BackgroundOsteoarthritis (OA) of the hip is a major cause of functional disability and reduced quality of life. Management options aim to reduce pain and improve or maintain physical functioning. Current evidence indicates that therapeutic exercise has a beneficial but short-term effect on pain and disability, with poor long-term benefit. The optimal content, duration and type of exercise are yet to be ascertained. There has been little scientific investigation into the effectiveness of manual therapy in hip OA. Only one randomized controlled trial (RCT) found greater improvements in patient-perceived improvement and physical function with manual therapy, compared to exercise therapy.Methods and designAn assessor-blind multicentre RCT will be undertaken to compare the effect of a combination of manual therapy and exercise therapy, exercise therapy only, and a waiting-list control on physical function in hip OA. One hundred and fifty people with a diagnosis of hip OA will be recruited and randomly allocated to one of 3 groups: exercise therapy, exercise therapy with manual therapy and a waiting-list control. Subjects in the intervention groups will attend physiotherapy for 6–8 sessions over 8 weeks. Those in the control group will remain on the waiting list until after this time and will then be re-randomised to one of the two intervention groups. Outcome measures will include physical function (WOMAC), pain severity (numerical rating scale), patient perceived change (7-point Likert scale), quality of life (SF-36), mood (hospital anxiety and depression scale), patient satisfaction, physical activity (IPAQ) and physical measures of range of motion, 50-foot walk and repeated sit-to stand tests.DiscussionThis RCT will compare the effectiveness of the addition of manual therapy to exercise therapy to exercise therapy only and a waiting-list control in hip OA. A high quality methodology will be used in keeping with CONSORT guidelines. The results will contribute to the evidence base regarding the clinical efficacy for physiotherapy interventions in hip OA.Trial RegistrationNumber: NCT00709566
Patients with RA attending for physiotherapy management present with varied profiles. This study provides valuable information on the characteristics of patients with RA attending for physiotherapy management which will contribute to physiotherapy service planning and delivery and will optimize patient care.
Background
Early Supported Discharge (ESD) allows patients to receive multidisciplinary stroke rehabilitation in their own home upon discharge from the acute hospital setting. ESD is recognised as international best practice for patients with mild to moderate impairments post stroke. An ESD team was set up in September 2020 from an acute hospital. A retrospective audit was carried out to profile the mobility of patients referred to the physiotherapy ESD service.
Methods
A retrospective chart audit was carried out on 42 patients referred to physiotherapy during the first six months of the ESD service. Data was collected on admission and discharge from hospital, for those patients being referred to ESD on the following: age, mobility, Berg Balance Scale score and length of stay.
Results
The mean age of the patient group was 70 (range 41 – 80 years). On discharge to ESD, 80 % of patients were independently mobile with or without an aid . Supervision or assistance of one person was required by 20% of patients. Thirty percent of patients were off their baseline mobility on discharge to the ESD service. The average Berg Balance Scale score was 51. The mean length of inpatient stay for ESD patients was 12 days compared to 33 days for those awaiting offsite rehabilitation.
Conclusion
This data demonstrates that the majority of patients admitted to ESD were independent with mobility. This patient cohort most likely required higher level physiotherapy interventions such as exercise tolerance progression, community integration and upper limb rehabilitation. Further research should evaluate the range of interventions provided within this ESD physiotherapy service.
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