Physical Therapy Program Research Articles

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.

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.

The Effects of Physiotherapy Programmes, Aided by Virtual Reality Solutions, on Balance in Older Women: A Randomised Controlled Trial

Background: Modern technologies are being applied to maintain and improve the functional performance of older adults. Fully immersive virtual reality (VR) combined with a scope of dual-task (DT) activities may effectively complement conventional physiotherapy programmes for seniors. The study aimed to compare the effectiveness of a fully immersive virtual reality (VR) environment combined with a scope of dual-task activities regarding balance in older women. Methods: Eighty women were recruited to the study protocol and, following randomisation, allocated to two equally sized groups, one pursuing conventional OTAGO exercises, the other one the VR-solutions-aided exercise programme combined with a scope of DT activities. Physiotherapy sessions spanned 6 weeks, each one lasting 60 min, three times a week, in both groups. Results: Homogeneity analysis of both study groups indicated no statistically significant differences at the first measurement point. After the intervention, both study groups achieved significantly improved scores on all tests. The VR + DT group obtained better results in dual-task gait and single-leg standing, whereas the greatest difference was observed during SLS CL (1.52 s vs. 2.33 s—difference 0.81 s 53.2% change, p = 0.001). The OTAGO group performed better in the TUG single-task gait (11.35 s vs. 12.60 s, p &lt; 0.001) and in the Berg balance scale. Conclusions: The VR + DT training is effective in improving individual balance as well as in reducing fall risks. VR-assisted physiotherapy should complement conventional physiotherapy programmes (e.g., OTAGO). The benefits of applying VR solutions indicate that older women might well use this form of activity regularly under the guidance of a therapist or a family member.

The Effect of Postural Rehabilitation on Pain, Balance, Mandibular Movement, and Posture in Temporomandibular Disorder Patients: A Comparison Between Posterior Edentulous and Dentate Groups.

Objective: Posterior edentulism reduces occlusal support, thus increasing the risk and symptoms of temporomandibular disorder. No previous study has explored its effect on the treatment of temporomandibular disorders. This study aimed to examine the relationship between neck posture, balance, and posterior edentulism in patients with temporomandibular disorder and compare the effectiveness of physical therapy. Methods: In a quasi-experimental controlled trial, 26 patients with temporomandibular disorder were divided into 13 in the partly edentulous group and 13 in the dentate group. Both groups received manual therapy, postural exercises, deep neck flexor stabilization, and Kinesio tapping for 6 weeks. Each participant completed 12 physiotherapy sessions, administered twice weekly, with a minimum interval of 48 hours between sessions. Outcomes were assessed at baseline and after the 6-week program, including pain, mandibular movement, posture, and balance. Results: The physical therapy program significantly improved all measured outcomes (P < .05). Furthermore, the partially edentulous group showed more remarkable improvement in pain and balance compared to the dentate group (P < .05). Conclusions: Postural exercises effectively alleviate symptoms in patients with temporomandibular disorder, with more significant improvements observed in the partially edentulous group than in the dentate group.

Experience-based co-design to develop innovative telehealth physiotherapy interventions and resources for children and young people with asthma and dysfunctional breathing

Introduction Healthcare requires new technologies to deliver hybrid services. Before embedding health-delivery transformations including physiotherapy in asthma clinics, it is essential to give young people and their carers a voice to facilitate co-designing of services. Objective To co-design hybrid telehealth physiotherapy services and online resources for, and in partnership with, young people with asthma and dysfunctional breathing, and their families. Methods Experience based co-design study undertaken at a specialist paediatric difficult asthma clinic, including online service user focus groups and electronic questionnaires for service providers. Eight children aged between 11 and 17 years and their families and 11 members of the multi-disciplinary team (MDT) managing children with difficult asthma were recruited purposively. Results A series of seven online videos were created, topics included: how to support a breathless child, education on how we breathe, breathing patterns, symptom differentiation, breathlessness, rescue breathing techniques, and exercise. Each video has downloadable resources. Five children and four parents wrote blogs to share their experiences. A live online 12-week physiotherapy program was developed on a web-based platform www.beamfeelgood.com called Asthma Kids. Conclusion Co-design enabled partnership working to develop hybrid telehealth physiotherapy services and prototype interventions to support home practice for children with asthma and dysfunctional breathing.

Capabilities for Using Telemonitoring in Physiotherapy Treatment: Exploratory Qualitative Study.

Telemonitoring (TM), as part of telehealth, allows physiotherapists to monitor and coach their patients using remotely collected data. The use of TM requires a different approach compared with face-to-face treatment. Although a telehealth capability framework exists for health care professionals, it remains unclear what specific capabilities are required to use TM during physiotherapy treatments. This study aims to identify the capabilities required to use TM in physiotherapy treatment. An exploratory qualitative study was conducted following a constructivist semistructured grounded theory approach. Three heterogeneous focus groups were conducted with 15 lecturers of the School of Physiotherapy (Bachelor of Science Physiotherapy program) from the Amsterdam University of Applied Sciences. Focus group discussions were audiotaped and transcribed verbatim. Capabilities for using TM in physiotherapy treatment were identified during an iterative process of data collection and analysis, based on an existing framework with 4 different domains. Team discussions supported further conceptualization of the findings. Sixteen capabilities for the use of TM in physiotherapy treatment were found addressing 3 different domains. Four capabilities were identified in the "digital health technologies, systems, and policies" domain, 7 capabilities in the "clinical practice and application" domain, and 5 capabilities in the "data analysis and knowledge creation" domain. No capabilities were identified in the "system and technology implementation" domain. The use of TM in physiotherapy treatment requires specific skills from physiotherapists. To best use TM in physiotherapy treatment, it is important to integrate these capabilities into the education of current and future physiotherapists.

Dynamics of the functional state of the cardiovascular system in individuals after cholecystectomy under the influence of a rehabilitation program in sanatorium-resort conditions.

The article discusses the dynamics of the functional state of the cardiovascular system (CVS) in individuals after laparoscopic cholecystectomy (LCС) under the influence of a rehabilitation program in SANATORIUM-RESORT CONDITIONS. The study involved 79 individuals after LCC aged 45 to 59 years. The individuals were divided into 2 groups: group A (n=39) and group B (n=40). Individuals in group A received rehabilitation services according to the clinical protocol (diet, hydrotherapy, mineral or coniferous baths, and physical therapy, etc.) In group B, individual rehabilitation programs were formed depending on the existing dysfunctions and the tolerance of the CVS to physical activity. In group B, the rehabilitation intervention to increase the function of endurance and physical performance was applied Nordic walking (NW). The initial examination in both groups revealed an increase in resting heart rate (RHR), diastolic (DBP) and systolic (SBP) blood pressure, a decrease in the performance of a 6- minute walk test and the presence of a feeling of shortness of breath during the test. The implementation of a physical rehabilitation (physical therapy) program in group B, which used Nordic walking to increase physical activity, tolerance to physical activity, and improve cardiovascular function, was effective. The use of NW in sanatorium-resort conditions of rehabilitation (lasting at least 18 days) has a positive effect and leads to a statistically significant decrease in RHR, SBP, DBP, an increase in walking distance in 6 minutes and a decrease in the feeling of shortness of breath when walking, compared to the control group. It was established that diet therapy, hydrotherapy, mineral or coniferous baths, and other water procedures, classical abdominal and back massage, group daily therapeutic gymnastics in group A did not have a positive effect on increasing the level of physical activity tolerance, CVS functioning in patients after LCC.

Academic Coaching in Entry-level Doctor of Physical Therapy Education.

Learners face a variety of academic and personal challenges that may impact performance in Doctor of Physical Therapy (DPT) programs. Academic coaching has emerged as a student support model within undergraduate medical education but has not yet been evaluated in DPT education. The purpose of this method/model presentation was to describe the development, implementation, and evaluation of 2 coaching programs. Two hybrid DPT programs implemented a coaching approach to support students. The coaching framework was centered around an individualized relationship between the learner and faculty coach to promote reflection, growth, agency, and persistence in educational and professional development. Faculty members were prepared and supported to serve as coaches. Coaches met with their assigned students at regular intervals throughout the program, including clinical experiences. The coaching programs were assessed through program exit surveys and an alumni survey. Graduates from both programs reported that the coaching program was effective and supported a sense of belonging or connectedness within their DPT program. They reported several specific activities that were part of the coaching program structure that supported its effectiveness, including group-based orientation activities and 1:1 meetings with their coach. Graduates also provided suggestions for program improvement including increased structure and more opportunities to connect with their peers and coaches in a nonacademic setting. Two DPT programs successfully implemented coaching as their student support model. With appropriate preparation, planning, and support, coaching programs have the potential to provide individualized and meaningful support for DPT students.

IMPROVEMENT OF THE QUALITY OF LIFE OF PATIENTS WITH CONCUSSION BY MEANS OF PHYSICAL THERAPY

Brain concussion from blast waves is one of the most common injuries in combat. This injury is three times more common than wounds. Blast wave brain concussion has significant consequences and impairs the quality of life for an indefinite period of time, so the use of physical therapy to improve the quality of life of patients with its consequences is an urgent issue. Purpose to prove the effectiveness of physical therapy in improving the quality of life of patients after blast concussion. Methods. To achieve the aim of the study, the scientific literature was analyzed and information was systematised using electronic databases such as PubMed, Google Scholar and others. To assess: sleep function, the Insomnia Severity Index (ISI) was used; pain perception, the Visual Analogue Scale (VAS) and the Verbal Rating Scale were used; changes in emotional functions, the Wessman-Ricks Emotional State Self-Assessment (WESA) was used; and quality of life, the Health Survey (SF-36 v2) was used. Research results. The initial treatment of concussion is of great importance and includes a number of important aspects that can be performed by a first responder. Since concussion leads to partial or complete disability and largely results in disability, which leads to other problems at different levels, the prerequisites for developing a physical therapy programme aimed at improving the quality of life of patients were the selection of ICF components appropriate to the patients' condition. The physical therapy programme was individualised, tailored to each patient individually, taking into account their condition and wishes, with special attention paid to the primary tasks of pain relief and normalisation of sleep function, which is key to reducing all other consequences of concussion and improving the quality of life. After the implementation of the proposed physical therapy programme, patients in the main group improved their sleep, decreased their pain levels and improved their emotional state. All indicators at the end of the study were better in the main group than in the control group, although at the beginning of the study the indicators in both groups did not differ significantly. Comparison of the results of the SF-36 v2 Health Survey proves the effectiveness of the developed physical therapy programme in combination with conventional treatment of blast injury. Conclusions. The results of the study proved the positive impact of the physical therapy programme for patients with blast concussion, which took into account the patient's condition and wishes, and whose primary objectives were to stop the manifestation of pain and normalise sleep function, actively involve the patient in the rehabilitation process through Pilates, Yoga, Nordic walking and an obstacle course with a sports focus. Motivation for action and normalisation of the emotional state are important during the rehabilitation period. The combination of active activities with massage therapy, namely Thai traditional massage, Thai foot massage, Tibetan singing bowl massage and Rebozo massage, contributed to general relaxation, reducing the effects of stress, muscle and emotional stress, harmonising the emotional state, improving blood circulation and restoring all body systems.

DYNAMICS OF ANTHROPOMETRIC AND PHYSICAL MARKERS OF SARCOPENIC OBESITY IN ELDERLY PERSONS WITH OSTEOARTHRITIS OF THE HIP IN THE PROCESS OF PHYSICAL THERAPY

Purpose: to determine the effect of a physical therapy program on anthropometric and physical indicators of elderly people with osteoarthritis of the hip, which occurs against the background of sarcopenic obesity. Material. 68 elderly people with osteoarthritis of the hip and sarcopenic obesity and 36 of their healthy peers (control group) were examined. Representatives of the comparison group (33 persons) corrected the signs of osteoarthritis according to the clinical guideline "Osteoarthrosis". Representatives of the main group (35 persons) were engaged in a physical therapy program for six months. Its goal was: reduction of pain and discomfort in the hip; improvement of the amplitude of movements in the hip, joints of the lower limbs, spine; optimization of general mobility and motor stereotype; decrease of body weight; facilitating activities of daily living; improvement of geriatric status. The physical therapy was implemented in rehabilitation center and in the form of telerehabilitation. It included kinesitherapy, Proprioceptive Neuromuscular Facilitation of the lower limbs and lower back; massage, kinesiological taping of the hip, thigh and lower back muscles; a course of shock wave therapy of the hip, nutritional correction, education of patients and their family members. The effectiveness of the program was evaluated by the dynamics of anthropometry (mass, body mass index, waist and hip circumferences and their ratio), body composition (fat content, muscle tissue, visceral fat), sarcopenia markers (hand dynamometry, Short Physical Performance Battery). Results. Application of the physical therapy program led to a decrease in body weight in patients of the main group: in men by 5.4 kg, in women by 4.51 kg, p&lt;0.05. Corresponding changes occurred in body mass index, and the women of the main group reached the level of overweight. The dynamics of the abdominal nature of obesity also changed: the decrease in waist circumference in men was 8.3 cm, in women - 5.9 cm, which had a favorable effect on the ratio of waist and hip circumferences. A decrease in the severity of the signs of sarcopenia in main group persons was confirmed by the results of a statistically significant increase in the content of muscle tissue both in men (from 22.17±1.30% to 28.12±1.09%) and in women (from 19, 01±1.20% to 23.44±1.15%). The content of visceral fat in the subjects of the main group decreased by almost 25%. The content of adipose tissue in the whole body decreased in men from 42.29±1.73% to 34.50±1.22%, in women – from 46.53±1.19% to 40.57±1.57%. The increase in hand dynamometry results in women was from 13.48±1.14 kg to 17.22±0.56 kg, in men - from 19.80±1.07 kg to 26.15±1.01 kg. The complex nature of the physical therapy program contributed to the improvement of performance of all Short Physical Performance Battery subtests in the main group, and the improvement of its total score was 35.5% (from 6.49±0.53 points to 10.07±0.44 points, p&lt;0, 05). Patients of the comparison group, who underwent rehabilitation according to the standard program for the correction of osteoarthritis, did not show improvement in the studied indicators of anthropometry and markers of sarcopenia (p&gt;0.05). Conclusions. Elderly patients with osteoarthritis of the hip and sarcopenic obesity require the development of physical therapy programs taking into account and correcting the specifics of each condition, which will increase the overall effectiveness of rehabilitation measures.

FAMILY-ORIENTED PHYSICAL THERAPY PROGRAM FOR CHILDREN WITH AUTISM SPECTRUM DISORDERS

Family-centered physical therapy programs for children with autism involve the child, family members, and professionals working together. They aim to provide support, education, and resources that enable the family to understand and cope with the special needs associated with the rehabilitation of a child with autism. By involving the entire family in the therapy process, such programs help improve communication, enhance the quality of life for the entire family, help the child develop skills to participate in various activities with peers, strengthen family ties and provide a more holistic approach to child care. Aim. To substantiate the structure and program of family-oriented physical therapy for preschool children with autism spectrum disorders (ASD). Materials and methods. Analysis of literature sources, including clinical guidelines and recommendations, as well as scientific research on the rehabilitation of patients with autism spectrum disorders; systematic analysis and synthesis, methods of analogy, abstraction and generalization. The experience of rehabilitation and physical therapy of children with ASD, gained by the NGO Agape, which is engaged in the rehabilitation and habilitation of children with disabilities in Khmelnytskyi, was also taken into account. Results. A child's atypical development and disabilities affect the entire family. Caregivers and family members may develop feelings of vulnerability and guilt, or they may feel unable to care for their child. In addition, the patient-centered and biopsychosocial approach assumes that decisions about therapy are made by caregivers, as they are the best experts on their needs and abilities. There has also been a shift in emphasis from impairment of body structures and functions to the child's participation in family life and activities with the family, as well as from what the child cannot do to what the child can do. Supporting the child and family through this complex process of rehabilitation and physical therapy with this in mind, and recognizing the family's interests and values, is crucial and helps families feel stronger and more confident as they face daily challenges. Family-centered physical therapy takes all of these approaches into account. Family-centered physical therapy is a set of activities aimed at involving the family and the family environment in the child's physical therapy process to provide support, necessary skills and resources to both the patient and the family at each stage of therapy, ensuring the best possible results. All phases of physical therapy involve the child and family members in the evaluation, goal and objective setting, education, implementation of the planned intervention program, counseling and monitoring, and adjustment of the goal, objectives and physical therapy program. Conclusions. Family-centered service programs encourage therapists to move from focusing on an isolated impairment and the needs of the child alone to understanding disability within the social model of services and the context of the family and community. A family-centered physical therapy program for children with ASD involves close collaboration between physical therapists, the child, and parents and other family members. This ensures an individualized approach to therapy, increased effectiveness of the sessions, and improved quality of life for the child and the entire family. Active involvement of parents and providing them with the knowledge and skills to conduct sessions at home helps to achieve sustainable results in the child's development and strengthens family ties, increasing the overall level of satisfaction.

CORRECTION OF THE SIGNS OF MYOFASCIAL DYSFUNCTION IN PERSONS WITH THE CONSEQUENCES OF FRACTURE OF THE JAW BY MEASURES OF PHYSICAL THERAPY

Purpose: to evaluate the effectiveness of the developed physical therapy program based on the dynamics of myofascial dysfunction parameters of the neck and orofacial area in patients with the consequences of a mandibular fracture. Methods. 77 people were examined. The control group consisted of 32 people without the consequences of injuries of the maxillofacial area and burdened dental status. Group 1 consisted of 24 people who underwent rehabilitation according to the general principles of rehabilitation of patients of the dental profile. Group 2 consisted of 21 people with the consequences of a fracture of the lower jaw, who underwent rehabilitation using therapeutic exercises for the muscles of mastication, face, neck, cervical collar zone, back , shoulder girdle; a course of massage (intraoral and classical) of the masticatory muscles, temporomandibular joint, neck, cervical collar zone; thermal procedures (dry heat) on the area of the temporomandibular joint; postisometric relaxation of masticatory muscles, neck muscles; kinesiological taping of the temporomandibular joint, masticatory muscles, neck; training (education) of the patient (reception of soft food, restriction of wide opening of the mouth, elimination of dental bad habits). Rehabilitation lasted three months. Effectiveness was assessed by complaints, examination results, palpation, measurement of chin-sternum distance, "Hamburg test", manual muscle test. Results. During the re-examination, no such complaints were found in people of group 2, such as complications in swallowing, sound phenomena and pain in the temporomandibular joint, pain in the masticatory muscles, complications in nasal breathing, and pain in the neck. Complications when chewing food were found only in 28.6%, restriction of mouth opening - 28.6%, "uncomfortable" position of the jaw - 9.5%. The psycho-emotional state and sleep improved; corresponding complaints were found in 14.3% and 23.8%. The expression of visual manifestations of dysfunction decreased in both main groups with an advantage in individuals of the group. Pathological palpable changes were not detected in the temporal, masticatory, bifidus and hypoglossal muscles in individuals of group 2. Other changes were detected in a small number of individuals - in the lateral pterygoid in 14.3%, medial pterygoid in 9.5%, sternoclavicular-mammoid in 14.3%, trapezoid in 28.6%. In people of group 2, the distance between the chin and sternum when the neck was bent decreased from 4.82±0.42 cm to 2.16±0.23 cm (p&lt;0.05). The decrease in manifestations of dysfunction in the temporomandibular joint during the "Hamburg test" was 11.9% in group 1, 38.3% in group 2, p&lt;0.05. There was an improvement in the strength of the masticatory muscles according to manual muscle test during the movements of raising and lowering the lower jaw, its deviation and protrusion. Group 1, which underwent rehabilitation with the use of independent classes and passive use of preformed physical factors, did not demonstrate an effect on indicators of myofascial dysfunction of the neck; the achieved improvement according to the studied parameters of the orofacial zone were statistically significantly worse than the parameters of group 2. Conclusions. The obtained result is a justification for the need to apply programs of active functional physical therapy for the correction of myofascial dysfunction of the orofacial zone and the neck area in patients with injuries of the jaw.

Transdermal iontophoresis versus high power pain threshold ultrasound in Mechanical Neck Pain: a randomized controlled trial

BackgroundThe investigation aimed to assess the impacts of magnesium sulphate (MgSO4) iontophoresis and high-power pain-threshold ultrasound (HPPT-US) on pain, range of motion (ROM), and functional activity in physical therapy students suffering from mechanical cervical pain.MethodsTypically, 75 males aged 19 to 30 years suffering from mechanical neck pain were enrolled in this investigation. Participants were divided at random into three groups. Group A received iontophoresis plus conventional physical therapy program, Group B received HPPTUS along with conventional therapy, and Group C received conventional therapy only. The outcomes were pain evaluated by visual analog scale (VAS) and Digital Electronic Pressure Algometer, cervical range of motion measured by Myrin gravity reference goniometer, and Arabic Neck disability index (ANDI) evaluate neck function.ResultsThe differences within and between groups were detected utilizing a mixed-design multivariate analysis of variance (MANOVA). The within- and between-group analysis of all outcome measures revealed that there were statistically significant differences at post-intervention between high-power ultrasound and conventional group at all variables and also between iontophoresis and conventional group, but there was no statistically significant variation between high-power ultrasound and iontophoresis.ConclusionMgSO4 iontophoresis and HPPT-US are effective in decreasing pain, improving neck function, and improving neck ROM in subjects with mechanical neck pain who have active myofascial trigger points (MTrPs) on the upper fibers of the trapezius with no superiority of one over the other.Trail registrationThe study was registered in the Clinical Trials Registry (registration no: NCT05474898) 26/7/2022.

MODERN VIEWS OF USE OF TELEREHABILITATION IN URINARY TRACT DYSFUNCTION IN PATIENTS WITH MULTIPLE SCLEROSIS

Multiple sclerosis is a chronic disease of the nervous system that often leads to various disorders, including urinary tract dysfunction. This significantly affects the quality of life of patients, causing physical and psychological complications. The term "bladder rehabilitation" summarizes treatment options aimed at restoring its function in patients with neurourological symptoms. A strong contraction of the sphincter of the urethra and/or pelvic floor, as well as anal dilatation, manipulation of the genital area, and physical activity reflexly inhibit urination. A comprehensive physical therapy program for patients with pelvic disoders includes pelvic floor vibration massage, training in proper breathing patterns, pelvic floor muscle relaxation and stabilization exercises and should last several months, during which the patient regularly visits the doctor. The pandemic and war have created barriers that affect almost every aspect of life, treatment and rehabilitation, especially for people with chronic neurological conditions. Traditional rehabilitation methods used to correct urinary tract dysfunction have their limitations, including difficulties in accessing specialists, especially in remote areas. This stimulates the development and implementation of telerehabilitation as an alternative approach. Telerehabilitation involves the use of digital technologies for the remote provision of medical services and patient monitoring. It allows doctors to monitor the condition of patients, provide recommendations and adjust treatment without the need for personal visits. Considering the existing data and our own clinical experience, we consider it appropriate to use telerehabilitation for the correction of disorders of the lower urinary tract, especially in the conditions of war, when access to rehabilitation centers may be difficult. In the department of medical rehabilitation of the University Clinic of the Kharkiv National Medical University, we successfully conducted telerehabilitation using Google Meet video conferencing for 10 patients with urinary incontinence on the background of multiple sclerosis, whose EDSS was no more than 4.0. When conducting online classes under the guidance of a physical therapist, patients noted a desire to strictly follow the recommendations and perform regular exercises. All patients kept a urination diary, according to which the frequency of urination was reduced by an average of 20-25%, which had a positive effect on their quality of life. Although our observations are not representative, in combination with existing studies, we consider telerehabilitation to be a promising direction in complex therapy and rehabilitation of this pathology. Conclusion The use of telerehabilitation for urinary tract dysfunction in patients with multiple sclerosis is a promising direction that requires further research. This approach can significantly improve the quality of life of patients, reduce the burden on the health care system and provide a more affordable and convenient treatment. A multidisciplinary team should be involved, including a neurologist, a urologist, a gynecologist, and a physical therapist to select the optimal tactics of drug treatment and physical therapy. A promising direction of further research is the development of standard protocols for conducting telerehabilitation for patients with lower urinary tract dysfunction against the background of multiple sclerosis and other pathologies.

CORR Insights®: Does Integration of Graded Motor Imagery Training Augment the Efficacy of a Multimodal Physiotherapy Program for Patients With Frozen Shoulder? A Randomized Controlled Trial.

CORR Insights®: Does Integration of Graded Motor Imagery Training Augment the Efficacy of a Multimodal Physiotherapy Program for Patients With Frozen Shoulder? A Randomized Controlled Trial.

What are the predictors of response to physiotherapy in patients with massive irreparable rotator cuff tears? Gaining expert consensus using an international e-Delphi study

BackgroundMassive irreparable rotator cuff tears can cause significant shoulder pain and disability. Treatment options include physiotherapy or surgery, with a lack of research comparing treatment options. For physiotherapy there is uncertainty about which patients will have a successful or unsuccessful response to treatment and a lack of consensus on what constitutes the best physiotherapy programme. With these significant gaps in the research, it is challenging for clinicians seeing patients with massive irreparable rotator cuff tears to advise on what is their best treatment pathway.MethodsA three round Delphi study was conducted with expert shoulder physiotherapists and orthopaedic surgeons to gain consensus on the important factors associated with response to physiotherapy in this patient population. Round 1 was an information-gathering round to identify predictors of response to physiotherapy in patients with massive irreparable rotator cuff tears. Rounds 2 and 3 were consensus-seeking rounds on the importance and modifiability of the predictors. Consensus criteria were determined a priori using median, interquartile range, percentage agreement and Kendall’s Coefficient of Concordance.ResultsParticipants were recruited April–October, 2023. 88 experts participated in Round 1 and of these, 70 completed Round 3 (79.54%). In Round 1, content analysis of 344 statements identified 45 predictors. In Round 2, 29 predictors reached consensus as important and 2 additional predictors were identified. In Round 3, of the 31 predictors from Round 2, 22 reached consensus as important and 12 of these reached consensus as modifiable by physiotherapists. Both patient factors and clinician factors from a broad range of domains reached consensus: biomechanical, psychological, social, co-morbidities, communication / healthcare interactions and pain.ConclusionsThe results of this Delphi study suggest that clinicians assessing patients with massive irreparable rotator cuff tears should assess across all these domains and target the modifiable factors with interventions. Particular emphasis should be placed on optimising modifiable clinician factors including therapeutic alliance, comprehensive explanation of the condition and collaborative and realistic goal-setting. These in turn may influence modifiable patient factors including patient expectations, engagement with the physiotherapy programme, motivation and self-efficacy thus creating the ideal environment to intervene on a biomechanical level with exercises.

Effect of Pilates exercises on pulmonary function, respiratory muscle strength, and functional capacity in patients with inhalation injury after flame thermal burn: A prospective randomized controlled trial

BackgroundInhalation injury is an acute respiratory tract injury that occurrs by inhalation of smoke, toxic gases, or steam. Early management is needed to reduce its mortality and morbidity. The purpose of this study was to ascertain whether Pilates training could help burn patients with inhalation injury after flame thermal burn in increasing pulmonary function, respiratory muscle strength, and functional ability. MethodsIn this prospective, randomized, controlled trial, sixty participants (26 males and 34 females) with inhalation injury and deep partial-thickness flame burns of 30–40 % total body surface area (TBSA) were randomized in blocks of four, with a 1:1 allocation ratio into two groups: Group A (Pilates Group); received Pilates training plus conventional physical therapy program, and Group B (Control Group); received conventional physical therapy program only. This study was conducted at the Faculty of Physical Therapy's outpatient clinic, Cairo University, 3 sessions/week for 12 weeks. The primary outcome measure was the forced vital capacity (FVC) measured by a spirometer, while the secondary outcome measures were peak expiratory flow rate (PEFR), forced expiratory volume in 1 s (FEV1), FEV1/FVC% assessed by a spirometer, strength of respiratory muscles (maximum inspiratory pressure (MIP) and maximum expiratory pressure (MEP) assessed by the digital manovacuometer, and the functional capacity evaluated by 6-Minute Walk Test (6-MWT). ResultsA two-way mixed-design MANOVA was used to analyze the results within and between groups. There were no significant differences in demographic data between groups (P > 0.05). There were significant differences in all variables after treatment in group A compared with group B; FVC (95 % CI: 0.38, 1.13) (P = 0.001), FEV1 (95 % CI: 0.39, 0.97) (P = 0.001), FEV1/FVC % (95 % CI: 1.90, 17.19) (P = 0.02), PEFR (95 % CI: 0.47, 0.99) (P = 0.001), MIP (95 % CI: 5.12, 11.44) (P = 0.001), MEP (95 % CI: 2.57, 8.24) (P = 0.001), 6-MWT (95 % CI: 27.22, 54.96) (P = 0.001), FVC (% predicted) (95 % CI: 3.58, 12.58) (P = 0.001), FEV1 (% predicted) (95 % CI: 1.21, 11.11) (P = 0.02), PEFR (% predicted) (95 % CI: 1.33, 10.83) (P = 0.01), MIP (% predicted) (95 % CI: 2.26, 11.72) (P = 0.001) and MEP (% predicted) (95 % CI: 1.33, 10.37) (P = 0.01). ConclusionThe current study demonstrated that a Pilates exercise program in addition to a traditional physical therapy program for 12 weeks significantly improved the pulmonary function (FVC, FEV1, PEFR and FEV1/FEV), strength of respiratory muscles (MIP and MEP), and functional capacity (6-MWT) in patients with inhalation injury after flame burns. These results underscore the importance of including Pilates exercises in the rehabilitation plan for burn patients with inhalation injury. Future studies are needed to evaluate the effect of Pilates exercises on other degrees and TBSA of burn, long-term follow up, and to measure cardiopulmonary parameters.

A place to call our home: innovative rural physical therapy training in Canada

BackgroundTo promote rural practice and increase enrollment in the entry-level Master of Science Physical Therapy program at the University of Alberta, the Department of Physical Therapy developed a rural physical therapy satellite campus located in a farming region in central Alberta. A distributed learning format was used to connect the rural cohort to the main urban campus. Real time video conferencing was used to connect the two campuses for all lectures, seminars and clinical skills classes. This evaluation aimed to describe a unique rural training program for physical therapy students and its effectiveness in promoting work in rural communities after graduation.MethodsPhysical Therapy students in the first three years (2012–2015) of commencing the rural satellite program (n = 280) were surveyed, and six focus groups were held to capture student experiences, satisfaction and engagement. Data were collected on employment locations of the 2012–2019 graduates’ first physical therapy position and current employment.ResultsSurvey results suggested comparable levels of satisfaction and engagement for all physical therapy students regardless of campus. Focus group data revealed that students quickly accepted the distributed learning technological interface, enjoyed their local campuses, and felt connected to instructors and student colleagues. Compared to the overall physical therapy workforce, a higher percentage of physical therapists graduating from the rural campus reported working in rural centers for both their first and current jobs.ConclusionRegardless of campus, students were satisfied and equally engaged in the physical therapy program. Students who completed the physical therapy program in a rural setting tended to work rurally after graduation. A distributed learning model may be useful for other healthcare training programs to promote engagement in rural health.

Effect of designed physical therapy program on correction of in-toeing gait in typically developed children

Effect of designed physical therapy program on correction of in-toeing gait in typically developed children