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Ghana Medical Journal Mar 2024In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and...
BACKGROUND
In Nigeria, there is a disparity among physiotherapists regarding therapeutic exercise as a core treatment for patients with knee osteoarthritis (OA). The attitudes and beliefs of physiotherapists could influence this.
OBJECTIVE
To investigate Nigerian physiotherapists' knowledge, attitude, and utilisation of evidence-based therapeutic exercises.
DESIGN
A mixed-method of cross-sectional survey and focus group discussion.
SETTING
Secondary and tertiary health institutions in Nigeria.
PARTICIPANTS
Physiotherapists consecutively sampled from the selected institutions.
MAIN OUTCOME MEASURES
Participants' knowledge, attitude and utilisation of evidence-based therapeutic exercises for the management of knee OA.
RESULTS
This study revealed that 81% of physiotherapists in Nigeria had a fair knowledge of evidence-based practice and the efficacy of therapeutic exercises in managing knee OA. Despite this fair knowledge, 95.3% had a poor attitude. The important emerging categories/themes are treatment preference, clinical experience, and strength of evidence.
CONCLUSION
Physiotherapists in Nigeria have a fair knowledge of evidence-based therapeutic exercises in managing patients with knee OA, although there is a poor attitude and disparity between the use and current recommendations.
FUNDING
The research received no funding from a commercial or non-profit organisation.
Topics: Humans; Nigeria; Osteoarthritis, Knee; Cross-Sectional Studies; Health Knowledge, Attitudes, Practice; Male; Female; Exercise Therapy; Physical Therapists; Adult; Middle Aged; Surveys and Questionnaires; Focus Groups; Evidence-Based Practice; Attitude of Health Personnel
PubMed: 38957280
DOI: 10.4314/gmj.v58i1.13 -
Cureus Jun 2024Cerebral palsy is a neurodevelopmental condition that results in impaired movement and posture, often accompanied by disturbances in balance and functional abilities....
Comparison of the Conjunct Effects of Electrical Stimulation and Whole-Body Vibration Therapy with Transcranial Direct Current Stimulation and Whole-body Vibration Therapy on Balance and Function in Children With Spastic Cerebral Palsy.
BACKGROUND AND OBJECTIVES
Cerebral palsy is a neurodevelopmental condition that results in impaired movement and posture, often accompanied by disturbances in balance and functional abilities. Recent advances in neurorehabilitation, including whole-body vibration therapy (WBVT), functional electrical stimulation, and transcranial direct current stimulation, show promise in enhancing traditional interventions and fostering neuroplasticity. However, the efficacy of their conjunct effects remains largely uncharted territory and warrants further exploration. The objective of the study was to compare the conjunct effects of functional electrical stimulation (FES) and WBVT with transcranial direct current stimulation (tDCS) and WBVT on lower extremity range of motion (ROM), dynamic balance, functional mobility, isometric muscle strength and hand grip strength in children with spastic cerebral palsy.
METHODS
A randomized clinical trial was carried out on 42 children of both genders with spastic cerebral palsy, aged 5-15 years. The children were divided at random into three groups (14 in each group). In Group A, there were three (21.42%) males and 11 (78.57%) females, in Group B, eight (57.14%) were males and six (42.85%) were females, and in Group C, six (42.85%) children were males and eight (57.14%) were females. Group A received WBVT only, Group B received WBVT and FES, and Group C received WBVT and tDCS. The intervention was applied four times a week for four consecutive weeks. The data was collected two times before and immediately after four weeks of intervention. Lower extremity ROM was measured by a goniometer, functional mobility or dynamic balance was measured by a Time Up and Go test, isometric muscle strength was measured by a digital force gauge, and hand grip strength was assessed by a digital hand-held dynamometer. IBM SPSS Statistics for Windows, Version 27.0 (Released 2020; IBM Corp., Armonk, New York, United States) was utilized for statistical analysis.
RESULTS
The mean age of the children in groups A, B, and C was 12.21±2.11 years, 11.71±2.01, and 11.07±2.01 years respectively. Intergroup analysis revealed a statistically significant difference (p<0.05) in the lower extremity range of motion, and functional mobility. Hand grip strength and isometric muscle strength between three groups. Post hoc analysis revealed that WBVT with transcranial direct current stimulation combined showed the most improvement.
CONCLUSION
The study concluded that positive effects were seen in all three groups but tDCS with WBVT was found to be most effective in improving lower extremity ROM, functional mobility or dynamic balance, isometric muscle strength, and hand grip strength in children with spastic CP. The differences between the groups were statistically significant. The effect size was substantial enough to surpass established clinical benchmarks, indicating that the observed improvements are likely to have meaningful and beneficial impacts on patient outcomes.
PubMed: 38957262
DOI: 10.7759/cureus.61511 -
Cureus Jun 2024The most common form of movement disorder presented in children with cerebral palsy is spasticity, and dynamic equinus is the most common spastic ankle deformity....
BACKGROUND
The most common form of movement disorder presented in children with cerebral palsy is spasticity, and dynamic equinus is the most common spastic ankle deformity. Botulinum toxin (BT) injection is now an established first-line treatment for focal spasticity.
AIM
To assess the effects of BT injection with casting in the treatment of dynamic equinus in children diagnosed with cerebral palsy with spastic diplegia.
SETTING AND DESIGN
A prospective randomized controlled trial was conducted among patients aged 2-12 years with cerebral palsy and spastic diplegia, attending the general outpatient department and admitted to the indoor facility of the Department of Physical Medicine and Rehabilitation and the Department of Pediatric Orthopedics at King George's Medical University, Lucknow.
MATERIAL AND METHODS
Two groups of 19 patients each were formed. Group A received BT injection with casting, whereas in group B, only a cast was applied. Outcome measures including spasticity by Modified Ashworth Scale (MAS), Modified Tardieu Scale (MTS), range of motion (ROM), passive ankle dorsiflexion, and Gross Motor Function Measure (GMFM-66) (dimensions D and E) were assessed before and after the intervention.
RESULTS
The participants in groups A and B were age-matched. A statistically significant difference was seen within group A and group B for MAS, passive ROM-dorsiflexion (PROM-DF), and passive ROM-plantarflexion (PROM-PF) at various follow-ups. In the 3rd week, MAS in each group was statistically insignificant (p-value> 0.05).
CONCLUSION
There was a significant improvement in tone and a significant increase in the passive range of motion in both groups.
PubMed: 38957257
DOI: 10.7759/cureus.61515 -
Frontiers in Physiology 2024There are various categorization models of high-intensity interval training (HIIT) in the literature that need to be more consistent in definition, terminology, and... (Review)
Review
There are various categorization models of high-intensity interval training (HIIT) in the literature that need to be more consistent in definition, terminology, and concept completeness. In this review, we present a training goal-oriented categorization model of HIIT, aiming to find the best possible consensus among the various defined types of HIIT. This categorization concludes with six different types of HIIT derived from the literature, based on the interaction of interval duration, interval intensity and interval:recovery ratio. We discuss the science behind the defined types of HIIT and shed light on the possible effects of the various types of HIIT on aerobic, anaerobic, and neuromuscular systems and possible transfer effects into competition performance. We highlight various research gaps, discrepancies in findings and not yet proved know-how based on a lack of randomized controlled training studies, especially in well-trained to elite athlete cohorts. Our HIIT "toolbox" approach is designed to guide goal-oriented training. It is intended to lay the groundwork for future systematic reviews and serves as foundation for meta-analyses.
PubMed: 38957216
DOI: 10.3389/fphys.2024.1414307 -
Trauma Case Reports Aug 2024Decision-making regarding limb amputation represents a significant clinical challenge, especially when the initial evaluation does not coincide with the criteria...
Decision-making regarding limb amputation represents a significant clinical challenge, especially when the initial evaluation does not coincide with the criteria established in scales used worldwide, as is the case of the MESS scale. This article presents the case of a 24-year-old female patient who was transferred to a university hospital after a road traffic accident with severe and large lesions in the left lower limb. Despite a poor initial prognosis and in-hospital complications, including multiple surgical procedures and foot drop, a favorable recovery was achieved with complete anatomical salvage of the limb at risk. The multidisciplinary approach and intensive rehabilitation were instrumental in achieving a satisfactory functional recovery. This case highlights the importance of considering factors beyond amputation scale scores, as well as the need for comprehensive care to improve outcomes in patients with complex extremity injuries.
PubMed: 38957172
DOI: 10.1016/j.tcr.2024.101062 -
ERJ Open Research Jul 2024https://bit.ly/3T7pnS9.
https://bit.ly/3T7pnS9.
PubMed: 38957165
DOI: 10.1183/23120541.00765-2023 -
Australian Journal of General Practice Jul 2024Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business...
BACKGROUND
Approximately 70% of Australians do not attend cardiac rehabilitation (CR). A potential solution is integrating CR into primary care OBJECTIVE: To propose a business model for primary care providers to implement CR using current Medicare items.
DISCUSSION
Using the chronic disease management plan, general practitioners (GPs) complete four clinical assessments at 1-2 weeks, 8-12 weeks, and 6 and 12 months after discharge. The net benefit of applying this model, compared with claiming the most used standard consultation Item 23, in Phase II CR is up to $505 per patient and $543 in Phase III CR. The number of rural GPs providing CR in partnership with the Country Access To Cardiac Health (CATCH) through the GP hybrid model has increased from 28 in 2021 to 32 in 2022. This increase might be attributed to this value proposition. The biggest limitation is access to allied health services in the rural areas.
Topics: Humans; Primary Health Care; Cardiac Rehabilitation; Australia; Medicare
PubMed: 38957068
DOI: 10.31128/AJGP-08-23-6923 -
Australian Journal of General Practice Jul 2024Ongoing symptoms of COVID-19 can persist for weeks or months after the initial COVID-19 infection. The aim of this study was to identify persistent symptoms (fatigue,... (Observational Study)
Observational Study
BACKGROUND AND OBJECTIVES
Ongoing symptoms of COVID-19 can persist for weeks or months after the initial COVID-19 infection. The aim of this study was to identify persistent symptoms (fatigue, cognition, quality of life, anxiety, depression and physical measures) in unvaccinated community-managed patients following COVID-19 infection.
METHOD
This was a prospective nested observational study of health and wellbeing measures determined seven and 13 months after COVID-19 infection, alongside physical abilities after 18 months.
RESULTS
Data analyses were completed on 62 participants (60% female, median age 35 years). Severe fatigue was noted in 47% of participants at seven months and this had not improved significantly by 13 months (45%). Quality of life and mental health scores were significantly worse in individuals with severe fatigue. One-quarter of participants demonstrated mild cognitive impairment at seven months. After 18 months, walking and lung function were normal, but grip strength was reduced in 26% of participants.
DISCUSSION
A significant proportion of unvaccinated COVID-19 patients had not returned to pre-illness levels of health and function after one year; screening functional ability and mental wellbeing is warranted in unvaccinated people with COVID-19.
Topics: Humans; COVID-19; Female; Male; Prospective Studies; Adult; Quality of Life; SARS-CoV-2; Fatigue; Anxiety; Depression; Cognitive Dysfunction; Middle Aged
PubMed: 38957067
DOI: 10.31128/AJGP-07-23-6900 -
Psychiatric Services (Washington, D.C.) Jul 2024The authors sought to determine whether providing recipients of supported employment with individual budgets from which they could purchase employment-related goods and...
OBJECTIVE
The authors sought to determine whether providing recipients of supported employment with individual budgets from which they could purchase employment-related goods and services would improve employment and financial outcomes.
METHODS
Sixty study participants were recruited from an individual placement and support (IPS) program and randomly assigned (1:1) to receive IPS services only (N=32) or IPS services with a 12-month $950 flexible fund called a career account (N=28). Participants receiving IPS and a career account met with staff who helped them identify employment goals and create a budget for purchases directly tied to these goals. The primary outcome was competitive employment; secondary outcomes included job tenure, days worked, total earnings, and financial well-being. Outcomes were analyzed by using adjusted generalized linear models (GLMs) with binary logistic, negative binomial, and linear distributions.
RESULTS
The proportion of participants who achieved competitive employment was largely similar for those in the career account+IPS group (54%) and in the IPS-only group (47%). However, the GLM analysis revealed that career account+IPS participants had significantly longer job tenure, more total days of employment, and higher total earnings than IPS-only participants. Feelings of financial well-being increased significantly among career account participants, whereas financial well-being declined among control participants. The amount of career account dollars participants spent was positively and significantly associated with longer job tenure, more days employed, and higher total earnings.
CONCLUSIONS
Combining flexible funds with IPS-supported employment achieved some superior outcomes compared with IPS only. Further research is needed to assess the longer-term effects of this practice and its cost-effectiveness.
PubMed: 38957051
DOI: 10.1176/appi.ps.20230597 -
Occupational Therapy in Health Care Jul 2024The aim of this study was to explore community-working occupational therapists' involvement in research and development projects. A cross-sectional survey of...
The aim of this study was to explore community-working occupational therapists' involvement in research and development projects. A cross-sectional survey of occupational therapists working in community-based services in Norway ( = 617) was conducted. In all, 117 of the 617 participants responded that they were involved in research and development projects. Greater likelihood of participation in research and development work were found for occupational therapists who had completed further education. Current and prioritized research topics were professional development and the development of interprofessional and professional service designs for occupational therapy. Service and quality development, rehabilitation and technology were areas where more knowledge was considered needed. To increase the growth and success of occupational therapy research and development, it is important that more occupational therapists in the municipality continue to complete further education. High-quality occupational therapy practice should be based on research and development projects in the municipalities.
PubMed: 38957005
DOI: 10.1080/07380577.2024.2364178