Postural Techniques Research Articles

Cephalic version by moxibustion for breech presentation.

Cephalic version by moxibustion for breech presentation.

嚥下手技，姿勢調整

摂食嚥下練習において嚥下手技，姿勢調整は，効率よく目標課題をめざすために不可欠な課題の難易度調整における重要な変数である．双方とも古くから臨床的に用いられているが，運動学的意味や効果のエビデンスは十分とはいえない．昨今，高解像度マノメトリーや嚥下CTの登場により運動解析が進み，主たる効果の理解が進んでいる．メンデルソン手技，努力嚥下では咽頭収縮に対する効果が明確となり咽頭クリアランスに有効な手技であることが示されてきている．姿勢調整では，頭部回旋は梨状窩の形態変化およびUES圧低下による咽頭クリアランスの効果，リクライニング位は重力に対する諸器官の運動調整による気道防御の効果が明らかとなっている．

Effects of a physical self-care support program for patients with fibromyalgia: A randomized controlled trial.

The effects of stretching exercises in fibromyalgia (FM) deserves further study. To evaluate the effectiveness of a Physical Self-Care Support Program (PSCSP), with emphasis on stretching exercises, in the treatment of FM. Forty-five women with FM were randomized to the PSCSP (n= 23) or to a control group (n= 22). The PSCSP consisted of weekly 90-minute learning sessions over 10weeks, providing instructions on wellness, postural techniques, and active stretching exercises to be done at home. The control group was monitored through 3 medical appointments over 10weeks and included in a waiting list. The primary outcomes were the Fibromyalgia Impact Questionnaire (FIQ), the Visual Analogue Scale (VAS) for pain, and the Sit and Reach Test (SRT) at the end of the study. Nineteen and 21 patients completed the trial in PSCSP and control groups, respectively. After 10 weeks, the PSCSP group showed significantly better FIQ (difference between adjusted means, -13.64, 95% CI, -21.78 to -5.49, P= 0.002) and SRT scores (7.24cm, 3.12 to 11.37, P= 0.001) than the control group, but no significant difference in pain VAS (-1.41, -3.04 to 0.22, P= 0.088). Analysis using multiple imputation (MI) and delta-adjusted MI for missing outcomes rendered similar results. A PSCSP emphasizing stretching exercises significantly improved FIQ and SRT scores, and may be a helpful therapy for FM.

Proposal for vocal rehabilitation in patients extubated by COVID-19

Vocal reeducation is known as a set of breathing, relaxation and posture techniques, which together help us to improve the quality of voice production after dysphonia due to vocal use and abuse, or a treatment that has been invasive for the patient's vocal cords. The objective of the following study is to investigate about the patients who have been intubated by SARS-COV-2 (COVID-19), through the statistics that the General Hospital 450 of the State of Durango can provide us, to raise awareness about the damage caused, and especially the intervention of the Human Communication Therapist, in the area of voice such as vocal reeducation. For this research, a study of 83 people infected from March 2020 to December 2020 was carried out, of which only 18 presented voice problems. It is worth mentioning that not all of these patients survived; of these 83, only 17 were successfully intubated, but of these successful extubations, only eight survived. These results, tell us that, not only they need to be extubated, but also, they must survive, since, to intubation being an invasive method, patients mostly fail to survive.

Preclinical dental training: Association between fine motor skills and compliance with ergonomic posture techniques.

The aim of this study was to evaluate the dental students' fine motor skills and their compliance with ergonomic posture techniques over the course of a preclinical training year. The correlation between fine motor skills and compliance was also assessed. The ergonomic posture of students enrolled in the second year of a five-year undergraduate dental degree programme (n=62) was assessed using the Compliance Assessment of Dental Ergonomic Posture Requirements (CADEP). This assessment relied on photographs of the students performing preclinical laboratory procedures during the school year. The photographs of each procedure received a score, and the final score obtained (0 to 10) corresponded to the extent of the student's compliance with ergonomic posture techniques. Initial compliance was calculated during the first two months of the training programme, whilst final compliance was calculated during the last two months. Fine motor skills were evaluated using the modified Dental Manual Dexterity Assessment (DMDA), which was also applied at the beginning and the end of the school year. Data were assessed statistically by Student's paired t test, and the correlation between fine motor skills and compliance with ergonomic posture techniques was estimated by Pearson's correlation coefficient (r) and Student's t test (α=0.05). The compliance scores were higher at the end of the academic year than at the beginning of year (p<0.001; t=-5.300). Fine motor skills improved significantly with time (p<0.001; t=-10.975). Non-significant correlations were found between students' fine motor skills and their economic posture compliance both at the beginning (r=-0.197; p=0.126) and at the end of the training year (r=0.226; p=0.078). The students' manual dexterity and compliance with ergonomic posture techniques increased over the course of the preclinical training year, and the correlation between students' fine motor skills and their ergonomic posture compliance was not significant.

Adjunct therapies after botulinum toxin injections in spastic adults: Systematic review and SOFMER recommendations.

Adjunct therapies (ATs) may further improve outcomes after botulinum toxin injections in spastic patients, but evidence was unclear in previous systematic reviews. To assess the efficacy of non-pharmacological ATs in spastic adults according to the International Classification of Functioning, Disability and Health and build an expert consensus-based on a Delphi process. Four electronic databases were searched up to May 2020 for reports of comparative trials of non-pharmacologic ATs after botulinum toxin injections in spastic adults. Then, 25 French experts participated in a two-round Delphi process to build recommendations on the use of ATs. We included 32 studies (1202 participants, median 32/study) evaluating the effects of physical agents (n=9), joint posture procedures (JPPs, n=11), and active ATs (n=14), mainly after stroke. The average quality of articles was good for randomised controlled trials (median [interquartile range] PEDro score=7 [6-8]) but moderate (n=2) or poor (n=2) for non-randomised controlled trials (Downs & Black checklist). Meta-analysis was precluded owing to the heterogeneity of ATs, control groups and outcome measures. There is evidence for the use of JPPs except low-dose manual stretching and soft posture techniques. Continuous postures (by taping or casting) are recommended; discontinuous postures (by orthosis) may be preferred in patients with active function. Device-free or device-assisted active ATs may be beneficial in the mid-term (>3months after botulinum toxin injections), particularly when performed at a high-intensity (>3h/week) as in constraint-induced movement therapy. Self-rehabilitation remains understudied after a focal treatment, but its interest is highlighted by the experts. The use of physical agents is not recommended. JPPs and active ATs (device-assisted or device-free) may further improve impairments and activities after botulinum toxin injections. Further studies are needed to better define the best strategies for ATs as a function of the individual treatment goals, participation and quality of life. PROSPERO (CRD42018105856).

Profil Pekerja Pemanen Kelapa Sawit Bagian Cutting Egrek

Musculoskeletal Disorders (MSDs) is a label for the perception of pain or pain in the musculoskeletal system. MSDs can be caused by the equipment, techniques, and activities performed during work. Harvesters who use manual techniques or cutting egrek have the potential risk for MSDs as a result of an ergonomic work attitude and posture. This study aims to determine the profile of oil palm harvesters using cutting egrek techniques. This research is a descriptive research with the survey method. Samples were obtained by systematic random sampling method, amounting to 82 people. The data used in this study are primary data and secondary data. Most CuE technique oil palm harvesters were at the age of 41-50 years, working period of 6-10 years, and with a work posture that needed immediate improvement, and 76.8% suffered from MSDs complaints. So that it is necessary to have immediate intervention from companies and workers to reduce the risk of MSDs complaints in the future, especially in posture and work techniques.

AN EFFECT OF POSTURAL DRAINAGE ON MANAGEMENT OF PNEUMONIA

Objective:To compare the patients with pneumonia with and without postural drainage and to measure the amount of sputum produced before and after physiotherapy treatment. Material and Method:This study was carried out at Lilamani Hospital, Kanpur. Total 7 patients was placed into two groups i.e. Group A and Group B. Group A included 4 patients, 3 females and 1 male with the age group is between 25-60. While Group B having 3 patients, 1 female and 2 males with the age group is between 26-62 years. Group A was received chest mobilization techniques, two times a day.While Group B received postural drainage in different positions with chest mobilisation twice a day. The amount of sputum before and after the physiotherapy techniques, the p-value was calculated for both groups by t-test and data was analysed through SPSS. Results: In this study, amount of sputum was significantly reduced in Group B as comparison to Group A. Conclusion: Postural drainage techniques with chest mobilisation are much effective. It also helps in reducing the amount of sputum in pneumonia patients.

Effect of position on gross motor function and spasticity in spastic cerebral palsy children.

To evaluate the effect of positioning on gross motor function and spasticity in spastic quadriplegic cerebral palsy children with Gross Motor Function Classification System level IV and V. A quasi-experimental study was conducted at two Paediatric Physical Therapy Centres from November 2018 to July 2019. The study comprised of seventy four children with quadriplegic cerebral palsy aged between 3 to 8 years. Data was obtained and gross motor functional abilities and spasticity were assessed by GMFM-88 and Modified Ashworth Scale, respectively. Twenty four-hour positioning in specific seats, night positioning and standing frames for six months. The child was being positioned 24 hours according to his challenges for the period of six months. Semi reclined positioning was performed to manage aspiration, oral leak and to develop retention. Prone positioning was done to develop righting reactions, functional sitting position was used in the treatment regime to attain better upright position and neutral pelvic standing using standing frames. SPSS 24 was used to analyse the data. Paired t-test reported significant improvement in the test scores in lying position, rolling, sitting position, crawling, kneeling, standing, walking or running. Fifty-nine subjects exhibited improvement in spasticity before and after interventional procedures, while 15 showed no improvement (p<0.05). Twenty-Four-hour proper body positioning and postural techniques improved gross motor functioning in all five dimensions of functioning. The overall spasticity in quadriplegic cerebral palsy children was also reduced due to appropriate positioning techniques.

Does nutritional treatment in patients with dysphagia affect malnutrition and anxiety?

Introduction: dysphagia is common in patients with cerebrovascular disease (CVD), with an incidence reported to be 35 %-50 %. Dysphagia can result in malnutrition, dehydration, and death, and negatively affects anxiety levels. Objectives: this study aimed to evaluate the effects of recommended nutritional treatment (NT) on nutritional status and anxiety levels in patients with dysphagia based on clinical and fiber-optic endoscopic evaluation of swallowing (FEES) tests. Methods: seventy-five patients over the age of 50 who were diagnosed with CVD, hospitalized at the Mersin City Research and Training Hospital, Neurology Clinic, from October 2019 to January 2020 were followed up for the study. The FEES test was performed to diagnose dysphagia in CVD patients. Anthropometric measurements of the patients were taken to calculate their body mass index (BMI) values. To determine a patient's daily energy and food intake, 24-h food recalls were taken, and the Nutritional Risk Screening 2002 (NRS 2002) test was used to identify patients at risk of malnutrition. State (SAI)-Trait Anxiety Inventories (TAI) were used to determine instant and general anxiety levels. After patient evaluations NT was provided. All evaluations were repeated 8 weeks after NT. Our study was carried out based on a longitudinal design since we worked with the same units at two different time points. Results: post-NT SAI scores were significantly lower than pre-NT scores (p < 0.05). A moderate correlation was found between pre- and post-NT SAI scores and daily energy and fluid intake status, and between TAI scores and daily energy, fat, and fluid intake amounts (p < 0.05). Post-NT SAI scores significantly decreased with both NRS 2002 and BMI values (p < 0.05). Conclusions: this study highlights the importance of NT in improving rehabilitation outcomes of patients with dysphagia. Since exercises such as postural techniques or maneuvers, and muscle strengthening to reduce swallowing difficulties are an important part of NT for dysphagia, a multidisciplinary study is required for the management of dysphagia, and further studies are needed on this subject.

Effects of a protocol with manual therapy and postural techniques for non-specific low back pain

Background: The effects of postural reeducation on low back pain (LBP) are well documented in the literature, as well as studies using manual therapy (MT). However, no studies were found that investigate the use of a protocol using both MT and postural techniques. Objective: To verify the effects of a protocol that associates the MT and postural techniques in pain symptoms and functionality of subjects with chronic non-specific LBP. Methods: The participants of this study were 09 patients from the physiotherapy outpatient clinic of a public hospital. The evaluation of the subjects was carried out with the application of the Visual Analog Scale for Pain, Oswestry Disability Index (ODI) and Pressure Algometry. Patients were treated with a protocol composed of manipulative and postural techniques performed twice a week for five weeks. Two new evaluations were performed after the 5th and 10th sessions. For statistical analysis, the ANOVA test was used followed by the Tukey post-hoc test, considering p&lt; 0.05. Results: In all the evaluated variables it was observed a greater difference of the scores between the initial and the tenth evaluation. There was significant improvement in the pain (p = 0.0167) and in the algometry of the piriformis and quadratus lumborum. There was no significant difference in disability (p = 0.0595). Conclusion: The protocol with MT and postural techniques promoted improvement of pain and increase of pressure sensitivity threshold in patients with chronic non-specific LBP.

Treatment of Dysphagia in Parkinson's Disease: A Systematic Review.

The incidence of oropharyngeal dysphagia in Parkinson’s disease (PD) is very high. It is necessary to search for effective therapies that could prevent pneumonia. Previous results should be interpreted cautiously as there is a lack of evidence to support the use of compensatory or rehabilitative approaches to dysphagia. We reviewed the scientific literature to describe the treatments of dysphagia in PD. A systematic review was performed in PubMed, Scopus, Elsevier, and Medline according to PRISMA standards in 2018. The articles that did not mention dysphagia secondary to PD or used surgical treatment were excluded. Eleven articles met the criteria with information from 402 patients. The review relates to different protocols, such as training in expiratory muscle strength, postural techniques, oral motor exercises, video-assisted swallowing therapy, surface electrical stimulation, thermal stimulation, touch, compensatory interventions, training regime for swallowing, neuromuscular electrical stimulation, Lee Silverman voice treatment, swallow maneuver, airway protection, and postural compensation maneuvers. This review identifies the rationing interventions in each trial, if they are efficient and equitable. Several rehabilitative therapies have been successful. An improvement was seen in the degenerative function (coordination, speed, and volume), quality of life, and social relationships of people with PD. Further investigations concerning the clinical applicability of these therapies based on well-designed randomized controlled studies are needed. Larger patient populations need to be recruited to evaluate the effectiveness, long-term effects, and new treatment techniques.

Yoga Breathing Techniques Have No Impact on Isokinetic and Isoinertial Power.

Wooten, SV, Cherup, N, Mazzei, N, Patel, S, Mooney, K, Rafiq, A, and Signorile, JF. Yoga breathing techniques have no impact on isokinetic and isoinertial power. J Strength Cond Res 34(2): 430-439, 2020-As an exercise discipline, yoga incorporates breathing (pranayama) and posture (asana) techniques to facilitate improvements in flexibility, strength, and meditation. Both techniques have been used to enhance muscular strength and power output. The purpose of this study was to determine the effects of various yoga breathing techniques on lower-limb power output. Thirty-two individuals (15 men and 17 women) participated in the study. All subjects performed a baseline 1 repetition maximum (1RM) on a pneumatic leg press machine and isokinetic testing on a Biodex 4 dynamometer. Participants then performed 3RM power tests at 50% of 1RM on the pneumatic leg press machine using 3 different yoga breathing techniques (Ujjayi, Bhastrika, and Kapalabhati) and normal breathing (control) across all repetitions. After power testing, participants completed an isokinetic test on the Biodex 4 dynamometer using their dominant leg. Subjects had their knee placed at a predetermined starting position (90°) and executed knee extension at 3 randomized testing speeds (60, 180, and 300°·s). The implementation of specific breathing protocols before and during the leg press produced no significant differences in power output. For isokinetic power measured at 60, 180, and 300°·s, there was a significant difference among testing speeds (η = 0.639; p < 0.0001) and a significant sex × speed interaction (η = 0.064; p < 0.0001), where men consistently demonstrated greater isoinertial power, isokinetic power, isokinetic torque, and isokinetic work than women. No other significant differences or interactions were detected. The differences between our study and others, which have concluded that adopting specific breathing techniques can enhance core stability and force production during lifting, may be attributable to the acute nature of the design, the novice participants who had insufficient time to practice the breathing techniques or testing protocols, and the use of tests that isolated specific muscle groups. Nonetheless, the current findings do not support the use of yoga breathing techniques as a method to enhance power output, whether used before or during power performance.

Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice.

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

Development and evaluation of wearable electro-goniometer for the assessment of repetitive efforts and measurement of joint trajectories during carpet weaving

The aim is to construct, calibrate and validate a low-cost sensor-embedded glove and elbow brace. This article establishes a common thread between electro-goniometry and postural assessment techniques. The output voltages from the sensors were converted into angles by implementing LabVIEW-Interface-for-Arduino based graphical environment. Ten experienced weavers participated in the study. Dynamic recordings of the finger, wrist and elbow bending trajectories were measured using sensory electro-goniometer. Assessment of repetitive task technique was used to identify the postural risks. Based on data output from each sensor, the voltage to angle optimal linear models were obtained for the measurement range of 0°-90° with 5° steps. The accuracy of the sensors was found within the limits of traditional goniometry. The cost-benefit breakdown revealed that wearable electro-goniometer is cost-effective as compared to commercially available electro-goniometers. The low-cost electro-goniometric glove and elbow brace for measurements of hand movements could be a promising tool for postural assessment and safety systems.

Effectiveness and Safety of Acupuncture and Moxibustion in Pregnant Women with Noncephalic Presentation: An Overview of Systematic Reviews.

Background Breech presentation at the time of delivery is 3.8–4%. Fetuses that maintain a noncephalic presentation beyond 32 weeks will have a lower probability of spontaneous version before labor. Given the increasing interest in exploring the use of complementary medicine during pregnancy and childbirth, the moxibustion technique, a type of traditional Chinese medicine, could be another option to try turning a breech baby into a cephalic presentation. Objectives To review the evidence from systematic reviews (SR) on the efficacy and safety of acupuncture and moxibustion in pregnant women with noncephalic presentation. Main Results Our SR synthesizes the results from five clinical trials on pregnant women with a singleton noncephalic presentation. There is evidence that moxibustion reduces the number of noncephalic presentations at the time of birth compared with no treatment. The adverse effects that acupuncture and moxibustion can cause seem to be irrelevant. Most SRs agree that there are no adverse effects directly related to acupuncture and moxibustion. Conclusions Even though the results obtained are positive and the five reviews conclude that moxibustion reduces the number of noncephalic presentations at birth (alone or combined with postural techniques or acupuncture), there is considerable heterogeneity between them. Better methodologically designed studies are required in the future to reaffirm this conclusion.

Effects of Sustained Natural Apophyseal Glides with and without thoracic posture correction techniques on mechanical back pain: a randomized control trial.

To determine effectiveness of sustained natural apophyseal glides with and without thoracic postural correction techniques on patients of chronic mechanical low back pain . The randomized control trial was conducted at the National Institute of Rehabilitation Medicine, Islamabad, Pakistan, from November 1, 2015, to January 31, 2016, and comprised females aged 20-60 years experiencing mechanical low back pain for more than 03 months. They were randomly assigned to two equal groups. Group 1 was given Mulligan sustained natural apophyseal glides mobilization, while group2 was given the same along with thoracic postural correction techniques for 4 weeks, 3 sessions per week and one session per day. Outcome measures included Numeric Pain Rating Scale, Oswestry Disability Index and Goniometry of Lumbar Range of Motion. Data was analysed using SPSS 20. Of the 40 patients, there were 20(50%) in each of the groups. Mean age of patients in group 1 was 41.30±10.45years, while in group 2 it was 35.12±9.04 years. Compared to the baseline readings, pain, functional independence and range of motion showed significant improvement (p<0.0001) postintervention in both groups. Mean scores in group 2 showed more improvement than group 1 (p<0.0001) in all variables. The effectiveness of thoracic postural correction exercises along with sustained natural apophyseal glides was noted in patients with mechanical low back pain.

Occupational Therapists' Role in Perinatal Care: A Health Promotion Approach.

This article establishes and examines occupational therapists' role in perinatal care and proposes a health promotion approach for new and expectant mothers. The author demonstrates the importance of maintaining meaningful occupational engagement during this critical life stage by incorporating evidence from orthopedic, rehabilitation, and hand therapy research. New and expectant mothers are at high risk for upper extremity (UE) conditions such as carpal tunnel syndrome, De Quervain's tenosynovitis, and tendinosis of the UE. Occupational therapists with basic knowledge of hand therapy are well prepared to manage these conditions conservatively. An occupation-based model and framework are presented to ensure a holistic view of the target population. Topics pertinent to this population include postural techniques, repetitive tasks, patient education, and strengthening related to the perinatal period.

Terapia postural e manual nas disfunções temporomandibulares

Objetivos: mostrar os benefícios da terapia manual e postural nas disfunções da articulação temporomandibular (DTM) e citar as técnicas que podem ser utilizadas no tratamento dessas disfunções. Metodologia: Foi realizada uma revisão narrativa da literatura científica sobre o assunto em livros das áreas de Fisioterapia e Odontologia, artigos científicos através de periódicos e sites referentes a publicações dos últimos dez anos, utilizando como palavras chaves: terapia manual e postural, disfunções da articulação temporomandibular e articulação temporomandibular. Resultados: Foram encontrados 1.930 estudos, dentre os quais 602 foram selecionados para leitura de título/resumo e 569 excluídos devido à falta de obediência aos critérios de inclusão e, assim, um total de 33 referências foram incluídas. A literatura relata várias técnicas manuais e posturais como recursos benéficos para o tratamento da DTM, pois atua desde a fase de prevenção até a reabilitação, utilizando técnicas de terapia manual e postural com finalidade de reagrupar os músculos comprometidos e devolver a funcionalidade da articulação temporomandibular. Conclusão: A fisioterapia é de suma importância para o tratamento das DTM, pois tem como objetivo ativar a circulação sanguínea, aliviar a dor, promover o relaxamento muscular e reeducar a postura, visando promover o bem-estar do paciente.

Ergonomic assessment and prevalence of musculoskeletal disorders among washer-men during carpet washing: guidelines to an effective sustainability in workstation design

The development of musculoskeletal disorders (MSDs) is the most common problem among the workers employed in carpet industry working at any stage of production. This study investigates the problems encountered during washing stage and establishes the guidelines for an ergonomically efficient workstation. The data about pain occurrence at different body and hand regions of male washer-men were collected by questionnaire. Postural assessment techniques were used to identify the postural risks and a mannequin was developed in CATIA for biomechanical analysis associated with washing. Most of the participants reported discomfort in different body and hand regions. A significant difference between the physical and physiological factors pre- and post- activity (p < 0.05) was reported. Postural techniques revealed that the working posture during carpet washing requires necessary action. This study proposes certain workstation guidelines that may reduce the symptoms of MSDs, lead to the improvement in working posture and efficiency of the worker.