Virtual walking integrated physiotherapy reduces pain and kinesiophobia, and improved function in patients with subacute and chronic non-specific low-back pain in short term.

ObjectiveThe objective of this study was to investigate the immediate effect of manual therapy (MT) on respiratory functions and inspiratory muscle strength in patients with COPD.Participants and methodsThirty patients with severe COPD (eight females and 22 males; mean age 62.4±6.8 years) referred to pulmonary physiotherapy were included in this study. The patients participated in a single session of MT to measure the short-term effects. The lung function was measured using a portable spirometer. An electronic pressure transducer was used to measure respiratory muscle strength. Heart rate, breathing frequency, and oxygen saturation were measured with a pulse oximeter. For fatigue and dyspnea perception, the modified Borg rating of perceived exertion scale was used. All measurements were taken before and immediately after the first MT session. The ease-of-breathing visual analog scale was used for rating patients’ symptoms subjectively during the MT session.ResultsThere was a significant improvement in the forced expiratory volume in the first second, forced vital capacity, and vital capacity values (P<0.05). The maximal inspiratory pressure and maximal expiratory pressure values increased significantly after MT, compared to the pre-MT session (P<0.05). There was a significant decrease in heart rate, respiratory rate (P<0.05), and dyspnea and fatigue perception (P<0.05).ConclusionA single MT session immediately improved pulmonary function, inspiratory muscle strength, and oxygen saturation and reduced dyspnea, fatigue, and heart and respiratory rates in patients with severe COPD. MT should be added to pulmonary rehabilitation treatment as a new alternative that is fast acting and motivating in patients with COPD.

Results: Seventy-three responses were received (100%). Singapore physiotherapist were similar to their peers in HK and WA in finding four of the six vignettes unacceptable. Similar to HK data, Singaporean physiotherapists were significantly (P < 0.01) less conservative than their WA peers. 84.7% of respondents thought it acceptable for a physiotherapist working for a sports team to date a player, while 49.3% thought it acceptable to date a work colleague to whom they had provided professional ergonomics advice. Only 5.5% reported feeling sexually attracted to a patient, and none (0%) had ever dated a patient who at the time was receiving physiotherapy or dated their ex-patients. Only 5.5% of respondents stated that they would advise a patient to make a complaint against their colleague to the appropriate authority or directly to the AHPC Singapore.Conclusion(s): Similarities and differences exist between Singapore, HK and WA physiotherapist with regard to professional sexual boundaries. Education on this topic is urged within the Singapore physiotherapy population.Implications: Education on the topic of professional sexual boundaries should be part of the continuing education and training for physiotherapist in Singapore. Members of AHPC need to remain familiar with the Code of Professional Conduct governing the way in which they operate, as it is essential that they practice in a manner consistent with the behaviours expected of them and their colleagues.

The implementation of physiotherapy and rehabilitation programs including postural stabilization exercises may improve strength and function and reduce pain in patients with PFPS.

Objectives:The psychosocial factors that may affect the prognosis of patients with low back pain are generally disregarded. The StarT Back Screening Tool can help clinicians to analyze prognostic indicators and the risk associated with outcome by examining physical and psychosocial factors. The aim of this study was to investigate the psychometric properties of the Turkish version of the StarT Back Screening Tool, including cross-cultural adaptation, internal consistency, test-retest reliability, and construct validity. Methods: In this study, 120 patients with non-specific low back pain were included. The Roland Morris Disability Questionnaire, Oswestry Disability Index, Beck Depression Inventory, Tampa Scale for Kinesiophobia, and the StarT Back Screening Tool were administered. One week after the initial testing, the same examiner repeated the tests. Results: The mean age of the patients who participated in the study was 35.54±12.45 years. Cronbach's alpha coefficients in the analysis of scale reliability were 0.747 for the overall scale and 0.738 for the psychosocial subscale. The test-retest reliability of StarT Back Screening Tool (intraclass correlation coefficient: 0.90-0.93) was found to be excellent. Pearson correlation coefficients for the correlations between the overall StarT Back Screening Tool and the other measures were very good (r=0.678; p<0.001) for the Roland Morris Disability Questionnaire, good (r=0.473; p<0.001) for the Tampa Scale for Kinesiophobia, good (r=0.541; p<0.001) for the Oswestry Disability Index, and moderate (r=0.336; p<0.001) for the Beck Depression Inventory. Conclusion: The Turkish version of the StarT Screening Tool for non-specific back pain was determined to be valid and reliable. A good assessment of both physical and psychosocial factors in symptomatic patients can help clinicians make a thorough prognosis.

No abstract

The benefits of inspiratory muscle training (IMT) in patients with COPD were reported. However, its effects are limited in severe COPD patients. Further researches are required in new and complementary modalities demonstrating IMT efficacy in severe COPD patients. This study aims to investigate effects of manual therapy (MT) additional over IMT on functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue, and quality of life in severe COPD patients. Sixty patients with COPD in GOLD stage III-IV were included in this prospective single-blind randomized trial. Patients were randomly assigned to receive either MT additional over IMT at 40% of maximal inspiratory pressure (MIP) (n = 30) or only IMT (n = 30) for 12 weeks. MT group received MT during 12 weeks for 30 min additional to IMT. Pulmonary function, respiratory muscle strength, functional capacity, dyspnea, fatigue, and quality of life were evaluated by spirometry, mouth pressure device, sixminute walk test, Modified Medical Research Council (mMRC) dyspnea scale, fatigue severity scale, and St. George's Respiratory Questionnaire (SGRQ), respectively. MT group had significantly greater improvement in FEV1%, FVC %, PEF%, respiratory muscle strength, function, dyspnea, fatigue, and quality of life compared with IMT group (p < 0.05). 6MWT (p < 0.001, effect size Cohen's d: 0.915), MIP (p < 0.001, effect size Cohen's d: 1.235), and mMRC score (p < 0.001, effect size Cohen's d: 0.982) were significantly improved in IMT with MT group. This study demonstrated that subjects in IMT with MT group had improved outcomes in functional capacity, respiratory muscle strength, pulmonary function, dyspnea, fatigue perception, and quality of life compared with alone IMT group.

Postural sway included eyes open without pillow, eyes open on pillow, eyes closed on pillow, risk of falling, function and postural stabilization included flexor endurance, extansor endurance are impared in patient with patellofemoral pain syndrome when compare to controls. In subjects with PFPS increased postural sway significantly associated with body mass index (r= 0.52), pain duration (r= 0.43), postural control (extansor endurance) (r= -0.50) and risk of falling (r= 0.62) on pillow with open eyes. In addition we found function significantly related with postural control (extansor endurance and flexor endurance) (r= -0.59 and r= -0.59) and risk of falling (r= 0.77)CONCLUSIONS: Decreased neuromuscular control of the trunk core and increased postural sway and falling risk were found in patients with PFPS. Patients may be evaluated for deficits in postural control and falling risk before treatment.