Physiotherapy Training Research Articles

Australian physiotherapists' knowledge and views on the relationship between climate change, health, and physiotherapy.

Climate change is an important issue for the health of communities globally and the conduct of health care practice. Little is currently known about the knowledge and views of Australian physiotherapists in relation to the issue of climate change. Thus, the purpose of this study was to investigate Australian physiotherapists' views on, and practice in relation to, climate change and its effects on health. A quantitative cross-sectional study using a modified version of a published survey was undertaken. Using a comprehensive distribution strategy, the survey (23 questions) was disseminated through professional associations, networks of the research team and social media. Data were summarized descriptively. One hundred and thirty physiotherapists accessed the final survey. Ninety-five surveys were eligible for analysis. 90.4% of participants were certain about the existence of climate change. 79.6% of participants thought that climate change was already impacting their patients' health, but only 19.4% of participants felt "very knowledgeable" about the health impacts of climate change. Main barriers to addressing climate change with patients were identified as lack of time and knowledge. 77.2% of participants indicated support for receiving education on climate change and health as continuing professional education. 70.9% of participants agreed that their professional association had a significant advocacy role in climate change and health. Australian physiotherapists are witnessing the impact of climate change and support strategies to mitigate it. These strategies can be implemented at an individual level (e.g., further physiotherapy training) and at a professional organizational level (e.g., guidance from professional associations).

What are the effects of aquatic physiotherapy exercises on speed and complex gait-related activities in individuals with Parkinson's disease?

Parkinson's disease (PD) is a central nervous system disease that results in deficits in motor activities such as walking. Gait speed and step length are frequently reduced. Aquatic physiotherapy serves as a form of complementary treatment to promote improvements in the disease's motor symptoms. The purpose of this study was to examine the effect of an aquatic physiotherapy training program on gait in individuals with PD. This is an interventional clinical study in which a group of participants with PD participated in an assessment on the ground of their usual and maximum gait speed using the 10-m Walk Test and complex activities related to gait using the Dynamic Gait Index (DGI) at baseline and 12 weeks of an aquatic physiotherapy intervention, twice a week for 50 min. For statistical analysis, the paired t-test and the Wilcoxon test were used. The study included 10 individuals with PD, in the intermediate stage of PD - H&Y 2 (60%) and 3 (40%), of both sexes with a mean age of 65.8 ± 13.69 years. There was a significant increase in usual gait speed (p = 0.001) and in the DGI score (p = 0.05), but there was no improvement in maximum gait speed (p = 0.119). The aquatic physiotherapy exercise program improved habitual gait speed and the performance of complex activities related to gait in this group individuals with PD.

Intelligent Robotics in Pediatric Cooperative Neurorehabilitation: A Review

The landscape of neurorehabilitation is undergoing a profound transformation with the integration of artificial intelligence (AI)-driven robotics. This review addresses the pressing need for advancements in pediatric neurorehabilitation and underscores the pivotal role of AI-driven robotics in addressing existing gaps. By leveraging AI technologies, robotic systems can transcend the limitations of preprogrammed guidelines and adapt to individual patient needs, thereby fostering patient-centric care. This review explores recent strides in social and diagnostic robotics, physical therapy, assistive robotics, smart interfaces, and cognitive training within the context of pediatric neurorehabilitation. Furthermore, it examines the impact of emerging AI techniques, including artificial emotional intelligence, interactive reinforcement learning, and natural language processing, on enhancing cooperative neurorehabilitation outcomes. Importantly, the review underscores the imperative of responsible AI deployment and emphasizes the significance of unbiased, explainable, and interpretable models in fostering adaptability and effectiveness in pediatric neurorehabilitation settings. In conclusion, this review provides a comprehensive overview of the evolving landscape of AI-driven robotics in pediatric neurorehabilitation and offers valuable insights for clinicians, researchers, and policymakers.

Self-Massage Acute Effects on Pressure Pain Threshold, Muscular Electrical Activity, and Muscle Force Production: A Systematic Review and Meta-Analysis.

Furlan, MR, Machado, E, Petter, GdN, Barbosa, IM, Geremia, JM, and Glänzel, MH. Self-massage acute effects on pressure pain threshold, muscular electrical activity, and muscle force production: a systematic review and meta-analysis. J Strength Cond Res 38(3): 620-635, 2024-Self-massage (SM) is often used in physiotherapy and sports training programs. However, the SM acute effects on pressure pain threshold (PPT), muscle electrical activity (MEA), and muscle force production remain unclear. A meta-analytical review was performed to verify the SM acute effects on neuromuscular responses in healthy adults or athletes. The review (CRD42021254656) was performed in the PubMed, Web of Science, and Embase databases. A synthesis of the included studies was performed, and both the risk of bias and the evidence certainty level were assessed through the PEDro scale and Grading of Recommendations Assessment, Development, and Evaluation approach, respectively. Nineteen studies were included, 5 evaluated the PPT, 7 the thigh muscles' MEA, and 15 the lower-limb strength. The SM application induces moderate increases in quadriceps' PPT (5 studies; standardized mean difference [SMD]: 0.487; 95% CI 0.251-0.723; p < 0.001; I2 = 0%). We found no SM effects on the hamstrings and plantar flexors' MEA. Also, we observed small increases in knee extensors' concentric torque (2 studies; SMD: 0.288; 95% CI 0.088-0.489; p = 0.005; I2 = 0%), without effects in isometric muscle strength, eccentric torque, and rate of force development. Grading of recommendations assessment, development, and evaluation analysis showed high and low certainty levels for the SM effects on quadriceps' PPT and muscle strength, respectively. Self-massage pressure-volume application seems to be a determining factor in inducing changes in these parameters, and it may vary among the treated muscles, where a higher pressure-volume application is required for increasing knee flexors and plantar flexors' PPT and strength. Thus, new studies with better methodological quality should be performed to strengthen this evidence.

The Effects of Combined Virtual Reality Exercises and Robot Assisted Gait Training on Cognitive Functions, Daily Living Activities, and Quality of Life in High Functioning Individuals With Subacute Stroke.

Stroke is a global health concern causing significant mortality. Survivors face physical, cognitive, and emotional challenges, affecting their life satisfaction and social participation. Robot-assisted gait training with virtual reality, like Lokomat, is a promising rehabilitation tool. We investigated its impact on cognitive status, activities of daily living, and quality of life in individuals with stroke. Between September 2022 and August 2023, we exposed 34 first stroke patients (8 women, 26 men; M age = 59.15, SD = 11.09; M height = 170.47, SD = 8.13cm; M weight = 75.97; SD = 10.87kg; M days since stroke = 70.44, SD = 33.65) in the subacute stage (3-6 months post-stroke) to Lokomat exercise. Participant exclusion criteria were Lokamat exercise inability, disabilities incompatible with intended measurements, and any cognitive limitations. The Control Group (CG) received conventional physiotherapy, while the Lokomat Group (LG) received both conventional physiotherapy and robot-assisted gait training with virtual reality, administered by an occupational therapist. Evaluations were conducted by a physiotherapist who was unaware of the participants' group assignments and included assessments with the Montreal Cognitive Assessment, Lawton Brody Instrumental Activities of Daily Living Scale, and Stroke Specific Quality of Life Scale (SS-QoL). Both groups demonstrated an improved quality of life, but the LG outperformed the CG with regard to SS-QoL (p = .01) on measures of Energy (p = .002) and Mobility (p = .005). Both groups showed improvements in cognitive functioning (p < .001) with no between-group difference, and in activities of daily living (p < .05) for which the LG was superior to the CG (p = .023). Thus, adding robot-assisted gait training with Lokomat and virtual reality improved self-reported quality of life and daily activities at levels beyond conventional physiotherapy for patients in the subacute stroke phase. An incremental impact on cognitive functions was not evident, possibly due to rapid cognitive recovery or this was undetected by limited cognitive testing.

Effects of the Three-Direction Movement Control Focus Complex Pain Program and Neurodynamic Focus Complex Pain Program on Pain, Mechanosensitivity, and Body Function in Taekwondo Athletes with Non-Specific Low Back Pain: A Preliminary Study.

We aimed to determine the effects of three-direction movement control focus complex pain program (3D-MCE) and neurodynamic focus complex pain program (NDT) on pain, mechanosensitivity, and body function in Taekwondo athletes with non-specific low back pain. This study used a two-group pretest-posttest design and was conducted at a university physiotherapy lab and training center. It included 21 Taekwondo athletes with non-specific low back pain from a Taekwondo studio and a University in Busan. Participants were divided into a 3D-MCE group (n = 10) and an NDT group (n = 10). The numerical rating pain scale (NRPS), pain pressure threshold (PPT), movement analysis, and Oswestry Disability Index (ODI) were measured before and after the intervention. The intervention was performed for 45 min twice a week for 4 weeks. Each group performed movement control exercises and neurodynamic techniques. The NRPS, motion analysis, and ODI were significantly changed after the intervention in the 3-DMCE group. The NRPS, PPT, and ODI changed significantly after the intervention in the NDT group. Moreover, the PPT and motion analysis showed significant differences between the two groups. For Taekwondo athletes with non-specific low back pain, 3D-MCE improved the stability control ability of the lumbar spine. It was confirmed that neurodynamic techniques reduce muscle and nerve mechanosensitivity.

Current practice, guideline adherence, and barriers to implementation for Achilles tendinopathy rehabilitation: a survey of physical therapists and people with Achilles tendinopathy

ObjectiveTo explore clinical practice patterns of physical therapists (PTs) who treat people with Achilles tendinopathy (AT), and identify perceived barriers and facilitators for prescribing and engaging with therapeutic exercise among...

Obstructive Ventilatory Dysfunctions-Functional Assessment and Rehabilitation Program.

Obstructive ventilatory dysfunctions have an increased incidence, and through functional assessment determined by the International Classification of Functioning, Disability and Health (ICF), appropriate treatment can be established. The objectives of our research are represented by the application of respiratory rehabilitation sessions according to the ICF in patients with obstructive ventilatory dysfunctions-with COPD or asthma, using a unique, international language and the evaluation of the results obtained before and after completion pulmonary rehabilitation. We conducted a randomized prospective study between November 2022-April 2023, which included 84 patients diagnosed with obstructive ventilatory dysfunctions and who performed respiratory rehabilitation. They were divided into two categories: category 1-C1 which included 43 patients with Chronic Obstructive Pulmonary Disease-COPD and category 2-C2 which included 41 patients diagnosed with asthma. The rehabilitation program lasted 8 weeks, with exercises performed from Monday to Friday, with a weekend break. Respiratory rehabilitation consisted of physical therapy, inspiratory and expiratory muscle training (IEMT), proper nutrition, and psychotherapy. At the end of the program, most of the patients showed improvements in the ICF qualifiers, a fact that supported us that respiratory recovery is one of the basic therapies of patients with obstructive ventilatory dysfunctions. The ICF allows the application of a personalized respiratory rehabilitation program. The ICF qualifiers are used for the functional assessment of patients and allow they to be included in individualized medical rehabilitation programs.

Evidence-based Practice Interventions for Reducing Postoperative Pulmonary Complications: A Narrative Review.

Specific surgical procedures, such as upper abdominal and thoracic surgery, are connected to an increased predisposition of postoperative pulmonary complications (PPCs). The incidence of PPCs could vary approximately between 20-90% with upper abdominal surgery, which can be minimized by using treatment procedures that increase lung capacity and encourage inspiration. This review aims to examine the effectiveness of already existing evidence-based interventions that promote lung expansion, thereby preventing PPCs. We mainly focused on the existing evidence of preoperative education on the incentive spirometer, early mobilization, directed coughing, deep breathing exercises, chest physiotherapy, and inspiratory muscle training (IMT) to prevent PPCs. The literature search was limited to experimental, observational studies, systemic reviews, and articles published in the last 15 years, January 2007- Dec. 2022, in PubMed and Google Scholar. This initial search yielded a total of 5301 articles. All articles with titles not related to the topic were eliminated. 1050 records were screened, and the final review was conducted with 22 articles, including 13 randomized controlled trials (RCTs), four systemic reviews, one retrospective review, three observational studies, and one non-experimental study. Our review reveals mixed evidence for individual interventions, including but not limited to incentive spirometry, inspiratory muscle training, early mobilization, cough, deep breathing, etc. Some studies maintain that intervention is effective; others imply there is no substantial difference in the choice of intervention. The literature review concluded that patients who received multiple interventions showed significant improvement in pulmonary function postoperatively. However, definitive studies need to be conducted to solidify this conclusion.

Simulation-based education within respiratory physiotherapy training: a scoping review

Simulation-based education within respiratory physiotherapy training: a scoping review

Perfil das doenças cardiovasculares e atuação fisioterapeutica em um serviço de emergência hospitalar

Abstract Introduction Cardiovascular disease (CVD) is the lead-ing cause of death globally, with a high proportion of hospitalizations and costs. In view of this, it is essential to understand the main CVDs in patients admitted to hospital emergency services and the role of physiotherapists, in order to plan and direct health services, and to denote participation and encourage specific physiotherapy training in the context of tertiary care. Objective To outline the profile of cardiovascular emergencies and to evaluate physiotherapy in adult patients in the emergency department of a hospital in the interior of the state of São Paulo. Methods This was an observational study which analyzed 1,256 on-call records over a period of eight months. The data collected included age, gender, cardiovascular diagnostic hypothesis and physiotherapy treatment carried out. Results A total of 75 patients with cardiovascular emergencies were included, the most prevalent of which were: heart failure (n = 21), acute coronary syndrome (n = 14), acute myocardial infarction (n = 13), bradyarrhythmia (n = 6) and hypertensive crisis (n = 5). Regarding physiotherapeutic actions and their applications, the most frequent were invasive mechanical ventilation management (n = 34), lung re-expansion maneuvers (n = 17), orotracheal intubation assistance (n = 17), non-invasive mechanical ventilation (n = 14), bronchial hygiene maneuvers (n = 12), kinesiotherapy (n = 10) and sedation (n = 10). Conclusion Heart failure and acute coronary syndrome were the cardiovascular diseases that caused the most admissions to the hospital emergency department and that the procedures with an emphasis on the respiratory system were the most applied.

An Aerial Insight on Physiotherapy Training in the University of Namibia during Covid-19 era

ABSTRACT— Teaching and learning in higher education context around the globe witnessed unique disturbances during the COVID-19 induced calamity. The educators had to adjust their old ways of teaching and learning in order to halt the spread of the deadly virus. in the University of Namibia, the physiotherapy training, despite its practicality, is not pardoned from virus induced transformation. These rapid transformation and migration to technology assisted pedagogies introduced new ways of normal. Therefore, higher education institutions are challenged to rethink of the way they will conduct educational activities post-COVID-19 era. This review paper focused on enabling teaching and learning in physiotherapy training during the COVID-19 at the University of Namibia and chart the way forward post-COVID-19.

Joint knee loads during squat with constant or variable resistance in males. A clinical trial

BackgroundIn the squat movement, the use of constant resistance (CR) generates greater compression and shear forces close to 90° of knee flexion, increasing joint overload. However, when used variable resistance (VR) there is no consensus about the effect of knee joint load. The aim of this study was to compare knee torques using constant or variable resistance during the squat exercise. MethodsTwenty-one healthy male subjects (mean age, 24 [SD, 3] years; height, 1.76 [SD, 0.04] m), who practice squats during strength training routine. Were simultaneously record data from the platform force and tridimensional kinematic to obtain torques around knee. 15 repetitions were performed up to maximum knee flexion with the use of variable (RV) or constant (CR) resistance in a single session. ResultsSignificant differences regarding the angles only in the sagittal plane at the end of the ascending phase of the squat, with less knee extension in the VR condition. In the sagittal and frontal planes, lower values of extensor and abductor torque were found in the VR condition at the angles of greater knee flexion. ConclusionThe use of variable resistance compared to constant resistance seems to be an alternative to be considered when the objective is to minimize the internal loads on the knee joint in exercises such as the squat in amplitudes of greater flexion. This study indicated that VR helps subjects who are learning the squat movement, enabling the application of this knowledge in physical therapy or physical training clinics.

Evidence-based Practice Interventions for Reducing Postoperative Pulmonary Complications: A Narrative Review

Background: Specific surgical procedures, such as upper abdominal and thoracic surgery, are connected to an increased predisposition of postoperative pulmonary complications (PPCs). The incidence of PPCs could vary approximately between 20-90% with upper abdominal surgery, which can be minimized by using treatment procedures that increase lung capacity and encourage inspiration. This review aims to examine the effectiveness of already existing evidence-based interventions that promote lung expansion, thereby preventing PPCs. Method: We mainly focused on the existing evidence of preoperative education on the incentive spirometer, early mobilization, directed coughing, deep breathing exercises, chest physiotherapy, and inspiratory muscle training (IMT) to prevent PPCs. The literature search was limited to experimental, observational studies, systemic reviews, and articles published in the last 15 years, January 2007- Dec. 2022, in PubMed and Google Scholar. Result: This initial search yielded a total of 5301 articles. All articles with titles not related to the topic were eliminated. 1050 records were screened, and the final review was conducted with 22 articles, including 13 randomized controlled trials (RCTs), four systemic reviews, one retrospective review, three observational studies, and one non-experimental study. Our review reveals mixed evidence for individual interventions, including but not limited to incentive spirometry, inspiratory muscle training, early mobilization, cough, deep breathing, etc. Some studies maintain that intervention is effective; others imply there is no substantial difference in the choice of intervention. Conclusion: The literature review concluded that patients who received multiple interventions showed significant improvement in pulmonary function postoperatively. However, definitive studies need to be conducted to solidify this conclusion.

Edukasi Sit to stand exercise dengan Walker pada Pasien Stroke di Posyandu Lansia Keprabon

Stroke is a blood vessel disease that is mostly caused by high blood pressure, resulting in rupture of blood vessels and bleeding in certain areas. This disease can be interpreted as a pathological condition that affects the entire body, for example paralysis, impaired cognitive function, difficulty speaking, emotional difficulties, pain and problems in daily life which cause various activity limitations for the sufferer. This of course requires appropriate medical rehabilitation that is appropriate to the condition of stroke sufferers. Medical rehabilitation is provided with the aim of optimizing and even returning the patient's body functions to normal. This rehabilitation has three main focuses, namely: medical, social and vocational rehabilitation. Stroke sufferers who are still recovering and do not receive a good rehabilitation program are certainly less able to carry out activities independently, such as from sitting to standing with balance and without the help of other people, as is found at the elderly posyandu in Keprabon Village. In the rehabilitation process, of course, family support is very necessary in helping to get optimal results. So this activity aims to provide education about sit to stand exercise to stroke sufferers and the families of sufferers at the elderly posyandu in Keprabon Village. With this physiotherapy training program activity, it is hoped that it will provide good benefits for sufferers and their families because it aims to increase the independence of stroke sufferers who are in the posyandu in Keprabon Village by increasing functional activities, especially balance in carrying out movements from sitting to standing by routinely doing sit to stand exercises. proper exercise.

Changes in Health-Related Quality of Life, Pain and Functional Parameters in People with Hemophilia and People with Osteoarthritis - a Comparative Follow-up of Physiotherapeutic Training (Physio-FUN Study)

Background: Spontaneous joint bleeding is common in people with hemophilia (PWH). These bleeds lead to reduced physical activity and thus to a weakening of the musculature. Common sequelae of this are synovitis and cartilage damage. In the long term, secondary osteoarthritis, so-called hemophilic arthropathy, occurs with changes and progressive destruction of joint structures (Lafeber et al., 2008). Hemophilic arthropathy is age-independent and can lead to severe movement restrictions and significant limitations in health-related quality of life (HRQoL) of affected PWH (Varaklioti et al., 2018). To prevent advanced stages of arthropathy not only regular assessment of musculoskeletal status and early detection of symptoms, but also daily rehabilitation exercises at home, and implementation of appropriate physiotherapy and medical training are important (Bossard et al., 2008). Home exercises and manual therapy can be used without causing bleeding or pain to improve pain, HRQoL and functionality (Tat et al., 2021). The primary aim of the Physio-FUN study was to assess the subjective (Hemophilia Exercise Project Test-Questionnaire [HEP-Test-Q]) and objective physical functioning (Hemophilia Joint Health Score [HJHS]) during the course of 1-year applied physiotherapy comparing PWH with arthropathy and patients with osteoarthritis (PWO). Methods: In this prospevtive, controlled monocentric cohort study it was planned to enroll 20 adult PWH A or B compared to 20 gender-matched adult PWO without a bleeding disorder. Patients with a blood pressure ≥ 180/110 mmHg were excluded. A positive ethical approval for the study was obtained by the Ethics Committee North Rhine, Germany. After informed consent had been obtained, the study participants underwent examinations based on clinician-reported outcomes (ClinRO) and performance outcomes (PerfO) and completed different patient-reported outcomes (PROs). ClinROs included ultrasound, functional movement screen (FMS) and the collection of anthropometric and clinical data; PerfOs included cardiopulmonary performance, 6-minute walk test (6MWT), blood pressure measurement before and after 6MWT, joint mobility (neutral-zero method) and Functional Movement Screen (FMS) to evaluate movement pattern quality; PROs included the assessment of sociodemographic data, HRQoL (SF-12), Physical Activity Questions (EPIC - Simple Index), pain sensation scale (SES) and Borg Rating of Perceived Exertion (RPE) measuring physical activity intensity level. All patients took part in regular physiotherapy (once a week) at the ARZD as prescribed by a physician. During the study, PWH continued to receive their usual hemophilia treatment regimen without study-related changes. Over a period of 12 months, ClinROs, PerfOs and PROs were collected repeatedly on a quarterly basis. Each patient was supposed to participate in 5 measure points (baseline, every 12 weeks over a one-year period). Ultrasound examinations were performed at baseline and at the conclusion at MZP5 in all patients. Results: At baseline 17 PWH (mean age 43.29±13.1 years) and 12 PWO (mean age 61.42±8.5 years) were enrolled; most PWH had HA (88.2%) were severely affected (58.8%) and 6/17 had a knee endoprosthesis. 88.2% of PWH had a disabled card (most with a disability degree of ≥ 80) compared to 45.5% of PWO (most with a disability degree of 50). PWH had a significant worse orthopaedic joint status ( p&amp;lt;.002) and subjective physical functioning ( p&amp;lt;.001) compared to PWO; PWH had a mean HJHS of 26.76±18.0 vs. 11.0±5.7 and a mean HEP-Test-Q of 48.12±16.4 vs. 67.08±9.1. PWO reported highest impairments in the domain ‘mobility’, while PWH suffered mainly under reduced ‘endurance’. With respect to their age, height and weight most of the PWH were below the predicted lower limit of the 6MWD compared to the PWO who all were above the lower limit of the 6MWD. No difference was found between the groups regarding FMS (11.34±3.8) and RPE before (11.5±3.3) after 6MWT (11.5±3.3). Conclusions: Our study took place during the Corona pandemic and was quite time consuming for the participants, resulting in a failure to reach the desired number of cases and lead to a high drop-out rate over the duration of the project. Although PWH were significantly younger than PWO, they had a significantly worse subjective (HEP-Test-Q) and objective physical functioning (HJHS).

A Comparison of Health-Related Quality of Life, Pain and Functional Parameters between People with Hemophilia and People with Osteoarthritis - Preliminary Results of the Physio-FUN Study

Background: Spontaneous joint bleeding is common in people with hemophilia (PWH) leading to reduced physical activity and weakening of the musculature. Common sequelae of this are synovitis and cartilage damage. Following, secondary osteoarthritis, so-called hemophilic arthropathy, occurs with changes and progressive destruction of joint structures (Lafeber et al., 2008). Hemophilic arthropathy can lead to severe movement restrictions and significant limitations in health-related quality of life (HRQoL) (Varaklioti et al., 2018). To prevent advanced stages of arthropathy not only regular assessment of musculoskeletal status and early detection of symptoms, but also daily rehabilitation exercises at home, and implementation of appropriate physiotherapy and medical training are important (Bossard et al., 2008). Home exercises and manual therapy can be used without causing bleeding or pain to improve pain, HRQoL and functionality (Tat et al., 2021). The primary aim of the Physio-FUN study was to assess subjective (HEP-Test-Q]) and objective physical functioning (HJHS]) during the course of 1-year applied physiotherapy comparing PWH with arthropathy and patients with osteoarthritis (PWO). Methods: In this prospective, controlled monocentric cohort study it was planned to enroll 20 adult PWH A or B compared to 20 matched adult PWO without a bleeding disorder. Patients with a blood pressure ≥ 180/110 mmHg were excluded. A positive ethical approval for the study was obtained by the Ethics Committee North Rhine, Germany. After informed consent had been obtained, the study participants underwent examinations and completed questionnaires for Clinical Outcome Assessments (COAs) (see table 1); clinical, anthropometric and socio-demographic data were collected. All patients took part in regular physiotherapy (once a week) at the ARZD as prescribed by a physician. During the study, PWH continued to receive their usual hemophilia treatment regimen without study-related changes. Over a period of 12 months, Clinical Outcome Assessment (COAs) were collected repeatedly on a quarterly basis. Each patient was supposed to participate in 5 measure points (baseline, every 12 weeks over a one-year period). Ultrasound examinations were performed at baseline and at the conclusion at MZP5 in all patients. Results: At baseline 17 PWH (mean age 43.29±13.1 years) and 12 PWO (mean age 61.42±8.5 years) were enrolled; most PWH had HA (88.2%), were severely affected (58.8%), had a target joint (52.6%) and 6/17 had a knee endoprosthesis. 88.2% of PWH had a disabled card (most with a disability degree of ≥ 80) compared to 45.5% of PWO (most with a disability degree of 50). PWH had a significant worse orthopaedic joint status ( p&amp;lt;.003) and subjective physical functioning ( p&amp;lt;.001) compared to PWO; PWH had a mean HJHS of 26.76±18.0 vs. 11.0±5.7 and a mean HEP-Test-Q of 48.12±16.4 vs. 67.08±9.1. PWO reported highest impairments in the HEP-Test-Q domain ‘mobility’, while PWH suffered mainly under reduced ‘endurance’. The NNM showed a significant impairment in the mobility of the left ( p&amp;lt;.001) and right ( p&amp;lt;.013) ankle, 58.3% PWO had no impairments compared to 58.9-76.5% of PWH with moderate-severe impairments. This was confirmed by the ultrasound showing a worse progression of their disease ( p&amp;lt;.001) compared to PWO (mean HEAD-US 11.41±6.5 vs. 3.75±3.3). PWH had a worse HRQoL ( p&amp;lt;.001) (mean PCS of 37.51±8.3 vs. 49.45±7.2) and reported a significant higher ( p&amp;lt;.001) emotional distress due to pain (mean SES affective 30.0±12.8, SES sensory 20.94±6.2 vs. SES affective 16.75±2.6, SES sensory 12.08±2.5). Compared to PWO, PWH had a significant lower PAL-value ( p&amp;lt;.045) describing the level of physical activity over the period of 24 hours, most had a sedentary job (87.5% vs. 50%). Most of the PWH were below the predicted lower limit of the 6MWD compared to the PWO who all were above the lower limit. No difference was found between the groups regarding FMS and RPE before and after 6MWT and in the MCS. Conclusions: Although PWH were significantly younger than PWO, they had a significantly worse subjective and objective physical functioning; in addition they had a worse HRQoL, HEAD-US, NNM, PAL and a higher pain experience. Our study took place during the Corona pandemic and was quite time consuming for the participants, resulting in a failure to reach the desired number of cases and led to a high drop-out rate over the duration of the project.

Physiotherapy training and education prior to elective Caesarean section and its impact on post-natal quality of life: a secondary analysis of a randomized controlled trial

BackgroundCaesarean section (CS) is associated with numerous complications that lead to the delayed return to functional activities that have a negative influence on the post-natal quality of life (QOL). It is evident that providing regular evidence-based physiotherapy training and education prior to elective CS helps to enhance the post-natal QOL by improving physical, mental, social, and general well-being. The purpose of this study was to examine the effectiveness of physiotherapy training and education prior to elective CS on post-natal QOL.MethodsThis single-blind parallel randomized controlled study was carried out at De Soysa Hospital for Women (DSHW), Colombo. The study enrolled 54 women who were scheduled to undergo elective CS. The intervention group (n = 27) of women received physiotherapy training and education, while the control group (n = 27) received standard nursing care. In addition to the primary outcome measures, post-natal QOL was measured. The results were examined using descriptive statistics and the independent samples t-test in IBM SPSS 20.ResultsThe intervention group showed a higher post-natal QOL for the domains of physical function, role limitation due to physical health, energy/fatigue, and pain than the control group (p < 0.05).ConclusionPhysiotherapy training and education prior to elective CS play a pivotal role in improving the physical health-related domains of QOL following CS.Trial RegistrationThe Sri Lanka Clinical Trials Registry (https://www.slctr.lk). Registration number: SLCTR/2019/029-APPL/2019/028; Registration date: 6th of September 2019.

Anterior cruciate ligament injuries in female athletes.

The anterior cruciate ligament (ACL) is frequently injured in elite athletes, with females up to eight times more likely to suffer an ACL tear than males. Biomechanical and hormonal factors have been thoroughly investigated; however, there remain unknown factors that need investigation. The mechanism of injury differs between males and females, and anatomical differences contribute significantly to the increased risk in females. Hormonal factors, both endogenous and exogenous, play a role in ACL laxity and may modify the risk of injury. However, data are still limited, and research involving oral contraceptives is potentially associated with methodological and ethical problems. Such characteristics can also influence the outcome after ACL reconstruction, with higher failure rates in females linked to a smaller diameter of the graft, especially in athletes aged < 21 years. The addition of a lateral extra-articular tenodesis can improve the outcomes after ACL reconstruction and reduce the risk of failure, and it should be routinely considered in young elite athletes. Sex-specific environmental differences can also contribute to the increased risk of injury, with more limited access to and availablility of advanced training facilities for female athletes. In addition, football kits are designed for male players, and increased attention should be focused on improving the quality of pitches, as female leagues usually play the day after male leagues. The kit, including boots, the length of studs, and the footballs themselves, should be tailored to the needs and body shapes of female athletes. Specific physiotherapy programmes and training protocols have yielded remarkable results in reducing the risk of injury, and these should be extended to school-age athletes. Finally, psychological factors should not be overlooked, with females' greater fear of re-injury and lack of confidence in their knee compromising their return to sport after ACL injury. Both intrinsic and extrinsic factors should be recognized and addressed to optimize the training programmes which are designed to prevent injury, and improve our understanding of these injuries.

Training, care delivery, and research in physiotherapy in sub-Saharan French-speaking Africa.

No abstract available.