Postural Training Research Articles

Single-Session Cerebellar Transcranial Direct Current Stimulation Improves Postural Stability and Reduces Ataxia Symptoms in Spinocerebellar Ataxia.

Spinocerebellar ataxia (SCA) results in balance and coordination impairment, and current treatments have limited efficacy. Recent evidence suggests that combining postural training with cerebellar transcranial direct current stimulation (ctDCS) can improve these symptoms. However, the combined effects of ctDCS and postural training on individuals with spinocerebellar ataxia remain underexplored. Ten volunteers with (SCA type 3) participated in a triple-blind, randomized, crossover study to receive a single session of ctDCS (2mA for 20min) and a sham ctDCS session separated by at least one week. The Biodex Balance System was used to assess balance at each session, measuring overall stability index, anteroposterior stability index, and medial-lateral stability index. As secondary outcomes, cerebellar ataxia symptoms were evaluated using the 8-item Scale for Assessment and Rating of Ataxia. The assessments were conducted before and after each session. The results indicated that ctDCS enhanced the overall stability index when compared to sham ctDCS (Z = -2.10, p = 0.03), although it did not significantly affect the anteroposterior or medial-lateral stability indices. Compared to the baseline, a single session of ctDCS reduced appendicular symptoms related to cerebellar ataxia, as evidenced by improvements in the nose-finger test (Z = -2.07, p = 0.04), fast alternating hand movements (Z = -2.15, p = 0.03), and heel-to-shin slide (Z = -1.91, p = 0.05). In conclusion, our study suggests that a single session of ctDCS, in combination with postural training, can enhance balance and alleviate ataxia symptoms in individuals with cerebellar ataxia. This study was approved by the local research ethics committee (No. 2.877.813) and registered on clinicaltrials.org (NCT04039048 - https://www.clinicaltrials.gov/study/NCT04039048 ) on 2019-07-28.

Study of musculoskeletal disorders risk factors and discomfort in sculptors in the north of Mexico

BACKGROUND: The sculpting craft must adopt awkward postures that lead to musculoskeletal disorders (MSDs). OBJECTIVE: This study investigated the prevalence of musculoskeletal discomfort (MD) and its associations with postural risk factors, demographics, and work characteristics among sculptors. They were determined the differences between MDs during the weeks of the study. METHODS: A longitudinal study was conducted; MD was investigated using the Cornell Musculoskeletal Discomfort Questionnaire (CMDQ). Posture was assessed using the Rapid Upper Limb Assessment method (RULA). Multivariate logistic regression (MLR) models analyzed associations with different factors. ANOVA was used to test for differences in MD prevalence. RESULTS: The analysis included 585 responses by body region. The prevalence of MD was high in the lower and upper limbs among sculptors (67.6%), with the lower back, upper arm, neck, and knees being the four most affected regions. Gender (female) (OR = 2.15), marital status (married) (OR = 1.80), health risk (obesity), the dual of a secondary job (OR = 1.94), job stress (OR = 2.10), duration of work (OR = 2.01), and difficulty keeping up with work (OR = 2.00) were significant predictors contributing to the occurrence of MD in different body regions. Only shoulder MD prevalence showed significant differences between study weeks. CONCLUSIONS: Sculptors suffer from MD. Demographic and work characteristic factors influence MD prevalence. Postural training, improved adaptation of work organization, and intervention guidance on ergonomic risks may reduce the prevalence of MD and the risk of MSDs in this population.

Examination of sensory reception and integration abilities in children with and without Prader-Willi syndrome

BackgroundGood postural stability control is dependent upon the complex integration of incoming sensory information (visual, somatosensory, vestibular) with neuromotor responses that are constructed in advance of a voluntary action or in response to an unexpected perturbation. AimsTo examine whether differences exist in how sensory inputs are used to control standing balance in children with and without Prader-Willi syndrome (PWS). Methods and ProceduresIn this cross-sectional study, 18 children with PWS and 51 children categorized as obese but without PWS (without PWS) ages 8–11 completed the Sensory Organization Test®. This test measures the relative contributions of vision, somatosensory, and vestibular inputs to the control of standing balance. The composite equilibrium score (CES) derived from performance in all sensory conditions, in addition to equilibrium scores (EQs) and falls per condition were compared between groups. Outcomes and ResultsThe CES was lower for children with PWS compared to children without PWS (M=53.93, SD=14.56 vs. M=66.17, SD=9.89, p = .001) while EQs declined in both groups between conditions 1 and 4 (F (1.305, 66.577) = 71.381, p < .001). No group differences in the percent of falls were evident in condition 5 but more children with PWS fell in condition 6 (χ2 (1) = 7.468, p = .006). Group differences in frequency of repeated falls also approached significance in conditions 5 (χ2 (3) = 4.630, p = .099) and 6 (χ2 (3) = 5.167, p = .076). Conclusions and ImplicationsChildren with PWS demonstrated a lower overall level of postural control and increased sway when compared to children with obesity. Both the higher incidence and repeated nature of falls in children with PWS in conditions 5 and 6 suggest an inability to adapt to sensory conditions in which vestibular input must be prioritized. Postural control training programs in this population should include activities that improve their ability to appropriately weight sensory information in changing sensory environments, with a particular focus on the vestibular system. What does this study add?This study shows that children with PWS demonstrate a lower level of postural stability. The results suggest that children with PWS show inability to adapt to sensory conditions that require prioritizing vestibular information to maintain postural control. This information can be used to help guide training programs in this population.

Effects of Transcutaneous Electrical Nerve Stimulation with Taping on Wrist Spasticity, Strength, and Upper Extremity Function in Patients with Stroke: A Randomized Control Trial.

Objective: Six months after the onset of stroke, over 60% of patients experience upper limb dysfunction, with spasticity being a major contributor alongside muscle weakness. This study investigated the effect of transcutaneous electrical nerve stimulation (TENS) with taping on wrist spasticity, strength, and upper extremity function in patients with stroke. Methods: In total, 40 patients with stroke were included and randomly divided into two groups: the TENS + taping (n = 20, age 52.4 ± 9.3 (range: 39 to 70)) and TENS (n = 20, age 53.5 ± 10.8 (range: 39 to 74)) groups. All subjects performed 30 sessions of task-related training, which included 10 min of postural control training and 20 min of task performance. Additionally, all subjects received TENS on the spastic muscle belly for 30 min before task-related training. In the TENS + taping group, taping was additionally applied to the forearm and wrist but not in the TENS group. The Modified Ashworth Scale was used to measure spasticity, and a handheld dynamometer was used to measure muscle strength. The Fugl-Meyer Assessment of Upper Extremity was used to evaluate the functional ability of the upper extremity. Results: In the TENS + taping group, spasticity and upper extremity function were significantly improved as compared to those in the TENS group (p < 0.05). However, no significant difference in muscle strength was observed between the two groups (p > 0.05). Conclusions: This study demonstrated that the combination of TENS and taping for spasticity and function of the upper extremity was more effective in relieving the spasticity than TENS alone. Therefore, we suggest this combination as an additional treatment for spasticity and function of the upper extremity.

Rehabilitation following Medial Meniscus tear and Lateral Tibial Plateau fracture managed conservatively: A Case Report

Background and purpose: Dashboard injuries with forced lateral rotation of the leg can cause tibial plateau fractures with medial meniscus and ACL injuries. Tibial plateau fractures are difficult to treat and can have devastating effects such as discomfort, deformity, restricted ROM causing early degenerative changes in the knee joint. The purpose of this case report is to explain the physiotherapy intervention options and to assess their success in the conservative management of such injury. Case description: 33-year-old female presented to physical therapy with severe pain over the right knee while standing, unable to bend or straighten the knee and had a feeling of giving away of knee while walking since the time patient experienced a fall from her motorcycle. The condition was managed with supervised and unsupervised physiotherapy for 8 weeks. Intervention consisted of patient’s education about the condition, immobilization, electrotherapeutic modalities, exercise therapy, posture, gait, balance and proprioception training and counselling for 8 weeks, six days a week, for 45–60 minutes each day. Outcome: The patient gained the knee ROM and strength in the lower extremities while achieving all short-term goals. She began ambulating independently and was mobile and autonomous in most situations. Her Oxford knee score improved by 75%. Discussion: It has been demonstrated that physical therapy interventions are helpful in reducing patients' functional limitations. Due to a lack of supporting data, this case report describes specific procedures that were used to reduce functional restrictions caused by a medial meniscus rupture and a lateral tibial plateau fracture. KEYWORDS: Meniscal cartilage, intra-articular fracture, physical therapy, ambulation, functional status.

Main characteristics of preventive postural hygiene training programs in the educational field

Objective: To determine the state of the art regarding preventive training programs on postural hygiene and back health in an educational context. Introduction: The prevalence of non-specific back pain in population reaches alarming figures and its causes are largely preventable. Adequate training in postural education is necessary along students' academic career. Method: Retrospective descriptive study, using the PRISMA method. Results: 61 original articles published from 2017 to 2021 have been analysed. Discussion: Postural education programs have demonstrated their effectiveness and have provided benefits for the participating students.

Effect of Postural Training in Improving Hand Eye Coordination in Autism Children - An Interventional Study

Autism is one of the major developmental delays that affect the children at an early age. It presents as a series of motor and sensory impairments that constantly needs adjustment in posture. Evaluation of motor skills and enhancing it quite often results in postural adjustment. The primary objective of this current study is to investigate the effect of postural training exercises prior to administration of motor activities in improving the hand eye coordination to perform upper limb tasks. The study was a randomised control trial that included children of both sexes with a diagnosis of autism between the age group of 5 and 10. All the participants of the study underwent the pre-test assessment of Gross motor skill and fine motor skill and were entered in the data sheet as pre-test score. The children’s Gross motor skill and Fine Motor Skill were assessed through Box and Block test and 25 grooved peg board test respectively. The test was performed for the dominant hand of the participant. The participants in control group underwent the motor and fine motor activities for a period of 30 minutes each session on alternate days for 8 weeks. The participants in experimental group received postural stability exercises along with these activities. At the end of 8 weeks the results of the study showed significant improvement in the experimental group. The study concluded that postural stability exercises prior to the activities improved the motor and fine motor skill of the autism children. Keywords: Autism, Postural Exercises in autism children, Hand eye coordination, Postural instability.

Comparing the effects of cerebellar and prefrontal anodal transcranial direct current stimulation concurrent with postural training on balance and fatigue in patients with multiple sclerosis: a double-blind, randomized, sham-controlled trial.

Fatigue and balance disorders are common challenges experienced by Multiple Sclerosis (MS) individuals. The purpose of this study was to compare the concurrent effects of cerebellar and prefrontal anodal trans-cranial direct current stimulation (a-tDCS) with postural training on balance and fatigue in MS patients. 51 patients were evaluated to randomly allocation to a-tDCS over cerebellum, a-tDCS over dorsolateral prefrontal cortex (DLPFC) and sham group. 46 individuals (n = 16 in experimental groups and n = 14 in control group) followed treatment. All the groups received 10 sessions of postural training. The experimental groups underwent a-tDCS with a current of 1.5mA for a period of 20min. While, in the sham group, tDCS was only activated for 30s and then turned off. The treatment included 10 sessions for four weeks. Before and after intervention, fatigue and balance were assessed using Fatigue Severity Scale (FSS), Timed Up and Go (TUG) test and Berg Balance Score (BBS), respectively. There was found a significant reduction in fatigue in the group receiving a-tDCS over the prefrontal cortex with postural training compared to the other two groups (P < 0.001). Additionally, a significant improvement was found in balance in the group receiving a-tDCS over the cerebellum concurrent with postural training in comparison to the other two groups (P < 0.001). Besides, in the sham group, the significant results were not reported in the variables. (P > 0.001). The results demonstrated that a-tDCS enhances the effects of postural training on balance and fatigue in MS patients.

Perioperative position management of 46 cases with simultaneous bilateral auricle reconstruction: A summary of experience

ObjectivesThe primary problem in simultaneous bilateral auricle reconstruction is the fragility of the reconstructed ear structure. Postoperative pressure is strictly prohibited to ensure the operation's effectiveness. The study aimed to summarize the experience of perioperative postural management in simultaneous bilateral auricular reconstruction. MethodThis study summarizes the experience of perioperative postural management, providing preoperative sleeping posture adaptability training, neck movement training, standardization of the head position angles and the head suspension time in surgery, using protective headrests, paying attention to the transfer and handover procedures, and using specially designed pillows. ResultsThe comprehensive nursing approach in simultaneous bilateral auricular reconstruction significantly reduced complications, improved patient comfort, and optimized postoperative adaptation. Preoperative posture training, standardized intraoperative head positions, and vigilant postoperative care played pivotal roles, demonstrating positive outcomes in 46 cases. DiscussionPerioperative position management can reduce the risk of complications and pressure injuries, improving patients' postoperative comfort, emotional state, tolerance, and adaptability. ConclusionAll ears were viable and in good shape after long-term follow-up. The experiences discussed in this study can be broadly applied to technically mature ear reconstruction teams.

The Effect of Postural Restoration Institute Training on Selected Kinematic Variables of Lower Limbs and Pelvis During Walking in Middle-Aged Men With Nonspecific Chronic Low Back Pain: A Prospective Observational Study

Background and Aims Concerning the effectiveness of training on people with chronic low back pain, the present study aimed to evaluate the effect of postural restoration institute (PRI) training on lower limb kinematics during walking in middle-aged subjects with discogenic low back pain. Methods In this prospective observational quasi-experimental study, 42 people participated in three groups: people without low back pain (healthy group, n=14) and people with low back pain in two groups (intervention group, n=14; and control group, n=14). Kinematic data were recorded by 7 Qualisys cameras with a frequency of 100 Hz in the pretest and post-test. Analysis of variance with repeated measures was used in SPSS software version 23 at a significance level 0.05. Results The results showed that people with low back pain in the intervention and control groups walk with a slower velocity, lower cadence, and shorter step length than healthy individuals for both right and left limbs. However, after the PRI training, the intervention group showed a significant increase in those three variables. Furthermore, there were significant differences between the healthy group and the two groups of intervention and control in the range of motion (ROM) for the pelvis in the sagittal and frontal planes, the right hip joint in the horizontal plane, the right ankle in the frontal plane, the left hip joint in the sagittal and horizontal planes as well as the left ankle in the sagittal plane. After applying PRI, the differences between the healthy and the intervention groups regarding the pelvis ROM on the sagittal plane, the right ankle ROM on the sagittal plane, the left hip joint ROM on the frontal plane, and the left knee ROM on the sagittal plane were minimized and became insignificant. Conclusion The present study’s findings confirmed the effectiveness of using PRI training in improving biomechanical indicators, such as the range of joint movements and increasing the velocity and step length of walking, to treat and manage the performance of people with discogenic chronic low back pain.

Robotic Postural Training With Epidural Stimulation for the Recovery of Upright Postural Control in Individuals With Motor Complete Spinal Cord Injury: A Pilot Study.

Activity-based training and lumbosacral spinal cord epidural stimulation (scES) have the potential to restore standing and walking with self-balance assistance after motor complete spinal cord injury (SCI). However, improvements in upright postural control have not previously been addressed in this population. Here, we implemented a novel robotic postural training with scES, performed with free hands, to restore upright postural control in individuals with chronic, cervical (n = 5) or high-thoracic (n = 1) motor complete SCI, who had previously undergone stand training with scES using a walker or a standing frame for self-balance assistance. Robotic postural training re-enabled and/or largely improved the participants' ability to control steady standing, self-initiated trunk movements and upper limb reaching movements while standing with free hands, receiving only external assistance for pelvic control. These improvements were associated with neuromuscular activation pattern adaptations above and below the lesion. These findings suggest that the human spinal cord below the level of injury can generate meaningful postural responses when its excitability is modulated by scES, and can learn to improve these responses. Upright postural control improvements can enhance functional motor recovery promoted by scES after severe SCI.

Age-Related Orthostatic Hypotension: A Comprehensive Analysis of Prevalence, Mechanisms, and Management in the Geriatric Population.

Geriatric patients frequently encounter orthostatic hypotension (OH), a multifaceted condition characterized by a significant drop in blood pressure upon assuming an upright position. As the elderly population is particularly susceptible to OH, our review endeavors to comprehensively explore the complex nature of this condition and various factors contributing to its development. We investigate the impact of comorbidities, polypharmacy, age-related physiological changes, and autonomic dysfunction in the pathogenesis of OH. Geriatric patients with OH are faced with an elevated risk of falls, syncope, a decline in their overall quality of life, and hence increased mortality. These implications require careful consideration, necessitating a thorough examination of therapeutic strategies. We evaluate various pharmaceutical and nonpharmacological therapies, delving into the effectiveness and safety of each approach in managing OH within geriatric populations. We explore the role of pharmacotherapy in alleviating symptoms and mitigating OH-related complications, as well as the potential benefits of volume expansion techniques to augment blood volume and stabilize blood pressure. We place particular emphasis on the significance of lifestyle changes and nonpharmacological interventions in enhancing OH management among the elderly. These interventions encompass dietary modifications, regular physical activity, and postural training, all tailored to the unique needs of the individual patient. To optimize outcomes and ensure patient safety, we underscore the importance of individualized treatment plans that take into account the geriatric patient's overall health status, existing comorbidities, and potential interactions with other medications. This review aims to improve clinical practice and patient outcomes by advocating for early detection, properly tailored management, and targeted interventions to address OH in the elderly population. By raising awareness of OH's prevalence and complexities among healthcare professionals, we hope to foster a comprehensive understanding of OH and contribute to the overall wellness and quality of life of this vulnerable demographic.

Development of a motion-based video game for postural training: a feasibility study on older adults with adult degenerative scoliosis.

Forward sagittal alignment affects physical performance, is associated with pain and impacts the health-related quality of life of the elderly. Interventions that help seniors to improve sagittal balance are needed to inhibit the progression of pain and disability. A motion-sensing video game (active game) is developed in this study to monitor sitting and standing postures in real-time and facilitate the postural learning process by using optical sensors to measure body movement and a video game to provide visual feedback. Ten female subjects (mean age: 60.0 ± 5.2 years old; mean BMI: 21.4 ± 1.9) with adult degenerative scoliosis (mean major Cobb's angle: 38.1°± 22.7°) participate in a 6-week postural training programme with three one-hour postural training sessions a week. Eleven body alignment measurements of their perceived "ideal" sitting and standing postures are obtained before and after each training session to evaluate the effectiveness of postural learning with the game. The participants learn to sit and stand with increased sagittal alignment with a raised chest and more retracted head position. The forward shift of their head and upper body is significantly reduced after each training session. Although this immediate effect only partially sustained after the 6-week program, the participants learned to adjust their shoulder and pelvis level for a better lateral alignment in standing. The proposed postural training system, which is presented as a gameplay with real-time visual feedback, can effectively help players to improve their postures. This pilot feasibility study explores the development and initial assessment of a motion-based video game designed for postural training in older adults with adult degenerative scoliosis, and demonstrates the usability and benefits of active gameplay in motor training.

Characterizing the Effects of Adding Virtual and Augmented Reality in Robot-Assisted Training.

Extended reality (XR) technology combines physical reality with computer synthetic virtuality to deliver immersive experience to users. Virtual reality (VR) and augmented reality (AR) are two subdomains within XR with different immersion levels. Both of these have the potential to be combined with robot-assisted training protocols to maximize postural control improvement. In this study, we conducted a randomized control experiment with sixty-three healthy subjects to compare the effectiveness of robot-assisted posture training combined with VR or AR against robotic training alone. A robotic Trunk Support Trainer (TruST) was employed to deliver assistive force at the trunk as subjects moved beyond the stability limits during training. Our results showed that both VR and AR significantly enhanced the training outcomes of the TruST intervention. However, the VR group experienced higher simulator sickness compared to the AR group, suggesting that AR is better suited for sitting posture training in conjunction with TruST intervention. Our findings highlight the added value of XR to robot-assisted training and provide novel insights into the differences between AR and VR when integrated into a robotic training protocol. In addition, we developed a custom XR application that suited well for TruST intervention requirements. Our approach can be extended to other studies to develop novel XR-enhanced robotic training platforms.

Exploring the Impact of Office Syndrome on Employee Productivity: A Literature Review

Introduction: Physiotherapy helps employees prevent injuries at work by improving workspaces and everyday routines, with a focus on acoustics and body mechanics. Working in a situation where every employee is aware of their individual physical needs, understands how to improve their posture, and takes regular pauses to stretch out decreases the likelihood of accidents while increasing productivity. Aim: To explore the impact of office syndrome on employee productivity. Materials and Methods: A total of twenty articles were reviewed in this narrative review. Twenty publications were evaluated, including 8 reviews, 2 experimental studies, 3 observational studies, 5 crosssectional studies, and 2 surveys. Results: According to the studies and publications included, the most common occupations with an increased risk of upper limb injuries were office workers. Workers reported increased weariness, upper backache, and neck discomfort after commencing work. Neck and back pain have been shown to interfere with participants' normal activities. We discovered a positive correlation between computer usage on a regular basis. Conclusion: The majority of research participants experienced symptoms of office syndrome, mostly related to stiffness in their upper extremities and back. Employees working in offices who are older, female, have more experience, and put in longer hours are at a higher risk of developing these problems and need extra care. Ergonomic modifications, such as adjustable workstations and raised desks; behavioural cures, such as regular stretch breaks and postural awareness training.

Efficacy of different postural control training in elderly people with chronic cerebral ischemia

Efficacy of different postural control training in elderly people with chronic cerebral ischemia

МОДЕЛЬ СИСТЕМЫ МОНИТОРИНГА ПОЛОЖЕНИЯ ПОЗВОНОЧНИКА

The article presents a model of a spine position monitoring system that can gather posture statistics, analyze them using neural networks, and provide the user with personalized posture training instructions. The study focuses on a mobile app as it is user-friendly and simplifi es system development. As a result, the requirements for the system’s structure and operation were identifi ed and described.

Concurrent vestibular activation and postural training recalibrate somatosensory, vestibular and gaze stabilization processes.

Postural instability is a common symptom of vestibular dysfunction that impacts a person's day-to-day activities. Vestibular rehabilitation is effective in decreasing dizziness, visual symptoms and improving postural control through several mechanisms including sensory reweighting of the vestibular, visual and somatosensory systems. As part of the sensory reweighting mechanisms, vestibular activation exercises with headshaking influence vestibular-ocular reflex (VOR). However, combining challenging vestibular and postural tasks to facilitate more effective rehabilitation outcomes is under-utilized. Understanding how and why this may work is unknown. The aim of the study was to assess sensory reweighting of postural control processing and VOR after concurrent vestibular activation and weight shift training (WST) in healthy young adults. Forty-two participants (18-35years) were randomly assigned into four groups: No training/control (CTL), a novel visual feedback WST coupled with a concurrent, rhythmic active horizontal or vertical headshake activity (HHS and VHS), or the same WST with no headshake (NHS). Training was performed for five days. All groups performed baseline- and post-assessments using the video head impulse test, sensory organization test, force platform rotations and electro-oculography. Significantly decreased horizontal eye movement variability in the HHS group compared to the other groups suggests improved gaze stabilization (p = .024). Significantly decreased horizontal VOR gain (p = .040) and somatosensory downweighting (p = .050) were found in the combined headshake groups (HHS and VHS) compared to the other two groups (NHS and CTL). The training also showed a significantly faster automatic postural response (p = .003) with improved flexibility (p = .010) in the headshake groups. The concurrent training influences oculomotor function and suggests improved gaze stabilization through vestibular recalibration due to adaptation and possibly habituation. The novel protocol could be modified into progressive functional activities that would incorporate gaze stabilization exercises. The findings may have implications for future development of vestibular rehabilitation protocols.

Comparison of McKenzie and Isometric Exercises on Neck Functions of Computer Users with Forward Head Posture

Introduction: Prolonged use of computer can lead to poor posture such as forward head posture (FHP). This posture is associated with imbalance and stiffness of the neck muscles, lack of postural awareness and inappropriate ergonomics, resulting in work-related musculoskeletal disorders. These disturbances can affect the performance and productivity of office workers. Postural awareness training, neck exercises, and modalities are interventions in FHP management. Research that compares the effectiveness of cervical McKenzie and isometric exercise on neck functional score in computer users with forward head posture has not been conducted.&#x0D; Methods: This research was a quasi-experimental. The participants, 24 computer users working at Kariadi Hospital, Semarang, were divided into 2 groups by purposive sampling receiving cervical McKenzie exercise (n=12) and cervical isometric exercise (n=12). Each group received different exercise. Neck functional score was assessed by Neck Disability Index (NDI) questionnaire before and after intervention. The mean differences before and after treatment, as well as between groups was compared statistically using paired t-test.&#x0D; Results: The mean NDI score in the McKenzie group after treatment showed an improvement of 7.84 ± 3.54 with p = 0.002. The mean NDI score in the isometric group after treatment also showed an improvement of 3.93 ± 3.75 with p = 0.004. The difference in NDI score improvement in the cervical McKenzie group was greater than the one in isometric group and statistically significant with p = 0.017.&#x0D; Conclusion: Cervical McKenzie exercise was proved to be more effective in improving neck functional scores in patients with FHP compared to cervical isometric exercise.

Exploring the Barriers and Facilitators to Caregiver Engagement in Postural Management Training for Children with Complex Neurodisabilities: a qualitative study

Twenty-four-hour postural management (PM) is widely recognised as being important for children with cerebral palsy (CP) and other complex neurodisabilities. Training for caregivers involved in delivering PM is essential. However, engagement with PM training by caregivers is variable. Little research has been conducted to date to establish how to engage caregivers in PM training. Karen Crozier*1, Kay Cooper1,2, Sharon Blair3, Rachel McDermott3, Irene Croal1 1 NHS Grampian Physiotherapy Department, Royal Aberdeen Children’s Hospital, Westburn Road, Aberdeen, UK 2 School of Health Sciences, Robert Gordon University, Aberdeen, UK. 3 NHS Grampian Aberdeen City Central Child Development Team, Mile End School, Midstocket Road, Aberdeen, UK *Corresponding author: karencrozier@hotmail.co.uk