BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department(ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and ...BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department(ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment(EPET) vs. standard care(SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back pain.METHODS: A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011. Neck Disability Index(NDI), Modifi ed Oswestry Low Back Pain Disability Questionnaire(MODI) and 11-point Numeric Pain Rating Scale were used as outcome measures and compared between groups at a mean of 34 days from their initial ED visit.RESULTS: We identifi ed a total of 125 patients. EPET group comprised 62 patients(mean age, 45 years; men, 63%) and SC group comprised 63 patients(mean age, 45 years; men, 43%). The EPET and SC groups received physiotherapy at a median of 4 and 34 days respectively from their fi rst ED visit. EPET patients had signifi cantly lower levels of disability(9.0% vs. 33.4%, Welch t-test, P<0.001) and pain(median value, 1 vs. 4 points, Mann-Whitney U-test, P<0.001) compared with SC patients.CONCLUSION: Early access to physiotherapy in ED was associated with reduced pain and disability levels. EPET protocol can potentially decrease the demand on outpatient orthopedic services, thereby freeing up available resources to treat patients who are more likely to benefi t from it.展开更多
This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECA...This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECAR(n = 24) or TENS(n = 26) session within 5 days following a hamstring injury, while the control(CON, n = 25)group was instructed to rest. Visual analogue scale(VAS), functional Assessment Scale for Acute Hamstring Injuries(FASH), straight leg raise test(SLR), and sit-and-reach scores(STR) were obtained prior to, immediately,24, and 48 h after therapy. Group differences were detected after therapy in VAS and FASH scores(p < 0.05).Compared to pre-therapy measurements, VAS scores showed a greater decrease in the TECAR group(-38.75% to-63.33%) than in the TENS group(-16.67% to-25.00%) and both were greater than in the CON group(-2.81%to-9.81%)(p < 0.05). The TECAR group improved FASH scores(28.57%–48.21%) more than the TENS group(15.89%–27.79%) and both groups more than the CON group(0%–8.33%)(p < 0.05). The increase in SLR and STR was greater in the TECAR group(6.26%–13.96%) than in the TENS(1.72%–9.53%) and CON groups(0%–3.03%). These results suggest that in the acute phase of hamstring injury, the use of TECAR and, to a lesser extent, TENS may relieve pain symptoms and bring some improvements in flexibility more than instructing patients to rest.展开更多
AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbi...AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbil,Iraq.The target population consisted of high school students selected through a multi-stage cluster sampling method.Comprehensive visual examinations were performed for all students,including measurement of uncorrected and corrected visual acuity,objective and subjective refraction,and distance and near cover tests.NPC was evaluated using a single 6/12 visual target mounted on a centrally positioned Gulden fixation stick.Ocular symptoms were investigated through interviews.RESULTS:Of the 996 selected students,921 participated in the study.Of them,543(58.96%)were female,and their ages ranged from 13 to 22y.The prevalence of tropia was 3.58%[95%confidence interval(CI):2.38%-4.78%],observed in 3.44%of males and 3.68%of females.Exotropia(1.95%,95%CI:1.06%-2.85%)was more common than esotropia(1.52%,95%CI:0.73%-2.31%).The 15.42%(95%CI:13.09%-17.75%)of students had phoria.Exophoria(13.79%,95%CI:11.56%-16.02%)was significantly more prevalent than esophoria(1.63%,95%CI:0.81%-2.45%).The prevalence of NPC abnormality in the total study population was 24.97%(95%CI:22.18%-27.77%).It was 26.72%(95%CI:22.26%-31.18%)in males and 23.76%(95%CI:20.18%-27.34%)in females(P=0.307).The most common symptom in phoria was headache(86.62%,95%CI:81.02%-92.22%),followed by tired or sore eyes(61.97%,95%CI:53.99%-69.96%).The most common symptoms in tropia were blurry vision(93.94%,95%CI:79.77%-99.26%)and difficulty concentrating(87.88%,95%CI:76.74%-99.01%).CONCLUSION:Among Erbil’s high school students,the prevalence of strabismus,particularly the exodeviation type,is relatively high,and a significant percentage of students have NPC abnormalities.Addressing and correcting these binocular vision problems,due to their associated visual symptoms,can lead to an improvement in students’quality of life and academic performance.展开更多
Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is ...Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.展开更多
Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients were divided into four groups according to their...Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients were divided into four groups according to their Hunt and Hess grade at admission and aneurysm treatment modality： Group 1,Hunt and Hess grade≤II and surgical clipping;Group 2,Hunt and Hess grade≤II and endovascular embolization;Group 3,Hunt and Hess grade≥III and surgical clipping;Group 4,Hunt and Hess grade≥III and endovascular embolization.Level of consciousness was evaluated using the Glasgow Coma Scale,functional status using the Glasgow Outcome Scale,level of the mobility using the Mobility Scale for acute stroke patients,and independence in activities of daily living using the Barthel Index.After early physiotherapy,the level of consciousness and functional status improved significantly in Groups 1,3,and 4;mobility improved significantly in all groups;and independence in activities of daily living improved significantly in Groups 1 and 3.At discharge, Groups 1 and 2 had better functional status than Groups 3 and 4.Level of consciousness,functional status,mobility and independence in activities of daily living improved after early physiotherapy. These findings suggest that early physiotherapy improved the prognosis of patients with cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients with a worse clinical status at presentation had a poorer functional status at discharge.The outcome of physiotherapy was not affected by whether surgical clipping or endovascular embolization was chosen for treatment of the aneurysm.展开更多
Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairments in the initial stage, which lead to severe cognitive dysfunction in the later stage. Action observation therapy (AOT) is...Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairments in the initial stage, which lead to severe cognitive dysfunction in the later stage. Action observation therapy (AOT) is a multisensory cognitive rehabilitation technique where the patient initially observes the actions and then tries to perform. The study aimed to examine the impact of AOT along with usual physiotherapy interventions to reduce depression, improve cognition and balance of a patient with AD. A 67 years old patient with AD was selected for this study because the patient has been suffering from depression, dementia, and physical dysfunction along with some other health conditions like diabetes and hypertension. Before starting intervention, a baseline assessment was done through the Beck Depression Inventory (BDI) tool, the Mini-Cog Scale, and the Berg Balance Scale (BBS). The patient received 12 sessions of AOT along with usual physiotherapy interventions thrice a week for four weeks, which included 45 minutes of each session. After four weeks of intervention, the patient demonstrated significant improvement in depression, cognition, and balance, whereas the BDI score declined from moderate 21/63 to mild 15/63 level of depression. The Mini-Cog score improved from 2/5 to 4/5, and the BBS score increased from 18/56 to 37/56. It is concluded that AOT along with usual physiotherapy intervention helps to reduce depression, improve cognition and balance of people with AD.展开更多
Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and ment...Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.展开更多
Aim: To compare the effects of group exercises under physiotherapist control and basketball program on the quality of life of obese children. Methods: 45 obese children aged 10 years were randomly included to the phys...Aim: To compare the effects of group exercises under physiotherapist control and basketball program on the quality of life of obese children. Methods: 45 obese children aged 10 years were randomly included to the physiotherapy (n=14), basketball (n:15), and control group (n:16). The children were assessed before and after 12-week study duration. The Pediatric Quality of Life Inventory (PedsQL) was used to determine and compare their quality of life (QoL). Results: No difference was found when the subheadings of the PedsQL were compared among the groups (p>0.05). When the changes were investigated within the groups, only significant increase was determined in the physical and emotional subheadings of the physiotherapy group (pConclusion: Although no change was determined in the quality of life, physiotherapy group exercise was found to be more successful to affect physical and emotional status of obese children.展开更多
BACKGROUND The Victorian institute of sports assessment for patellar tendons questionnaire(VISA-P),a valid tool for patellar tendinopathy,has been used for patellofemoral pain(PFP).AIM To validate VISA-P in PFP.METHOD...BACKGROUND The Victorian institute of sports assessment for patellar tendons questionnaire(VISA-P),a valid tool for patellar tendinopathy,has been used for patellofemoral pain(PFP).AIM To validate VISA-P in PFP.METHODS Study of validity,responsiveness and feasibility following COSMIN.Inclusion criteria:Subjects with PFP,aged 18 to 55.Agreement among 10 experts on the relevance and clarity of each item using Aiken's V coefficient determined content validity.An exploratory factorial analysis established structural validity.The correlation of VISA-P with knee injury and osteoarthritis outcome score for PFP and Osteoarthritis(KOOS-PF)and Kujala patellofemoral score(KPS;specific for PFP)analyzed the construct validity.Internal consistency was calculated with Cronbach'sαand test-retest reliability with the intraclass correlation coefficient(ICC).Feasibility considered the subjects'self-completion time.RESULTS The sample consisted of 103 knees from 73 subjects(47 female/26 male;aged 34.9±13 SD).The items were relevant and clear,with the exception of item-8,which didn't reach an acceptable level of agreement on clarity.Exploratory factorial analysis found a 2-factor solution,which explained 63.48%of the variance.VISAP achieved a strong and significant correlation with KOOS-PF(Spearman rho=0.826;P<0.001)and KPS(Spearman rho=0.771;P<0.001).The questionnaire showed adequate reliability(Cronbach'sα:0.752;ICC:0.934;P<0.0001;95%CI:0.902-0.955).The mean self-completion time was 232±0.52 SD seconds.CONCLUSION VISA-P proved to be valid and reliable to functionally assess PFP and/or chondromalacia patella.VISA-P is a feasible tool in the clinical and research environment,quick and easy to complete.展开更多
Physical exercise is a cornerstone of cardiac rehabilitation,with resistance training increasingly recognized as essential due to the"muscular hypothesis"in cardiacrelated frailty.However,many patients are u...Physical exercise is a cornerstone of cardiac rehabilitation,with resistance training increasingly recognized as essential due to the"muscular hypothesis"in cardiacrelated frailty.However,many patients are unable to achieve the required training intensities to gain the associated benefits,highlighting the need for alternative approaches.Blood flow restriction(BFR)training has recently emerged as a promising strategy for this population.This qualitative mini-review explores the acute effects and long-term adaptations of BFR training in patients undergoing cardiac rehabilitation,aiming to provide insights into its potential as a viable and effective intervention in health-related outcomes.展开更多
BACKGROUND Liver cirrhosis often leads to significant impairments in functional capacity,which are associated with disease severity and prognosis.Simple,reliable,and low-cost tests are essential to monitor these patie...BACKGROUND Liver cirrhosis often leads to significant impairments in functional capacity,which are associated with disease severity and prognosis.Simple,reliable,and low-cost tests are essential to monitor these patients in clinical practice.The 6-min walk test(6MWT)is widely used in other chronic conditions,but its measurement properties in cirrhosis remain underexplored.AIM To assess the reliability of the 6MWT in patients with liver cirrhosis(LC).METHODS This cross-sectional study was conducted at a teaching hospital in Juiz de Fora-Minas Gerais.Patients diagnosed with LC at any stage of the disease and under clinical follow-up were included.Patients with grade 2 or higher encephalopathy,respiratory,and/or musculoskeletal diseases or who did not understand the test were excluded.Initially,anamnesis and anthropometric evaluation were performed,followed by the 6MWT.After 24 h the test was repeated.Descriptive statistics were used to present the data.Continuous variables were tested for normality using the Shapiro-Wilk test.The reliability of the 6MWT was tested through Bland-Altman analysis,typical error of measurement,and intraclass correlation coefficient(ICC)as well as a one-sample t-test.A paired Student’s ttest was used to check for differences between means,and Pearson’s correlation coefficient was used to verify the relationship between the two moments[first 6MWT(6MWT-1)and second 6MWT(6MWT-2)].RESULTS The mean difference between 6MWT-2 and 6MWT-1 was-18.9 m;the lower limit of the Bland-Altman agreement was-83.5 m,and the upper limit was 45.7 m.One participant was excluded from further analyses for being outside these limits.The typical error of measurement was 18.9 m.The ICC showed excellent reliability between the two tests(ICC=0.97,95%confidence internal:0.90-0.99,P<0.001).The Student’s one-sample t-value was-2.35(P=0.03).The paired t-value was 2.35(P=0.03).Pearson’s correlation coefficient between the 6MWT-1 and 6MWT-2 was r=0.98(P=0.0001).CONCLUSION The 6MWT is a test with excellent reliability.It is safe,easy to administer,inexpensive,and can be introduced into routine practice without loss of diagnostic precision in estimating the functional capacity of patients with LC.展开更多
Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this s...Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.展开更多
In the era of growing environmental challenges,an ecological lifestyle is no longer an option,but a necessity.The benefits of an eco-friendly approach to health include:(1)Improved health:avoiding harmful substances i...In the era of growing environmental challenges,an ecological lifestyle is no longer an option,but a necessity.The benefits of an eco-friendly approach to health include:(1)Improved health:avoiding harmful substances in food and cosmetics,improving air quality at home.(2)Stress reduction:spending time outdoors,physical activity,as well as living in harmony with nature and protecting the environment.An ecological approach in medical facilities protects the local environment and translates into more effective,safe and sustainable healthcare.Medical facilities that engage in pro-ecological initiatives can also promote a healthy lifestyle in the local community.Activities in this area may include the organisation of programmes to encourage physical activity,education on healthy eating,as well as the provision of recreational areas for patients and staff.(3)Promoting sustainable mobility:encouraging workers to use public transport,bicycles or electric cars can help to reduce greenhouse gas emissions associated with commuting.An ecological approach to health is a holistic view that emphasizes the relationship between human health and the state of the natural environment.Physiotherapy services provided by physiotherapists to individuals and the population are designed to develop,maintain and restore their maximum fitness and improve their functioning throughout their lives.On the basis of selected articles,I present issues related to physiotherapy and an ecological approach to it.Physical activity,along with its alleviating effect on Parkinson's disease symptoms,remains an underestimated factor that can be used to achieve a treatment outcome.Modern evidence supports the positive impact of non-pharmacological approaches to treating Parkinson's disease symptoms,in particular the effect of exercise on motor and non-motor symptoms.Physical activity can have a protective and stimulating effect,providing better functional performance in higher-level cognitive networks.It can also improve balance and motor function by improving muscle strength.In a study on the initial effectiveness of yoga in treating moderate to severe depression,participants rated yoga positively.Many children with brain impairment thrive despite negative risk factors or prognosis.Most follow-up studies do not show inconclusive effects of specific physiotherapy programs or activations.Evidence is accumulating about the effects of the environment on brain plasticity,but it's unclear what exactly this means for humans.Environmental changes affect human health.The practice of clinical ecology includes environmental sensitivity practices and its theories.Most methods of diagnosis and treatment have been debunked,and the concepts underlying these theories are not scientific.I believe that physiotherapy in the current world is a very ecological solution to the diseases that affect us.However,this requires constant review,literature analysis,research and research in this direction.展开更多
Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity....Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity.As an autoimmune disease where the body's immune system attack insulin-producing beta cells in the pancreas,leading up to complete or near-complete inability to control the blood glucose levels independently.The lack of glycemic control calls for lifelong exogenous insulin administration in conjunction with careful monitoring to control blood sugar levels and prevent acute and chronic health issues complications.Regular physical activity,notably resistance exercise(RE),may be beneficial in the glycemic management of this population,enhancement of muscle strength,and general health for the growing,development and maturation in children.The evidence depicting its benefits and safeguard for RE in pediatric T1DM patients remains underexamined.This mini-review seeks to synthesize qualitatively the current evidence on RE regarding its global effects on the T1DM in children.A search for peer-reviewed papers is carried out through primary databases,centering on publications that examined the physiological,metabolic,and psychosocial consequences of RE in children with T1DM.Emerging evidence indicates that RE is one potential method of safe and efficacious intervention to improve glycemic management,physical capacity,and quality of life.However,there is still some reluctance to this type of training in the pediatric population.The available research has not only refuted the belief that strength training was contraindicated in the pediatric population but also recommends its systematic practice to enjoy its benefits on the three spheres of health.Nevertheless,methodological differences and small population studies pose challenges to drawing firm conclusions.The review underscores other areas,including the need for standardizing protocols for including patients such as follow-ups and greater considerations for psychosocial effects of RE in this population.This minireview underlines the importance of RE in a global approach to pediatric diabetes care by providing practical insight for both clinicians and researchers.展开更多
BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rate...BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.展开更多
Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,...Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,an understanding of metabolic changes and their mechanisms remain unexplored.The objective of this study was therefore to understand the metabolic basis of exercise in a monocrotaline model of PAH.24 male Wistar rats(age:8–12 weeks and mean body weight:[262.16±24.49]gms)were assigned to one of the four groups(i.e.,Control,PAH,Exercise and PAH t Exercise).The exercise groups participated in treadmill running at 13.3 m/min,five days a week for five weeks.Demographic and clinical characteristics were monitored regularly.Following the intervention,LC-MS based metabolomics were performed on blood samples from all groups at the end of five weeks.Metabolite profiling,peak identification,alignment and isotope annotation were also performed.Statistical inference was carried out using dimensionality reducing techniques and analysis of variance.Partial-least-squares discrimination analysis and variable importance in the projection scores showed that the model was reliable,and not over lifting.The analysis demonstrated significant perturbations to lipid and amino acid metabolism,arginine and homocysteine pathways,sphingolipid(p<0.05),glycerophospholipid(p<0.05)and nucleotide metabolism in PAH.Exercise,however,was seen to restore arginine(p<0.05)and homocysteine(p<0.0001)levels which were independent effects,irrespective of PAH.Dysregulated arginine and homocysteine pathways are seen in PAH.Exercise restores these dysregulated pathways and could potentially impact severity and outcome in PAH.展开更多
Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor ...Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.展开更多
Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Severa...Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.展开更多
Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary con...Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.展开更多
AIM: To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.METHODS: This prospective, single-blinded cohort study ...AIM: To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.METHODS: This prospective, single-blinded cohort study evaluated 31 community-dwelling patients from four outpatient geriatric health centres aged 60 years or older, who started a 6-wk programme at a mean of 17.5 ± 5.7 d after hip fracture surgery. The intervention consisted primarily of progressive fractured kneeextension and bilateral leg press strength training(twice weekly), with relative loads commencing at 15 and increasing to 10 repetitions maximum(RM), with three sets in each session. The main measurements included progression in weight loads, hip fracture-related pain during training, maximal isometric knee-extension strength, new mobility score, the timed up and go test, the 6-min walk test and the 10-meter fast speed walk test, assessed before and after the programme.RESULTS: Weight loads in kilograms in the fractured limb knee-extension strength training increased from 3.3 ± 1.5 to 5.7 ± 1.7 and from 6.8 ± 2.4 to 7.7 ± 2.6, respectively, in the first and last 2 wk(P < 0.001). Correspondingly, the weight loads increased from 50.3 ± 1.9 to 90.8 ± 40 kg and from 108.9 ± 47.7 to 121.9 ± 54 kg in the bilateral leg press exercise(P < 0.001). Hip fracture-related pain was reduced, and large improvements were observed in the functional outcome measurements, e.g., the 6-min walk test improved from 200.6 ± 79.5 to 322.8 ± 68.5 m(P < 0.001). The fractured limb knee-extension strength deficit was reduced from 40% to 17%, compared with the non-fractured limb. Ten patients reported knee pain as a minor restricting factor during the last 10 RM knee-extension strength-training sessions, but with no significant influences on performance. CONCLUSION: Progressive strength training, initiated shortly after hip fracture surgery, seems feasible and does not increase hip fracture-related pain. Progressive strength training resulted in improvement, although a strength deficit of 17% persisted in the fractured limb compared with the non-fractured limb.展开更多
文摘BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department(ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment(EPET) vs. standard care(SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back pain.METHODS: A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011. Neck Disability Index(NDI), Modifi ed Oswestry Low Back Pain Disability Questionnaire(MODI) and 11-point Numeric Pain Rating Scale were used as outcome measures and compared between groups at a mean of 34 days from their initial ED visit.RESULTS: We identifi ed a total of 125 patients. EPET group comprised 62 patients(mean age, 45 years; men, 63%) and SC group comprised 63 patients(mean age, 45 years; men, 43%). The EPET and SC groups received physiotherapy at a median of 4 and 34 days respectively from their fi rst ED visit. EPET patients had signifi cantly lower levels of disability(9.0% vs. 33.4%, Welch t-test, P<0.001) and pain(median value, 1 vs. 4 points, Mann-Whitney U-test, P<0.001) compared with SC patients.CONCLUSION: Early access to physiotherapy in ED was associated with reduced pain and disability levels. EPET protocol can potentially decrease the demand on outpatient orthopedic services, thereby freeing up available resources to treat patients who are more likely to benefi t from it.
文摘This study compared the acute effects of electrical energy transfer(TECAR) and transcutaneous electrical stimulation(TENS) on pain and flexibility after a hamstring injury. Young athletes received either a 20 min TECAR(n = 24) or TENS(n = 26) session within 5 days following a hamstring injury, while the control(CON, n = 25)group was instructed to rest. Visual analogue scale(VAS), functional Assessment Scale for Acute Hamstring Injuries(FASH), straight leg raise test(SLR), and sit-and-reach scores(STR) were obtained prior to, immediately,24, and 48 h after therapy. Group differences were detected after therapy in VAS and FASH scores(p < 0.05).Compared to pre-therapy measurements, VAS scores showed a greater decrease in the TECAR group(-38.75% to-63.33%) than in the TENS group(-16.67% to-25.00%) and both were greater than in the CON group(-2.81%to-9.81%)(p < 0.05). The TECAR group improved FASH scores(28.57%–48.21%) more than the TENS group(15.89%–27.79%) and both groups more than the CON group(0%–8.33%)(p < 0.05). The increase in SLR and STR was greater in the TECAR group(6.26%–13.96%) than in the TENS(1.72%–9.53%) and CON groups(0%–3.03%). These results suggest that in the acute phase of hamstring injury, the use of TECAR and, to a lesser extent, TENS may relieve pain symptoms and bring some improvements in flexibility more than instructing patients to rest.
文摘AIM:To determine the prevalence of tropia,phoria,and abnormality of near point of convergence(NPC),along with associated ocular symptoms,in high school students.METHODS:This cross-sectional study was conducted in Erbil,Iraq.The target population consisted of high school students selected through a multi-stage cluster sampling method.Comprehensive visual examinations were performed for all students,including measurement of uncorrected and corrected visual acuity,objective and subjective refraction,and distance and near cover tests.NPC was evaluated using a single 6/12 visual target mounted on a centrally positioned Gulden fixation stick.Ocular symptoms were investigated through interviews.RESULTS:Of the 996 selected students,921 participated in the study.Of them,543(58.96%)were female,and their ages ranged from 13 to 22y.The prevalence of tropia was 3.58%[95%confidence interval(CI):2.38%-4.78%],observed in 3.44%of males and 3.68%of females.Exotropia(1.95%,95%CI:1.06%-2.85%)was more common than esotropia(1.52%,95%CI:0.73%-2.31%).The 15.42%(95%CI:13.09%-17.75%)of students had phoria.Exophoria(13.79%,95%CI:11.56%-16.02%)was significantly more prevalent than esophoria(1.63%,95%CI:0.81%-2.45%).The prevalence of NPC abnormality in the total study population was 24.97%(95%CI:22.18%-27.77%).It was 26.72%(95%CI:22.26%-31.18%)in males and 23.76%(95%CI:20.18%-27.34%)in females(P=0.307).The most common symptom in phoria was headache(86.62%,95%CI:81.02%-92.22%),followed by tired or sore eyes(61.97%,95%CI:53.99%-69.96%).The most common symptoms in tropia were blurry vision(93.94%,95%CI:79.77%-99.26%)and difficulty concentrating(87.88%,95%CI:76.74%-99.01%).CONCLUSION:Among Erbil’s high school students,the prevalence of strabismus,particularly the exodeviation type,is relatively high,and a significant percentage of students have NPC abnormalities.Addressing and correcting these binocular vision problems,due to their associated visual symptoms,can lead to an improvement in students’quality of life and academic performance.
基金supported by a Project Grant(Grant No.PJT183705)an Early Career Investigator Prize(Grant No.ECP 184184)from the Canadian Institutes of Health Research+7 种基金a Prentice Institute Research Affiliate Fund Grant from the Prentice Institute for Global Population and Economy(Grant No.G00004116)a Te Herenga Waka Victoria University of Wellington Division of Science Health Engineering Architecture and Design Innovation Faculty Strategic Research Grant(Grant No.FSRG-SHEADI-10724)The Thailand Physical Activity Knowledge Development Centre(TPAK)/Thai Health Promotion Foundation provided funding for the cognitive interviews and pilot study in Thailand(Grant No.66-P1-0473)The University Pablo de Olavide provided a scholarship for 2 undergraduate students working on the project(codes PPI2207 and PPI2308)In the Czech Republicthe study was supported by Palacky University IGA(Grant No.IGA_FTK_2023_017)supported by the Division of Intramural Research at the National Institute on Minority Health and Health Disparities of the National Institutes of Healthsupported by the Key Project of the National Philosophy and Social Science Foundation of China(23&ZD197)。
文摘Background:Investigators from low-,middle-,and high-income countries representing 6 continents contributed to the development of the Global Adolescent and Child Physical Activity Questionnaire(GAC-PAQ).The GAC-PAQ is designed to assess physical activity(PA)across all key domains(i.e.,school,chores,work/volunteering,transport,free time,outdoor time).It aimed to address multiple gaps in global PA surveillance(e.g.,omission of important PA domains,insufficient cultural adaptation,underrepresentation of rural areas in questionnaire validation studies).The purpose of this study was to assess the content validity of the GAC-PAQ among PA experts,8-to 17-year-olds,and one of their parents/guardians,and to discuss changes made to the questionnaire based on participants'feedback.Methods:Sixty-two experts in PA measurement and/or surveillance from 24 countries completed an online survey that included both closed-and open-ended questions about the content validity of the GAC-PAQ.The proportion of experts who agreed or strongly agreed with the items was calculated.Child-parent/guardian dyads from 15 countries(n=250;10-40 per country)participated in a structured cognitive interview to assess the clarity of the questions and response options,and they were encouraged to provide suggestions to improve clarity and facilitate completion of the questionnaire.Participating countries are:Aotearoa New Zealand,Brazil,Canada,China,Colombia,Czech Republic,India,Malawi,Mexico,Nepal,Nigeria,Spain,Sweden,Thailand,and the United Arab Emirates.Interviews were conducted in 13 different languages and structured by PA domain.Generic images were included to help participants in answering questions about PA intensity.Results:Expert agreement with the items for each domain exceeded 75%,and their qualitative feedback was used to revise the questionnaire before cognitive interviews.In general,participants found the questionnaire to be comprehensive.Adolescents(12-17 years)found it easier than children(8-11 years)to answer the questions.Several children struggled to answer questions about the duration and intensity of activities and/or concepts related to travel modes,active trips,and organized activities.Many parents/guardians were unsure about the frequency,duration,and intensity of their children's or adolescents'PA at school and/or recommended using more culturally relevant and appropriate images.Some participants misunderstood the concept of activities that“make you stronger”(intended to assess resistance activities)and/or struggled to differentiate between work,volunteering,and chores.Conclusion:Participants'feedback was used to develop a revised,simplified,and culturally adapted GAC-PAQ,which will be pilot-tested in all15 countries in an App that will include country-specific images and narration in local languages.Further research is needed to assess the reliability and validity of the revised GAC-PAQ.
文摘Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients were divided into four groups according to their Hunt and Hess grade at admission and aneurysm treatment modality： Group 1,Hunt and Hess grade≤II and surgical clipping;Group 2,Hunt and Hess grade≤II and endovascular embolization;Group 3,Hunt and Hess grade≥III and surgical clipping;Group 4,Hunt and Hess grade≥III and endovascular embolization.Level of consciousness was evaluated using the Glasgow Coma Scale,functional status using the Glasgow Outcome Scale,level of the mobility using the Mobility Scale for acute stroke patients,and independence in activities of daily living using the Barthel Index.After early physiotherapy,the level of consciousness and functional status improved significantly in Groups 1,3,and 4;mobility improved significantly in all groups;and independence in activities of daily living improved significantly in Groups 1 and 3.At discharge, Groups 1 and 2 had better functional status than Groups 3 and 4.Level of consciousness,functional status,mobility and independence in activities of daily living improved after early physiotherapy. These findings suggest that early physiotherapy improved the prognosis of patients with cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients with a worse clinical status at presentation had a poorer functional status at discharge.The outcome of physiotherapy was not affected by whether surgical clipping or endovascular embolization was chosen for treatment of the aneurysm.
文摘Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairments in the initial stage, which lead to severe cognitive dysfunction in the later stage. Action observation therapy (AOT) is a multisensory cognitive rehabilitation technique where the patient initially observes the actions and then tries to perform. The study aimed to examine the impact of AOT along with usual physiotherapy interventions to reduce depression, improve cognition and balance of a patient with AD. A 67 years old patient with AD was selected for this study because the patient has been suffering from depression, dementia, and physical dysfunction along with some other health conditions like diabetes and hypertension. Before starting intervention, a baseline assessment was done through the Beck Depression Inventory (BDI) tool, the Mini-Cog Scale, and the Berg Balance Scale (BBS). The patient received 12 sessions of AOT along with usual physiotherapy interventions thrice a week for four weeks, which included 45 minutes of each session. After four weeks of intervention, the patient demonstrated significant improvement in depression, cognition, and balance, whereas the BDI score declined from moderate 21/63 to mild 15/63 level of depression. The Mini-Cog score improved from 2/5 to 4/5, and the BBS score increased from 18/56 to 37/56. It is concluded that AOT along with usual physiotherapy intervention helps to reduce depression, improve cognition and balance of people with AD.
文摘Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.
文摘Aim: To compare the effects of group exercises under physiotherapist control and basketball program on the quality of life of obese children. Methods: 45 obese children aged 10 years were randomly included to the physiotherapy (n=14), basketball (n:15), and control group (n:16). The children were assessed before and after 12-week study duration. The Pediatric Quality of Life Inventory (PedsQL) was used to determine and compare their quality of life (QoL). Results: No difference was found when the subheadings of the PedsQL were compared among the groups (p>0.05). When the changes were investigated within the groups, only significant increase was determined in the physical and emotional subheadings of the physiotherapy group (pConclusion: Although no change was determined in the quality of life, physiotherapy group exercise was found to be more successful to affect physical and emotional status of obese children.
文摘BACKGROUND The Victorian institute of sports assessment for patellar tendons questionnaire(VISA-P),a valid tool for patellar tendinopathy,has been used for patellofemoral pain(PFP).AIM To validate VISA-P in PFP.METHODS Study of validity,responsiveness and feasibility following COSMIN.Inclusion criteria:Subjects with PFP,aged 18 to 55.Agreement among 10 experts on the relevance and clarity of each item using Aiken's V coefficient determined content validity.An exploratory factorial analysis established structural validity.The correlation of VISA-P with knee injury and osteoarthritis outcome score for PFP and Osteoarthritis(KOOS-PF)and Kujala patellofemoral score(KPS;specific for PFP)analyzed the construct validity.Internal consistency was calculated with Cronbach'sαand test-retest reliability with the intraclass correlation coefficient(ICC).Feasibility considered the subjects'self-completion time.RESULTS The sample consisted of 103 knees from 73 subjects(47 female/26 male;aged 34.9±13 SD).The items were relevant and clear,with the exception of item-8,which didn't reach an acceptable level of agreement on clarity.Exploratory factorial analysis found a 2-factor solution,which explained 63.48%of the variance.VISAP achieved a strong and significant correlation with KOOS-PF(Spearman rho=0.826;P<0.001)and KPS(Spearman rho=0.771;P<0.001).The questionnaire showed adequate reliability(Cronbach'sα:0.752;ICC:0.934;P<0.0001;95%CI:0.902-0.955).The mean self-completion time was 232±0.52 SD seconds.CONCLUSION VISA-P proved to be valid and reliable to functionally assess PFP and/or chondromalacia patella.VISA-P is a feasible tool in the clinical and research environment,quick and easy to complete.
文摘Physical exercise is a cornerstone of cardiac rehabilitation,with resistance training increasingly recognized as essential due to the"muscular hypothesis"in cardiacrelated frailty.However,many patients are unable to achieve the required training intensities to gain the associated benefits,highlighting the need for alternative approaches.Blood flow restriction(BFR)training has recently emerged as a promising strategy for this population.This qualitative mini-review explores the acute effects and long-term adaptations of BFR training in patients undergoing cardiac rehabilitation,aiming to provide insights into its potential as a viable and effective intervention in health-related outcomes.
文摘BACKGROUND Liver cirrhosis often leads to significant impairments in functional capacity,which are associated with disease severity and prognosis.Simple,reliable,and low-cost tests are essential to monitor these patients in clinical practice.The 6-min walk test(6MWT)is widely used in other chronic conditions,but its measurement properties in cirrhosis remain underexplored.AIM To assess the reliability of the 6MWT in patients with liver cirrhosis(LC).METHODS This cross-sectional study was conducted at a teaching hospital in Juiz de Fora-Minas Gerais.Patients diagnosed with LC at any stage of the disease and under clinical follow-up were included.Patients with grade 2 or higher encephalopathy,respiratory,and/or musculoskeletal diseases or who did not understand the test were excluded.Initially,anamnesis and anthropometric evaluation were performed,followed by the 6MWT.After 24 h the test was repeated.Descriptive statistics were used to present the data.Continuous variables were tested for normality using the Shapiro-Wilk test.The reliability of the 6MWT was tested through Bland-Altman analysis,typical error of measurement,and intraclass correlation coefficient(ICC)as well as a one-sample t-test.A paired Student’s ttest was used to check for differences between means,and Pearson’s correlation coefficient was used to verify the relationship between the two moments[first 6MWT(6MWT-1)and second 6MWT(6MWT-2)].RESULTS The mean difference between 6MWT-2 and 6MWT-1 was-18.9 m;the lower limit of the Bland-Altman agreement was-83.5 m,and the upper limit was 45.7 m.One participant was excluded from further analyses for being outside these limits.The typical error of measurement was 18.9 m.The ICC showed excellent reliability between the two tests(ICC=0.97,95%confidence internal:0.90-0.99,P<0.001).The Student’s one-sample t-value was-2.35(P=0.03).The paired t-value was 2.35(P=0.03).Pearson’s correlation coefficient between the 6MWT-1 and 6MWT-2 was r=0.98(P=0.0001).CONCLUSION The 6MWT is a test with excellent reliability.It is safe,easy to administer,inexpensive,and can be introduced into routine practice without loss of diagnostic precision in estimating the functional capacity of patients with LC.
基金the staff of UUTH for their support during data collection.
文摘Background:Recovery after stroke is often hindered when healthcare professionals work in isolation.Coordinated efforts between nurses and physiotherapists may improve patient outcomes.Objective:The objective of this study was to examine the effect of nurse-physiotherapist collaborative rehabilitation on functional recovery,motor function,quality of life,and disability among stroke patients.Materials and Methods:A parallel-group randomized controlled trial was conducted at the University of Uyo Teaching Hospital,Nigeria.Ninety adult stroke patients were randomized into intervention(n=45)and control(n=45)groups.The intervention group received a 6-week rehabilitation program combining joint goal setting,coordinated nursing and physiotherapy sessions,shared documentation,and weekly team reviews,whereas the control group received standard care.Outcomes were measured at baseline,6 weeks,and 3 months using the Barthel Index(primary),Fugl-Meyer assessment,stroke-specific quality of life(SS-QOL),and modified Rankin scale(mRS).Data were analyzed with repeated measures analysis of variance,with P<0.05 considered significant.Results:Patients in the intervention group showed greater functional improvement than controls.Barthel Index scores increased from 35.4±10.2 at baseline to 85.1±10.7 at 3 months,compared with 36.1±9.8-68.9±12.0 in controls(P<0.001).Similar patterns were observed for Fugl-Meyer assessment,SS-QOL,and mRS.High adherence,few adverse events,and consistent program fidelity supported feasibility.Improvements were attributed to the combination of nursing reinforcement,structured physiotherapy,patient education,and psychosocial support.Conclusion:Nurse-physiotherapist collaboration significantly enhances functional recovery,motor function,quality of life,and reduces disability in stroke patients.Implementing structured interprofessional rehabilitation in clinical practice is feasible and beneficial.
文摘In the era of growing environmental challenges,an ecological lifestyle is no longer an option,but a necessity.The benefits of an eco-friendly approach to health include:(1)Improved health:avoiding harmful substances in food and cosmetics,improving air quality at home.(2)Stress reduction:spending time outdoors,physical activity,as well as living in harmony with nature and protecting the environment.An ecological approach in medical facilities protects the local environment and translates into more effective,safe and sustainable healthcare.Medical facilities that engage in pro-ecological initiatives can also promote a healthy lifestyle in the local community.Activities in this area may include the organisation of programmes to encourage physical activity,education on healthy eating,as well as the provision of recreational areas for patients and staff.(3)Promoting sustainable mobility:encouraging workers to use public transport,bicycles or electric cars can help to reduce greenhouse gas emissions associated with commuting.An ecological approach to health is a holistic view that emphasizes the relationship between human health and the state of the natural environment.Physiotherapy services provided by physiotherapists to individuals and the population are designed to develop,maintain and restore their maximum fitness and improve their functioning throughout their lives.On the basis of selected articles,I present issues related to physiotherapy and an ecological approach to it.Physical activity,along with its alleviating effect on Parkinson's disease symptoms,remains an underestimated factor that can be used to achieve a treatment outcome.Modern evidence supports the positive impact of non-pharmacological approaches to treating Parkinson's disease symptoms,in particular the effect of exercise on motor and non-motor symptoms.Physical activity can have a protective and stimulating effect,providing better functional performance in higher-level cognitive networks.It can also improve balance and motor function by improving muscle strength.In a study on the initial effectiveness of yoga in treating moderate to severe depression,participants rated yoga positively.Many children with brain impairment thrive despite negative risk factors or prognosis.Most follow-up studies do not show inconclusive effects of specific physiotherapy programs or activations.Evidence is accumulating about the effects of the environment on brain plasticity,but it's unclear what exactly this means for humans.Environmental changes affect human health.The practice of clinical ecology includes environmental sensitivity practices and its theories.Most methods of diagnosis and treatment have been debunked,and the concepts underlying these theories are not scientific.I believe that physiotherapy in the current world is a very ecological solution to the diseases that affect us.However,this requires constant review,literature analysis,research and research in this direction.
文摘Type 1 diabetes mellitus(T1DM)is an autoimmune condition whose prevalence is prominent in children and adolescents,resulting in insulin deficiency with a potential for long-term complications induced by glucotoxicity.As an autoimmune disease where the body's immune system attack insulin-producing beta cells in the pancreas,leading up to complete or near-complete inability to control the blood glucose levels independently.The lack of glycemic control calls for lifelong exogenous insulin administration in conjunction with careful monitoring to control blood sugar levels and prevent acute and chronic health issues complications.Regular physical activity,notably resistance exercise(RE),may be beneficial in the glycemic management of this population,enhancement of muscle strength,and general health for the growing,development and maturation in children.The evidence depicting its benefits and safeguard for RE in pediatric T1DM patients remains underexamined.This mini-review seeks to synthesize qualitatively the current evidence on RE regarding its global effects on the T1DM in children.A search for peer-reviewed papers is carried out through primary databases,centering on publications that examined the physiological,metabolic,and psychosocial consequences of RE in children with T1DM.Emerging evidence indicates that RE is one potential method of safe and efficacious intervention to improve glycemic management,physical capacity,and quality of life.However,there is still some reluctance to this type of training in the pediatric population.The available research has not only refuted the belief that strength training was contraindicated in the pediatric population but also recommends its systematic practice to enjoy its benefits on the three spheres of health.Nevertheless,methodological differences and small population studies pose challenges to drawing firm conclusions.The review underscores other areas,including the need for standardizing protocols for including patients such as follow-ups and greater considerations for psychosocial effects of RE in this population.This minireview underlines the importance of RE in a global approach to pediatric diabetes care by providing practical insight for both clinicians and researchers.
文摘BACKGROUND Total knee arthroplasty(TKA)aims to restore motion and alleviate pain,enabling patients to return to daily activities.Despite advances in implants,surgery,and perioperative care,patient dissatisfaction rates remain significant.AIM To determine whether ankle symptoms are associated with inferior results of functional recovery of the knee following TKA.METHODS This prospective study included all patients with advanced knee osteoarthritis who underwent a primary unilateral TKA between August 2019 and December 2019 with data documented by the treating surgeon and outpatient physical therapists.Patients were categorized based on ankle symptoms using the Ame-rican Orthopaedic Foot and Ankle Society(AOFAS)score:(1)Group 1(AOFAS≤85,n=30);and(2)Group 2(AOFAS>85,n=49).Active range of motion(ROM),the Knee Injury and Osteoarthritis Outcome Score(KOOS),and the visual ana-logue scale(VAS)were compared between two groups.RESULTS Postoperative KOOS,ROM,and VAS significantly improved in both groups(P<0.001).However,at three months,KOOS(P=0.02)and extension motion(P=0.01)improvements were significantly greater in group 2.CONCLUSION These findings suggest that preoperative ankle symptoms may negatively impact early knee functional recovery,particularly in KOOS scores and extension motion.
基金supported by the Senior Research Fellowship from the Indian Council of Medical Research,Govt of India through the research grant to ASBsupported by an extramural research grant from the Indian Council of Medical Research to ASB(5/4/1-9/2019-NCD-Ⅱ)financially supported by Dr.TMA Pai Fellowship from Manipal Academy of Higher Education,Manipal.
文摘Exercise training in pulmonary arterial hypertension(PAH)has been gaining popularity with guidelines now recommending it as an important adjunct to medical therapy.Despite improvements in function and quality of life,an understanding of metabolic changes and their mechanisms remain unexplored.The objective of this study was therefore to understand the metabolic basis of exercise in a monocrotaline model of PAH.24 male Wistar rats(age:8–12 weeks and mean body weight:[262.16±24.49]gms)were assigned to one of the four groups(i.e.,Control,PAH,Exercise and PAH t Exercise).The exercise groups participated in treadmill running at 13.3 m/min,five days a week for five weeks.Demographic and clinical characteristics were monitored regularly.Following the intervention,LC-MS based metabolomics were performed on blood samples from all groups at the end of five weeks.Metabolite profiling,peak identification,alignment and isotope annotation were also performed.Statistical inference was carried out using dimensionality reducing techniques and analysis of variance.Partial-least-squares discrimination analysis and variable importance in the projection scores showed that the model was reliable,and not over lifting.The analysis demonstrated significant perturbations to lipid and amino acid metabolism,arginine and homocysteine pathways,sphingolipid(p<0.05),glycerophospholipid(p<0.05)and nucleotide metabolism in PAH.Exercise,however,was seen to restore arginine(p<0.05)and homocysteine(p<0.0001)levels which were independent effects,irrespective of PAH.Dysregulated arginine and homocysteine pathways are seen in PAH.Exercise restores these dysregulated pathways and could potentially impact severity and outcome in PAH.
文摘Male breast cancer(MBC)is rare,representing 0.5%–1%of all breast cancers,but its incidence is increasing due to improved diagnostics and awareness.MBC typically presents in older men,is human epidermal growth factor receptor 2(HER2)-negative and estrogen receptor(ER)-positive,and lacks routine screening,leading to delayed diagnosis and advanced disease.Major risk factors include hormonal imbalance,radiation exposure,obesity,alcohol use,and Breast Cancer Gene 1 and 2(BRCA1/2)mutations.Clinically,it may resemble gynecomastia but usually appears as a unilateral,painless mass or nipple discharge.Advances in imaging and liquid biopsy have enhanced early detection.Molecular mechanisms involve hormonal signaling,HER2/epidermal growth factor receptor(EGFR)pathways,tumor suppressor gene alterations,and epigenetic changes.While standard treatments mirror those for female breast cancer,emerging options such as cyclin-dependent kinase 4 and 6(CDK4/6),and poly(ADP-ribose)polymerase(PARP)inhibitors,immunotherapy,and precision medicine are reshaping management.Incorporating artificial intelligence,molecular profiling,and male-specific clinical trials is essential to improve outcomes and bridge current diagnostic and therapeutic gaps.
基金TagedPThis work was supported by the following grants:Instituto de Salud Carlos III and co-funded by FEDER(Grant number PIE15/00013)SAF2016-75508-R from the Spanish Ministry of Education and Science(MEC)+2 种基金CB16/10/00435(CIBERFES)PROMETEOII2014/056 from Conselleria,de Sanitat de la Generalitat Valenciana and EU Funded CM1001 and FRAILOMICHEALTH.2012.2.1.1-2ADVANTAGE-724099 Join Action(HP-JA)3rd EU Health Programme and DIALBFRAIL-LATAM(825546 H2020-SC1-BHC).
文摘Dementia is one of the greatest global challenges for health and social care in the 21st century.Alzheimer’s disease(AD),the most common type of dementia,is by no means an inevitable consequence of growing old.Several lifestyle factors may increase,or reduce,an individual’s risk of developing AD.Much has been written over the ages about the benefits of exercise and physical activity.Among the risk factors associated with AD is a low level of physical activity.The relationship between physical and mental health was established several years ago.In this review,we discuss the role of exercise(aerobic and resistance)training as a therapeutic strategy for the treatment and prevention of AD.Older adults who exercise are more likely to maintain cognition.We address the main protective mechanism on brain function modulated by physical exercise by examining both human and animal studies.We will pay especial attention to the potential role of exercise in the modulation of amyloid b turnover,inflammation,synthesis and release of neurotrophins,and improvements in cerebral blood flow.Promoting changes in lifestyle in presymptomatic and predementia disease stages may have the potential for delaying one-third of dementias worldwide.Multimodal interventions that include the adoption of an active lifestyle should be recommended for older populations.
文摘Trunk function has been identified as an important early predictor of functional outcome after stroke and the same deteriorates on both contralateral and ipsilateral sides of the body following stroke. The primary contribution of the trunk muscles is to allow the body to remain upright, adjust weight shifts, and control movements against constant pull of gravity and is considered central key point of the body. Proximal stability of the trunk is a pre-requisite for distal limb mobility, balance, gait and functional activities and its positive correlation in hemiplegia has been demonstrated in a cross- sectional study. Both isokinetic and handheld dynamometer muscle strength testing demonstrated the weakness of bilateral trunk flexors, extensors and rotator muscles in both acute and chronic hemiplegic patients. This was confirmed by electromyography analysis which identified poor bilateral trunk muscles activity in patients with stroke. Trunk impairment scale is sensitive to evaluate the selective muscle control of upper and lower trunk, and it has been reported that lateral flexion of the trunk is easier than rotation of the trunk and the clinical observation concurs to the difficulty in lower trunk rotation of stroke patients. However, trunk exercises given early after stroke could produce enhanced balance performance post- stroke. This review attempts to report the evidence supporting the involvement of the trunk and its influence on balance and functional performance in post-stroke hemiplegia.
基金Supported by The Danish Physical Therapist’s Research Fund
文摘AIM: To investigate the feasibility of a 6-wk progressive strength-training programme commenced shortly after hip fracture surgery in community-dwelling patients.METHODS: This prospective, single-blinded cohort study evaluated 31 community-dwelling patients from four outpatient geriatric health centres aged 60 years or older, who started a 6-wk programme at a mean of 17.5 ± 5.7 d after hip fracture surgery. The intervention consisted primarily of progressive fractured kneeextension and bilateral leg press strength training(twice weekly), with relative loads commencing at 15 and increasing to 10 repetitions maximum(RM), with three sets in each session. The main measurements included progression in weight loads, hip fracture-related pain during training, maximal isometric knee-extension strength, new mobility score, the timed up and go test, the 6-min walk test and the 10-meter fast speed walk test, assessed before and after the programme.RESULTS: Weight loads in kilograms in the fractured limb knee-extension strength training increased from 3.3 ± 1.5 to 5.7 ± 1.7 and from 6.8 ± 2.4 to 7.7 ± 2.6, respectively, in the first and last 2 wk(P < 0.001). Correspondingly, the weight loads increased from 50.3 ± 1.9 to 90.8 ± 40 kg and from 108.9 ± 47.7 to 121.9 ± 54 kg in the bilateral leg press exercise(P < 0.001). Hip fracture-related pain was reduced, and large improvements were observed in the functional outcome measurements, e.g., the 6-min walk test improved from 200.6 ± 79.5 to 322.8 ± 68.5 m(P < 0.001). The fractured limb knee-extension strength deficit was reduced from 40% to 17%, compared with the non-fractured limb. Ten patients reported knee pain as a minor restricting factor during the last 10 RM knee-extension strength-training sessions, but with no significant influences on performance. CONCLUSION: Progressive strength training, initiated shortly after hip fracture surgery, seems feasible and does not increase hip fracture-related pain. Progressive strength training resulted in improvement, although a strength deficit of 17% persisted in the fractured limb compared with the non-fractured limb.
