Physical Therapy Program Research Articles

The effects of telerehabilitation-based motor imagery training on motor imagery ability, motor function and physical performance in Duchenne muscular dystrophy

Purpose To explore the effects of telerehabilitation-based motor imagery (Tele-MI) training on motor imagery ability (MI), motor function, and performance in children with Duchenne muscular dystrophy (DMD). Methods The research involved twenty-three children with DMD and twelve healthy children. DMD cohort were randomized into two groups: treatment [Tele-MI training and telerehabilitation-based physiotherapy program (Tele-PTP), n = 12] and control (Tele-PTP, n = 11). MI ability [Kinesthetic and Visual Imagery Questionnaire-10 (KVIQ-10), Motor Imagery Questionnaire for Children (MIQ-C), mental chronometry tests], motor function [Motor Function Measure (MFM), North Star Ambulation Assessment, Four Square Step Test] and timed performance were assessed at baseline and after 8-week training. Results MI ability scores of DMD cohort were lower than healthy children. A large interaction effect was found for KVIQ-10 visual and total, MIQ-C internal visual and kinesthetic scores, and delta time of 10–meter walk test of mental chronometry (η2 > 0.14). The small-medium interaction effect was found in motor function and ambulation results (η2<0.14). Conclusions This study demonstrated that Tele-MI training improved MI ability of DMD cohort. The small-to-medium effects of Tele-MI training on motor function, particularly those involving the trunk, have demonstrated its potential as a complementary approach in rehabilitation to improve motor functions in children with DMD. Clinical Trial Registration Number and URL NCT06109103 (https://clinicaltrials.gov/study/NCT06109103?term=merve%20bora%20zereyak&rank=1)

Arriba y Adelante: Looking Outward and Moving Ahead.

Judith E. Deutsch, PT, PhD, FAPTA, the 55th McMillan Lecturer, is professor and director of the Research in Virtual Environments and Rehabilitation Sciences (Rivers) Lab in the Doctoral Programs in Physical Therapy in the School of Health Professions at Rutgers University. Her current research includes the development and testing of virtual reality, serious games to improve mobility and fitness of individuals with neurologic health conditions, and knowledge translation to strengthen evidence-based practice. Her research has been funded by the National Institutes of Health, the National Science Foundation, and the American Hospital Association. She also has longstanding interest and scholarship in integrating complementary therapies into physical therapy. Dr Deutsch has been recognized with awards for teaching, research, mentoring, service and publications from the American Physical Therapy Association (APTA), Academy of Neurologic Physical Therapy, the New Jersey chapter of APTA, the International Society for Virtual Rehabilitation, the Kessler Institute for Rehabilitation, the University of Southern California, and Rutgers University.

Comparisons between chest trunk mobilization with sustained maximum inspiration and flow incentive spirometry on chest expansion, respiratory muscle strength, and functional exercise capacity in patients undergoing video-assisted thoracoscopic surgery

IntroductionChest trunk mobilization with sustained maximum inspiration (SMI) and flow incentive spirometry (flow IS) are breathing techniques that mostly apply to patients undergoing video-assisted thoracoscopic surgery (VATS). The purpose of this study was to determine the effects of chest trunk mobilization with SMI and flow IS on chest expansion, respiratory muscle strength, and functional exercise capacity in patients undergoing VATS.MethodsSixty VATS patients were randomly allocated into chest trunk mobilization with SMI (&lt;i&gt;n&lt;/i&gt; = 30) and flow IS (&lt;i&gt;n&lt;/i&gt; = 30) groups. Each group performed a physical therapy program preoperatively and 4 days post-operatively. Chest expansion at upper, middle, and lower levels, inspiratory and expiratory muscle strengths, and functional exercise capacity were determined at pre- and post-VATS.ResultsIn both groups, chest expansion at all levels, expiratory muscle strength, and distance of the 6MWT significantly increased (&lt;i&gt;p&lt;/i&gt; &lt; 0.05) post-operatively compared to pre-operative assessments, although there was no significant difference between groups. In addition, inspiratory muscle strength significantly improved from baseline in both groups (&lt;i&gt;p&lt;/i&gt; &lt; 0.05), but the flow IS group showed a greater increase than the chest trunk mobilization with the SMI group (78.17 ± 24.16 and 65.57 ± 20.39 cmH2O, respectively, &lt;i&gt;p&lt;/i&gt; &lt; 0.05).ConclusionsChest trunk mobilization with SMI and flow IS can improve chest expansion at all levels, as well as respiratory muscle strength and the distance of the 6MWT. However, flow IS enhances inspiratory muscle strength to a greater extent than chest trunk mobilization with SMI. Ultimately, both techniques can be applied effectively in patients undergoing VATS.

Impact of Health Education Programme on Adherence to Treatment in Knee Osteoarthritis: An Interventional Study on Egyptian Patients.

To measure the level of adherence of patients with primary knee osteoarthritis (KOA) to an interventional therapeutic and rehabilitation programme and investigate factors that hinder patients' adherence. A total of 154 participants with primary knee osteoarthritis (KOA) were divided into intervention and control groups. The intervention protocol included patient education on the nature and treatment of KOA, therapeutic exercise, a weight loss programme for overweight patients, and a physical therapy programme. Participants were followed for 3months. The Visual Analog Scale for Pain (VAS-p), the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), and knee Kellgren-Lawrence OA grading were measured before and after the intervention. Additionally, the Morisky adherence questionnaire and the WHO Multidimensional Framework for factors affecting adherence were assessed. One fifty four participants with KOA were randomly allocated into intervention and control groups. A low level of adherence was detected in both groups (68.8% in the intervention group vs. 84.4% in the control group). Patients who followed the interventional programme were more adherent. Adherence to therapy was associated with a reduction in the Visual Analog Scale for Pain (VAS-p) (p=0.016) and improved function as measured by WOMAC (p=0.018). Factors primarily associated with patient non-adherence included unemployment (67.8%), low income (59.3%), no previous response to therapy (58.5%), less frequent follow-up visits (55.1%), lack of insurance (66.9%), difficult access to services (59.3%), and high cost of services (55.1%). Adherence to treatment in OA patients is a significant concern and a common problem, appearing to be associated more with socioeconomic factors than with pain and function.

The Effectiveness of Focus of Attention in Static Balance and Functional Ability of Chronic Ankle Instability: A Pilot Study

Objectives: The focus of patients’ attention during the physiotherapy program has been reported to affect the rehabilitation goals. The study aimed to investigate the effectiveness of an external focus of attention (EFA) on static balance and functional ability in individuals with chronic ankle instability (CAI). Methods: Fourteen subjects with CAI, aged from 19 to 25 years, were randomly assigned to two groups: external and internal focus of attention (IFA) group. The outcome measures of the study were static balance and functional ability. A pre-intervention evaluation was performed. Following instructions to an external or an IFA, subjects practiced on a balance board 3 times per week for 4 weeks. At the end of each week, they performed evaluation tests, including a time balance test, foot lift test, side hop test, figure-8 test, and star excursion balance test (SEBT). Parametric (mixed analysis of variance) and non-parametric analysis (the Mann–Whitney and Friedman tests) were performed between measurements and groups. Results: The intervention program showed a statistically significant improvement in static balance and functional ability in both groups. The results indicated the main effect of time (F(2.488, 29.855)=43.880, P&lt;0.001). For the time in balance test, analysis of variance revealed a main effect of time (F(2.571, 30.855)=11.188, P&lt;0.001). Regarding the SEBT, every direction indicated a main effect of time for both groups. No significant differences between the two groups were found in static balance and functional ability. Discussion: Even though there were no statistically significant differences between the two groups, both types of focus of attention contributed to the improvement of static balance and functional ability, which may reveal an increase in motor control and neuromuscular ability of the subjects with CAI.

A physical therapy program to treat late-effect vaginal stenosis in gynecological cancer survivors: An interventional study.

To evaluate the effect of a physical therapy program on vaginal length and diameter, pelvic floor strength, and quality of life among gynecological cancer survivors suffering from late-effect vaginal stenosis. Thirty-four women who were previously diagnosed with gynecological cancer and experiencing vaginal stenosis, at least 12months post-oncological treatment, were enrolled. The intervention program consisted of ten weeks of individualized weekly sessions, each lasting 50min, involving perineal massage, progressive vaginal dilation, and pelvic floor exercises. Pre- and post-treatment evaluations included assessments of pelvic floor muscle strength through digital palpation, measurements of vaginal length and diameter using a silicone vaginal dilator, and classification of stenosis according to the Common Terminology Criteria for Adverse Events (CTCAE v5.0). Health-related quality of life was assessed using the FACT-G and FACT-Cx questionnaires. Twenty-one women completed the physical therapy program. There was a significant increase in vaginal length (p < 0.001), vaginal diameter (p < 0.001) and improvement in pelvic floor muscle strength (p < 0.001), with a large effect size (r = 0.81), a medium effect size (r = -0.77) and a medium effect size (r = -0.78), respectively. This resulted in resolution of vaginal stenosis in 14 participants (66.7%) following intervention. Mean scores for FACT-Cx and FACIT-G, encompassing total scores and physical, social, and functional well-being domains, increased significantly after the treatment. The proposed physical therapy program demonstrated positive effects on vaginal stenosis, pelvic floor muscle strength and health-related quality of life in gynecological cancer survivors.

New Non‐Invasive Approach for a Woman With Dyssynergic Defecation Associated With Dyspareunia: A Case Report

ABSTRACTBackgroundThe pelvic floor muscles are a complicated muscular structure with three major functions: defecation, urination, and sexual function. Constipated patients rarely have sexual or urinary complaints. The objective of this case is to provide a new and successful therapy strategy for a patient with dyssynergic defection and dyspareunia.Study DesignThe case study below discusses physical therapy rehabilitation and the consequences for both current and future physical therapy programs of constipation caused by PFM dyssynergia and dyspareunia.Case DescriptionA 22‐year‐old married nulliparous woman was referred by her urogynecologist for the management of PFM tightness, with the main complaints being pain during intercourse and chronic constipation. The diagnosis had been confirmed by MR defecography, which revealed puborectalis and external anal muscle tightness. Neuromuscular reeducation employing electromyography biofeedback, improved rectal sensation, intravagival massage, the application of an intermittent pneumatic compression belt on the abdominiopelvic region, and suprapubic water bag ultrasound therapy were among the pelvic floor rehabitation strategies.ConclusionThe intermittent pneumatic compression belt and water bag ultrasound approach, combined with standard program rehabitation, was successfully used in patients with defection dyssynergia and dyspareunia. After 3 weeks, stool frequency decreased from once every 10 days to one bowel movement per week; a condition reported less bloating and stomach pain, as well as a pain rating of 5/10 during sexual activity and 0/10 immediately afterward; and FSFI increased from 15.1 to 19.1. After 12 weeks, stool frequency is three bowel movements per week, a condition has less bloating and stomach discomfort and rates pain as 1/10 during sexual activity and 0/10 immediately, and FSFI has risen from 15.1 to 25.1.

Effect of Radial Extracorporeal Shockwave Therapy on Pain Intensity Level in Patient with Calcaneal Spur

Background: Heel pain is a common musculoskeletal issue that significantly impacts patient daily activities and, consequently, their quality of life. This clinical study aims to evaluate the effectiveness of radial extracorporeal shockwave therapy in reducing pain intensity in patients with calcaneal spurs.Objective: To investigate the effects of radial extracorporeal shockwave therapy on pain intensity in patient with calcaneal spur.Methods: A total of 60 patients diagnosed with calcaneal spurs based on clinical examination and lateral radiography between September 2022 and June 2023 were included in this study. Participants were randomly assigned to two groups: Group A (radial extracorporeal shockwave therapy) and Group B (traditional physical therapy). All participants followed an exercise program; however, those in Group A received six sessions of radial extracorporeal shockwave therapy (10 Hz, 2000 pulses, at 2.4 bar). The Visual Analog Scale (VAS) was used to assess pain intensity both before and after treatment in all participants.Results: No significant differences were observed between Group A and Group B regarding gender, affected side, condition distribution, age, weight, height, or BMI (p &gt; 0.05). Both groups experienced significant reductions in VAS scores post-treatment (p &lt; 0.001); however, Group A demonstrated a greater improvement, with a percentage reduction in pain of -50.65%, compared to -28.17% in Group B. Additionally, post-treatment VAS scores were significantly lower in Group A than in Group B (p = 0.003), indicating that shockwave therapy yielded a more substantial reduction in painConclusions: Both radial extracorporeal shockwave therapy and traditional physical therapy programs significantly reduced pain intensity in patients with calcaneal spurs, with a favorable effect observed for radial extracorporeal shockwave therapy. These methods can be considered effective, safe, and conservative treatment options for managing calcaneal spurs.

Use of SMART objectives in an interprofessional training event: screening for fall and osteoporosis risk

IntroductionSMART objectives are a major component of health coaching and lifestyle medicine, however, there are limited studies describing their use in current health care curriculums. This study incorporated SMART objectives within an Interprofessional Education (IPE) event offered to students who were screening community-dwelling adults within their community for falls and osteoporosis risk. The purpose was to evaluate if students could confidently develop a SMART objective with their client that was relevant to the screening results. MethodsStudent participants were recruited from pharmacy, nursing, and physical therapy programs at Rutgers University. The IPE event consisted of an educational pre-session assignment, 2-h virtual training session, student-led home screening with a self-selected community volunteer, and a 2-h virtual educational and debriefing session. Students taught peers through interprofessional education on their respective discipline's screening assessment tools during each session. Based on the screening results, students collaborated with their clients to develop a SMART objective aimed at addressing an identified problem. ResultsPost 3 yearly programs, 520 pharmacy, nursing, and DPT students completed the SMART objective, and 518 SMART objectives were analyzed. Analysis indicated all students were about 90 % confident in developing SMART objectives and 92 % confident in communicating with clients. Most students, regardless of discipline, felt comfortable developing a SMART objective and communicating with clients. ConclusionA significant number of people screened were found to have risk factors for falls or osteoporosis. Regardless of discipline, students worked with their client to develop appropriate SMART objectives. SMART objectives can enhance IPE programs, curriculums that include client counseling regarding lifestyle changes, and client engagement.

Prognostic Factors in Patients Undergoing Physiotherapy for Chronic Low Back Pain: A Level I Systematic Review.

Background: Low back pain is common. For patients with mechanic or non-specific chronic LBP (cLBP), the current guidelines suggest conservative, nonpharmacologic treatment as a first-line treatment. Among the available strategies, physiotherapy represents a common option offered to patients presenting with cLBP. The present systematic review investigates the prognostic factors of patients with mechanic or non-specific cLBP undergoing physiotherapy. Methods: In September 2024, the following databases were accessed: PubMed, Web of Science, Google Scholar, and Embase. All the randomised controlled trials (RCTs) which evaluated the efficacy of a physiotherapy programme in patients with LBP were accessed. All studies evaluating non-specific or mechanical LBP were included. Data concerning the following PROMs were collected: the pain scale, Roland Morris Disability Questionnaire (RMQ), and Oswestry Disability Index (ODI). A multiple linear model regression analysis was conducted using the Pearson Product-Moment Correlation Coefficient. Results: Data from 2773 patients were retrieved. The mean length of symptoms before the treatment was 61.2 months. Conclusions: Age and BMI might exert a limited influence on the outcomes of the physiotherapeutic management of cLBP. Pain and disability at baseline might represent important predictors of health-related quality of life at the six-month follow-up. Further studies on a larger population with a longer follow-up are required to validate these results.

COMPLEX PHYSICAL THERAPY OF PATIENTS WITH ADHESIVE CAPSULITIS

Adhesive capsulitis is predominantly an idiopathic condition and is more common in patients with metabolic disorders. PS contracture can be of varying degrees of severity, depending on the pathology of the PS with which we are dealing. This condition greatly aff ects work capacity and quality of life due to the presence of pain, discomfort and limitation of daily life activities. Prolonged pain syndrome can provoke sleep disorders and depression. Disruption of normal sleep, pain and depression form a pathological closed circle and contribute to the maintenance of the pathological process in the locus morbi.The development of a comprehensive program of physical therapy for patients with adhesive capsulitis with the use of modern means of recovery, which will reduce the risk of the disease re-emerging, and will also contribute to the faster recovery of the functional capacity of the musculoskeletal system of the patients.The objective of the study. The develop and practically substantiate a comprehensive program of therapy for patients with adhesive capsulitis using physical therapy.Materials and Research Methods. The study is based on a comprehensive therapeutic approach for 36 patients diagnosed with adhesive capsulitis in the acute phase of the condition. The assessed parameters included X-ray and computed tomography results, evaluation of range of motion in the shoulder joint, joint- muscle apparatus, and analysis of pain intensity indicators.Conclusions. To improve the condition of patients and optimize the process of treatment and rehabilitation of patients with adhesive capsulitis of the shoulder joint in the acute period, it is advisable to use with the diff erentiation of means of therapeutic intervention according to the diagnosis of the international classifi cation of functioning, optimization of physiotherapeutic means and special means of physical therapy allowed to shorten the terms of treatment and recovery of patients with adhesive capsulitis. It was determined that the best combination of means of therapeutic intervention for patients with adhesive capsulitis is the use of a complex of ideomotor exercises to create the patient’s idea of correct movement; correct positioning of the limb during sleep, everyday and professional activity; passive exercises to increase the volume of painless movements (bending, external rotation); restorationof the pattern of typical motor actions and optimization of physiotherapeutic means due to the use of shock wave and TENS therapy signifi cantly improved the eff ectiveness of their recovery in the short-term and long-term stages of the acute period of rehabilitation.

First Nations Peoples' perspectives on telehealth physiotherapy: a qualitative study focused on the therapeutic relationship.

Relationships are the core of Indigenous Peoples' spiritual and cultural identities, and therapeutic relationships are an integral part of the physical rehabilitation process, directly influencing health outcomes. However, participating in therapeutic relationships can be difficult for First Nations Peoples, particularly in the virtual landscape. There is limited understanding of First Nations Peoples' perspectives on this issue, and this understanding is crucial to developing culturally safe and effective telehealth physiotherapy programs. Therefore, the purpose of this study is to explore the perspectives of First Nations Peoples from British Columbia, Canada, on telehealth physiotherapy, with an emphasis on the virtual therapeutic relationship. A narrative qualitative study that utilized one-on-one, semistructured interviews was conducted with 19 First Nations adults from remote and rural First Nations communities in north-central British Columbia, Canada. Interviews were recorded, transcribed verbatim, and analyzed using an inductive approach to reflexive thematic analysis. Three themes emerged from data analysis. 'Therapist's attitude and rapport' captures participants' perceptions of what matters the most in how physiotherapists relate to First Nations Peoples and carry out their work. 'Remote nature of virtual care' encompasses the main challenges of virtual care visits, particularly how these were perceived to impact establishing and maintaining solid therapeutic relationships. 'Fostering culturally appropriate and safe telehealth physiotherapy' focuses on what is needed to advance telehealth physiotherapy in a manner that respects and reflects First Nations cultures, equipping all involved parties to provide comprehensive and sensitive services. Our findings advocate a hybrid model that combines in-person and telehealth visits to address communication barriers and the absence of physical interaction. Bridging the digital health literacy gap through training and collaboration with local support staff is crucial (as it is to bridge the possible cultural literary gap of therapists), and the incorporation of cultural elements holds promise for enhancing the engagement and effectiveness of telehealth services in these communities. The pursuit of equitable health care for First Nations communities demands not only increased access but also a thoughtful, culturally safe, trauma-informed, and holistic approach. This approach must be tailored to the unique needs of First Nations Peoples, emphasizing the integration of cultural elements and community support. A hybrid model combining in-person and telehealth visits is recommended to address logistical challenges and enhance the therapeutic relationship, ensuring that care is both effective and respectful of cultural values and practices.

PHYSICAL REHABILITATION FOR YOUNG MEN WITH GRADE I AND II OBESITY

The goal of this study is to study the role of exercise and dietary modification in the treatment of obesity in young men. Materials and methods. A study was conducted with 10 young men aged 25 to 30 who had a body mass index (BMI) exceeding 30 kg/m², indicative of obesity. The primary intervention combined diet therapy with increased physical activity. Most participants also had obesity-related comorbidities, including arterial hypertension, autonomic-vascular dystonia, type II diabetes, and spinal osteochondrosis. Patient motivation was considered crucial in program development, and thus only individuals with a high motivation level were selected for participation. Results and discussion. Based on data from dynamic observations, we can state that the physical therapy program studied has a positive effect on body weight reduction in cases of mild forms of alimentary obesity. After three months of participation, an average weight loss of 8.5% was observed, which represents a very favorable outcome. The results indicate that physical exercises combined with dietary adjustments positively influence weight loss dynamics in young men with grade 1 alimentary obesity. Weight loss occurred most rapidly during the first month of the program. Conclusion. The physical therapy program for grade 1 obesity involves a comprehensive approach, combining physical exercises conducted in a medical rehabilitation department with a specially designed dietary plan. This program is recommended for individuals with mild forms of alimentary obesity and a body mass index (BMI) up to 35 kg/m². After three months of implementing this approach, participants showed an average reduction in excess body weight of 8.5%. This physical therapy program may be effectively used for managing grade I obesity.

HE ROLE OF PHYSICAL THERAPY IN MANAGING SYMPTOMS OF TEMPOROMANDIBULAR JOINT DYSFUNCTION SECONDARY TO OSTEOARTHRITIS

The purpose of the study is to evaluate the effectiveness of the physical therapy in managing symptoms of temporomandibular joint dysfunction in patients with osteoarthritis. Materials and methods. 48 people with diagnosis of osteoarthritis of the temporomandibular joints were examined. In Group 1 (23 participants), correction involved wearing customized relieving splints. In addition to splint therapy, Group 2 received a course of physical therapy, which included therapeutic exercises targeting the masticatory muscles, facial muscles, tongue, and anterior neck muscles, as well as a course of transcutaneous electrical nerve stimulation (TENS) using the unipolar method on the masticatory and temporal muscles. The correction period for both groups was 1 month. Outcomes were evaluated using the Hamburg Test, the Helkimo Index, and the Jaw Functional Limitation Scale. Results. After the application of relaxing splints and the implementation of the physical therapy program, the total score of the "Hamburg test" decreased by 39.6% in group 1, and by 59.4% in group 2 (p&lt;0.05). The positive dynamics of the Helkimo index was 34.5% in group 1, 48.6% in group 2 (р&lt;0.05), passing within the parameters of moderate temporomandibular joint dysfunction. When re-evaluating the functional state of the temporomandibular region according to the Jaw Functional Limitation Scale, the improvement of chewing in group 1 was 28.8%, in group 2 – 62.3%, the mobility of the lower jaw was 21.9% and 44.3%, respectively, verbal and emotional communication – 26% and 41.7%, the total score – by 26.2% and 49.6%. The developed program of physical therapy against the background of wearing individual relief splints demonstrated a statistically significantly better effect (p&lt;0.05) on all the studied indicators of the functioning of the orofacial zone compared to the initial data and the results of the group that corrected the dysfunction of the temporomandibular joint with talc splints. Conclusion. Use the means of physical therapy can be recommended to increase the effectiveness of dental orthopedic correction in patients with osteoarthritis of the temporomandibular joint.

Interprofessional Education in Neurology Intensive Care Unit: Learning Activity for Students Completing Clerkships and Field Experiences.

Teaching learners the benefits and challenges of interprofessional collaborative practice (IPCP) in acute care is best done in the context of authentic patient care rather than classroom settings. Yet differing clinical schedules of students and faculty as well as structured, controlled environments of intensive care units are not conducive to bringing multiple interprofessional learners to the bedside. We developed a 2.5-hour interprofessional education (IPE) activity based around neurology intensive care unit patients that was implemented using team-based learning (TBL) methodologies, including individual/team readiness assessments (iRAT/tRAT) and application activities comprising interprofessional student-led care conferences in which authentic patients and their unique, deidentified clinical parameters were discussed. Students represented medicine, nursing, chaplain, physician assistant, social work, respiratory therapy, pharmacy, physical therapy, and law programs. Two hundred ninety-three students participated online during the first year. Mean tRAT scores were 14.9 points higher than iRAT scores (39.5 vs. 24.6 of 44 possible). There was strong agreement from students that the session met educational objectives (all >4.0 on a 5-point Likert scale). Individualized feedback was provided to learners using a rubric; 276 students shared personal reflections of knowledge learned through interactions with other health professional students/faculty. IPE activities that use authentic patient chart data as the basis for student application exercises are useful learning tools since students must teach and learn from each other, interpret data, and propose care plans based upon their collaborations. This enables students to experience acute care IPCP in a low-stakes environment.

Efficacy of whole body vibration on fascicle length and joint angle in children with hemiplegic cerebral palsy.

Enhancing joint range of motion is regarded as one of the most long-term goals in the management of cerebral palsy (CP). With CP, there are well-documented changes in the neurological drive to skeletal muscle, which leads to modifications in the architecture of the muscles. Whole-body vibration (WBV) is one intervention to modify muscle and joint. However, its efficacy needs to be accurately studied. This study investigates the effects of WBV on fascicle length, knee joint angle and function in children with spastic hemiplegic CP. Eighty children with hemiplegic CP aged 4-6years were enrolled. Participants were randomly divided into experimental and control groups. The control group received a designated physical therapy program and the experimental group received a designated physical therapy program in addition to WBV. Program was performed 3 times a week for 12weeks. Goniometry, ultrasonography and gross motor function measurements were used to measure knee extension joint angle, fascicle length of hamstrings and function, respectively. The results of this study indicated that, designed physical therapy program with WBV could increase the active range of motion in knee extension (p=0.001) and fascicle length of hamstring (p=0.001) muscles as well as improve function in children with hemiplegic CP (p=0.001). According to the findings, the use of WBV can be considered as an effective treatment in increasing the range of motion of knee extension and fascicle length and finally improving function in children with CP.

The Impact of Executive Function on Retention and Compliance in Physical Therapy in Veterans

ObjectiveTo examine retention and compliance to a novel Physical Therapy (PT) treatment among Veterans with and without executive function deficits (EFD+/EFD-). DesignThis study was a preplanned secondary analysis of an ongoing randomized controlled trial. SettingOutpatient PT at VA Boston Healthcare System (VABHS). ParticipantsSeventy-two community-dwelling middle-aged and older Veterans (mean age 72, (range 51-91); 87% male) with gait speed between 0.5 and 1.0 m/s were recruited from primary care practices. InterventionsEight-week moderate to vigorous intensity PT program. Main outcome measureVeterans’ baseline mobility, retention (dropouts), and treatment compliance and post-treatment exercise compliance to 8-week PT treatment were evaluated based on their baseline EFD status. ResultsOf the 72 participants, 22% (n=16) were EFD+. Veterans with EFD+ at baseline had worse mobility performance (Short Physical Performance Battery (SPPB), 7.7 vs. 9.5, p<0.001) and patient-reported mobility (Activity Measure for Post-Acute Care (AM-PAC), 57.6 vs. 62.2, p<0.01) after adjusting for age, gender, number of comorbidities, depressive symptoms, and pain interference. Dropout rates for EFD+ and EFD- were 44% and 25%, respectively (p>0.05). In multivariable logistic regression modeling, pain interference, depressive symptoms, mobility, and living alone but not EFD status were associated with dropping out. There was no evidence of significant differences in treatment compliance or post-treatment exercise compliance, measured by the number of attended sessions and the number of post-treatment exercise days by EFD status. ConclusionEFD+ was associated with poor baseline mobility. While the dropout rate was higher among Veterans with EFD+, we were unable to conclude whether EFD status impacts retention or compliance due to the small sample size. Further investigation is needed to determine whether EFD status may identify individuals who need additional support during and/or after rehabilitation treatment.

Catalyzing Inclusive Excellence: Transformative Practices of Auburn University’s School of Kinesiology

The School of Kinesiology (KINE) at Auburn University (AU) has demonstrated exemplary commitment to diversity, equity, and inclusion, earning the 2024 American Kinesiology Association’s Inclusive Excellence Award. This article describes the strategic planning and actions taken by AU KINE over more than a decade to promote inclusive excellence by enhancing diversity and fostering inclusion. The article discusses how AU KINE overcame challenges, such as misconceptions about diversity initiatives, and how the unit continues to evolve, including developing an inclusive Doctor of Physical Therapy program. Throughout the process, AU KINE has aligned its diversity and inclusion mission and goals with the broader institution. The authors aim to demystify the process of creating a more diverse and inclusive kinesiology department and offer insights for other programs seeking to enhance their diversity and inclusion efforts. AU KINE’s success demonstrates the transformative power of strategic, sustained initiatives to promote inclusive excellence in kinesiology.

Effect of cognitive training on selected gait parameters in patients with stroke

Background. Not only may early cognitive rehabilitation help stroke patients with their cognitive impairment, but it can also help patients restore their capabilities to do everyday activities. There isn’t much data on how cognitive training affects spatiotemporal gait variables in stroke survivors. Objective. To examine the impact of cognitive training on selected gait parameters in stroke patients. Subjects and Methods. Forty male and female patients with mild ischemic chronic stroke, ranging in age from 45 to 60 years, were recruited and distributed into two equal groups at random (G1 and G2). The Montreal Cognitive Assessment Scale (MOCA) and the Rehacom system were utilized to evaluate the patient’s cognitive function. The Biodex gait trainer device was utilized to measure several gait variables for all patients. Rehacom cognitive training and a selected physiotherapy program were administered to the study group (G1). The similar selected physiotherapy program utilized for the G1 was applied to the control group (G2). For eight weeks, the treatment was administrated three sessions each week, day after day. All variables were evaluated before- and after-intervention. Results. The step length and walking speed, as well as the MOCA scale score of G1, were significantly higher after treatment than those of G2 (p = 0.001). The correlation between step length and median reaction time (MRT) was moderate negative significant correlation (r = – 0.698, p = 0.001). Conclusion. Cognitive training has a beneficial impact on improving the selected spatiotemporal gait parameters in stroke patients.

Examining the effects of non-immersive virtual reality game-based training on knee hyperextension control and balance in chronic stroke patients: a single-blind randomized controlled study.

Post-stroke hemiparesis can lead to decreased mobility, gait disturbances, impaired balance, postural instability, limitations in activities of daily living (ADL), and long-term disability. The aim of this study was to examine the effect of non-immersive virtual reality game-based training (nIVRGT) in addition to conventional rehabilitation in stroke patients on dynamic balance, knee hyperextension control, and ADL. Twenty-five chronic stroke patients aged between 51 and 70 were included in the study. Stroke patients were randomized to a control group (n = 12) and a study group (n = 13). Individuals in control group participated conventional physiotherapy and rehabilitation program for 60min, 3 days a week for 6 weeks. individuals in the study group received 40min of conventional physiotherapy and rehabilitation program plus 20min nIVRGT. Functional Reach Test, Timed Up and Go Test, Computerized Gait Evaluation System and Barthel Index were used in the evaluation. The study group improved significantly in dynamic balance, knee control, and ADL (p < 0.05). In the control group, significant improvements were observed in dynamic balance and knee control (p < 0.05), except ADL (p > 0.05). The study group improved in dynamic balance compared with the control group (p < 0.05). Knee control and ADL improved similarly in both groups (p > 0.05). Our results showed that conventional and additional nIVRGT rehabilitation improved dynamic balance and knee hyperextension control in chronic stroke. However, it was observed that the non-immersive virtual reality (nIVR) approach was more effective in improving dynamic balance in stroke patients than conventional rehabilitation alone. NCT05907473.