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Jameson TSO, Caldow MK, Stephens F, Denehy L, Lynch GS, Koopman R, Krajcova A, Urban T, Berney S, Duska F, Puthucheary Z. Inflammation and altered metabolism impede efficacy of functional electrical stimulation in critically ill patients. Crit Care 2023; 27:428. [PMID: 37932834 PMCID: PMC10629203 DOI: 10.1186/s13054-023-04664-7] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2023] [Accepted: 09/26/2023] [Indexed: 11/08/2023] Open
Abstract
BACKGROUND Critically ill patients suffer from acute muscle wasting, which is associated with significant physical functional impairment. We describe data from nested muscle biopsy studies from two trials of functional electrical stimulation (FES) that did not shown improvements in physical function. METHODS Primary cohort: single-centre randomized controlled trial. Additional healthy volunteer data from patients undergoing elective hip arthroplasty. Validation cohort: Four-centre randomized controlled trial. INTERVENTION FES cycling for 60-90min/day. ANALYSES Skeletal muscle mRNA expression of 223 genes underwent hierarchal clustering for targeted analysis and validation. RESULTS Positively enriched pathways between healthy volunteers and ICU participants were "stress response", "response to stimuli" and "protein metabolism", in keeping with published data. Positively enriched pathways between admission and day 7 ICU participants were "FOXO-mediated transcription" (admission = 0.48 ± 0.94, day 7 = - 0.47 ± 1.04 mean log2 fold change; P = 0.042), "Fatty acid metabolism" (admission = 0.50 ± 0.67, day 7 = 0.07 ± 1.65 mean log2 fold change; P = 0.042) and "Interleukin-1 processing" (admission = 0.88 ± 0.50, day 7 = 0.97 ± 0.76 mean log2 fold change; P = 0.054). Muscle mRNA expression of UCP3 (P = 0.030) and DGKD (P = 0.040) decreased in both cohorts with no between group differences. Changes in IL-18 were not observed in the validation cohort (P = 0.268). Targeted analyses related to intramuscular mitochondrial substrate oxidation, fatty acid oxidation and intramuscular inflammation showed PPARγ-C1α; (P < 0.001), SLC25A20 (P = 0.017) and UCP3 (P < 0.001) decreased between admission and day 7 in both arms. LPIN-1 (P < 0.001) and SPT1 (P = 0.044) decreased between admission and day 7. IL-18 (P = 0.011) and TNFRSF12A (P = 0.009) increased in both arms between admission and day 7. IL-1β (P = 0.007), its receptor IL-1R1 (P = 0.005) and IL-6R (P = 0.001) decreased in both arms between admission and day 7. No between group differences were seen in any of these (all p > 0.05). CONCLUSIONS Intramuscular inflammation and altered substrate utilization are persistent in skeletal muscle during first week of critical illness and are not improved by the application of Functional Electrical Stimulation-assisted exercise. Future trials of exercise to prevent muscle wasting and physical impairment are unlikely to be successful unless these processes are addressed by other means than exercise alone.
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Affiliation(s)
- T S O Jameson
- Nutritional Physiology Group, Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, Devon, UK
| | - M K Caldow
- Centre for Muscle Research, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - F Stephens
- Nutritional Physiology Group, Department of Sport and Health Sciences, College of Life and Environmental Sciences, University of Exeter, Exeter, Devon, UK
| | - L Denehy
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
| | - G S Lynch
- Centre for Muscle Research, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - R Koopman
- Centre for Muscle Research, Department of Anatomy and Physiology, The University of Melbourne, Melbourne, VIC, Australia
| | - A Krajcova
- Department of Anaesthesia and Intensive Care Medicine, Third Faculty of Medicine, Charles University, FNKV University Hospital, Srobarova 50, 10034, Prague, Czech Republic
| | - T Urban
- Department of Anaesthesia and Intensive Care Medicine, Third Faculty of Medicine, Charles University, FNKV University Hospital, Srobarova 50, 10034, Prague, Czech Republic
| | - S Berney
- Department of Physiotherapy, School of Health Sciences, The University of Melbourne, Melbourne, Australia
- Department of Physiotherapy Division of Allied, Health Austin Health, Austin, TX, USA
| | - F Duska
- Department of Anaesthesia and Intensive Care Medicine, Third Faculty of Medicine, Charles University, FNKV University Hospital, Srobarova 50, 10034, Prague, Czech Republic.
| | - Z Puthucheary
- William Harvey Research Institute, Barts and The London School of Medicine, Queen Mary University of London, London, UK
- Adult Critical Care Unit, Royal London Hospital Barts Health NHS Trust, London, UK
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Patti A, Thornton JS, Giustino V, Drid P, Paoli A, Schulz JM, Palma A, Bianco A. Effectiveness of Pilates exercise on low back pain: a systematic review with meta-analysis. Disabil Rehabil 2023:1-14. [PMID: 37632387 DOI: 10.1080/09638288.2023.2251404] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 08/18/2023] [Accepted: 08/18/2023] [Indexed: 08/28/2023]
Abstract
PURPOSE Low back pain is the most frequently reported musculoskeletal disorder and represents one of the highest patient burdens in healthcare. This systematic review and meta-analysis aimed to investigate the effectiveness of Pilates exercise on pain intensity and functional disability caused by low back pain (LBP). MATERIALS AND METHODS A Systematic review with meta-analysis was conducted. Data sources: MEDLINE-NLM and MEDLINE-EBSCO. We also searched on Scopus Elsevier, Cochrane, DOAJ, SciELO, PEDro, and PLOS ONE databases. Eligibility criteria: randomized controlled trials (RCTs) evaluating LBP in which the primary treatment was based on Pilates exercise compared with no exercise, or non-specific exercise. RESULTS The search returned 1566 records of which 36 articles were included in the systematic review and 19 in the meta-analysis. Twenty-two studies compared the effects of Pilates exercise vs no exercise and 13 studies examined the effects of Pilates exercise vs non-specific exercise. Analysis showed that Pilates had a positive effect on the perception of LBP vs no exercise. A similar trend occurred with non-specific exercise. CONCLUSIONS Pilates exercise can decrease LBP compared to no exercise and non-specific exercise. General practitioners should consider Pilates exercise as an effective strategy to manage LBP and counteract the growing health. TRIAL REGISTRATION PROSPERO registration number: CRD42022308387.IMPLICATIONS FOR REHABILITATIONPilates is a good strategy for improving low back pain and is more effective than other exercise programs or no exercise.Pilates is a safe tool to apply to most of the population with low back pain.Pilates is a non-pharmacological strategy useful for counteracting low back pain.
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Affiliation(s)
- Antonino Patti
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Jane S Thornton
- Western Centre for Public Health and Family Medicine, University of Western Ontario Schulich School of Medicine and Dentistry, London, ON, Canada
| | - Valerio Giustino
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
| | - Patrik Drid
- Faculty of Sport and Physical Education, University of Novi Sad, Novi Sad, Serbia
| | - Antonio Paoli
- Department of Biomedical Sciences, University of Padua, Padua, Italy
| | - Jenna M Schulz
- School of Physical Therapy, Faculty of Health Sciences, University of Western Ontario, London, Canada
- Bone and Joint Institute, University of Western Ontario, London, Canada
| | - Antonio Palma
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
- Regional Sports School of Italian National Olympic Committee (CONI) Sicilia, Palermo, Italy
| | - Antonino Bianco
- Sport and Exercise Sciences Research Unit, Department of Psychology, Educational Science and Human Movement, University of Palermo, Palermo, Italy
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3
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Muñoz-Tomás MT, Burillo-Lafuente M, Vicente-Parra A, Sanz-Rubio MC, Suarez-Serrano C, Marcén-Román Y, Franco-Sierra MÁ. Telerehabilitation as a Therapeutic Exercise Tool versus Face-to-Face Physiotherapy: A Systematic Review. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2023; 20:4358. [PMID: 36901375 PMCID: PMC10002129 DOI: 10.3390/ijerph20054358] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Revised: 02/24/2023] [Accepted: 02/27/2023] [Indexed: 06/18/2023]
Abstract
UNLABELLED Digital physiotherapy, often referred to as "Telerehabilitation", consists of applying rehabilitation using telecommunication technologies. The objective is to evaluate the effectiveness of therapeutic exercise when it is telematically prescribed. METHODS We searched PubMed, Embase, Scopus, SportDiscus and PEDro (30 December 2022). The results were obtained by entering a combination of MeSH or Emtree terms with keywords related to telerehabilitation and exercise therapy. RCTs on patients over 18 years and two groups were included, one working with therapeutic exercise through telerehabilitation and one working with conventional physiotherapy group. RESULTS a total of 779 works were found. However, after applying the inclusion criteria, only 11 were selected. Telerehabilitation is most frequently used to treat musculoskeletal, cardiac and neurological pathologies. The preferred telerehabilitation tools are videoconferencing systems, telemonitoring and online platforms. Exercise programs ranged from 10 to 30 min and were similar in both intervention and control groups. In all the studies, results proved to be similar for telerehabilitation and face-to-face rehabilitation in both groups when measuring functionality, quality of life and satisfaction. CONCLUSION this review generally concludes that intervention through telerehabilitation programs is as feasible and efficient as conventional physiotherapy in terms of functionality level and quality of life. In addition, telerehabilitation shows high levels of patients' satisfaction and adherence, being values equivalent to traditional rehabilitation.
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Affiliation(s)
| | | | | | - Mª Concepción Sanz-Rubio
- Physiotherapy Primary Care, Department of Nursing, Physiotherapy and Occupational Therapy, University of Zaragoza, 50009 Zaragoza, Spain
| | | | - Yolanda Marcén-Román
- Department of Anatomy and Human Embryology, IIS Aragón, University of Zaragoza, 50009 Zaragoza, Spain
| | - Mª Ángeles Franco-Sierra
- Department of Nursing, Physiotherapy and Occupational Therapy, IIS Aragón, University of Zaragoza, 50009 Zaragoza, Spain
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4
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Dowell RJ, Dattani J, Nagy M, Al Wadiya A, Maher M, Ashwood N. Physiotherapy-Led Musculoskeletal Telephone Triage and Advice Service: A Valid Option for Patients Referred From the Emergency Department. Cureus 2023; 15:e34720. [PMID: 36909019 PMCID: PMC9998116 DOI: 10.7759/cureus.34720] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2023] [Indexed: 02/10/2023] Open
Abstract
Introduction Musculoskeletal (MSK) conditions create a significant demand for healthcare services in the United Kingdom. The emergency department is one of the main providers of initial care for patients with MSK disorders or injuries. As attendances increase within the emergency department the demand for MSK physiotherapy services also increases. The MSK physiotherapy department at Queens Hospital, Burton, GBR introduced a telephone triage and advice (TTAD) service for patients referred from the emergency department to try and reduce waiting times and the number of initial appointments not attended. The primary outcome of the study was to investigate the number of patients discharged via the TTAD service. Secondly, the study aimed to assess if the TTAD service eased the pressures of face-to-face appointments as well as analyze the effects on the number of failed attendances and canceled appointments for both initial and follow-up face-to-face appointments. Method Data were collected retrospectively from the electronic medical records system Meditech Version 6 (Medical Information Technology, Inc., MA) from the months of August, September, and October in 2017 (pre-TTAD) and 2018 (post-TTAD). Once the data had been collected, analysis was performed comparing results from 2017 to 2018 using Statistical Product and Service Solutions (SPSS) (IBM SPSS Statistics for Windows, Armonk, NY) analysis software. Results The overall number of referrals from emergency to MSK physiotherapy increased by 11.2% between 2017 and 2018. Following the introduction of the TTAD service, 59.8% of the total referrals were offered a face-to-face initial appointment with 40.2% of patients referred being discharged via the TTAD service in 2018. The percentage of patients that failed to attend the initial appointment in 2018 also fell by 4.9%. Conclusion The introduction of a TTAD service for referrals from the emergency department has been demonstrated to be effective in reducing the number of face-to-face appointments required in the MSK physiotherapy management of these patients. Both initial and follow-up face-to-face appointments were lower in 2018 when compared to 2017, this is despite an 11.2% increase in the number of referrals throughout August, September, and October. It can therefore be concluded that the TTAD service also had a positive impact on the failed attendance rate of initial face-to-face appointments.
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Affiliation(s)
- Richard J Dowell
- Emergency Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR
| | - Janki Dattani
- Physiotherapy Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR
| | - Mohamed Nagy
- Trauma and Orthopaedics Department, Cairo University Hospitals, Kasr Alainy, Cairo, EGY.,Trauma and Orthopaedics Department, Manchester University Hospitals NHS Foundation Trust, Manchester, GBR
| | - Ahmed Al Wadiya
- Trauma and Orthopaedics Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR
| | - Moustafa Maher
- Trauma and Orthopaedics Department, Cairo University Hospitals, Kasr Alainy, Cairo, EGY.,UC Health Orthopaedic Surgery Department, Foot and Ankle Surgery Division, University of Colorado Hospital, Colorado, USA
| | - Neil Ashwood
- Trauma and Orthopaedics Department, University Hospitals of Derby and Burton NHS Foundation Trust, Derby, GBR.,Research Institute, University of Wolverhampton, Wolverhampton, GBR
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5
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Li TS, Wang R, Su X, Wang XQ. Effect and mechanisms of exercise for complex regional pain syndrome. Front Mol Neurosci 2023; 16:1167166. [PMID: 37206984 PMCID: PMC10188984 DOI: 10.3389/fnmol.2023.1167166] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/17/2023] [Indexed: 05/21/2023] Open
Abstract
Complex regional pain syndrome characterized by severe pain and dysfunction seriously affects patients' quality of life. Exercise therapy is gaining attention because it can effectively relieve pain and improve physical function. Based on the previous studies, this article summarized the effectiveness and underlying mechanisms of exercise interventions for complex regional pain syndrome, and described the gradual multistage exercise program. Exercises suitable for patients with complex regional pain syndrome mainly include graded motor imagery, mirror therapy, progressive stress loading training, and progressive aerobic training. In general, exercise training for patients with complex regional pain syndrome not only alleviates pain but also improves physical function and positive mental status. The underlying mechanisms of exercise interventions for complex regional pain syndrome include the remodeling of abnormal central and peripheral nervous system, the regulation of vasodilation and adrenaline levels, the release of endogenous opioids, and the increased anti-inflammatory cytokines. This article provided a clear explanation and summary of the research on exercise for complex regional pain syndrome. In the future, more high-quality studies with sufficient sample sizes may provide more exercise regimens and better evidence of efficacy.
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Affiliation(s)
- Tian-Shu Li
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Rui Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
| | - Xuan Su
- Department of Rehabilitation Medicine, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University, Shanghai, China
- Xuan Su,
| | - Xue-Qiang Wang
- Department of Sport Rehabilitation, Shanghai University of Sport, Shanghai, China
- Shanghai Shangti Orthopaedic Hospital, Department of Rehabilitation Medicine, Shanghai, China
- *Correspondence: Xue-Qiang Wang,
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6
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Wakaizumi K, Reckziegel D, Jabakhanji R, Apkarian AV, Baliki MN. Influence of exercise on pain is associated with resting-state functional connections: A cross-sectional functional brain imaging study. NEUROBIOLOGY OF PAIN 2023; 13:100125. [PMID: 37025929 PMCID: PMC10070934 DOI: 10.1016/j.ynpai.2023.100125] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/28/2023] [Revised: 03/18/2023] [Accepted: 03/18/2023] [Indexed: 03/29/2023]
Abstract
Exercise is associated with lower prevalence and severity of pain, and is widely recommended for pain management. However, the mechanisms the exercise effect on pain remain unclear. In this study, we examined the association of exercise with pain and aimed to identify its neurobiological mediators. We utilized a baseline data of a clinical trial for people with low back pain. Participants reported pain intensity and exercise habit, as well as pain-related psychological and emotional assessments. We also obtained brain imaging data using a resting-state functional MRI and performed mediation analyses to identify brain regions mediating the exercise effect on pain. Forty-five people with low back pain (mean pain intensity = 59.6 and mean duration = 9.9 weeks) were included in this study. Participants with an exercise habit (n = 29) showed significant less pain compared to those without an exercise habit (n = 16). Mediation analysis using resting-state functional connectivity identified the left thalamus, right amygdala, and medial prefrontal cortex as statistical mediators of the exercise effect on pain (indirect effect = -0.460, 95% confidence interval = -0.767 to -0.153). In conclusion, our findings suggest that brain function of the specific regions is probably a neuro-mechanism of exercise alleviating pain.
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Affiliation(s)
- Kenta Wakaizumi
- Department of Anesthesiology, Keio University School of Medicine, Tokyo, Japan
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, USA
- Corresponding author at: Department of Anesthesiology, Keio University School of Medicine, 35 Shinanomachi, Shinjuku-ku, Tokyo 160-8582, Japan.
| | - Diane Reckziegel
- Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Rami Jabakhanji
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - A. Vania Apkarian
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Physiology, Northwestern University Feinberg School of Medicine, Chicago, USA
- Department of Anesthesia, Northwestern University Feinberg School of Medicine, Chicago, USA
| | - Marwan N. Baliki
- Shirley Ryan AbilityLab, Chicago, IL, USA
- Department of Physical Medicine and Rehabilitation, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Center for Translational Pain Research, Northwestern University Feinberg School of Medicine, Chicago, USA
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7
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Grandeo J, Favaro L, Rhon DI, Young JL. Exercise therapy reporting in clinical trials for chronic neck pain: A systematic review. Musculoskeletal Care 2022; 20:796-811. [PMID: 35596275 DOI: 10.1002/msc.1644] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 04/23/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVE The aim of this systematic review was to assess the reproducibility of exercise therapy used in clinical trials for chronic neck pain (CNP) based on reported items from the Template for Intervention Description and Replication (TIDieR) and the Consensus on Exercise Reporting Template (CERT) checklists. METHODS Two researchers systematically searched, screened, and selected trials that assessed exercise therapy for CNP between 2000 and 2021 from PubMed, CINAHL, and Ovid Medline. Included studies were published in English, and study participants experienced neck pain for longer than 3 months. Thoroughness of reporting of exercise therapy was assessed using the TIDierR and CERT checklists. Methodological quality of each study was screened with the Revised Cochrane Risk of Bias Tool. Data analysis was performed for descriptive and correlational statistics. RESULTS Sixty-three clinical trials using exercise therapy for treatment of CNP met the inclusion criteria. No study reported all TIDieR or CERT items. The mean number of items reported was 5.44 (SD 2.40, range of 1-11) on the TIDieR, and 8.27 (SD 4.14, range of 0-17) for the CERT. Risk of bias was high for 30 studies (47.6%), somewhat concerning for 20 studies (31.7%), and low for 13 studies (21.7%). Higher risk of bias was associated with a lower number of TIDieR and CERT items reported. DISCUSSION & CONCLUSION The majority of exercise therapy trials for CNP lack proper reporting, limiting reproducibility of the interventions in real world clinical practice and follow-on research. After checklists were published, reporting did not improve.
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Affiliation(s)
- Jason Grandeo
- Bellin College, Green Bay, WI, USA
- University of Lynchburg, School of Physical Therapy, Lynchburg, VA, USA
| | - Laura Favaro
- Bellin College, Green Bay, WI, USA
- Department of Physical Therapy, Daemen University, Amherst, NY, USA
| | - Daniel I Rhon
- Bellin College, Green Bay, WI, USA
- Department of Rehabilitation Medicine, School of Medicine, Uniformed Services University of Health Sciences, Bethesda, MD, USA
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van Wissen MAT, Berger MAM, Schoones JW, Gademan MGJ, van den Ende CHM, Vliet Vlieland TPM, van Weely SFE. Reporting quality of interventions using a wearable activity tracker to improve physical activity in patients with inflammatory arthritis or osteoarthritis: a systematic review. Rheumatol Int 2022; 43:803-824. [PMID: 36454326 PMCID: PMC10073167 DOI: 10.1007/s00296-022-05241-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2022] [Accepted: 10/23/2022] [Indexed: 12/03/2022]
Abstract
AbstractTo assess the reporting quality of interventions aiming at promoting physical activity (PA) using a wearable activity tracker (WAT) in patients with inflammatory arthritis (IA) or hip/knee osteoarthritis (OA). A systematic search was performed in eight databases (including PubMed, Embase and Cochrane Library) for studies published between 2000 and 2022. Two reviewers independently selected studies and extracted data on study characteristics and the reporting of the PA intervention using a WAT using the Consensus on Exercise Reporting Template (CERT) (12 items) and Consolidated Standards of Reporting Trials (CONSORT) E-Health checklist (16 items). The reporting quality of each study was expressed as a percentage of reported items of the total CERT and CONSORT E-Health (50% or less = poor; 51–79% = moderate; and 80–100% = good reporting quality). Sixteen studies were included; three involved patients with IA and 13 with OA. Reporting quality was poor in 6/16 studies and moderate in 10/16 studies, according to the CERT and poor in 8/16 and moderate in 8/16 studies following the CONSORT E-Health checklist. Poorly reported checklist items included: the description of decision rule(s) for determining progression and the starting level, the number of adverse events and how adherence or fidelity was assessed. In clinical trials on PA interventions using a WAT in patients with IA or OA, the reporting quality of delivery process is moderate to poor. The poor reporting quality of the progression and tailoring of the PA programs makes replication difficult. Improvements in reporting quality are necessary.
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Affiliation(s)
- M A T van Wissen
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
| | - M A M Berger
- The Hague University of Applied Sciences, The Hague, The Netherlands
| | - J W Schoones
- Directorate of Research Policy (Walaeus Library), Leiden, The Netherlands
| | - M G J Gademan
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
- Department of Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands
| | - C H M van den Ende
- Department of Research, Sint Maartenskliniek, Nijmegen, The Netherlands
- Department of Rheumatology, Radboud University Medical Center, Nijmegen, The Netherlands
| | - T P M Vliet Vlieland
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
| | - S F E van Weely
- Department of Orthopaedics, Rehabilitation and Physical Therapy, Leiden University Medical Center, Albinusdreef 2, P.O. Box 9600, 2300 RC, Leiden, The Netherlands
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9
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Roren A, Daste C, Coleman M, Rannou F, Freyssenet D, Moro C, Lefèvre-Colau MM, Nguyen C. Physical activity and low back pain: A critical narrative review. Ann Phys Rehabil Med 2022; 66:101650. [PMID: 35240326 DOI: 10.1016/j.rehab.2022.101650] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Revised: 01/05/2022] [Accepted: 02/10/2022] [Indexed: 12/02/2022]
Abstract
BACKGROUND Non-specific low back pain (LBP) is the leading cause of years lived with disability worldwide. Physical activity is an integral part of LBP treatment. OBJECTIVE To critically review available evidence regarding the efficacy of physical activity for people with LBP. METHODS Up to date critical narrative review of the efficacy of physical activity for the managment LBP. The process of article selection was unsystematic; articles were selected based on authors' expertise, self-knowledge and reflective practice. RESULTS Therapeutic physical activity for LBP includes a wide range of non-specific and specific activities. The efficacy of physical activity on pain and activity limitations has been widely assessed. In acute and subacute LBP, exercise did not reduce pain compared to no exercise. In chronic low back pain (CLBP), exercise reduced pain at the earliest follow-up compared with no exercise. In a recent systematic review, exercise improved function both at the end of treatment and in the long-term compared with usual care. Exercice also reduced work disability in the long-term. We were unable to establish a clear hierarchy between different exercise modalities. Multidisciplinary functional programs consistently improved pain and function in the short- and long-term compared with usual care and physiotherapy and improved the long-term likelihood of returning to work compared to non-multidisciplinary programs. CONCLUSION Physical activity of all types is an effective treatment for CLBP.
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Affiliation(s)
- Alexandra Roren
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité, ECaMO Team, Paris 75004, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France.
| | - Camille Daste
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France
| | - Marvin Coleman
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Laboratoire de l'Institut des Sciences du Sport-Santé de Paris, URP 3625, Université Paris Cité, Paris, France
| | - François Rannou
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Faculté des Sciences Fondamentales et Biomédicales, Université Paris Cité, Sorbonne Paris Cité, Paris 75006, France
| | - Damien Freyssenet
- Laboratoire Inter-universitaire de biologie de la motricité (LIBM), EA 7424, Université de Lyon, Université Jean Monnet, Saint-Etienne, France
| | - Cedric Moro
- Inserm/UPS UMR1297, Université Paul Sabatier, Institut des Maladies Métaboliques et Cardiovasculaires (I2MC), Equipe MetaDiab, Toulouse, France
| | - Marie-Martine Lefèvre-Colau
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1153, Centre de Recherche Épidémiologie et Statistique Paris Sorbonne Cité, ECaMO Team, Paris 75004, France; Fédération pour la Recherche sur le Handicap et l'Autonomie, Paris 75013, France
| | - Christelle Nguyen
- AP-HP, Groupe Hospitalier AP-HP, Centre-Université Paris Cité, Hôpital Cochin, Service de Rééducation et de Réadaptation de l'Appareil Locomoteur et des Pathologies du Rachis, Assistance Publique - Hopitaux de Paris, 27 rue du Faubourg Saint Jacques, Paris 75014, Ile de France, France; Université Paris Cité, Faculté de Santé, UFR Médecine Paris Descartes, Paris 75006, France; INSERM UMR-S 1124, Toxicité Environnementale, Cibles Thérapeutiques, Signalisation Cellulaire et Biomarqueurs (T3S), Faculté des Sciences Fondamentales et Biomédicales, Université Paris Cité, Sorbonne Paris Cité, Paris 75006, France
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10
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Kite C, Parkes E, Taylor SR, Davies RW, Lagojda L, Brown JE, Broom DR, Kyrou I, Randeva HS. Time to Load Up-Resistance Training Can Improve the Health of Women with Polycystic Ovary Syndrome (PCOS): A Scoping Review. Med Sci (Basel) 2022; 10:53. [PMID: 36278523 PMCID: PMC9590069 DOI: 10.3390/medsci10040053] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Revised: 09/15/2022] [Accepted: 09/21/2022] [Indexed: 01/13/2024] Open
Abstract
BACKGROUND Guidelines for the management of polycystic ovary syndrome (PCOS) focus on lifestyle changes, incorporating exercise. Whilst evidence suggests that aerobic exercise may be beneficial, less is known about the effectiveness of resistance training (RT), which may be more feasible for those that have low fitness levels and/or are unable to tolerate/participate in aerobic exercise. OBJECTIVES To identify the available evidence on RT in women with PCOS and to summarise findings in the context of a scoping review. ELIGIBILITY CRITERIA Studies utilising pre-post designs to assess the effectiveness of RT in PCOS; all outcomes were included. SOURCES OF EVIDENCE Four databases (PubMed, CENTRAL, CINAHL and SportDiscus) were searched and supplemented by hand searching of relevant papers/reference lists. CHARTING METHODS Extracted data were presented in tables and qualitatively synthesised. RESULTS Searches returned 42 papers; of those, 12 papers were included, relating to six studies/trials. Statistical changes were reported for multiple pertinent outcomes relating to metabolic (i.e., glycaemia and fat-free mass) and hormonal (i.e., testosterone and sex hormone-binding globulin) profiles. CONCLUSIONS There is a striking lack of studies in this field and, despite the reported statistical significance for many outcomes, the documented magnitude of changes are small and the quality of the evidence questionable. This highlights an unmet need for rigorously designed/reported and sufficiently powered trials.
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Affiliation(s)
- Chris Kite
- School of Public Health Studies, Faculty of Education, Health and Wellbeing, University of Wolverhampton, Wolverhampton WV1 1LY, UK
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
| | - Elizabeth Parkes
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Suzan R. Taylor
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Robert W. Davies
- Chester Medical School, University of Chester, Shrewsbury SY3 8HQ, UK
| | - Lukasz Lagojda
- Clinical Evidence Based Information Service (CEBIS), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
| | - James E. Brown
- School of Biosciences, College of Health and Life sciences, Aston University, Birmingham B4 7ET, UK
| | - David R. Broom
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
| | - Ioannis Kyrou
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Centre for Sport, Exercise and Life Sciences, Research Institute for Health & Wellbeing, Coventry University, Coventry CV1 5FB, UK
- Aston Medical School, College of Health and Life Sciences, Aston University, Birmingham B4 7ET, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
- Laboratory of Dietetics and Quality of Life, Department of Food Science and Human Nutrition, School of Food and Nutritional Sciences, Agricultural University of Athens, 11855 Athens, Greece
| | - Harpal S. Randeva
- Warwickshire Institute for the Study of Diabetes, Endocrinology and Metabolism (WISDEM), University Hospitals Coventry and Warwickshire NHS Trust, Coventry CV2 2DX, UK
- Warwick Medical School, University of Warwick, Coventry CV4 7AL, UK
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11
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Antinozzi C, Grazioli E, De Santis M, Motta F, Sgrò P, Mari F, Mauri C, Parisi A, Caporossi D, Duranti G, Ceci R, Di Luigi L, Dimauro I. The Preventive Role of Physical Activity in Systemic Sclerosis: A Cross-Sectional Study on the Correlation with Clinical Parameters and Disease Progression. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:10303. [PMID: 36011938 PMCID: PMC9407825 DOI: 10.3390/ijerph191610303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 08/11/2022] [Accepted: 08/16/2022] [Indexed: 06/15/2023]
Abstract
Although exercise is associated with improved health in many medical conditions, little is known about the possible influences of physical activity (PA) habits pre- and post- a diagnosis of systemic sclerosis (SSc) on disease activity and progression. This cross-sectional study assessed, for the first time, self-reported pre- and post-diagnostic PA levels with the aim to verify if changes in these levels were correlated with demographic/anthropometric data (e.g., weight, height, gender, age, BMI), disease duration, diagnostic/clinical parameters (e.g., skin involvement, pulmonary hemodynamic/echocardiographic data, disease activity) related to disease activity and progression, and quality of life in a population-based sample of patients with SSc. Adult participants (n = 34, age 56.6 ± 13.3 years) with SSc (limited cutaneous SSc, lcSSc, n = 20; diffuse cutaneous SSc, dcSSc, n = 9; sine scleroderma SSc, n = 5) were enrolled at the Division of Rheumatology and Clinical Immunology of the Humanitas Research Hospital. All medical data were recorded during periodic clinical visits by a rheumatologist. Moreover, all subjects included in this study completed extensive questionnaires to evaluate their health-related quality of life (HRQOL), and others related to health-related physical activity performed before (PRE) and after (POST) the diagnosis of disease. The linear regression analysis has shown that either a high Sport_index or Leisure_index in the PRE-diagnostic period was correlated with lower disease duration in dcSSc patients. Physical load during sport activity and leisure time accounted for ~61.1% and ~52.6% of the individual variation in disease duration, respectively. In lcSSc patients, a high PRE value related to physical load during sporting activities was correlated with a low pulmonary artery systolic pressure (sPAP) and the POST value of the Work_index was positively correlated with the left ventricular ejection fraction (LVEF), and negatively with creatine kinase levels (CK). Interestingly, the univariate analysis showed that Work_index accounts for ~29.4% of the variance in LVEF. Our analysis clearly reinforces the concept that high levels of physical load may play a role in primary prevention-delaying the onset of the disease in those subjects with a family history of SSc-as well as in secondary prevention, improving SSc management through a positive impact on different clinical parameters of the disease. However, it remains a priority to identify a customized physical load in order to minimize the possible negative effects of PA.
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Affiliation(s)
- Cristina Antinozzi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Elisa Grazioli
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
- Department of Experimental and Clinical Medicine, “Magna Graecia” University, 88100 Catanzaro, Italy
| | - Maria De Santis
- IRCCS Humanitas Research Hospital—Division of Rheumatology and Clinical Immunology, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Francesca Motta
- IRCCS Humanitas Research Hospital—Division of Rheumatology and Clinical Immunology, Via Manzoni 56, Rozzano, 20089 Milan, Italy
- Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, Pieve Emanuele, 20090 Milan, Italy
| | - Paolo Sgrò
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Federico Mari
- Unit of Bioengineering and Neuromechanics of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Caterina Mauri
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Attilio Parisi
- Unit of Physical Exercise and Sport Sciences, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Daniela Caporossi
- Unit of Biology and Human Genetic, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Guglielmo Duranti
- Unit of Biochemistry of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Roberta Ceci
- Unit of Biochemistry of Movement, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Luigi Di Luigi
- Unit of Endocrinology, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
| | - Ivan Dimauro
- Unit of Biology and Human Genetic, Department of Movement, Human and Health Sciences, University of Rome “Foro Italico”, 00135 Rome, Italy
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12
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Li S, Liu Y, Zhou G, Zhang W, Wei S, He J, Stephen LS, Wei H. Pre-collapse femoral head necrosis treated by hip abduction: a computational biomechanical analysis. Health Inf Sci Syst 2022; 10:8. [PMID: 35582206 PMCID: PMC9107530 DOI: 10.1007/s13755-022-00175-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2022] [Accepted: 04/12/2022] [Indexed: 11/27/2022] Open
Abstract
Abstract
Background and objective
Clinical studies indicated that femoral head collapse (FHC) occurs in 90% of patients without intervention within five years after the diagnosis of femoral head necrosis (FHN). The management of the FHN is still a great challenging task. Clinical studies indicated that hip abduction as physical therapy represents an effective hip preservation method. However, the mechanism is unclear. In this study, we use computational biomechanical technology to investigate mechanical response in FHN patients with hip abduction and establish guide protocols for FHN rehabilitation.
Materials and methods
Thirty computational models were constructed for evaluating the safety of hip abduction and comparing the biomechanical performance of hip abduction for the treatment of different necrotic classifications. The distribution of principal compressive stress (PCS) and load share ratio (LSR) were computed and used for biomechanical evaluation.
Results
Before the start of physical therapy, when the size of necrotic segment is increased and located more laterally, the damage area of PCS enlarged and LSR of subchondral cortical to trabecular bone increased. As the increase of hip abduction angle, PCS of Type B transformed into Type A, PCS of Type C1 transformed into Type B, PCS of Type C2 transformed into Type C1; Except Type C2, the LSR return to normal level.
Discussion and conclusion
Stress transfer damaged pattern correlated significantly with necrotic classification. Hip abduction motions effectively enlarge the area of PCS and recover the LSR of different structures by altering motion posture during gait. The results indicated that hip abduction may be an effective physical therapy in improving hip function and interrupt the disease pathway of FHC and THA.
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Affiliation(s)
- Shaochi Li
- Institute of Systems Engineering, Macau University of Science and Technology, Taipa, China
- Guangzhou Administration Institute, Guangzhou, China
| | - Yan Liu
- Dept of Information Systems, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Guangquan Zhou
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Wenjuan Zhang
- The First Affiliated Hospital of Kashi Prefecture, Kashi, China
| | - Shengmei Wei
- The First Affiliated Hospital of Kashi Prefecture, Kashi, China
| | - Jiajia He
- The First Affiliated Hospital, Guangzhou University of Chinese Medicine, Guangzhou, China
| | - Liao Shaoyi Stephen
- Dept of Information Systems, City University of Hong Kong, Kowloon Tong, Hong Kong
| | - Hang Wei
- School of Medical Information Engineering, Guangzhou University of Chinese Medicine, Guangzhou, China
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13
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Larivière C, Rabhi K, Preuss R, Coutu MF, Roy N, Henry SM. Derivation of clinical prediction rules for identifying patients with non-acute low back pain who respond best to a lumbar stabilization exercise program at post-treatment and six-month follow-up. PLoS One 2022; 17:e0265970. [PMID: 35476707 PMCID: PMC9045609 DOI: 10.1371/journal.pone.0265970] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2021] [Accepted: 03/10/2022] [Indexed: 11/19/2022] Open
Abstract
Low back pain (LBP) remains one of the most common and incapacitating health conditions worldwide. Clinical guidelines recommend exercise programs after the acute phase, but clinical effects are modest when assessed at a population level. Research needs to determine who is likely to benefit from specific exercise interventions, based on clinical presentation. This study aimed to derive clinical prediction rules (CPRs) for treatment success, using a lumbar stabilization exercise program (LSEP), at the end of treatment and at six-month follow-up. The eight-week LSEP, including clinical sessions and home exercises, was completed by 110 participants with non-acute LBP, with 100 retained at the six-month follow-up. Physical (lumbar segmental instability, motor control impairments, posture and range of motion, trunk muscle endurance and physical performance tests) and psychological (related to fear-avoidance and home-exercise adherence) measures were collected at a baseline clinical exam. Multivariate logistic regression models were used to predict clinical success, as defined by ≥50% decrease in the Oswestry Disability Index. CPRs were derived for success at program completion (T8) and six-month follow-up (T34), negotiating between predictive ability and clinical usability. The chosen CPRs contained four (T8) and three (T34) clinical tests, all theoretically related to spinal instability, making these CPRs specific to the treatment provided (LSEP). The chosen CPRs provided a positive likelihood ratio of 17.9 (T8) and 8.2 (T34), when two or more tests were positive. When applying these CPRs, the probability of treatment success rose from 49% to 96% at T8 and from 53% to 92% at T34. These results support the further development of these CPRs by proceeding to the validation stage.
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Affiliation(s)
- Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Québec, Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- * E-mail:
| | - Khalil Rabhi
- Independent Statistician Consultant, Montréal, Québec, Canada
| | - Richard Preuss
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- School of Physical & Occupational Therapy, McGill University, Montréal, Québec, Canada
| | - Marie-France Coutu
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
- Charles-Le Moyne Hospital Research Centre, Université de Sherbrooke, Longueuil, Quebec, Canada
| | - Nicolas Roy
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut Universitaire sur la Réadaptation en Déficience Physique de Montréal (IURDPM), Centre Intégré Universitaire de Santé et de Services Sociaux du Centre-Sud-de-l’Ile-de-Montréal (CCSMTL), Montréal, Québec, Canada
| | - Sharon M. Henry
- Department of Neurological Sciences, University of Vermont, Burlington, Vermont, United States of America
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14
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Gallardo Vidal MI, Calleja Delgado L, Tenezaca Marcatoma JC, Calleja Guadix I, Daimiel Yllera A, Morales Tejera D. [Physiotherapy and health education protocol in chronic musculoskeletal shoulder pain. Experience in Primary Care]. Aten Primaria 2022; 54:102284. [PMID: 35461039 PMCID: PMC9046942 DOI: 10.1016/j.aprim.2022.102284] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Revised: 09/28/2021] [Accepted: 01/02/2022] [Indexed: 11/12/2022] Open
Abstract
Objetivo Evaluar la experiencia de un programa de educación para la salud en atención primaria en pacientes con dolor de hombro crónico de origen musculoesquelético, sobre el dolor y la discapacidad e instaurar el protocolo en atención primaria. Diseño Estudio observacional descriptivo longitudinal quasi-experimental. Emplazamiento Centro de Salud Arroyo de la Vega. Alcobendas, Madrid. Participantes Pacientes remitidos por su médico de atención primaria a la unidad de fisioterapia de atención primaria por dolor de hombro de origen musculoesquelético. Intervención Siete sesiones grupales de educación para la salud y ejercicio terapéutico. Mediciones principales Se valoró la intensidad del dolor a través de la escala visual analógica, la discapacidad del miembro superior con el cuestionario Disabilities of the Arm, Shoulder and Hand y el nivel de discapacidad y dolor de hombro con el questionario Shoulder Pain and Disability Index. Resultados Se encontraron diferencias estadísticamente significativas en la reducción del dolor y la discapacidad (p < 0,01), además se redujo el consumo de fármacos y las recidivas. Conclusiones El protocolo de fisioterapia de hombro con educación para la salud fue eficaz para reducir el dolor y la discapacidad en pacientes con dolor de hombro crónico, de origen musculoesquelético, en atención primaria.
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Affiliation(s)
- María Isabel Gallardo Vidal
- Unidad de Fisioterapia, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España; Departamento de Fisioterapia, Universidad de Antonio Nebrija, Madrid, España
| | - Leonor Calleja Delgado
- Unidad de Medicina, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España
| | | | - Iván Calleja Guadix
- Unidad de Medicina, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España
| | - Alicia Daimiel Yllera
- Unidad de Fisioterapia, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España; Departamento de Fisioterapia, Universidad de Antonio Nebrija, Madrid, España; Unidad de Medicina, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España; Escuela Internacional de Doctorado, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Alcorcón, Madrid, España; Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo CEU, Campus de Montepríncipe, Madrid, España
| | - David Morales Tejera
- Unidad de Fisioterapia, Gerencia de Atención Primaria de la Comunidad de Madrid, Madrid, España; Escuela Internacional de Doctorado, Departamento de Fisioterapia, Terapia Ocupacional, Rehabilitación y Medicina Física, Universidad Rey Juan Carlos, Alcorcón, Madrid, España; Departamento de Fisioterapia, Facultad de Medicina, Universidad San Pablo CEU, Campus de Montepríncipe, Madrid, España.
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15
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Effect of task-oriented training on pain, functionality, and quality of life in rheumatoid arthritis. Turk J Phys Med Rehabil 2022; 68:76-83. [PMID: 35949976 PMCID: PMC9305652 DOI: 10.5606/tftrd.2022.6666] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/03/2020] [Accepted: 02/01/2021] [Indexed: 11/28/2022] Open
Abstract
Objectives
The aim of this study was to demonstrate additional effects of task-oriented training (TOT) in patients with rheumatoid arthritis (RA) regarding pain, dexterity, muscle strength, and ability to perform activities of daily living (ADLs) within five weeks.
Patients and methods
Between June 2016 and February 2018, a total of 46 female RA patients (mean age: 51.17±7.9 years; range, 29 to 68 years) who were volunteer for participating in the study were randomized into two groups as follows: conventional exercise group (Group 1) and conventional + TOT group (Group 2). The exercises of Group 1 included passive range of motion (PROM), isometric grip strength exercises, and mobilization of metacarpophalangeal, proximal interphalangeal, and distal interphalangeal joints. In Group 2, in addition to conventional exercises, the patients completed an exercise program consisting of washing their faces, using forks, drinking water from a glass, sitting up, and putting on a shirt. Exercises were performed twice a week for a five-week period. Before and after the exercise programs, hand grip strength was assessed with a Jamar hand dynamometer, hand dexterity with Nine Hole Peg Test (NHPT), pain with Visual Analog Scale (VAS), and ADLs with Health Assessment Questionnaire (HAQ) and Duruöz Hand Index (DHI).
Results
There was no significant difference in NHPT and Jamar in both groups (p>0.05). Although a significant decrease was observed within the groups in VAS and HAQ scores before and after the exercise programs in both groups (p<0.05), no significant difference was found between the groups (p>0.05). The DHI showed a significant improvement in Group 2 and a significant difference was observed between the two groups (p<0.05).
Conclusion
This study shows that exercise programs may be beneficial in alleviating pain and performing daily activities. Also, adding task-oriented training to a program may facilitate ADLs in RA patients.
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Lamberti V, Palermi S, Franceschin A, Scapol G, Lamberti V, Lamberti C, Vecchiato M, Spera R, Sirico F, Della Valle E. The Effectiveness of Adapted Personalized Motor Activity (AMPA) to Improve Health in Individuals with Mental Disorders and Physical Comorbidities: A Randomized Controlled Trial. Sports (Basel) 2022; 10:sports10030030. [PMID: 35324639 PMCID: PMC8952683 DOI: 10.3390/sports10030030] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2021] [Revised: 02/18/2022] [Accepted: 02/22/2022] [Indexed: 02/01/2023] Open
Abstract
Mental disorders are highly prevalent worldwide and have a high impact on daily functioning. Exercise therapy was found to improve health of individuals with physical and mental disorders. This study aims to investigate the effectiveness of an Adapted Personalized Motor Activity (AMPA) in improving health in individuals with physical and mental disorders. Forty-three patients affected by both mental and chronic nontransmissible conditions were randomly assigned to intervention group (AMPA intervention) and control group (no intervention). Perceived physical and mental health were assessed using the Short Form 12 (SF-12) questionaries. Moreover, subjects underwent an accurate medical screening process, complete clinical evaluation, body composition evaluation, and cardiopulmonary assessment. Repeated Measurement Analysis of the Variance (RM-ANOVA) was used to compare any changes in health and physiological parameters in-between groups. AMPA group showed a statistically significant improvement in both perceived mental and physical health. Moreover, Body Mass Index (BMI), glycolipid profile, aerobic functional capacity and cardiopulmonary parameters improved significantly among individuals from the intervention group compared with the individuals from the control group. AMPA may be considered a possible intervention to improve health in individuals suffering from multiple physical and mental disorders. Future studies should examine the effectiveness in larger and heterogeneous sample of chronically ill patients and the long-term effect of AMPA.
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Affiliation(s)
- Vito Lamberti
- Sport Medicine and Motor Activity Institute c.FMSI-CONI, Vittorio Veneto, 31029 Treviso, Italy; (V.L.); (A.F.); (G.S.); (V.L.); (C.L.)
| | - Stefano Palermi
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (R.S.); (F.S.); (E.D.V.)
- Correspondence:
| | - Andrea Franceschin
- Sport Medicine and Motor Activity Institute c.FMSI-CONI, Vittorio Veneto, 31029 Treviso, Italy; (V.L.); (A.F.); (G.S.); (V.L.); (C.L.)
| | - Giovanni Scapol
- Sport Medicine and Motor Activity Institute c.FMSI-CONI, Vittorio Veneto, 31029 Treviso, Italy; (V.L.); (A.F.); (G.S.); (V.L.); (C.L.)
| | - Vincenzo Lamberti
- Sport Medicine and Motor Activity Institute c.FMSI-CONI, Vittorio Veneto, 31029 Treviso, Italy; (V.L.); (A.F.); (G.S.); (V.L.); (C.L.)
| | - Chiara Lamberti
- Sport Medicine and Motor Activity Institute c.FMSI-CONI, Vittorio Veneto, 31029 Treviso, Italy; (V.L.); (A.F.); (G.S.); (V.L.); (C.L.)
| | - Marco Vecchiato
- Sports and Exercise Medicine Division, Department of Medicine, University of Padova, 35100 Padova, Italy;
| | - Rocco Spera
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (R.S.); (F.S.); (E.D.V.)
| | - Felice Sirico
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (R.S.); (F.S.); (E.D.V.)
| | - Elisabetta Della Valle
- Department of Public Health, University of Naples Federico II, Via S. Pansini 5, 80131 Naples, Italy; (R.S.); (F.S.); (E.D.V.)
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17
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Knippenberg E, Van Hout L, Smeets W, Palmaers S, Timmermans A, Spooren A. Developing an intelligent activity-based client-centred training system with a user-centred approach. Technol Health Care 2021; 28:355-368. [PMID: 31796713 DOI: 10.3233/thc-191854] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND In neurorehabilitation, clinicians and managers are searching for new client-centred task-oriented applications which can be administered without extra costs and effort of therapists, and increase the client's motivation. OBJECTIVE To develop and evaluate a prototype of an intelligent activity-based client-centred training (i-ACT) system based on Microsoft Kinect®. METHODS Within an iterative user centred process, the i-ACT prototype was developed and necessary features were established for use in neurological settings. After the test trial with a high fidelity prototype, the value, usefulness, and credibility were evaluated. RESULTS Seven therapists participated in focus groups and 54 persons with neurological problems participated in test trials. A prototype was established based on the user's experience. Results show that clients and therapists acknowledge the value and usefulness (clients 5.71/7; therapists 4.86/7), and credibility (clients 21.00/27; therapists 14.50/27) of i-ACT. CONCLUSIONS Therapists want to be able to record an endless range of movements and activities which enables individualised exercise programs for persons with disabilities. For therapists it is important that the system provides feedback about the quality of movement and not only results. In future work, clinical trials will be performed towards feasibility and effectiveness of i-ACT in neurorehabilitation and other rehabilitation domains.
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Affiliation(s)
- Els Knippenberg
- Innovation in Care, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium.,Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Lode Van Hout
- Smart-ICT, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium
| | - Wout Smeets
- Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Steven Palmaers
- Smart-ICT, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium
| | - Annick Timmermans
- Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Annemie Spooren
- Innovation in Care, Centre of Expertise, PXL University College, 3500 Hasselt, Belgium.,Reval Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
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Dynamic evaluation of the contractile function of lumbodorsal muscles during locust pose in yoga by real-time ultrasound. BMC Sports Sci Med Rehabil 2021; 13:87. [PMID: 34376224 PMCID: PMC8353835 DOI: 10.1186/s13102-021-00313-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2020] [Accepted: 07/15/2021] [Indexed: 11/10/2022]
Abstract
Background and Purpose Chronic low back pain (CLBP), which has a close relationship with lumbar muscle degeneration, can be effectively treated by exercise therapy, and yoga has been widely accepted by clinicians and patients with CLBP. The purpose of this study was to observe the changes in the thickness of lumbodorsal muscles that occur during locust pose in yoga and how these changes occur. From the changes in muscle thickness that occur in the locust pose, the contractile function of lumbodorsal muscles can be evaluated. Methods Fifty-two healthy volunteers (from May 2019 to August 2019, age from 28 to 68 years, 23 males and 29 females (age: 40 ± 8 years; weight: 68.3 ± 5.2 kg; height: 170.2 ± 13.1 cm) were recruited, and lumbodorsal muscle, including the multifidus, longissimus, iliocostalis, and quadratus lumborum, ultrasonic examinations were carried out in the relaxed and contracted states. The changes in the thickness of the lumbodorsal muscles in the relaxed and contracted states were dynamically observed by real-time ultrasound when subjects were performing the locust yoga pose. Then, the thicknesses of the muscles during the two states were measured to calculate the ratio of contraction of each muscle and determine the statistical significance of the change in thickness of each muscle. Results The mean thickness of the left multifidus in the relaxed state was 1.32 ± 0.27 cm (95 % CI: 1.24 ~ 1.39), that in the contracted state was 1.60 ± 0.30 cm (95 % CI: 1.52 ~ 1.69) (obviously different between the relaxed and contracted states, P < 0.001), and those in the corresponding right side were 1.37 ± 0.31 cm (95 % CI: 1.29 ~ 2.46) and 1.68 ± 0.38 cm (95 % CI: 1.58 ~ 1.79) (P < 0.001), respectively. The mean thickness of the left quadratus lumborum in the relaxed state was 1.38 ± 0.32 cm (95 % CI: 1.29 ~ 1.47), that in the contracted state was 1.62 ± 0.40 cm (95 % CI: 1.50 ~ 1.73) (P = 0.001), and those in the corresponding right side were 1.30 ± 0.32 cm (95 % CI: 1.21 ~ 1.39) and 1.55 ± 0.41 cm (95 % CI: 1.44 ~ 1.67) (P = 0.001), respectively. The mean thickness of the left longissimus in the relaxed was 2.33 ± 0.51 cm (95 % CI: 2.19 ~ 2.47), that in the contracted state was 3.20 ± 0.61 cm (95 % CI: 3.03 ~ 3.37) (P < 0.001), and those in the corresponding right side were 2.34 ± 0.49 cm (95 % CI 2.20 ~ 2.48) and 3.26 ± 0.68 cm (95 % CI 3.07 ~ 3.45) (P < 0.001), respectively. The mean thickness of the left iliocostalis in the relaxed state was 1.88 ± 0.41 cm (95 % CI: 1.76 ~ 1.99), that in the contracted state was 2.34 ± 0.49 cm (95 % CI: 2.00 ~ 2.47) (P < 0.001), and those in the corresponding right side were 1.98 ± 0.40 cm (95 % CI: 1.87 ~ 2.09) and 2.44 ± 0.56 cm (95 % CI: 2.29 ~ 2.60) (P < 0.001), respectively. The mean contracted state/resting state (C/R) of the longissimus was 1.39 ± 0.14 on the left and 1.40 ± 0.16 on the right. The multifidus and iliocostalis had the second highest C/R. The mean C/R of the multifidus was 1.23 ± 0.12 on the left and 1.24 ± 0.15 on the right, and the mean C/R of the iliocostalis was 1.25 ± 0.12 on the left and 1.24 ± 0.14 on the right. The quadratus lumborum had the lowest C/R, and the mean C/R of the quadratus lumborum was 1.17 ± 0.10 on the left and 1.19 ± 0.11 on the right. Conclusions Ultrasound can be used to dynamically assess the contractile function of the lumbar muscle in the locust pose of yoga, the C/R ratio can be used to indicate the ability of a muscle to contract, and dynamic ultrasound can guide lumbar exercise and feedback the exercise results. The establishment of this model allowed data regarding the contraction state of the lumbar muscle to be obtained in a normal population, and based on this, future studies can further explore and evaluate the contraction state of the lumbar muscle after yoga exercise in CLBP patients, the effect exercise on lumbar instability and on a patient population after lumbar operation.
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Effectiveness of Combined Stretching and Strengthening Exercise Using Rehabilitation Exercise System with a Linear Actuator and MR Damper on Static and Dynamic Sitting Postural Balance: A Feasibility Study. APPLIED SCIENCES-BASEL 2021. [DOI: 10.3390/app11167329] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Postural imbalance induced by prolonged sitting can be improved by exercise therapy. The aim of study was to evaluate the influence of combined stretching and strengthening exercise using rehabilitation exercise system with a linear actuator and MR damper on static and dynamic sitting postural balance. Twelve subjects who sit almost 10 h a day participated in this study. The rehabilitation exercise system with a linear actuator and MR damper was manufactured to provide stretching and strengthening exercise. All subjects were asked to perform an exercise program that was designed to enhance postural balance by stretching the tight muscle and strengthening the weakened muscle. Body pressure distributions were analyzed for mean force and mean pressure using a seat sensor system. Trunk muscle activities were measured by attaching surface electrodes to the thoracic erector spinae, lumbar erector spinae, and lumbar multifidus muscle. All data were divided into two regions (dominant and non-dominant side) under four conditions: no pelvic tilt, lateral pelvic tilt, anterior pelvic tilt, and posterior pelvic tilt. Body pressure distributions and trunk muscle activities were compared between before and after performing exercise under static and dynamic sitting conditions. Both in static and dynamic sitting conditions, there were significant differences in body pressure distributions and trunk muscle activities between the DS and NDS before performing the exercise (p < 0.01). After performing exercise, the body pressure distributions increased on the dominant side while those decreased on the non-dominant side significantly (p < 0.01). In addition, the activities of all trunk muscles on the non-predominant side increased significantly (p < 0.01 and p < 0.05). These results showed that postural balance was improved by decreasing the differences in body pressure distribution and trunk muscle activity between the dominant and non-dominant side after performing exercise. From the results of this study, we concluded that the rehabilitation exercise system with a linear actuator and MR damper is suitable for providing combined stretching and strengthening exercise, and it could be helpful to maintain correct posture by enhancing postural balance during sitting.
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Hip-Focused Neuromuscular Exercise Provides Immediate Benefits in Foot Pronation and Dynamic Balance: A Sham-Controlled Cross-Over Study. J Sport Rehabil 2021; 30:1088-1093. [PMID: 34303314 DOI: 10.1123/jsr.2020-0549] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 04/01/2021] [Accepted: 04/09/2021] [Indexed: 12/16/2022]
Abstract
CONTEXT Knowledge on how to utilize a kinetic chain approach in foot and ankle rehabilitation is important. OBJECTIVE The aim of this study was to investigate the immediate effects of hip-focused neuromuscular exercise on foot pronation and single-leg neuromuscular control. DESIGN Cross-over study. SETTING University laboratory. PARTICIPANTS This cross-over study included 44 asymptomatic volunteers with foot pronation. INTERVENTIONS All participants performed (1) a hip-focused neuromuscular exercise and (2) a sham exercise in randomized order. MAIN OUTCOME MEASURES Foot pronation was assessed by the navicular drop test, and lower-extremity neuromuscular control was assessed by the Modified Star Excursion Balance Test and frontal plane projection angle during single-leg squat before and after the experiments. RESULTS Navicular drop test scores were significantly lower after the hip-focused neuromuscular exercise than after the sham exercise (mean difference [95% CI] = 2.84 [-1.08 to 6.77], P = .003). Modified Star Excursion Balance Test scores in the anterior (P = .008), posteromedial (P = .04), and posterolateral (P < .001) directions were significantly increased after hip-focused neuromuscular exercise. No statistically significant condition × time interaction was found for the frontal plane projection angle (P > .05). However, a main effect of time (P = .003) indicated that less dynamic knee valgus occurred during single-leg squat after both experiments. CONCLUSIONS Hip-focused neuromuscular exercise produced immediate alterations in foot pronation and dynamic balance. Thus, the hip-focused neuromuscular exercise may be used to control foot posture in foot rehabilitation integrated with a kinetic chain approach and could be an effective prevention and treatment strategy.
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Young JL, Snodgrass SJ, Cleland JA, Rhon DI. The relationship between knee radiographs and the timing of physical therapy in individuals with patellofemoral pain. PM R 2021; 14:496-503. [PMID: 34288533 DOI: 10.1002/pmrj.12678] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/06/2021] [Revised: 07/07/2021] [Accepted: 07/09/2021] [Indexed: 11/06/2022]
Abstract
BACKGROUND Routine knee radiographs are discouraged for individuals with non-traumatic knee pain, but they are often still ordered despite limited evidence for their value in guiding treatment choices. Radiograph utilization may delay the use of physical therapy, which has been associated with improved outcomes and lower long-term costs. OBJECTIVE To examine the relationship between obtaining knee radiographs for patients with patellofemoral pain (PFP) and the timing of physical therapy, and the association between ordering radiographs for patients who use physical therapy and the likelihood of knee pain recurrence. STUDY DESIGN Retrospective cohort. SETTING United States Military Health System civilian and military clinics. PATIENTS 23,332 individuals aged 18 to 50 diagnosed with PFP between 2010 and 2011 in the United States Military Health System who received physical therapy. INTERVENTIONS Physical therapy provided to individuals who did or did not receive an initial radiograph. MAIN OUTCOME MEASURES Timing of physical therapy and recurrence of knee pain were compared between groups (with and without initial radiographs). RESULTS If radiographs were used, the odds of initiating physical therapy (aOR = 0.78; 95% CI 0.64 to 0.94) within 30 days of the initial diagnosis were significantly lower. The mean days from diagnosis to initiating physical therapy was 12.1 (95% CI 9.1 to 16.1) if patients had radiographs versus 6.9 (95% CI 5.2 to 9.1) without. The odds of knee pain recurrence were no greater if radiographs were used (aOR = 1.01; 95% CI 0.83 to 1.22). CONCLUSIONS Receiving knee radiographs as part of initial care for PFP was associated with delayed initiation of physical therapy, but there was no association between early knee radiographs and recurrence of knee pain. Routine use of radiographs for PFP is not warranted, and can potentially delay appropriate treatment. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Jodi L Young
- Doctor of Science in Physical Therapy, Bellin College, 3201 Eaton Rd., Green Bay, WI, USA.,Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, University Dr., Callaghan, NSW, Australia
| | - Suzanne J Snodgrass
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, University Dr., Callaghan, NSW, Australia
| | - Joshua A Cleland
- Doctor of Physical Therapy Program, Department of Public Health and Community Medicine, Tufts University School of Medicine, Boston, MA, USA
| | - Daniel I Rhon
- Discipline of Physiotherapy, School of Health Sciences, The University of Newcastle, University Dr., Callaghan, NSW, Australia.,TX, USA.,Physical Therapy Department, Baylor University, Stanley, TX, USA
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22
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Knippenberg E, Lamers I, Timmermans A, Spooren A. Motivation, Usability, and Credibility of an Intelligent Activity-Based Client-Centred Training System to Improve Functional Performance in Neurological Rehabilitation: An Exploratory Cohort Study. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2021; 18:7641. [PMID: 34300092 PMCID: PMC8304931 DOI: 10.3390/ijerph18147641] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/28/2021] [Revised: 07/12/2021] [Accepted: 07/15/2021] [Indexed: 12/29/2022]
Abstract
(1) Background: technology-based training systems are increasingly integrated in neurorehabilitation but are rarely combined with a client-centred task-oriented approach. To provide a low-cost client-centred task-oriented system, the intelligent activity-based client-centred task-oriented training (i-ACT) was developed. The objective was to evaluate the usability, credibility and treatment expectancy of i-ACT, and the motivation towards i-ACT use in rehabilitation over time. Additionally, this study will evaluate the upper limb treatment effects after training with i-ACT. (2) Methods: a mixed-method study was performed in four rehabilitation centres. Training with i-ACT was provided during six weeks, three times per week, forty-five minutes per day, additional to conventional care. (3) Results: seventeen persons with central nervous system diseases were included. High scores were seen in the system usability scale (score ≥ 73.8/100), credibility (score ≥ 22.0/27.0)/expectancy (score ≥ 15.8/27.0) questionnaire, and intrinsic motivation inventory (score ≥ 5.2/7.0), except the subscale pressure (score ≤ 2.0/7.0). Results from the interviews corroborate these findings and showed that clients and therapists believe in the i-ACT system as an additional training support system. Upper limb functional ability improved significantly (p < 0.05) over time on the Wolf motor function test. (4) Conclusion: i-ACT is a client-centred task-oriented usable and motivational system which has the potential to enhance upper limb functional training in persons with neurological diseases.
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Affiliation(s)
- Els Knippenberg
- Department of Healthcare, Centre of Expertise–Innovation in Care, PXL University of Applied Sciences and Arts, 3500 Hasselt, Limburg, Belgium;
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
| | - Ilse Lamers
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
- Noorderhart, Rehabilitation and MS Center, 3900 Pelt, Limburg, Belgium
| | - Annick Timmermans
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
| | - Annemie Spooren
- Department of Healthcare, Centre of Expertise–Innovation in Care, PXL University of Applied Sciences and Arts, 3500 Hasselt, Limburg, Belgium;
- Faculty of Rehabilitation Sciences, REVAL, Hasselt University, 3590 Diepenbeek, Limburg, Belgium; (A.T.); (I.L.)
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Kelly M, Higgins A, Murphy A, McCreesh K. A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study. Arch Physiother 2021; 11:4. [PMID: 33550990 PMCID: PMC7868119 DOI: 10.1186/s40945-020-00098-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Accepted: 12/26/2020] [Indexed: 12/02/2022] Open
Abstract
BACKGROUND In response to issues with timely access and high non-attendance rates for Emergency Department (ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvement project. This telehealth option requires minimal resources, with the added benefit of allowing the healthcare professional streamline care. A primary aim was to investigate whether this service model can reduce wait times and non-attendance rates, compared to usual care. A secondary aim was to evaluate service user acceptability. METHODS This was a single-site quality improvement cohort study that compares data on wait time to first physiotherapy contact, non-attendance rates and participant satisfaction between patients that opted for a service based on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients were referred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, XMercy University Hospital, Cork, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with 40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on wait time and non-attendance rates was gathered using the hospital data reporting system. Satisfaction data was collected on discharge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data, Chi-Square tests were performed. A level of significance of p ≤ 0.05 was set for this study. RESULTS Those that contacted the telephone assessment and advice service had a significantly reduced wait time (median 6 days; 3-8 days) compared to those that opted for usual care (median 35 days; 19-39 days) (p ≤ 0.05). There was no significant between-group differences for non-attendance rates or satisfaction. CONCLUSION A telephone assessment and advice service may be useful in minimising delays for advice for those referred to ED Physiotherapy for musculoskeleltal problems. This telehealth option appears to be broadly acceptable and since it can be introduced rapidly, it may be helpful in triaging referrals and minimising face-to-face consultations, in line with COVID-19 recommendations. However, a large scale randomised controlled trial is warranted to confirm these findings.
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Affiliation(s)
- Marie Kelly
- Department of Physiotherapy, Mercy University Hospital, Grenville Place, Cork, T12 WE28 Ireland
| | - Anna Higgins
- Department of Physiotherapy, Mercy University Hospital, Grenville Place, Cork, T12 WE28 Ireland
| | - Adrian Murphy
- Emergency Department, Mercy University Hospital, Cork, Ireland
| | - Karen McCreesh
- School of Allied Health, Ageing Research Centre, Health Research Institute, University of Limerick, Limerick, Ireland
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Guzmán-Pavón MJ, Cavero-Redondo I, Martínez-Vizcaíno V, Fernández-Rodríguez R, Reina-Gutierrez S, Álvarez-Bueno C. Effect of Physical Exercise Programs on Myofascial Trigger Points-Related Dysfunctions: A Systematic Review and Meta-analysis. PAIN MEDICINE 2020; 21:2986-2996. [PMID: 33011790 DOI: 10.1093/pm/pnaa253] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
OBJECTIVE Myofascial pain syndrome is one of the primary causes of health care visits. In recent years, physical exercise programs have been developed for the treatment of myofascial trigger points, but their effect on different outcomes has not been clarified. Thus, this study aimed to assess the effect of physical exercise programs on myofascial trigger points. METHODS A systematic search was conducted in Pubmed, Web of Science, and Scopus. Articles analyzing the effect of physical exercise programs on pain intensity, pressure pain threshold, range of motion, and disability were included. Risk of bias was assessed using the Cochrane RoB2 tool. The DerSimonian-Laird method was used to compute the pooled effect sizes (ES) and their 95% confidence interval (95% CI) for pain intensity, pressure pain threshold, range of motion, and disability. RESULTS A total of 24 randomized controlled trials were included in this systematic review and meta-analysis. The pooled ES were -0.47 (95% CI = -0.61 to -0.33) for pain intensity, 0.63 (95% CI = 0.31 to 0.95) for pressure pain threshold, 0.43 (95% CI = 0.24 to 0.62) for range of motion, and -0.18 (95% CI = -0.45 to 0.10) for disability. CONCLUSIONS Physical exercise programs may be an effective approach in the treatment of pain intensity, pressure pain threshold, and range of motion among patients with myofascial trigger points.
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Affiliation(s)
| | - Iván Cavero-Redondo
- Universidad de Castilla la-Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
| | - Vicente Martínez-Vizcaíno
- Universidad de Castilla la-Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Autónoma de Chile, Facultad de Ciencias de la Salud, Talca, Chile
| | | | - Sara Reina-Gutierrez
- Universidad de Castilla la-Mancha, Health and Social Research Center, Cuenca, Spain
| | - Celia Álvarez-Bueno
- Universidad de Castilla la-Mancha, Health and Social Research Center, Cuenca, Spain.,Universidad Politécnica y Artística del Paraguay, Asunción, Paraguay
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Aagaard TV, Moeini S, Skou ST, Madsen UR, Brorson S. Benefits and Harms of Exercise Therapy for Patients With Diabetic Foot Ulcers: A Systematic Review. INT J LOW EXTR WOUND 2020; 21:219-233. [PMID: 32924691 DOI: 10.1177/1534734620954066] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
AIM Exercise therapy is a core element in the treatment of diabetes, but the benefits and harms for patients with a diabetic foot ulcer (DFU) are unknown. We therefore aimed to systematically review the benefits on health-related quality of life (HRQoL) and harms of exercise therapy for patients with DFU. METHODS We searched 6 major databases. We performed citation and reference searches of included studies and contacted authors of ongoing trials. We included randomized controlled trials (RCTs) to assess potential benefits on HRQoL and harms of exercise therapy. Observational studies were included to identify potential harms of exercise therapy. RESULTS We included 10 published publications of 9 trials and results from 2 unpublished trials including a total of 281 individuals with DFUs receiving various forms of exercise therapy. Due to lack of HRQoL measurements and high heterogeneity, it was not possible to perform meta-analyses. Results on HRQoL was present in one unpublished study. Harms reported ranged from musculoskeletal problems, increased wound size, to amputation; however, no safe conclusions could be drawn from the available data due to high heterogeneity and risk of bias in the trials. CONCLUSIONS/INTERPRETATION Protective strategies are often preferred over therapeutic exercise that might have unforeseen consequences for patients over time. Based on the current literature, no evidence-based recommendations can be provided on the benefits and harms of exercise therapy for patients with DFUs. Well-conducted RCTs are needed to guide rehabilitation including detailed description of adverse events and an exercise program in a semisupervised or fully supervised setting.
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Affiliation(s)
- Thomas Vedste Aagaard
- Department of Physiotherapy and Occupational Therapy, Holbaek Hospital, Holbaek, Denmark.,Department of Orthopaedic Surgery, Holbaek Hospital, Holbaek, Denmark.,Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
| | - Sahar Moeini
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark
| | - Søren T Skou
- Department of Physiotherapy and Occupational Therapy, Naestved-Slagelse-Ringsted Hospitals, Slagelse, Denmark.,Research Unit for Musculoskeletal Function and Physiotherapy, Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Ulla Riis Madsen
- Department of Orthopaedic Surgery, Holbaek Hospital, Holbaek, Denmark.,The Danish Knowledge Centre for Rehabilitation and Palliative Care. University of Southern Denmark, Odense, Denmark
| | - Stig Brorson
- Department of Orthopaedic Surgery, Zealand University Hospital, Koege, Denmark.,Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
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Carrignan JA, Simmet RT, Coddington M, Gill NW, Greenlee TA, McCafferty R, Rhon DI. Are Exercise and Physical Therapy Common Forms of Conservative Management in the Year Before Lumbar Spine Surgery? Arch Phys Med Rehabil 2020; 101:1389-1395. [DOI: 10.1016/j.apmr.2020.04.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Revised: 04/13/2020] [Accepted: 04/16/2020] [Indexed: 12/29/2022]
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Segura C, Eraso M, Bonilla J, Mendivil CO, Santiago G, Useche N, Bernal-Pacheco O, Monsalve G, Sanchez L, Hernández E, Peláez-Jaramillo MJ, Cárdenas-Mojica A. Effect of a High-Intensity Tandem Bicycle Exercise Program on Clinical Severity, Functional Magnetic Resonance Imaging, and Plasma Biomarkers in Parkinson's Disease. Front Neurol 2020; 11:656. [PMID: 32793096 PMCID: PMC7393207 DOI: 10.3389/fneur.2020.00656] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Accepted: 06/02/2020] [Indexed: 12/11/2022] Open
Abstract
Rationale: The optimal modality, intensity, duration, frequency, and dose-response of exercise as a therapy for Parkinson's Disease (PD) are insufficiently understood. Objective: To assess the impact of a high-intensity tandem bicycle program on clinical severity, biomarkers, and functional MRI (fMRI) in PD. Methods: A single-center, parallel-group clinical trial was conducted. Thirteen PD patients aged 65 or younger were divided in two groups: a control group and an intervention group that incorporated a cycling program at 80% of each individual's maximum heart rate (HR) (≥80 rpm), three times a week, for 16 weeks. Both groups continued their conventional medications for PD. At baseline and at the end of follow-up, we determined in all participants the Unified Parkinson's Disease Rating Scale, anthropometry, VO2max, PD biomarkers, and fMRI. Results: VO2max improved in the intervention group (IG) (+5.7 ml/kg/min), while it slightly deteriorated in the control group (CG) (-1.6 ml/kg/min) (p = 0.041). Mean Unified Parkinson's Disease Rating Scale (UPDRS) went down by 5.7 points in the IG and showed a small 0.9-point increase in the CG (p = 0.11). fMRI showed activation of the right fusiform gyrus during the motor task and functional connectivity between the cingulum and areas of the frontal cortex, and between the cerebellar vermis and the thalamus and posterior temporal gyrus. Plasma brain-derived neurotrophic factor (BDNF) levels increased more than 10-fold in the IG and decreased in the CG (p = 0.028). Larger increases in plasma BDNF correlated with greater decreases in UPDRS (r = -0.58, p = 0.04). Conclusions: Our findings suggest that high-intensity tandem bicycle improves motor function and biochemical and functional neuroimaging variables in PD patients. Trial registration number: ISRCTN 13047118, Registered on February 8, 2018.
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Affiliation(s)
- Carolina Segura
- Vida Activa, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Mauricio Eraso
- Vida Activa, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogota, Colombia.,School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Javier Bonilla
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Carlos O Mendivil
- School of Medicine, Universidad de los Andes, Bogota, Colombia.,Endocrinology Section, Department of Internal Medicine, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Giselle Santiago
- Radiology and Diagnostic Imaging Department, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Nicolás Useche
- Radiology and Diagnostic Imaging Department, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | | | - Guillermo Monsalve
- Neurosurgery Section, Department of Surgery, Fundación Santa Fe de Bogotá, Bogota, Colombia
| | - Laura Sanchez
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
| | - Enrique Hernández
- School of Medicine and Health Sciences, Universidad del Rosario, Bogota, Colombia
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Ryu M, Lee S, Kim H, Baek WC, Kimm H. Effect of Aerobic Physical Activity on Health-Related Quality of Life in Middle Aged Women with Osteoarthritis: Korea National Health and Nutrition Examination Survey (2016-2017). INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17020527. [PMID: 31947669 PMCID: PMC7013511 DOI: 10.3390/ijerph17020527] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 01/09/2020] [Accepted: 01/10/2020] [Indexed: 12/12/2022]
Abstract
Background: There have been few studies reporting the association between health-related quality of life (HRQoL) and osteoarthritis (OA) in female subjects performing aerobic exercise or not. The aim of this study is to compare HRQoL between OA patients and non-OA subjects in middle aged Korean women (40–59 years) with/without aerobic physical activity, and also to identify an association between EQ-5D instrument based HRQoL and OA controlling for aerobic exercise. Methods: This study used the cross-sectional data, the Korea National Health and Nutrition Examination Survey (KNANES) from 2016 to 2017. We only selected those who had completed the evaluations of aerobic physical activity and osteoarthritis diagnosis. In total, 2445 middle aged women were finally selected for this study. The European quality of life-5 dimensions (EQ-5D) was used for the evaluation of HRQoL as a dependent variable. In socio-demographic factors, age, sex, income level, education level, marital status, economic activity, type of insurance and private insurance and behaviour-related factors were included. One-way analysis of variance was conducted to compare the EQ-5D index and multiple linear regression analysis was employed to identify associated factors with the EQ-5D index. Results: In total, 2445 middle aged women were included in this study, in which 2209 participants were normal (90.0%) with aerobic physical activity (no: 55.0%, yes: 45.0%) and 246 participants were diagnosed with osteoarthritis (10.0%) with aerobic physical activity (no: 56.1%, yes: 43.9%). In group 2-2 (OA with aerobic), the moderate level of muscle exercise (less than 5 days per week) showed the highest HRQoL (p < 0.05) and high level exercise showed the lowest HRQoL (p < 0.05). In menopause status, the participants under menopause status showed lower HRQoL (p < 0.05) than those not under menopause status in group 2-2 (OA with aerobic) only. Conclusions: The HRQoL of OA patients was significantly lower than that of normal participants in middle aged Korean women (40–59 years). Especially, OA patients with maintained aerobic physical activity showed significantly higher HRQoL than those without that under controlling covariates such as age, income level, education level, marital status, economic activity, type of insurance, etc.
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Affiliation(s)
- Mikyung Ryu
- Department of Sport & Leisure Studies, College of Physical Science, Kyonggi University, Suwon 16227, Korea;
- Institute on Aging, Ajou University Medical Center, Suwon 16499, Korea
| | - Sol Lee
- Department of bbko Research Center, bbko Big-Data R&D, Seoul 04146, Korea; (S.L.); (H.K.)
- Department of Health Policy and Management, Korea University, Seoul 02841, Korea
| | - Ho Kim
- Department of bbko Research Center, bbko Big-Data R&D, Seoul 04146, Korea; (S.L.); (H.K.)
- Department of Epidemiology and Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
| | - Weon-Chil Baek
- Department of Sports and Health Science, College of Human-Centered Convergence, Kyonggi University, Suwon 16227, Korea;
| | - Heejin Kimm
- Department of Epidemiology and Health Promotion, Institute for Health Promotion, Graduate School of Public Health, Yonsei University, Seoul 03722, Korea
- Correspondence: ; Tel.: +82-2-2228-1531; Fax: +82-2-365-5118
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Santilli O, Santilli H, Nardelli N, Tripoloni D, Etchepare H. Sports rehabilitation after laparoscopic hernioplasty. INTERNATIONAL JOURNAL OF ABDOMINAL WALL AND HERNIA SURGERY 2020. [DOI: 10.4103/ijawhs.ijawhs_28_20] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Liem SIE, Vliet Vlieland TPM, Schoones JW, de Vries-Bouwstra JK. The effect and safety of exercise therapy in patients with systemic sclerosis: a systematic review. Rheumatol Adv Pract 2019; 3:rkz044. [PMID: 31858074 PMCID: PMC6913710 DOI: 10.1093/rap/rkz044] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 10/21/2019] [Indexed: 01/08/2023] Open
Abstract
Given the shortcomings of previous literature reviews evaluating the effect and safety of exercise therapy in SSc, we aimed to carry out a systematic review of the literature specifically on this topic. A structured search strategy was performed in Medline (via PubMed) and other electronic databases from 1990 to 3 September 2019. Randomized controlled trials, observational designs, conference abstracts and trial registrations were included if they concerned SSc patients ≥18 years of age, exercise therapy and reported outcomes related to physical functioning. Nine articles were included. Four randomized controlled trials compared (a) hand exercises, (b) orofacial exercises, (c) aerobic exercises or (d) aerobic exercises plus resistance training with no exercise, demonstrating effects on hand function (a), maximum mouth opening (b), peak oxygen uptake (c + d) and quality of life. All five observational studies concerning hand, orofacial, aerobic and/or strengthening exercises reported improvements of hand function, mouth opening, aerobic capacity and/or muscle strength. In conclusion, the evidence on the effect and safety of exercise therapy in SSc is scanty.
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Affiliation(s)
| | | | - Jan W Schoones
- Walaeus Library, Leiden University Medical Center, Leiden, The Netherlands
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Effects of kinesio taping alone versus sham taping in individuals with musculoskeletal conditions after intervention for at least one week: a systematic review and meta-analysis. Physiotherapy 2019; 105:412-420. [DOI: 10.1016/j.physio.2019.04.001] [Citation(s) in RCA: 24] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2018] [Indexed: 11/22/2022]
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Periosteal Electrical Dry Needling as an Adjunct to Exercise and Manual Therapy for Knee Osteoarthritis: A Multicenter Randomized Clinical Trial. Clin J Pain 2019; 34:1149-1158. [PMID: 29864043 PMCID: PMC6250299 DOI: 10.1097/ajp.0000000000000634] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Objectives: To compare the effects of adding electrical dry needling into a manual therapy (MT) and exercise program on pain, stiffness, function, and disability in individuals with painful knee osteoarthritis (OA). Materials and Methods: In total, 242 participants (n=242) with painful knee OA were randomized to receive 6 weeks of electrical dry needling, MT, and exercise (n=121) or MT and exercise (n=121). The primary outcome was related-disability as assessed by the Western Ontario and McMaster Universities (WOMAC) Osteoarthritis Index at 3 months. Results: Individuals receiving the combination of electrical dry needling, MT, and exercise experienced significantly greater improvements in related-disability (WOMAC: F=35.504; P<0.001) than those receiving MT and exercise alone at 6 weeks and 3 months. Patients receiving electrical dry needling were 1.7 times more likely to have completely stopped taking medication for their pain at 3 months than individuals receiving MT and exercise (OR, 1.6; 95% confidence interval, 1.24-2.01; P=0.001). On the basis of the cutoff score of ≥5 on the global rating of change, significantly (χ2=14.887; P<0.001) more patients (n=91, 75%) within the dry needling group achieved a successful outcome compared with the MT and exercise group (n=22, 18%) at 3 months. Effect sizes were large (standardized mean differences >0.82) for all outcome measures in favor of the electrical dry needling group at 3 months. Discussion: The inclusion of electrical dry needling into a MT and exercise program was more effective for improving pain, function, and related-disability than the application of MT and exercise alone in individuals with painful knee OA. Level of Evidence: Level 1b—therapy. Prospectively registered February 10, 2015 on www.clinicaltrials.gov (NCT02373631).
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Shahabi S, Rezapour A, Arabloo J. Economic evaluations of physical rehabilitation interventions in older adults with hip and/or knee osteoarthritis: a systematic review. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1672785] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Affiliation(s)
- Saeed Shahabi
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Aziz Rezapour
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Jalal Arabloo
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
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Niemeijer A, Lund H, Stafne SN, Ipsen T, Goldschmidt CL, Jørgensen CT, Juhl CB. Adverse events of exercise therapy in randomised controlled trials: a systematic review and meta-analysis. Br J Sports Med 2019; 54:1073-1080. [PMID: 31563884 DOI: 10.1136/bjsports-2018-100461] [Citation(s) in RCA: 68] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/03/2019] [Indexed: 01/25/2023]
Abstract
OBJECTIVE To evaluate the relative risk (RR) of serious and non-serious adverse events in patients treated with exercise therapy compared with those in a non-exercising control group. DESIGN Systematic review and meta-analysis. DATA SOURCES Primary studies were identified based on The Cochrane Database of Systematic Reviews investigating the effect of exercise therapy. ELIGIBILITY CRITERIA At least two of the authors independently evaluated all identified reviews and primary studies. Randomised controlled trials were included if they compared any exercise therapy intervention with a non-exercising control. Two authors independently extracted data. The RR of serious and non-serious adverse events was estimated separately. RESULTS 180 Cochrane reviews were included and from these, 773 primary studies were identified. Of these, 378 studies (n=38 368 participants) reported serious adverse events and 375 studies (n=38 517 participants) reported non-serious adverse events. We found no increase in risk of serious adverse events (RR=0.96 (95%CI 0.90 to 1.02, I2: 0.0%) due to exercise therapy. There was, however, an increase in non-serious adverse events (RR=1.19 (95%CI 1.09 to 1.30, I2: 0.0%). The number needed to treat for an additional harmful outcome for non-serious adverse events was 6 [95%CI 4 to 11). CONCLUSION Participating in an exercise intervention increased the relative risk of non-serious adverse events, but not of serious adverse events. Exercise therapy may therefore be recommended as a relatively safe intervention.PROSPERO registration numberCRD42014014819.
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Affiliation(s)
- Andre Niemeijer
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Hans Lund
- Centre for Evidence-Based Practice, Hogskulen pa Vestlandet, Bergen, Norway
| | - Signe Nilssen Stafne
- Department of Public Health and Nursing, University of Science and Technology (NTNU), Trondheim, Norway.,Clinic of Clinical Services, Trondheim University Hospital (St Olavs Hospital), Trondheim, Norway
| | - Thomas Ipsen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | | | - Claus Thomas Jørgensen
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark
| | - Carsten B Juhl
- Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, Odense, Denmark.,Department of Physiotherapy and Occupational Therapy, University of Copenhagen, Herlev and Gentofte Hospital, Copenhagen, Denmark
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Nonoperative Management Prior to Hip Arthroscopy for Femoroacetabular Impingement Syndrome: An Investigation Into the Utilization and Content of Physical Therapy. J Orthop Sports Phys Ther 2019; 49:593-600. [PMID: 31092124 DOI: 10.2519/jospt.2019.8581] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BACKGROUND There has been a significant increase in surgeries for femoroacetabular impingement syndrome in recent years, but little is known about the use of physical therapy prior to surgery. OBJECTIVES To investigate the use of physical therapy prior to hip arthroscopy for femoroacetabular impingement syndrome, by assessing the number of visits and use of exercise. A secondary objective was to evaluate whether comorbidities prior to surgery were associated with the use of physical therapy. METHODS In this retrospective observational cohort study, eligible participants between the ages of 18 and 50 years undergoing hip arthroscopy between 2004 and 2013 in the Military Health System were included. Patients were categorized based on whether they saw a physical therapist for their hip in the year prior to surgery. For physical therapy patients, dosing variables were identified, including total number of visits and visits that included an exercise therapy procedure code. RESULTS Of 1870 participants, 1106 (59.1%) did not see a physical therapist for their hip prior to surgery. For those who did, the median number of visits was 2. Only 220 (11.8%) had 6 or more unique visits with an exercise therapy procedure code. Exercise was coded in 43.4% to 63.0% of the total visits in each individual course of care (mean, 52.3%). There was an association between substance abuse and exercise utilization. No other comorbidities were associated with physical therapy or exercise therapy utilization. CONCLUSION Physical therapy was not commonly used before undergoing arthroscopic hip surgery by patients seeking care in the Military Health System. Further research is needed to understand the reasons for poor utilization and better define failed nonoperative management. LEVEL OF EVIDENCE Therapy, level 2b. J Orthop Sports Phys Ther 2019;49(8):593-600. Epub 15 May 2019. doi:10.2519/jospt.2019.8581.
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Edgerton K, Hall J, Bland MK, Marshall B, Hulla R, Gatchel RJ. A physical therapist’s role in pain management: A biopsychosocial perspective. ACTA ACUST UNITED AC 2019. [DOI: 10.1111/jabr.12170] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022]
Affiliation(s)
| | - Jarod Hall
- Greater Therapy Centers Lewisville Texas
| | - Michelle K. Bland
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Blaine Marshall
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Ryan Hulla
- Department of Psychology University of Texas at Arlington Arlington Texas
| | - Robert J. Gatchel
- Department of Psychology University of Texas at Arlington Arlington Texas
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L’Heureux J, Coutu MF, Berbiche D, Larivière C. Adherence to a home exercise programme following a clinical programme for non-acute non-specific low back pain: an exploratory study. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2019. [DOI: 10.1080/21679169.2019.1617777] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Affiliation(s)
- Judith L’Heureux
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Marie-France Coutu
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Charles-LeMoyne Hospital Research Centre, Longueuil, Canada
| | - Djamal Berbiche
- Université de Sherbrooke, Longueuil, Canada
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
| | - Christian Larivière
- Centre for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montréal, Canada
- Institut Robert-Sauvé en santé et en sécurité du travail (IRSST), Montréal, Canada
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Bavan L, Surmacz K, Beard D, Mellon S, Rees J. Adherence monitoring of rehabilitation exercise with inertial sensors: A clinical validation study. Gait Posture 2019; 70:211-217. [PMID: 30903993 DOI: 10.1016/j.gaitpost.2019.03.008] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/10/2018] [Revised: 02/21/2019] [Accepted: 03/11/2019] [Indexed: 02/02/2023]
Abstract
BACKGROUND Rehabilitation has an established role in the management of a wide range of musculoskeletal conditions. Much of this treatment relies on self-directed exercises at home, where adherence of execution is unknown. Demonstrating treatment fidelity is necessary to draw conclusions about the efficacy of rehabilitation interventions in both clinical and research settings. There is a lack of tools and methods to achieve this. RESEARCH QUESTION This study aims to evaluate the feasibility of using a single inertial sensor to recognise and classify shoulder rehabilitation activity using supervised machine learning techniques. METHODS Twenty patients with shoulder pain were monitored performing five rehabilitation exercises routinely prescribed for their condition. Accelerometer, gyroscope and magnetometer data were collected via a device mounted onto an arm sleeve. Non-specific motion data was included in the analysis. Time and frequency domain features were calculated from labelled data segments and ranked in terms of their predictive importance using the ReliefF algorithm. Selected features were used to train four supervised learning algorithms: decision tree, k-nearest neighbour, support vector machine and random forests. Performance of algorithms in accurately classifying exercise activity was evaluated with ten-fold cross-validation and leave-one-subject-out-validation methods. RESULTS Optimal predictive accuracies for ten-fold cross-validation (97.2%) and leave-one-subject-out-validation (80.5%) were achieved by support vector machine and random forests algorithms, respectively. Time domain features derived from accelerometer, magnetometer and orientation data streams were shown to have the highest predictive value for classifying rehabilitation activity. SIGNIFICANCE Classification models performed well in differentiating patient exercise activity from non-specific movement and identifying specific exercise type using inertial sensor data. A clinically useful account of home rehabilitation activity will help guide treatment strategies and facilitate methods to improve patient engagement. Future work should focus on evaluating the performance of such systems in natural and unsupervised settings.
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Affiliation(s)
- Luckshman Bavan
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Old Road, Oxford, OX3 7LD, United Kingdom.
| | - Karl Surmacz
- McLaren Applied Technologies, McLaren Technology Centre, Chertsey Road, Woking, GU21 4YH, United Kingdom.
| | - David Beard
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Old Road, Oxford, OX3 7LD, United Kingdom.
| | - Stephen Mellon
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Old Road, Oxford, OX3 7LD, United Kingdom.
| | - Jonathan Rees
- Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Botnar Research Centre, Old Road, Oxford, OX3 7LD, United Kingdom.
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Larivière C, Henry SM, Gagnon DH, Preuss R, Dumas J. Ultrasound Measures of the Abdominal Wall in Patients with Low Back Pain Before and After an 8‐week Lumbar Stabilization Exercise Program, and Their Association With Clinical Outcomes. PM R 2019; 11:710-721. [DOI: 10.1002/pmrj.12000] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2018] [Accepted: 10/10/2018] [Indexed: 12/12/2022]
Affiliation(s)
- Christian Larivière
- Institut de recherche Robert‐Sauvé en santé et en sécurité du travail (IRSST), 505, boul. De Maisonneuve Ouest Montréal Québec H3A 3C2 Canada
- Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Institut universitaire sur la réadaptation en déficience physique de Montréal (IURDPM)Centre intégré universitaire de santé et de services sociaux du Centre‐Sud‐de‐l'Ile‐de‐Montréal (CCSMTL)MontréalQuébecCanada
| | - Sharon M. Henry
- Department of Rehabilitation TherapyThe University of Vermont Medical Center Burlington VT
| | - Dany H. Gagnon
- School of Rehabilitation, Faculty of MedicineUniversité de Montréal Montréal Québec Canada
| | - Richard Preuss
- School of Physical & Occupational TherapyMcGill University Montréal Québec Canada
| | - Jean‐Pierre Dumas
- School of Rehabilitation, Faculty of MedicineUniversité de Sherbrooke Sherbrooke Québec Canada
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West SL, Banks L, Schneiderman JE, Caterini JE, Stephens S, White G, Dogra S, Wells GD. Physical activity for children with chronic disease; a narrative review and practical applications. BMC Pediatr 2019; 19:12. [PMID: 30621667 PMCID: PMC6325687 DOI: 10.1186/s12887-018-1377-3] [Citation(s) in RCA: 36] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/02/2017] [Accepted: 12/18/2018] [Indexed: 12/17/2022] Open
Abstract
BACKGROUND Physical activity (PA) is associated with a diverse range of health benefits. International guidelines suggest that children should be participating in a minimum of 60 min of moderate to vigorous intensity PA per day to achieve these benefits. However, current guidelines are intended for healthy children, and thus may not be applicable to children with a chronic disease. Specifically, the dose of PA and disease specific exercise considerations are not included in these guidelines, leaving such children with few, if any, evidence-based informed suggestions pertaining to PA. Thus, the purpose of this narrative review was to consider current literature in the area of exercise as medicine and provide practical applications for exercise in five prevalent pediatric chronic diseases: respiratory, congenital heart, metabolic, systemic inflammatory/autoimmune, and cancer. METHODS For each disease, we present the pathophysiology of exercise intolerance, summarize the pediatric exercise intervention research, and provide PA suggestions. RESULTS Overall, exercise intolerance is prevalent in pediatric chronic disease. PA is important and safe for most children with a chronic disease, however exercise prescription should involve the entire health care team to create an individualized program. CONCLUSIONS Future research, including a systematic review to create evidence-based guidelines, is needed to better understand the safety and efficacy of exercise among children with chronic disease.
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Affiliation(s)
- Sarah L. West
- Department of Biology, Trent/Fleming School of Nursing, Trent University, Toronto, Canada
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
| | | | - Jane E. Schneiderman
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Jessica E. Caterini
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Samantha Stephens
- Child Health Evaluative Sciences, The Hospital for Sick Children, Toronto, Canada
- Institute of Health Policy Management and Evaluation, The University of Toronto, Toronto, Canada
| | - Gillian White
- Translational Medicine, The Hospital for Sick Children, Toronto, Canada
- Faculty of Kinesiology and Physical Education, The University of Toronto, Toronto, Canada
| | - Shilpa Dogra
- Faculty of Health Sciences (Kinesiology), University of Ontario Institute of Technology, Oshawa, Canada
| | - Greg D. Wells
- Translational Medicine, The Hospital for Sick Children, Peter Gilgan Centre for Research and Learning, 10th floor, 686 Bay St., Toronto, ON M5G 0A4 Canada
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Nakayama S, Tolbert TJ, Nov O, Porfiri M. Social Information as a Means to Enhance Engagement in Citizen Science‐Based Telerehabilitation. J Assoc Inf Sci Technol 2018. [DOI: 10.1002/asi.24147] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Affiliation(s)
- Shinnosuke Nakayama
- Department of Mechanical and Aerospace Engineering New York University Tandon School of Engineering 6 MetroTech Center, Brooklyn NY 11201
| | - Tyrone J. Tolbert
- Department of Mechanical and Aerospace Engineering New York University Tandon School of Engineering 6 MetroTech Center, Brooklyn NY 11201
| | - Oded Nov
- Department of Technology Management and Innovation New York University Tandon School of Engineering 5 MetroTech Center, Brooklyn NY 11201
| | - Maurizio Porfiri
- Department of Mechanical and Aerospace Engineering and Department of Biomedical Engineering, New York University Tandon School of Engineering 6 MetroTech Center, Brooklyn NY 11201
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van der Leeden M, Stuiver MM, Huijsmans R, Geleijn E, de Rooij M, Dekker J. Structured clinical reasoning for exercise prescription in patients with comorbidity. Disabil Rehabil 2018; 42:1474-1479. [DOI: 10.1080/09638288.2018.1527953] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- Marike van der Leeden
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
| | - Martijn M. Stuiver
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
- Faculty of Health, ACHIEVE, Amsterdam University of Applied Sciences, Amsterdam, The Netherlands
| | - Rosalie Huijsmans
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Edwin Geleijn
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
| | - Mariëtte de Rooij
- Reade, Amsterdam Rehabilitation Research Centre, Amsterdam, The Netherlands
| | - Joost Dekker
- Department of Rehabilitation Medicine, VU University Medical Center, Amsterdam, The Netherlands
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Kashyap R, Iqbal A, Alghadir AH. Controlled intervention to compare the efficacies of manual pressure release and the muscle energy technique for treating mechanical neck pain due to upper trapezius trigger points. J Pain Res 2018; 11:3151-3160. [PMID: 30588067 PMCID: PMC6296190 DOI: 10.2147/jpr.s172711] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Purpose This study aimed at comparing the clinical efficacies of two manual therapies to determine the most beneficial result-oriented physiotherapeutic approach for treating nonspecific neck pain due to myofascial trigger points (MTrPs). Methods This was a randomized, controlled pretest–posttest experimental study that compared manual pressure release (MPR), the muscle energy technique (MET), and a control condition. These techniques were compared using a convenience sample of 45 female participants with neck pain due to MTrPs (mean age±SD=21.49±3.66; age range=18–30 years). The visual analog scale, pressure pain threshold, Neck Disability Index Questionnaire, and a standardized measuring tape were used to assess the participants’ neck pain, muscle tenderness, functional disability due to neck pain, and range of neck rotation, respectively, at baseline (day 0), day 1, and day 5 postintervention and at days 10 and 15 during follow-up. All groups were given postural advice and at-home neck exercises. Repeated-measures ANOVA and one-way ANOVA were used to analyze the data. Results The within-group analyses showed significant improvement (P<0.05) in all outcome measures at days 1 and 5 postintervention and at days 10 and 15 during the follow-up for all groups. The between-group analyses confirmed nonsignificant differences (P>0.05) between all groups for all variables. Conclusion MPR and the MET are equally effective for reducing pain and muscle tenderness and for improving neck disability and range of rotation in patients with nonspecific neck pain. Furthermore, advice promoting postural correction can be an adjunct to physiotherapeutic interventions for reducing neck pain and its symptoms. A combination of these manual therapies with postural advice might be a good treatment option for nonspecific pain in physiotherapy clinics.
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Affiliation(s)
- Richa Kashyap
- Department of Physiotherapy, Prakash Institute of Physiotherapy Rehabilitation and Allied Medical Sciences, Chaudhary Charan Singh University (Meerut), Uttar Pradesh, India
| | - Amir Iqbal
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia,
| | - Ahmad H Alghadir
- Rehabilitation Research Chair, College of Applied Medical Sciences, King Saud University, Riyadh, Saudi Arabia,
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Trunk postural adjustments: Medium-term reliability and correlation with changes of clinical outcomes following an 8-week lumbar stabilization exercise program. J Electromyogr Kinesiol 2018; 41:66-76. [DOI: 10.1016/j.jelekin.2018.04.006] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2016] [Revised: 02/09/2018] [Accepted: 04/20/2018] [Indexed: 12/25/2022] Open
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Wang J, Yang L, Li Q, Wu Z, Sun Y, Zou Q, Li X, Xu Z, Ye C. Construction of an adherence rating scale for exercise therapy for patients with knee osteoarthritis. BMC Musculoskelet Disord 2018; 19:263. [PMID: 30053843 PMCID: PMC6064120 DOI: 10.1186/s12891-018-2200-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2018] [Accepted: 07/18/2018] [Indexed: 12/12/2022] Open
Abstract
Background Knee osteoarthritis (KOA) is one of the most common chronic diseases in the elderly and is the primary cause of the loss of motor function and disability in this population. Exercise therapy is a core, basic and matureand treatment method of treating patients with KOA. Exercise therapy is “strongly recommended” or “recommended” in the diagnosis and treatment guidelines of osteoarthritis in many countries, and most scholars advocate exercise therapy as the preferred rehabilitation method for KOA patients. However, poor long-term adherence is a serious problem affecting the therapeutic effect of this mature treatment. The objective of this study was to construct a concise and practical adherence rating scale (ARS) based on the exercise therapy adherence prediction model in patients with knee osteoarthritis. Methods A binary logistic regression model was established, with the adherence of 218 cases of KOA patients as the dependent variable. The patients’ general information, exercise habits, knowledge, attitude, and exercise therapy were independent variables. The regression coefficients were assigned to various variables in the model, and the ARS was constructed accordingly. Receiver operating characteristic curves and curve fitting were used to analyse the effect of the ARS in predicting the adherence and to determine the goodness of fit for the adherence. The external validity of the ARS was examined in a randomized controlled trial. Results The construction of the adherence model and the ARS included the following variables: age (1 point), education level (1 point), degree of social support (2 points), exercise habits (3 points), knowledge of KOA prevention and treatment (2 points), degree of care needed to treat the disease (1 point), familiarity with exercise therapy (4 points) and treatment confidence (3 points). The critical value of the total score of the ARS was 6.50, with a sensitivity of 87.20% and a specificity of 76.34%. Conclusions A KOA exercise therapy adherence model and a simple and practical ARS were constructed. The ARS has good internal validity and external validity and can be used to evaluate the adherence to exercise therapy in patients with KOA.
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Affiliation(s)
- Jianji Wang
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Long Yang
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Qingjun Li
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Zhanyu Wu
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Yu Sun
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Qiang Zou
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Xuanze Li
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Zhe Xu
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China.,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China.,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China
| | - Chuan Ye
- Department of Orthopedic Surgery, Affiliated Hospital of Guizhou Medical University, Guiyang, China. .,Center for Bioprinting and Biomanufacturing, Guizhou Medical University, Guiyang, China. .,Center for Tissue Engineering and Stem Cells, Guizhou Medical University, Guiyang, China. .,China Orthopedic Regenerative Medicine Group (CORMed), Guiyang, China.
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Hay E, Dziedzic K, Foster N, Peat G, van der Windt D, Bartlam B, Blagojevic-Bucknall M, Edwards J, Healey E, Holden M, Hughes R, Jinks C, Jordan K, Jowett S, Lewis M, Mallen C, Morden A, Nicholls E, Ong BN, Porcheret M, Wulff J, Kigozi J, Oppong R, Paskins Z, Croft P. Optimal primary care management of clinical osteoarthritis and joint pain in older people: a mixed-methods programme of systematic reviews, observational and qualitative studies, and randomised controlled trials. PROGRAMME GRANTS FOR APPLIED RESEARCH 2018. [DOI: 10.3310/pgfar06040] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
BackgroundOsteoarthritis (OA) is the most common long-term condition managed in UK general practice. However, care is suboptimal despite evidence that primary care and community-based interventions can reduce OA pain and disability.ObjectivesThe overall aim was to improve primary care management of OA and the health of patients with OA. Four parallel linked workstreams aimed to (1) develop a health economic decision model for estimating the potential for cost-effective delivery of primary care OA interventions to improve population health, (2) develop and evaluate new health-care models for delivery of core treatments and support for self-management among primary care consulters with OA, and to investigate prioritisation and implementation of OA care among the public, patients, doctors, health-care professionals and NHS trusts, (3) determine the effectiveness of strategies to optimise specific components of core OA treatment using the example of exercise and (4) investigate the effect of interventions to tackle barriers to core OA treatment, using the example of comorbid anxiety and depression in persons with OA.Data sourcesThe North Staffordshire Osteoarthritis Project database, held by Keele University, was the source of data for secondary analyses in workstream 1.MethodsWorkstream 1 used meta-analysis and synthesis of published evidence about effectiveness of primary care treatments, combined with secondary analysis of existing longitudinal population-based cohort data, to identify predictors of poor long-term outcome (prognostic factors) and design a health economic decision model to estimate cost-effectiveness of different hypothetical strategies for implementing optimal primary care for patients with OA. Workstream 2 used mixed methods to (1) develop and test a ‘model OA consultation’ for primary care health-care professionals (qualitative interviews, consensus, training and evaluation) and (2) evaluate the combined effect of a computerised ‘pop-up’ guideline for general practitioners (GPs) in the consultation and implementing the model OA consultation on practice and patient outcomes (parallel group intervention study). Workstream 3 developed and investigated in a randomised controlled trial (RCT) how to optimise the effect of exercise in persons with knee OA by tailoring it to the individual and improving adherence. Workstream 4 developed and investigated in a cluster RCT the extent to which screening patients for comorbid anxiety and depression can improve OA outcomes. Public and patient involvement included proposal development, project steering and analysis. An OA forum involved public, patient, health professional, social care and researcher representatives to debate the results and formulate proposals for wider implementation and dissemination.ResultsThis programme provides evidence (1) that economic modelling can be used in OA to extrapolate findings of cost-effectiveness beyond the short-term outcomes of clinical trials, (2) about ways of implementing support for self-management and models of optimal primary care informed by National Institute for Health and Care Excellence recommendations, including the beneficial effects of training in a model OA consultation on GP behaviour and of pop-up screens in GP consultations on the quality of prescribing, (3) against adding enhanced interventions to current effective physiotherapy-led exercise for knee OA and (4) against screening for anxiety and depression in patients with musculoskeletal pain as an addition to current best practice for OA.ConclusionsImplementation of evidence-based care for patients with OA is feasible in general practice and has an immediate impact on improving the quality of care delivered to patients. However, improved levels of quality of care, changes to current best practice physiotherapy and successful introduction of psychological screening, as achieved by this programme, did not substantially reduce patients’ pain and disability. This poses important challenges for clinical practice and OA research.LimitationsThe key limitation in this work is the lack of improvement in patient-reported pain and disability despite clear evidence of enhanced delivery of evidence-based care.Future work recommendations(1) New thinking and research is needed into the achievable and desirable long-term goals of care for people with OA, (2) continuing investigation into the resources needed to properly implement clinical guidelines for management of OA as a long-term condition, such as regular monitoring to maintain exercise and physical activity and (3) new research to identify subgroups of patients with OA as a basis for stratified primary care including (i) those with good prognosis who can self-manage with minimal investigation or specialist treatment, (ii) those who will respond to, and benefit from, specific interventions in primary care, such as physiotherapy-led exercise, and (iii) develop research into effective identification and treatment of clinically important anxiety and depression in patients with OA and into the effects of pain management on psychological outcomes in patients with OA.Trial registrationCurrent Controlled Trials ISRCTN06984617, ISRCTN93634563 and ISRCTN40721988.FundingThis project was funded by the National Institute for Health Research (NIHR) Programme Grants for Applied Research Programme and will be published in full inProgramme Grants for Applied Research Programme; Vol. 6, No. 4. See the NIHR Journals Library website for further project information.
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Affiliation(s)
- Elaine Hay
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Krysia Dziedzic
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Nadine Foster
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - George Peat
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Danielle van der Windt
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Bernadette Bartlam
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Milisa Blagojevic-Bucknall
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - John Edwards
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Emma Healey
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Melanie Holden
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Rhian Hughes
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Clare Jinks
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Kelvin Jordan
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Sue Jowett
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Martyn Lewis
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Christian Mallen
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Andrew Morden
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Elaine Nicholls
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Bie Nio Ong
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Mark Porcheret
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Jerome Wulff
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Jesse Kigozi
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Raymond Oppong
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
- Health Economics Unit, University of Birmingham, Birmingham, UK
| | - Zoe Paskins
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
| | - Peter Croft
- Arthritis Research UK Primary Care Centre, Institute of Primary Care and Health Sciences, Keele University, Keele, UK
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Carlton L, Maccio JR, Maccio JG, McGowan C. The application of mechanical diagnosis and therapy on hip osteoarthritis: A case report. Physiother Theory Pract 2018; 36:347-357. [PMID: 29924661 DOI: 10.1080/09593985.2018.1485194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Abstract
Background: The prevalence and cost of hip osteoarthritis (OA) is rising. Mechanical diagnosis and therapy (MDT) is an orthopedic classification and treatment system based on mechanical and symptomatic response to repeated and sustained end-range movements. There has been no investigation of the association between MDT and patients diagnosed with hip OA. Case Description: This case report presents a 71-year-old female diagnosed with hip OA and matching the currently accepted clinical prediction rule (CPR) for symptomatic hip OA. The patient was classified and treated by a Diplomat of MDT and co-examiner using MDT. Outcomes: Short- and long-term (13 months) outcomes were excellent, demonstrating rapid abolishment of symptoms and improvement in function in 5 visits over 21 days. The patient demonstrated the ability to prevent and manage reoccurrence of symptoms independently; nevertheless, she received a total hip replacement which was not in accordance with current guidelines and recommendations. Conclusion: This case report raises questions about whether or not pathologies traditionally associated with the etiology of hip OA are actually at fault. Moreover, it raises questions about the utility of special tests and CPRs typically utilized to identify those structures. The case report provides preliminary evidence from one patient that MDT may be capable of providing effective short- and long-term outcomes in the management of hip OA.
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Peek K, Carey M, Mackenzie L, Sanson-Fisher R. Patient adherence to an exercise program for chronic low back pain measured by patient-report, physiotherapist-perception and observational data. Physiother Theory Pract 2018; 35:1304-1313. [PMID: 29771180 DOI: 10.1080/09593985.2018.1474402] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
Abstract
The effectiveness of exercise programs for chronic low back pain (CLBP) is dependent upon patient adherence which is problematic to measure accurately. This cross-sectional observational study aimed to compare patient-reported levels of adherence with physiotherapists' perceptions of patient adherence; and to explore the proportion of patients who could accurately recall and demonstrate the exercises contained within their prescribed exercise program for CLBP. Participating patients (n = 61) included those attending for a follow-up consultation with a physiotherapist (n = 15) at a consenting practice (n = 6) who had been prescribed an exercise program for CLBP. Patients were asked to self-report their level of adherence to the exercise program which was then compared to their physiotherapist's perception of adherence. Patients were also asked to recall and demonstrate the exercise program to an independent researcher, which was compared to the prescribed program. Results indicated that in total, 24 patients (39%; 95% CI: 27-52%) self-reported as being completely adherent compared with 10 patients (16%; 95% CI: 8-28%) who were perceived by their physiotherapists as completely adherent (raw agreement: 0.21). However, only nine patients (15%, 95% CI: 7-26%) were able to accurately recall and demonstrate their prescribed exercise program to the researcher, of which eight of these nine patients self-reported complete adherence to the exercise program. In comparison, only four of these nine patients were perceived by the physiotherapist to be completely adherent. These results suggest that patient adherence to home-based exercise programs for CLBP might be assessed more accurately using multi-faceted measures which include an observational component.
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Affiliation(s)
- Kerry Peek
- Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
| | - Mariko Carey
- Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
| | - Lisa Mackenzie
- Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
| | - Robert Sanson-Fisher
- Health Behaviour Research Group, School of Medicine and Public Health, University of Newcastle, University Drive, Callaghan, Australia
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Moral-Munoz JA, Arroyo-Morales M, Herrera-Viedma E, Cobo MJ. An Overview of Thematic Evolution of Physical Therapy Research Area From 1951 to 2013. Front Res Metr Anal 2018. [DOI: 10.3389/frma.2018.00013] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Shahvarpour A, Gagnon D, Preuss R, Henry SM, Larivière C. Trunk postural balance and low back pain: Reliability and relationship with clinical changes following a lumbar stabilization exercise program. Gait Posture 2018; 61:375-381. [PMID: 29448220 DOI: 10.1016/j.gaitpost.2018.02.006] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2017] [Revised: 01/05/2018] [Accepted: 02/06/2018] [Indexed: 02/02/2023]
Abstract
Lumbar stabilization programs reduce pain and disability, but the mechanisms of action underlying this treatment are unknown. Trunk postural control during unstable sitting represents a surrogate measure of motor control mechanisms involved to maintain the dynamic stability of the spine. This exploratory study aimed to determine the reliability of trunk postural control measures over an 8-week interval, their sensitivity to low back pain status and treatment and their relationship with clinical outcomes. Trunk postural control measures were determined in patients with low back pain before and after an 8-week lumbar stabilization exercise program. Healthy controls were assessed over the same interval, but without any treatment, to determine the reliability of the measures and act as a control group at baseline. The kinematics of a wobble chair during unstable sitting was summarized using different linear and nonlinear measures quantifying the quantity and quality of movement, respectively. The reliability of the measures was moderate to excellent. The results showed significant reduction in pain and disability following the intervention. While no impairment at baseline scores was found, some linear and nonlinear measures changed over the intervention period among the patient group. However, for nonlinear measures only, significant correlations were detected with the change scores of pain and disability. The change of measures over the intervention period was likely due to learning rather than the intervention as similar alteration was detected in the healthy subjects. The results suggest that only the quality (not the quantity) of movement may have relationship with pain and disability.
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Affiliation(s)
- Ali Shahvarpour
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Dany Gagnon
- School of Rehabilitation, Faculty of Medicine, Université de Montréal, 2900 Boul, Edouard-Montpetit, Montreal, Quebec , H3T 1J4 Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Richard Preuss
- School of Physical and Occupational Therapy, McGill University, 3654 prom Sir-William-Osler, Montreal, Quebec, H3G 1Y5, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
| | - Sharon M Henry
- Department of Rehabilitation and Movement Science, The University of Vermont, 305 Rowell Building, Burlington, VT, United States.
| | - Christian Larivière
- Institut de recherche Robert-Sauvé en santé et en sécurité du travail (IRSST), 505 Boul, de Maisonneuve O. Montreal, Quebec, H3A 3C2, Canada; Center for Interdisciplinary Research in Rehabilitation of Greater Montreal (CRIR), Montreal Rehabilitation Institute, Montreal, Quebec, Canada.
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