of a tertiary care hospital. Subjects and Methods: The study recruited 124 boys diagnosed with DMD who were randomly divided into two groups. Group I received home-based physiotherapy exercise program and was advised to perform twice daily for all days of the week. Group II was advised to perform physiotherapy and yoga at home. Functional status of the participants was assessed using muscular dystrophy functional rating scale (MDFRS) and timed functional test (TFT), taken at baseline, and on regular intervals of 3 months, up to 1 year. Statistical Analysis Used: Repeated measures ANOVA, Fisher's least significant difference analysis, and t-test analysis were used for statistical analysis. P &lt; 0.05 was considered statistically significant. Results: Eighty-eight participants completed the entire study with 45 in Group I and 43 in Group II. Significant time effect was demonstrated in both the groups for MDFRS (P &lt; 0.05) and TFT (P &lt; 0.01) measures, demonstrating beneficial effects of treatment protocols of both groups. Conclusions: The study identified that the combined yoga and physiotherapy interventions were as effective as physiotherapy alone.

Progressive exercise compared with best practice advice, with or without corticosteroid injection, for the treatment of patients with rotator cuff disorders (GRASP): a multicentre, pragmatic, 2 × 2 factorial, randomised controlled trial

SummaryBackgroundCorticosteroid injections and physiotherapy exercise programmes are commonly used to treat rotator cuff disorders but the treatments' effectiveness is uncertain. We aimed to compare the clinical effectiveness and cost-effectiveness of a progressive exercise programme with a single session of best practice physiotherapy advice, with or without corticosteroid injection, in adults with a rotator cuff disorder.MethodsIn this pragmatic, multicentre, superiority, randomised controlled trial (2 × 2 factorial), we recruited patients from 20 UK National Health Service trusts. We included patients aged 18 years or older with a rotator cuff disorder (new episode within the past 6 months). Patients were excluded if they had a history of significant shoulder trauma (eg, dislocation, fracture, or full-thickness tear requiring surgery), neurological disease affecting the shoulder, other shoulder conditions (eg, inflammatory arthritis, frozen shoulder, or glenohumeral joint instability), received corticosteroid injection or physiotherapy for shoulder pain in the past 6 months, or were being considered for surgery. Patients were randomly assigned (centralised computer-generated system, 1:1:1:1) to progressive exercise (≤6 sessions), best practice advice (one session), corticosteroid injection then progressive exercise, or corticosteroid injection then best practice advice. The primary outcome was the Shoulder Pain and Disability Index (SPADI) score over 12 months, analysed on an intention-to-treat basis (statistical significance set at 1%). The trial was registered with the International Standard Randomised Controlled Trial Register, ISRCTN16539266, and EuDRACT, 2016-002991-28.FindingsBetween March 10, 2017, and May 2, 2019, we screened 2287 patients. 708 patients were randomly assigned to progressive exercise (n=174), best practice advice (n=174), corticosteroid injection then progressive exercise (n=182), or corticosteroid injection then best practice advice (n=178). Over 12 months, SPADI data were available for 166 (95%) patients in the progressive exercise group, 164 (94%) in the best practice advice group, 177 (97%) in the corticosteroid injection then progressive exercise group, and 175 (98%) in the corticosteroid injection then best practice advice group. We found no evidence of a difference in SPADI score between progressive exercise and best practice advice when analysed over 12 months (adjusted mean difference −0·66 [99% CI −4·52 to 3·20]). We also found no evidence of a difference between corticosteroid injection compared with no injection when analysed over 12 months (−1·11 [–4·47 to 2·26]). No serious adverse events were reported.InterpretationProgressive exercise was not superior to a best practice advice session with a physiotherapist in improving shoulder pain and function. Subacromial corticosteroid injection provided no long-term benefit in patients with rotator cuff disorders.FundingUK National Institute for Health Research Technology Assessment Programme.