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
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: 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
Introduction: Teaching evidence-based practice (EBP) has become part of the standard curriculum for health care students and professionals. Teaching EBP skills should be emphasized in entry level physiotherapy educati...Introduction: Teaching evidence-based practice (EBP) has become part of the standard curriculum for health care students and professionals. Teaching EBP skills should be emphasized in entry level physiotherapy education as physiotherapists are expected to practice in an evidence-based way. Identifying barriers to the application of EBP in clinical placement plays an important role in developing physiotherapy programs. The present study aimed to explore physiotherapy students’ perceived barriers toward the use of EBP during their clinical placements. Methods: A cross-sectional study was conducted among third-year physiotherapy students at the Faculty of Health Sciences University of Ljubljana, Slovenia. Participants were asked to complete a self-reported questionnaire that was developed by the researcher based on previously developed surveys. The analyses applied included descriptive statistics and calculation of frequencies, percentages, means and standard deviations of the participating students’ scores. Results: Fifty final-year undergraduate students with a mean age of 23.7 (±4.3, range 23 - 27) years participated in the study. Majority of participants reported lack of formal training, poor ability to critically appraise research evidence, insufficient time, their clinical supervisors, or other therapists not using EBP when treating patients as barriers towards practicing EBP. Conclusions: Physiotherapy students face many challenges in terms of training, organizational, and personal barriers toward the use of EBP during clinical placement. Lack of formal training, lack of research skills, insufficient time and their clinical supervisors or other therapists not using EBP when treating patients, emerged as top barriers. This fact underlines the importance of teaching students EBP skills, which would enable them to use EBP when working with patients.展开更多
<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span>&l...<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>展开更多
Relevance and Method: The purpose of this project was to evaluate the effectiveness of the Emergency Physiotherapy Practitioner (EPP) service against quality care indicators identified as part of the “gold standard”...Relevance and Method: The purpose of this project was to evaluate the effectiveness of the Emergency Physiotherapy Practitioner (EPP) service against quality care indicators identified as part of the “gold standard” for emergency care in England. The study was prospective and evaluated time to initial assessment, total time in the emergency department and un-planned re-attendance rate within a seven-day period for all patients seen by the EPP’s over a period of one year. Outcomes: One thousand and seven patients were seen by EPPs in the emergency department. The median wait time for treatment by an EPP was 34.5 minutes (95th percentile = 122). Regional median wait time was 45 minutes (95th percentile = 138). National median wait time was 55 minutes (95th percentile = 192). Median total time spent in ED for patients seen by EPPs was 99 minutes (95th percentile = 224). Regional median total time in ED was 223 (95th percentile = 239). Nationally median total time in ED was 136 minutes (95th percentile = 336). Three percent of patients seen by an EPP returned to the ED, compared to 6% regionally and 7.5% nationally. Conclusions: EPPs excelled in all three indicators and exceeded regional and national figures. The re-return rate met the current standard of being less than 5%. It could be justified that the addition of the EPPs to the emergency department was an efficient and effective service development.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
Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the ...Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.展开更多
Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment f...Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.展开更多
Background:Physiotherapy is an integral part of treatment for paediatric burns.In Zimbabwe,children are admitted in paediatric burn unit with their caregivers,who play important roles such as providing explanation and...Background:Physiotherapy is an integral part of treatment for paediatric burns.In Zimbabwe,children are admitted in paediatric burn unit with their caregivers,who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy,which is often uncomfortable or painful to the patient.The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospitals in Harare,Zimbabwe.Methods:A descriptive cross-sectional study was conducted using self-administered questionnaires.The study was carried out at two large central hospitals(Parirenyatwa Hospital and Harare Central Hospital).The study targeted all the caregivers of children below the age of 12 years with a diagnosis of burns,irrespective of severity or area affected,who were admitted in the two paediatric burn units.Of the 34 caregivers eligible to participate,31(91.1%)questionnaires had complete data and were analysed.The analyses were done using Statistica version 12.0.Results:The median age of the caregivers was 28 years(IQR=24–33 years).Female caregivers constituted 90.3%of the sample.The majority of the caregivers(n=26,83.9%)were biological mothers to the hospitalised child.The majority of children(n=20,64.5%)hospitalised were between 0 and 4 years.The commonest cause of burns was scalding(n=19,61.2%).The burns were mainly in the upper extremities(n=11,35.5%).Physiotherapy for the burns was mainly active and passive joint range of motion exercises(n=30,96.8%).The caregivers’perceptions towards physiotherapy were mainly positive(n=20,64.5%)indicating that physiotherapy plays an important role in burn management.Of the 21 caregivers given a ward exercise programme,13(61.9%)were not compliant.Conclusions:Caregivers’perspectives towards physiotherapy were largely positive and are similar to those found in other studies.The majority of the caregivers indicated that physiotherapy was important in the overall management of burns leading to proper healing of the wounds without complications.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
BACKGROUND Extracorporeal membrane oxygenation(ECMO)is mainly applied to patients with significant cardiorespiratory failure who do not respond to existing conventional treatments.Patients that are supported with veno...BACKGROUND Extracorporeal membrane oxygenation(ECMO)is mainly applied to patients with significant cardiorespiratory failure who do not respond to existing conventional treatments.Patients that are supported with veno-arterial ECMO(VA-ECMO)are considered very-high risk patients to participate in any type of physical therapy(PT)or mobilization.However,cumulative evidence suggests that early mobilization of critically ill patients is feasible,safe,and efficient under certain circumstances.AIM To summarize the existing evidence on the impact of early mobilization and physiotherapy on VA-ECMO patients.METHODS This is a scoping review that used systematic electronic literature searches(from inception until January 2025)on MEDLINE(PubMed),PEDro,DynaMed,CINAHL,Scopus,Science direct and Hellenic Academic Libraries.Snowball searching method was also applied.Eligible studies included those reporting patients on VA-ECMO who participated in early mobilization or PT,published in English and utilized any primary evidence study design.Studies on children,animals and patients placed on any other ECMO,secondary evidence,and‘grey’literature were excluded.RESULTS A total of 316 articles were retrieved and 13 were included in the study.Of those,1 study was a randomized control trial,4 retrospective studies,4 retrospective cohort studies,1 case series and 3 case reports.The sample size of the included studies ranged from 1 to 104 VA-ECMO patients,who were ambulated or received PT inter-ventions,and mobilization frequency ranged from 2 per day to 4 per week.Mobilization of VA-ECMO patients seems to be safe regardless the cannula’s position.PT and early mobilization were associated with better weaning from mechanical ventilation,gradual reduction of inotropes and functional capacity improvement after ECMO discharge.CONCLUSION Early mobilization in VA-ECMO seems to be safe and can potentially help reduce vasoconstrictors and speed up rehabilitation times.High quality research on early mobilization in VA-ECMO patients is warranted.展开更多
Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-t...Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.展开更多
Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff ...Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.展开更多
BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adver...BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adverse effects and poor patient compliance.Tuina’s abdominal vibration technique,a traditional non-pharmacological intervention,has shown promising results in glycemic regulation.However,its effects on psychological well-being remain largely unexplored.AIM To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.METHODS A prospective cohort study(April 2025 to April 2026)at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients.Participants were allocated to three groups based on vibration frequency:(1)Lowfrequency(400 times/minute,n=40);(2)Medium-frequency(500 times/minute,n=40);and(3)High-frequency(600 times/minute,n=40).All participants received 30-minute sessions three times weekly for 3 months,with follow-up at 6 months and 12 months.Primary outcomes included changes in depression(Beck Depression Inventory-Ⅱ),anxiety(State-Trait Anxiety Inventory),and stress(Perceived Stress Scale)levels.RESULTS After a 3-month intervention period,with follow-ups at 6 months and 12 months,patients in all three groups showed significant improvements in depression,anxiety,and stress scores compared to baseline(P<0.001).The high-frequency group demonstrated the most substantial psychological improvements(mean reduction in depression scores:9.2±2.3 points;anxiety:8.7±2.1 points;stress:10.4±2.5 points).These psychological improvements correlated significantly with reductions in insulin resistance(r=0.68,P<0.001).The high-frequency group also showed the most significant improvements in glycemic parameters,with mean reductions in fasting plasma glucose,2-hour postprandial glucose,and glycosylated hemoglobin concentrations of 0.92 mmol/L,1.87 mmol/L,and 0.51%,respectively.Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.CONCLUSION Tuina’s abdominal vibration technique,especially at high frequency reduces depression,anxiety,and stress in prediabetes patients,correlating with enhanced glycemic control and insulin sensitivity,suggesting a bidirectional relationship between psychological and metabolic health.展开更多
Background:The extensor carpi radial muscle may become imbalanced compared to other muscles in the upper arm and can disrupt the overall muscle balance in the upper limb.This muscular imbalance may then cause inflamma...Background:The extensor carpi radial muscle may become imbalanced compared to other muscles in the upper arm and can disrupt the overall muscle balance in the upper limb.This muscular imbalance may then cause inflammation or irritation in the tendon.Regular physical activity is rarely used as the only treatment for lowering limb edema.Heavy slow resistance(HSR)training is effective compared to regular exercises.HSR affects functional abilities and physical refinement differently from conventional workouts.This study evaluated the effects of HSR and conventional exercise(CE)on subjects aged 45–65 years with unilateral elbow pain on,in Chennai city.Methods:Patient received conservative care in the Physiotherapy Department from January 2022 to April 2022.This study compares the pre-and posttypes.Tennis Elbow Evaluation(Patient-Rated Tennis Elbow Evaluation,PRTEE)questionnaires,a patient-specific functional scale,and grip strength tests were used in the study.Results from the study's treatment HSR group and treatment CE group are contrasted.Results:After 12 weeks of therapy,investigators reassessed grip strength,PRTEE scores,and functional scale responses.In the posttest results of the Patient-Rated Tennis Elbow Evaluation survey,there is a statistically significant difference between Group HSR and Group CE(p<0.001).The posttest outcomes from the patient-specific activity scoring scheme questionnaire revealed a statistically significant disparity between Groups HSR and CE(p<0.001).The mean values for both groups exhibited a noteworthy change,with Team HSR demonstrating higher values in contrast to the control treatment.Conclusion:HSR exercise demonstrates superior effectiveness over CEs for lateral epicondylitis(LE)management,emphasizing its significance in treatment.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
Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and...Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.展开更多
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: 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Introduction: Teaching evidence-based practice (EBP) has become part of the standard curriculum for health care students and professionals. Teaching EBP skills should be emphasized in entry level physiotherapy education as physiotherapists are expected to practice in an evidence-based way. Identifying barriers to the application of EBP in clinical placement plays an important role in developing physiotherapy programs. The present study aimed to explore physiotherapy students’ perceived barriers toward the use of EBP during their clinical placements. Methods: A cross-sectional study was conducted among third-year physiotherapy students at the Faculty of Health Sciences University of Ljubljana, Slovenia. Participants were asked to complete a self-reported questionnaire that was developed by the researcher based on previously developed surveys. The analyses applied included descriptive statistics and calculation of frequencies, percentages, means and standard deviations of the participating students’ scores. Results: Fifty final-year undergraduate students with a mean age of 23.7 (±4.3, range 23 - 27) years participated in the study. Majority of participants reported lack of formal training, poor ability to critically appraise research evidence, insufficient time, their clinical supervisors, or other therapists not using EBP when treating patients as barriers towards practicing EBP. Conclusions: Physiotherapy students face many challenges in terms of training, organizational, and personal barriers toward the use of EBP during clinical placement. Lack of formal training, lack of research skills, insufficient time and their clinical supervisors or other therapists not using EBP when treating patients, emerged as top barriers. This fact underlines the importance of teaching students EBP skills, which would enable them to use EBP when working with patients.
文摘<span style="font-family:Verdana;"><strong>Background:</strong></span><span "=""><span style="font-family:Verdana;"> Ea</span><span><span style="font-family:Verdana;">rly intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside i</span><span style="font-family:Verdana;">n regional areas underrepresented in the literature to date. Consequentia</span></span><span style="font-family:Verdana;">lly, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. </span><b><span style="font-family:Verdana;">Methods:</span></b><span style="font-family:Verdana;"> This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). </span><b><span style="font-family:Verdana;">Discussion:</span></b><span style="font-family:Verdana;"> This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.</span></span>
文摘Relevance and Method: The purpose of this project was to evaluate the effectiveness of the Emergency Physiotherapy Practitioner (EPP) service against quality care indicators identified as part of the “gold standard” for emergency care in England. The study was prospective and evaluated time to initial assessment, total time in the emergency department and un-planned re-attendance rate within a seven-day period for all patients seen by the EPP’s over a period of one year. Outcomes: One thousand and seven patients were seen by EPPs in the emergency department. The median wait time for treatment by an EPP was 34.5 minutes (95th percentile = 122). Regional median wait time was 45 minutes (95th percentile = 138). National median wait time was 55 minutes (95th percentile = 192). Median total time spent in ED for patients seen by EPPs was 99 minutes (95th percentile = 224). Regional median total time in ED was 223 (95th percentile = 239). Nationally median total time in ED was 136 minutes (95th percentile = 336). Three percent of patients seen by an EPP returned to the ED, compared to 6% regionally and 7.5% nationally. Conclusions: EPPs excelled in all three indicators and exceeded regional and national figures. The re-return rate met the current standard of being less than 5%. It could be justified that the addition of the EPPs to the emergency department was an efficient and effective service development.
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Lateral elbow tendinopathy(LET) is a common musculoskeletal/sports injury. A plethora of physiotherapy techniques has been proposed in the management of LET. The exercise programme is the most common treatment in the management of LET. The optimal protocol of exercise programme is still unknown. The effectiveness of the exercise programme is low when it is applied as monotherapy. Therefore, exercise programme is combined with other physiotherapy modalities such as soft tissue techniques, external support, acupuncture, manual therapy and electrotherapy, in the treatment of LET. Future research is needed to determine which treatment strategy combined with exercise programme will provide the best results in LET rehabilitation.
文摘Low back pain remains a most common clinical entity among musculoskeletal disorders. Pain reducing modalities, Manual therapy various specific techniques were widely used physiotherapeutic means as part of treatment for subjects with low back pain. An emerging trend with Independent physiotherapy practice, knowing red flags, conditions requiring investigations and experts treatment were to be recognized and adhered for maximizing patients care and benefits. Prostate cancer among men above 50 years were more found to be linked with Low back pain. This original research presentation where a subject having chronic low back pain found to have prostate cancer were analyzed and discussed with scientific evidence on clinical manifestations, investigations and medical management. Underlines the importance of recognizing, directing and getting treated of the root cause of subjects suffering with Low back pain due to prostate cancer and not just keep treating the symptoms alone were major purpose of this study.
文摘Background:Physiotherapy is an integral part of treatment for paediatric burns.In Zimbabwe,children are admitted in paediatric burn unit with their caregivers,who play important roles such as providing explanation and obtaining cooperation of the child during physiotherapy,which is often uncomfortable or painful to the patient.The aim of this study was to determine the perspectives of caregivers towards physiotherapy interventions administered to hospitalized children at central hospitals in Harare,Zimbabwe.Methods:A descriptive cross-sectional study was conducted using self-administered questionnaires.The study was carried out at two large central hospitals(Parirenyatwa Hospital and Harare Central Hospital).The study targeted all the caregivers of children below the age of 12 years with a diagnosis of burns,irrespective of severity or area affected,who were admitted in the two paediatric burn units.Of the 34 caregivers eligible to participate,31(91.1%)questionnaires had complete data and were analysed.The analyses were done using Statistica version 12.0.Results:The median age of the caregivers was 28 years(IQR=24–33 years).Female caregivers constituted 90.3%of the sample.The majority of the caregivers(n=26,83.9%)were biological mothers to the hospitalised child.The majority of children(n=20,64.5%)hospitalised were between 0 and 4 years.The commonest cause of burns was scalding(n=19,61.2%).The burns were mainly in the upper extremities(n=11,35.5%).Physiotherapy for the burns was mainly active and passive joint range of motion exercises(n=30,96.8%).The caregivers’perceptions towards physiotherapy were mainly positive(n=20,64.5%)indicating that physiotherapy plays an important role in burn management.Of the 21 caregivers given a ward exercise programme,13(61.9%)were not compliant.Conclusions:Caregivers’perspectives towards physiotherapy were largely positive and are similar to those found in other studies.The majority of the caregivers indicated that physiotherapy was important in the overall management of burns leading to proper healing of the wounds without complications.
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.
文摘BACKGROUND Extracorporeal membrane oxygenation(ECMO)is mainly applied to patients with significant cardiorespiratory failure who do not respond to existing conventional treatments.Patients that are supported with veno-arterial ECMO(VA-ECMO)are considered very-high risk patients to participate in any type of physical therapy(PT)or mobilization.However,cumulative evidence suggests that early mobilization of critically ill patients is feasible,safe,and efficient under certain circumstances.AIM To summarize the existing evidence on the impact of early mobilization and physiotherapy on VA-ECMO patients.METHODS This is a scoping review that used systematic electronic literature searches(from inception until January 2025)on MEDLINE(PubMed),PEDro,DynaMed,CINAHL,Scopus,Science direct and Hellenic Academic Libraries.Snowball searching method was also applied.Eligible studies included those reporting patients on VA-ECMO who participated in early mobilization or PT,published in English and utilized any primary evidence study design.Studies on children,animals and patients placed on any other ECMO,secondary evidence,and‘grey’literature were excluded.RESULTS A total of 316 articles were retrieved and 13 were included in the study.Of those,1 study was a randomized control trial,4 retrospective studies,4 retrospective cohort studies,1 case series and 3 case reports.The sample size of the included studies ranged from 1 to 104 VA-ECMO patients,who were ambulated or received PT inter-ventions,and mobilization frequency ranged from 2 per day to 4 per week.Mobilization of VA-ECMO patients seems to be safe regardless the cannula’s position.PT and early mobilization were associated with better weaning from mechanical ventilation,gradual reduction of inotropes and functional capacity improvement after ECMO discharge.CONCLUSION Early mobilization in VA-ECMO seems to be safe and can potentially help reduce vasoconstrictors and speed up rehabilitation times.High quality research on early mobilization in VA-ECMO patients is warranted.
文摘Low back pain(LPB)is a common and impactful health concern globally,affecting individuals across various demographics and imposing a significant burden on the health care system.Nonspecific chronic LBP(NCLBP),charac-terized as pain lasting over 12 weeks without an identifiable cause,leads to notable functional limitations and reduced quality of life.Traditional rehabil-itation programs,often focusing on dynamic exercises for lumbar strengthening,typically do not target the deep stabilizing muscles crucial for lumbar support and effective recovery.Multi-angular isometric lumbar exercise(MAILE)offers a low-impact method for strengthening lumbar stabilizers through multi-angular isometric contractions,reducing risks from dynamic movements.This article examines MAILE’s potential in addressing motor control dysfunctions in NCLBP,highlighting studies on lumbar muscle activation,core stability,and isometric exercises.The article explores the prevalence and socioeconomic impact of NCLBP in the Middle East,highlighting the need for affordable treatment options in areas like Qatar and Saudi Arabia.This article aims to validate the efficacy of MAILE in reducing pain,enhancing mobility,and improving lumbar stability,offering a valuable option for NCLBP management.Future research should focus on large-scale clinical trials to substantiate these findings and guide clinical practice.
文摘Nursing staff provides patient care in an occupational environment that often imposes challenges that affect significantly the musculoskeletal system.Work-related musculoskeletal disorders are common in nursing stuff and have a negative impact in their professional and daily activities.In the current editorial,the duties of nursing staff,the types of musculoskeletal disorders,the predis-posing factors(including factors related to professional tasks/ergonomics and to working schedules,psychological,social and individual factors)and their impact on working ability and quality of life nursing staff are summarized and pre-ventive measures are proposed.
基金Supported by National High Level Chinese Medicine Hospital Clinical Research Funding,No.DFGZRA-2024GJRC010The Fundamental Research Funds for the Central Universities,No.2024-JYB-JBZD-031.
文摘BACKGROUND Prediabetes is a high-risk precursor for diabetes development and is associated with increased psychological distress.Conventional pharmacological treatments for prediabetes have limitations,including adverse effects and poor patient compliance.Tuina’s abdominal vibration technique,a traditional non-pharmacological intervention,has shown promising results in glycemic regulation.However,its effects on psychological well-being remain largely unexplored.AIM To investigate efficacy of abdominal vibration at varying frequencies in Tuina for alleviating psychological and metabolic effects in prediabetes patients.METHODS A prospective cohort study(April 2025 to April 2026)at Dongfang Hospital of Beijing University of Chinese Medicine included 120 prediabetes patients.Participants were allocated to three groups based on vibration frequency:(1)Lowfrequency(400 times/minute,n=40);(2)Medium-frequency(500 times/minute,n=40);and(3)High-frequency(600 times/minute,n=40).All participants received 30-minute sessions three times weekly for 3 months,with follow-up at 6 months and 12 months.Primary outcomes included changes in depression(Beck Depression Inventory-Ⅱ),anxiety(State-Trait Anxiety Inventory),and stress(Perceived Stress Scale)levels.RESULTS After a 3-month intervention period,with follow-ups at 6 months and 12 months,patients in all three groups showed significant improvements in depression,anxiety,and stress scores compared to baseline(P<0.001).The high-frequency group demonstrated the most substantial psychological improvements(mean reduction in depression scores:9.2±2.3 points;anxiety:8.7±2.1 points;stress:10.4±2.5 points).These psychological improvements correlated significantly with reductions in insulin resistance(r=0.68,P<0.001).The high-frequency group also showed the most significant improvements in glycemic parameters,with mean reductions in fasting plasma glucose,2-hour postprandial glucose,and glycosylated hemoglobin concentrations of 0.92 mmol/L,1.87 mmol/L,and 0.51%,respectively.Correlation analysis revealed significant associations between improved psychological parameters and enhanced glycemic control.CONCLUSION Tuina’s abdominal vibration technique,especially at high frequency reduces depression,anxiety,and stress in prediabetes patients,correlating with enhanced glycemic control and insulin sensitivity,suggesting a bidirectional relationship between psychological and metabolic health.
文摘Background:The extensor carpi radial muscle may become imbalanced compared to other muscles in the upper arm and can disrupt the overall muscle balance in the upper limb.This muscular imbalance may then cause inflammation or irritation in the tendon.Regular physical activity is rarely used as the only treatment for lowering limb edema.Heavy slow resistance(HSR)training is effective compared to regular exercises.HSR affects functional abilities and physical refinement differently from conventional workouts.This study evaluated the effects of HSR and conventional exercise(CE)on subjects aged 45–65 years with unilateral elbow pain on,in Chennai city.Methods:Patient received conservative care in the Physiotherapy Department from January 2022 to April 2022.This study compares the pre-and posttypes.Tennis Elbow Evaluation(Patient-Rated Tennis Elbow Evaluation,PRTEE)questionnaires,a patient-specific functional scale,and grip strength tests were used in the study.Results from the study's treatment HSR group and treatment CE group are contrasted.Results:After 12 weeks of therapy,investigators reassessed grip strength,PRTEE scores,and functional scale responses.In the posttest results of the Patient-Rated Tennis Elbow Evaluation survey,there is a statistically significant difference between Group HSR and Group CE(p<0.001).The posttest outcomes from the patient-specific activity scoring scheme questionnaire revealed a statistically significant disparity between Groups HSR and CE(p<0.001).The mean values for both groups exhibited a noteworthy change,with Team HSR demonstrating higher values in contrast to the control treatment.Conclusion:HSR exercise demonstrates superior effectiveness over CEs for lateral epicondylitis(LE)management,emphasizing its significance in treatment.
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Background:Acupuncture is widely used in modulating brain excitability and motor function,as a form of complementary and alternative medicine.However,there is no existing meta-analysis evaluating the effectiveness and safety of acupuncture on corticospinal excitability(CSE),and the credibility of the evidence has yet to be quantified.Objective:This study was designed to assess the efficacy and safety of electroacupuncture(EA)and manual acupuncture(MA)in enhancing brain excitability,specifically focusing on CSE as measured by transcranial magnetic stimulation(TMS).Search strategy:This study followed a systematic approach,searching 9 databases up to August 2024 and examining grey literature,in compliance with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines.Inclusion criteria:Studies were included if they compared the clinical efficacy of EA or MA with sham acupuncture,no treatment or usual training.Data extraction and analysis:Three investigators independently conducted literature screening,data extraction,and risk of bias assessment.The primary outcome focused on motor-evoked potentials as measured by TMS,with treatment effects quantified using mean differences or standardized mean differences between pre-and post-treatment.Subgroup analyses were conducted using mixed-effects models,while random-effects or fixed-effects models were used to estimate average treatment differences across studies.Results:Based on 34 studies involving 1031 adults,acupuncture techniques significantly enhanced CSE.EA had a greater impact than MA,with effect sizes of 0.53 mV vs 0.43 mV(95%confidence interval[CI]:[0.30,0.76],P<0.00001 vs 95%CI:[0.28,0.59],P<0.00001).The 5 most frequently used acupoints were LI4(Hegu,32 times),ST36(Zusanli,10 times),LI11(Quchi,7 times),TE5(Waiguan,6 times),and GB34(Yanglingquan,5 times).Conclusion:This systematic review indicates that both EA and MA could effectively and safely enhance CSE,bringing the corticospinal pathway closer to the threshold for firing,which may ultimately improve motor function.LI4,ST36,LI11,TE5 and GB34 are the most commonly used acupoints.
