Physiotherapy Recommendations Research Articles

PHYSIOTHERAPY RECOMMENDATION, COACHING AND ACCURACY MEASURING USING KINECT SENSOR

PHYSIOTHERAPY RECOMMENDATION, COACHING AND ACCURACY MEASURING USING KINECT SENSOR

ASSESSMENT OF KNOWLEDGE, ATTITUDE, AND PRACTICE TOWARDS OSTEOPOROSIS SCREENING AMONG PRIMARY HEALTH CARE PHYSICIANS IN PRIMARY HEALTH CARE CENTERS IN MAKKAH AL-MOKARRAMAH CITY, 2023. (ACROSS SECTIONAL STUDY)

Background:Osteoporosis, a silent disease characterized by decreased bone density and increased fracture risk, poses a significant public health challenge. This study aims to investigate the knowledge, attitudes, and practices of Primary Health Care (PHC) physicians in MakkahAl-Mokarramah regarding osteoporosis screening. Osteoporosis is a multifactorial skeletal disorder with increasing prevalence, especially in regions with an aging population, such as Saudi Arabia. Understanding the current state of awareness and practices among PHC physicians is essential for early detection and intervention. Method:This study employs a cross-sectional design and targets PHC physicians in Makkah Al-Mokarramah in 2023. The sample size was calculated, and participants were selected through simple random sampling. Data was collected using a structured electronic questionnaire with sections on demographics, knowledge, attitudes, and practices related to osteoporosis screening. Results: The study focused on PHC physicians, with a significant proportion below the age of 30 and a university-level education. The gender distribution was nearly even, with a focus on both males and females. Regarding knowledge, the majority of participants exhibited adequate knowledge (58%) of osteoporosis, while 19.2% had poor knowledge, and 22.8% had proper knowledge. There were notable knowledge gaps, especially among those with poor knowledge. Regarding attitude,most participants believed that osteoporosis is a major health concern (85.2%) and that it is preventable (83.6%). Confidence in screening and managing osteoporosis varied based on knowledge levels, with those having proper knowledge expressing the highest confidence. Regarding practice, the study revealed variations in participants practices related to osteoporosis, including calcium and vitamin D supplementation, physiotherapy recommendations, participation in continuous medical education, and the use of tools like FRAX. Conclusion: The study reveals that while there is general awareness of osteoporosis, there are significant knowledge gaps among PHC physicians. Attitudes toward prevention are positive, but these attitudes must be translated into concrete practices, such as improved dietary habits and physical activity. We recommend further research initiatives and calls for both government and non-government organizations to intensify their efforts in promoting preventive programs, particularly tailored to the needs of the population. Overall, the study contributes to the understanding of osteoporosis awareness and behaviors, offering a foundation for public health interventions in this domain.

Arterial thromboembolism in a feline without cardiac changes: Case report

Arterial thromboembolism (ATE) is a clinically challenging condition that affects feline health, with a higher incidence in cats with heart disease. This case report presents a less common scenario, where a four-year-old feline with no history of heart problems was diagnosed with ATE. The animal was treated at a Veterinary Center in the city of São Paulo (Brazil), in a state of emergency, with complaints of acute paraplegia and intense pain in the pelvic limbs. Before the event, the cat was in good health, with normorexia, normodipsia, normuria and normochesia. Analgesia and sedation were performed to control pain and provide better assessment, and the absence of superficial or deep pain was identified in both pelvic limbs during the physical examination. The patient was referred to hospitalization for pain control, blood collection, imaging and cardiological tests for screening. Through tomography, a mass (thrombus/embolus) was identified in the right iliac artery. During the entire hospitalization period, the patient underwent specific protocols for ATE and, after stabilization of the condition, surgical thrombectomy intervention was indicated. The procedure occurred without complications, and the patient remained hospitalized for another 2 (two) days for evaluation and evolution of the clinical condition, being released with assisted discharge, physiotherapy recommendations and weekly returns for definitive discharge.

A Retrospective Cohort Study of Effects of Physiotherapy in Rehabilitation in Post Covid-19 Patients

Background: The coronavirus pandemic elucidated how a single highly infectious virus can overburden the health care system of highly developed nations. Elderly people and those with an underlying health condition are considered to be more at risk of developing severe symptoms and have a higher risk of physical deconditioning during their hospital stay & post-COVID-19. Objective: To describe the importance and assess the effects of Physiotherapy in rehabilitation in Post Covid-19 Patients in full recovery Method: This retrospective cohort study was determined to witness the evidence of the primary outcome of quantifying Dyspnea (through the Dyspnea grading scale), SpO2levels, and oxygen requirement of the patient. The secondary outcome included assessment and evaluation of functional activity using various scales such as the Functional mobility scale (FMS), Functional Independence Measure (FIM), and Rating of Perceived Exertion (RPE) at the time of admission and the end of the rehabilitation program. Results: Using the mentioned scales, data on each patient, O2 support, mobility status, and independence regarding ADLs have all improved gradually over the study period, as evidenced by the outcomes that were revealed by our statistical analysis. By the completion of the rehabilitation program, precisely 92.30% of patients were on room air, 73.33% gained no Dyspnea, 86.67% achieved full activity, 53.33% gained complete independence of ADLs,and 40.00% gained no exertion with physical activity. Conclusion: The study revealed concrete proof of the efficacy of the physiotherapy recommendations accompanied by the significant results derived through the above variable study scores. Additional research is required, to support these preliminary findings. Keywords: Physiotherapy, Rehabilitation, COVID-19, Respiratory support.

The Obstacles that encounter Jordanian Citizens to Adhere to Physiotherapy Sessions

Aim. to know the obstacles that encounter patients in Jordan to adhere to physical therapy treatment. Material and Method. A survey was developed based on the available literature reviews. A pilot survey was tested on a small sample of physiotherapy clients at one center to assess time and the ease of completion. After the pilot survey was completed, the survey was revised and modified, and the final electronic version was developed. Results. The study found varied level of adherence to the physiotherapy sessions, and adherence to the physiotherapist recommendations. The adherence to physiotherapy sessions was about 54.3% ranged between 61.9% in governmental sectors, and 80% in private sectors. However, the adherence to physiotherapy recommendations was lesser as be estimated to be about 50% (66.7% in governmental sectors, and 60% in private sectors). Conclusion. This Study indicates that there are varieties of reasons that encounter Jordanian citizens to adhere to physiotherapy sessions. One of the main reason in private center is based on cost of session but there are lot of reasons that limiting adhere the session related to the patients states and Circumstances in both private and government, since we could not determine the actual main cause of non-adhere.

The impact of a physician's recommendation and gender on informed decision making: A randomized controlled study in a simulated decision situation.

ObjectiveThis study examined the influence of physicians’ recommendations and gender on the decision‐making process in a preference‐sensitive situation.MethodsN = 201 participants were put in a hypothetical scenario in which they suffered from a rupture of the anterior cruciate ligament (ACL). They received general information on two equally successful treatment options for this injury (surgery vs physiotherapy) and answered questions regarding their treatment preference, certainty and satisfaction regarding their decision and attitude towards the treatment options. Then, participants watched a video that differed regarding physician's recommendation (surgery vs physiotherapy) and physician's gender (female vs male voice and picture). Afterwards, they indicated again their treatment preference, certainty, satisfaction and attitude, as well as the physician's professional and social competence.ResultsParticipants changed their treatment preferences in the direction of the physician's recommendation (P < .001). Decision certainty (P < .001) and satisfaction (P < .001) increased more strongly if the physician's recommendation was congruent with the participant's prior attitude than if the recommendation was contrary to the participant's prior attitude. Finally, participants’ attitudes towards the recommended treatment became more positive (surgery recommendation: P < .001; physiotherapy recommendation: P < .001). We found no influence of the physician's gender on participants’ decisions, attitudes, or competence assessments.ConclusionThis research indicates that physicians should be careful with recommendations when aiming for shared decisions, as they might influence patients even if the patients have been made aware that they should take their personal preferences into account. This could be particularly problematic if the recommendation is not in line with the patient's preferences.

Rekomendasi Fisioterapis Pada Pasien Low Back Pain Kronis

Background: Low Back Pain (LBP) chronic is a health problem that not only involves biomechanical factors but also involves cognitive, psychological, and social factors. The last decade has seen a shift in understanding in chronic case management that can affect physiotherapy recommendations for chronic LBP patients to return to work/activities normally. This study aims to determine the related between the characteristics of physiotherapists in Denpasar City and Badung Regency, attitudes and beliefs, as well as a diagnosis of the recommendations given in chronic LBP cases. Methods: The study design was a cross-sectional web-based survey with a total of 124 physiotherapists who are members of the Indonesian Physiotherapy Association (IFI), Central Bali Branch. Characteristics data were collected through a questionnaire, attitudes and beliefs with ABS-mp and PABS-PT, diagnosis and recommendations using a scenario. Data were analyzed using SPSS univariate, bivariate and multivariate. Results: Physiotherapists in Denpasar City and Badung Regency 21.8% have a biopsychosocial orientation. Multivariate analysis showed that the variable that had a significant relationship with physiotherapist recommendations was the personal interaction attitude variable with a value of p = 0.039 (AOR = 6.511, 95% CI = 1.099-38.581). Conclusion: Factors that related on recommendations physiotherapists to return to work/activities normally in patients with chronic LBP are age, work experience, training, personal interaction attitudes, physiotherapy beliefs, and physiotherapy diagnosis

99 Safer Mobility: Practice vs Preach

Abstract Background Activity levels in older people undergoing inpatient rehabilitation are low. Intervention by the rehabilitation team amounts to 2% of a patient’s day. Interdisciplinary working helps to ensure that therapy continues beyond the physiotherapy gym. However, safe handling is required. Aims Examine the awareness of ward staff of the mobility status of their patients. Investigate if staff on a general geriatric rehabilitation ward are compliant with physiotherapy mobility recommendations. Methods Data collection took place on a general geriatric rehabilitation ward from February to March 2019. Staff Awareness was assessed by individually asking ward staff (Nurses and Health Care Assistants) to identify the mobility status of their patients. Their responses were recorded and compared with the physiotherapy mobility recommendations as per the MDT (multi-disciplinary) communication whiteboard. The mobility status of each patient was observed by means of random visual audits. Observations were recorded and subsequently compared to the physiotherapy mobility recommendations as above for compliance. Results For the staff awareness audit, 95 responses were obtained from 10 different staff members. 50.5% of responses (n=48) correctly identified patients’ mobility status. 49.5% (n=47) incorrectly identified patients’ mobility status. From 10 visual audits, a total of 196 patient observations were recorded. In 37.2% (n=73) of observations, patients were not mobilising as per physiotherapy recommendations. 39.3% (n=77) of observations were as recommended. In 23.5% (n=46) of observations, patients were not mobilised at all. Conclusion There was limited awareness among ward staff of the mobility status of their patients. Over 1/3 of patients were not mobilised as per physiotherapy recommendations. These findings can compromise both patient and staff safety. The visual audit also highlighted low physical activity levels in some patients. Implications for clinical practice include the need for education on safer mobility and the promotion of patient physical activity at ward level. Physiotherapy led educational and practical handling sessions for ward staff have proven to be beneficial in this regard.

Application of Standardised Yoga Protocols as the Basis of Physiotherapy Recommendation in Treatment of Sleep Apneas: Moving Beyond Pranayamas.

Yoga is an ancient Indian practice of mental and physical exercises (syn: asanas), postures (syn: mudras), movements and breathing techniques which sustain healthy living of the body and the mind. It incorporates various exercises of breathing, oropharyngeal structures and facial expressions, the physiology and effect of which are comparable to international physiotherapy recommendations in treatment of obstructive sleep apnea (OSA) i.e. to preserve upper airway patency by maintaining airway dilator muscle tone. Preliminary results show that yoga can be an effective and constructive alternative to physiotherapy for sleep apnea and snoring patients. To compare the physiotherapy recommendations in snoring patients with various yoga exercises postures. To determine the efficacy of yoga in treatment of sleep apnea. To formulate a standardized yoga protocol for universal usage in sleep apnea. We studied the available literature on physiotherapy recommendations for OSA and yoga asanas involving the nasal, oropharynx and facial structures and perceived a noteworthy similarity in physiological basis of both. A set of these yogasanas were put together and patients presenting with snoring and diagnosed with mild to moderate sleep apnea were presented and encouraged to perform the standardized set of yoga exercises for a period of 3months. A total of 23 patients were recommended yoga protocols as initial form of treatment in snoring and mild to moderate sleep apnea. Clinical and statistically significant improvement gauzed by recommended score chart was discerned in majority of subjects. The results were comparable to the efficacy of existing physiotherapy regimen published in international literature. The benefits of yoga in sleep disorders go beyond the scope of measured outcomes. Standardizing the protocols for yoga in treatment for snoring and sleep apnea is the need of the hour. Further studies on efficacy of yoga need to be performed to understand its full realm of potential.

Influence of physiotherapy on patients’ quality of life after decompressive surgery of lumbar spine stenosis

Physiotherapy after lumbar spine stenosis surgery should be an integral process of treatment. It is a process whose goal is patient 's return to optimal fitness in the safest way. The aim of this study was to determine whether patients after surgery apply to physiotherapy recommendations, and estimate the impact of exercise on the quality of life. The study involved 58 patients, mean age 52.33 ± 14.12. The quality of life of the patients was measured using the WHOQOL-BREF questionnaire. Statistical analysis In the cases where the independent variables were dichotomous, Student's t-test was applied for independent trials, while the equality of variance was controlled with the use of Levene's test. In the cases of independent variables measured on at least the rank level, correlation was established by the Tau b Kendall (tau-b) rank correlation coefficient. In both cases, bilateral statistical significance was the basis. Regularly 31 patients (53.4%) exercise. Only 15 patients (25.9%) reported that they always manage to follow the recommendations on the proper care of the spine. Regularity of exercise correlated with physical (tau-b -,224 for p<0.05, psychological (tau-b -,235 for p<0.05) and environmental health (tau-b -,323 for p<0.01). 1. Influence of physiotherapy on patients' quality of life after decompressive surgery of lumbar spine stenosis was positive. 2.Exercises after surgery performed regularly just over half of the patients. A small percentage of patients followed recommendations concerning proper care of the spine. 3. The results of the analysis of the quality of life of patients were significantly reduced compared to the standards of the Polish population.

Communication style and exercise compliance in physiotherapy (CONNECT): a cluster randomized controlled trial to test a theory-based intervention to increase chronic low back pain patients' adherence to physiotherapists' recommendations: study rationale, design, and methods.

BackgroundPhysical activity and exercise therapy are among the accepted clinical rehabilitation guidelines and are recommended self-management strategies for chronic low back pain. However, many back pain sufferers do not adhere to their physiotherapist’s recommendations. Poor patient adherence may decrease the effectiveness of advice and home-based rehabilitation exercises. According to self-determination theory, support from health care practitioners can promote patients’ autonomous motivation and greater long-term behavioral persistence (e.g., adherence to physiotherapists’ recommendations). The aim of this trial is to assess the effect of an intervention designed to increase physiotherapists’ autonomy-supportive communication on low back pain patients’ adherence to physical activity and exercise therapy recommendations.Methods/DesignThis study will be a single-blinded cluster randomized controlled trial. Outpatient physiotherapy centers (N =12) in Dublin, Ireland (population = 1.25 million) will be randomly assigned using a computer-generated algorithm to either the experimental or control arm. Physiotherapists in the experimental arm (two hospitals and four primary care clinics) will attend eight hours of communication skills training. Training will include handouts, workbooks, video examples, role-play, and discussion designed to teach physiotherapists how to communicate in a manner that promotes autonomous patient motivation. Physiotherapists in the waitlist control arm (two hospitals and four primary care clinics) will not receive this training. Participants (N = 292) with chronic low back pain will complete assessments at baseline, as well as 1 week, 4 weeks, 12 weeks, and 24 weeks after their first physiotherapy appointment. Primary outcomes will include adherence to physiotherapy recommendations, as well as low back pain, function, and well-being. Participants will be blinded to treatment allocation, as they will not be told if their physiotherapist has received the communication skills training. Outcome assessors will also be blinded.We will use linear mixed modeling to test between arm differences both in the mean levels and the rates of change of the outcome variables. We will employ structural equation modeling to examine the process of change, including hypothesized mediation effects.DiscussionThis trial will be the first to test the effect of a self-determination theory-based communication skills training program for physiotherapists on their low back pain patients’ adherence to rehabilitation recommendations.Trial RegistrationCurrent Controlled Trials ISRCTN63723433

Rehabilitation Performance in the New NHS: Modern and dependable?

Summary This paper discusses selected issues in the practice of cardio-pulmonary rehabilitation using the theoretical framework of the national performance programme. Five strategic physiotherapy recommendations are proposed. The principles underlying the recommendations should be applicable to most clinical practice. If implemented, such strategies would allow the profession to realise and achieve the aims of NHS reform. This paper discusses selected issues in the practice of cardio-pulmonary rehabilitation using the theoretical framework of the national performance programme. Five strategic physiotherapy recommendations are proposed. The principles underlying the recommendations should be applicable to most clinical practice. If implemented, such strategies would allow the profession to realise and achieve the aims of NHS reform.