Physiotherapy Practice and Research - Volume 44, issue 2

Authors: Kitaji, Yu | Sato, Haruhiko | Ishida, Shinnosuke | Harashima, Hiroaki | Miyano, Satoshi

Article Type: Research Article

Abstract: BACKGROUND: Clinical gait analysis of sagittal plane lower-limb kinematics using video images is a quantitative tool for clinicians. However, the reliability and validity of limb kinematics after stroke using video images has not been fully investigated. OBJECTIVE: This study aimed to examine the within-session inter-rater reliability and criterion-related validity of lower limb angles measured in sagittal plane images captured using a smartphone for assessing post-stroke gait and to determine which asymmetric parameters are associated with faster gait velocity. METHODS: Thirty-two patients with stroke were included; video images were recorded as they walked at their preferred pace …for 1–3 cycles. Lower limb angles (contact, push-off, and excursion angles) and degree of asymmetry were determined based on video images using markers of acromion, greater trochanter, and fifth metatarsal head. Measurement reliability was calculated using the two-way random effects model of intraclass correlation coefficients and minimal detectable change. The criterion validity investigated Pearson’s correlation between lower limb angles and their asymmetry and gait velocity. RESULTS: The lower value of the 95% confidence interval of intraclass correlation coefficients (2.3) of the lower limb was 0.891, and the maximum minimal detectable change was 9.6 degrees. Push-off angle showed a moderate-to-strong correlation with gait velocity, whereas the asymmetry of the push-off angle showed a weak correlation with gait velocity. CONCLUSIONS: Assessing post-stroke gait utilizing video images using a smartphone is feasible. The push-off angle, in particular, may provide insight into the clinical assessment of post-stroke gait. Show more

Keywords: Gait analysis, gait kinematics, stroke rehabilitation, video recording, reliability

DOI: 10.3233/PPR-230739

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 69-77, 2023

Authors: Takahashi, Aisuke | Kitsunai, Shun | Kawana, Hikaru | Furukawa, Katsuhiro

Article Type: Research Article

Abstract: BACKGROUND: Although proprioceptive impairment is observed in about half of patients with stroke and is a factor affecting functional recovery and length of hospital stay, there is a discrepancy in terms of its measurement methods between physiotherapy research and the clinical field. This study aimed to examine the concurrent validity and reliability of knee proprioception using an electrogoniometer and a mobile app in patients with stroke. METHODS: In this cross-sectional study, we conducted proprioception tests with an electrogoniometer (custom-made device; Unimec, Japan) and an app (Goniometer Pro; 5fuf5, Bloomfield, NJ) in 28 hospitalized patients with stroke, with an …average of 11.21 days (range 2–4 days) from the onset of stroke. Threshold to detect passive motion (TDPM), TDPM+muscle tendon vibration (MTV), and joint position sense (JPS) were used for proprioception tests. These tests were performed three times each in a random order, and the intraclass correlation coefficient, correlation, and absolute reliability for the electrogoniometer and the app were analyzed. RESULTS: Both TDPM and TDPM+MTV measured by the electrogoniometer and the app showed high correlation and “good” to “excellent” reliability regarding the variation in measured values, indicating that the two instruments are compatible, while JPS showed “poor” to “moderate” reliability and weak correlation for the electrogoniometer and the app. CONCLUSIONS: In conclusion, in patients with stroke, TDPM and TDPM+MTV measurements using the Goniometer Pro app can replace measurements with an electrogoniometer. Show more

Keywords: Proprioception, stroke, mobile application, reliability, validity

DOI: 10.3233/PPR-220702

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 79-87, 2023

Authors: Alashram, Anas Radi

Article Type: Research Article

Abstract: BACKGROUND: Motor impairments are common consequences in people with multiple sclerosis (PwMS). These impairments limit function independence and decrease activities of daily living. Focal muscle vibration (FMV) produces vibration signals affecting the central nervous system. No systematic review has been published investigating the effects of FMV on motor impairments in people with MS. OBJECTIVES: This review was conducted to investigate the effects of FMV in motor rehabilitation in PwMS. METHODS: PubMed, SCOPUS, REHABDATA, PEDro, CINAHL, EMBASE, MEDLINE, and Web of science were searched from their inception until May 2023. Studies were included if they were experimental …studies, used FMV in PwMS, and evaluated motor impairments. Studies were excluded if they used other forms of vibration application (e.g., whole-body vibration) or used pharmacological treatments as a primary intervention. We evaluate the risk of bias using the Physiotherapy Evidence Database (PEDro) scale. RESULTS: Five studies met our eligibility criteria. Three studies were randomized controlled trials, a clinical controlled trial (n  = 1), and a pilot study (n  = 1). A total of 123 participants were included in this review (Mean age = 47), 42.28% of whom were men. The PEDro scale scores ranged from three to eight. The findings revealed beneficial and non-beneficial effects of FMV on motor function in PwMS. CONCLUSIONS: The FMV application is safe and well-tolerated in PwMS. The evidence for the impacts of FMV on motor impairments in PwMS was limited. Additional studies with long-term follow-ups are encouraged. Show more

Keywords: Multiple sclerosis, vibration, motor, rehabilitation, gait, spasticity, balance

DOI: 10.3233/PPR-230771

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 89-98, 2023

Authors: Kamat, Kinjol | Kage, Vijay | Sequeira, Sherin

Article Type: Research Article

Abstract: BACKGROUND: Physical activity plays an important role in management and preventing complications of type 2 diabetes mellitus (DM). Effectiveness of Pilates on DM showed that there was improvement in glucose control. Presently, resistance training forms are becoming very popular for weight loss and DM. Calisthenics is a relatively new form of resistance exercise training that has been less studied in obese and diabetic individuals. STUDY PURPOSE: To evaluate and compare the effect of Calisthenics and Pilates training approaches on percentage body fat and glycemic control (HbA1C, Post Prandial Blood Glucose (PPBG)) in overweight individuals with type 2 Diabetes …mellitus (DM). METHODS: Thirty (n  = 30) over weight individuals with type 2 DM with HbA1C levels >6.5% were recruited for the study. The participants were randomly allocated to calisthenics (CG) and Pilates (PG) study groups who received respective exercise interventions for 12 weeks. The outcome measures were HbA1C, PPBG and percentage body fat assessed at pre and post intervention. RESULTS: Both CG and PG study groups showed statistically significant difference for glycemic control (HbA1C, PPBG) post 12 week intervention. However, significant improvement was noted in CG than PG in terms of HbA1c (p  = 0.03), PPBG (P  = 0.01) and body fat percentage (p  < 0.0001). CONCLUSION: Calisthenics exercise training was more effective than the Pilates training in achieving long term (HbA1c) and post meal (PPBS) glycemic control with significant reduction in body fat percentage in overweight individuals with type 2 DM. Show more

Keywords: Type 2 diabetes mellitus, glycemic control, post prandial blood, calisthenics, pilates

DOI: 10.3233/PPR-220688

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 99-108, 2023

Authors: Saravan Kumar, J. | Prakash, V. | Hariohm, K. | Naveen Kumar, I.

Article Type: Research Article

Abstract: BACKGROUND: The distortion of truth or “spin” has become a major concern in various fields as it can affect the accuracy of research dissemination. Recognizing the extent of this issue in physiotherapy research is essential for promoting good-quality research and raising awareness. OBJECTIVE: This study aimed to determine the prevalence of spin in randomized controlled trials (RCTs) published by Indian physiotherapists. METHODS: A Medline search was conducted to identify RCTs published by Indian physiotherapists from January 2000 to November 2018. We included studies with nonsignificant primary outcomes and reviewed them for spin in both abstracts and …full texts using the Boutron checklist. Three reviewers were involved in the process. RESULTS: Of the 44 RCTs with nonsignificant outcomes, 40 (90%) showed spin in their abstracts and 39 (88%) in their main text conclusions. CONCLUSIONS: Our findings reveal a significant prevalence of spin in nonsignificant RCTs published by physiotherapy researchers. Improving research knowledge, enhancing scientific writing skills, and providing mentorship may help reduce spin in result reporting. Show more

Keywords: Spin, misinterpretation, overinterpretation, interpretation bias, physiotherapy, randomized controlled trial

DOI: 10.3233/PPR-230747

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 109-115, 2023

Authors: McShane, Sarah | McCabe, Elaine | French, Helen | Hand, Eilis | Gilsenan, Deirdre | Hynes, Orlagh | Bisseru, Abishekar | Glynn, Aaron

Article Type: Research Article

Abstract: BACKGROUND: Hip fractures are a life changing injury for many; often patients sustaining a hip fracture do not regain their pre-injury function. Early rehabilitation improves patient outcomes (e.g. Mobility, independence & function). OBJECTIVES: The aim of this study was to investigate whether patients with hip fracture progressed differently depending on their surgery type, specifically whether arthroplasty or internal fixation (IF) was employed as part of the surgical management. METHODS: A prospective audit was completed on hip fracture patients presenting to our unit between October 2019 and October 2020 who received surgical intervention for their fracture. The …audit collected data on patient outcomes, specifically Timed Up and Go scores (TUG), Discharge destination and Cumulative Ambulatory Scores. The study group comprised 89 patients with femoral neck fractures (60 females, 29 males). The average age was 77 (range 50–96) years. Sixty-nine patients were managed with an arthroplasty, 20 patients were managed with IF. RESULTS: Results from this audit highlighted that at discharge, TUG scores had improved in both groups with the arthroplasty group completing their TUG in a mean of 46 seconds (median 39 seconds) and the IF group in a mean of 55.7 seconds (median 46 seconds). Eleven (55%) of the patients treated with IF were discharged home directly, while 26 (38%) of the patients treated with an arthroplasty were discharged home directly. Hip fracture patients treated with arthroplasty had lower functional ability on day one post-operatively based on the CAS. Patients treated with arthroplasty showed greater improvement in function and mobility at the time of discharge when compared to the IF group. A greater proportion of the IF group were discharged directly home (55% vs 38%) and able to receive any ongoing rehabilitation as an outpatient while a greater portion of the arthroplasty group required further inpatient rehabilitation (35% vs 48%). CONCLUSION: This audit indicated that irrespective of surgical intervention (Arthroplasty or IR) there is little difference in patient outcomes in the post-operative period. Show more

Keywords: Hip fracture, arthroplasty, internal fixation, physiotherapy, rehabilitation

DOI: 10.3233/PPR-220724

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 117-123, 2023

Authors: Hussein, Hisham M. | Alshdokhi, Maryam S. | Almuqati, Eman H. | Albjeedi, Amal M. | Aljbreen, Khayal N. | Albrak, Rawabi R. | Alshammari, Fahd M. | Ibrahim, Ahmed A.

Article Type: Review Article

Abstract: OBJECTIVES: Muscle energy technique (MET) is a voluntary contraction of a patient’s muscle in a predetermined direction, at varying levels of intensity. Its commonly used as a treatment option in musculoskeletal rehabilitation. This study aims to investigate the effectiveness of MET in the treatment of people with musculoskeletal injuries with particular emphasis on flexibility, range of motion (ROM), and function. METHODS: Scopus (via Science Direct), CINAHL via (EBSCO), Embase (via OvidSP), PubMed, and PEDro were searched using specified keywords to select randomized controlled trials that assessed the effect of MET on flexibility, ROM, or function in patients with …musculoskeletal disorders. Two authors extracted all related information from the included trials and presented them in an excel spreadsheet. Two other authors independently conducted the quality assessment. Meta-analysis was performed where homogeneity (similirty regarding population and outcomes) was sufficient and required data were available. RESULTS: A total of 42 studies were included. Yet, twelve joined the meta-analysis where six comparisons were conducted. Of them, four comparisons were composed of two trials, one comparison consisted of six, and another one was composed of four. No statistically significant differences were observed between MET and other comparators regarding function and ROM, especially in patients with low back or neck pain. MET was statistically significantly better than control or sham interventions on the flexibility of patients with sacroiliac joint (SIJ) problems. CONCLUSIONS: MET can produce better flexibility than placebo and control interventions in patients with SIJ problems. MET is not better than other interventions regarding function and ROM. Although the existence of multiple trials testing the effectiveness of MET, there is obvious heterogeneity. There is no sufficient evidence to reliably determine the clinical effect of MET in practice. Show more

Keywords: Muscle, range of motion, disability, flexibility, systematic review

DOI: 10.3233/PPR-230741

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 125-145, 2023

Authors: Carr, Emma | Spirtos, Michelle

Article Type: Research Article

Abstract: BACKGROUND: The trapeziometacarpal or first carpometacarpal (CMC) joint is the second most common joint affected in osteoarthritis (OA) of the hand. Surgical intervention may be required when conservative measures fail to alleviate symptoms. OBJECTIVE: To investigate operative and post-operative management of trapeziometacarpal osteoarthritis in Ireland. METHODS: An on-line Qualtrics survey was used to determine practice patterns of hand surgeons and therapists including surgical technique, patterns of referral to therapy, treatment protocol and perceived pain impact. RESULTS: Twenty surgeon’s responses were received. Trapeziectomy with Ligament Reconstruction and Tendon Interposition (LRTI) was the most common procedure …for all stages of arthritis for sedentary and manual patients. Sixty seven percent (n  = 18) stated they perform an additional procedure if stage IV arthritis is present. Eighty percent (n  = 16) stated they would perform an additional procedure for MCP joint hyperextension. There were 28 therapist responses. Almost all respondents indicated that patients are initially casted post-surgery with 88% (n  = 24) indicating they remain casted for 1-2 weeks. A rigid long thumb spica and neoprene splint are most commonly used. The commencement of exercises differed between respondents and surgical procedures. All participants stated that pain is an issue in the rehabilitation of these patients. CONCLUSIONS: There was consistency in the surgical procedure choice. The stage of arthritis and functional level of the patient was not found to be an important factor for choosing this procedure. There is some consensus for post-operative casting and splinting but more variability in terms of exercise prescription. Pain is a factor to consider post-operatively. Show more

Keywords: First carpometacarpal joint, trapeziometacarpal joint, thumb osteoarthritis, operative management, post-operative management

DOI: 10.3233/PPR-230746

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 147-156, 2023

Authors: Festersen, Michael Krag | Mose, Caroline Broberg | Kloosterman, Anne Michelle | Sivesgaard, Heidi | Ramskov, Daniel | Schmidt, Jannie Tygesen

Article Type: Research Article

Abstract: BACKGROUND: Running-related injuries (RRI) are common among recreational runners, but research exploring lived experiences of a RRI is limited. OBJECTIVE: This study aimed to explore the psychosocial aspects experienced by recreational runners hindered in usual running because of RRI. METHODS: Individual semi-structured interviews based on a qualitative phenomenological methodology explored injured recreational runners experiences, reactions, thoughts, and feelings. Systematic text condensation was used as the analysis method. RESULTS: Three main codes were identified: Reasons for running: ‘Calm for me is a feeling of my body just relaxing. It may sound a bit weird because …you run, but it is kind of a feeling of just being able to unplug ‘, Daily life during an injury - besides running: ‘When I couldn’t run at all, it was super annoying. Several months it was completely empty. It was like there was a hole. There seemed to be missing something because I usually ran ‘, Running while injured: ‘Do I feel pain? Or is it something else? And should I navigate regarding the length of the route and where I run, how fast I run, and with whom I run? ‘. CONCLUSION: The recreational runners experiences explored in this study support the importance of bio-psycho-social awareness when physiotherapists meet runners hindered in usual running because of RRI. Show more

Keywords: Physiotherapy, recreational runners, running-related injury, psychosocial consequences, phenomenology

DOI: 10.3233/PPR-220726

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 157-167, 2023

Authors: Miyachi, Ryo | Sano, Ayaka | Tanaka, Nana | Tamai, Misaki | Miyazaki, Junya

Article Type: Research Article

Abstract: BACKGROUND: The evaluation and treatment of patients with low back pain (LBP) often involve categorization based on movement direction. However, it is not certain whether the lumbar spine and hip motion angles are associated with movement direction in individuals with LBP. OBJECTIVE: The purpose of this study was to verify whether the motion angles of the lumbar spine and hip joint are associated with the movement direction in individuals with LBP. METHODS: Participants were recruited as volunteers at the authors’ institutions. In this cross-sectional observational study, participants were divided into two groups: those without LBP and …those with LBP. To measure lumbar spine and hip motion angles in clinical movement tests (trunk forward bending and prone hip extension), those with LBP were divided into a flexion LBP group and an extension LBP group. Wearable sensors were used to measure lumbar spine and hip motion angles. RESULTS: Participants with LBP had a greater hip motion angle in the early stages of movement than that of those without LBP; this was associated with the movement direction in which pain appeared. CONCLUSIONS: In individuals with LBP, the motion angles of the lumbar spine and hip joint are associated with the movement direction. Therefore, this pain subgroup and associated movement direction should be considered when evaluating and treating individuals with LBP. Show more

Keywords: Low back pain, motion angle, movement direction, lumbar spine, hip

DOI: 10.3233/PPR-230744

Citation: Physiotherapy Practice and Research, vol. 44, no. 2, pp. 169-175, 2023