Fear of falling was the best indicator of falling. Receiving physical therapy after a stroke seems to highly contribute to improved functional independence of activities in daily living, and increased self-confidence and cognitive function.

BackgroundEvidence-based practice (EBP) enhances healthcare services and keeps providers current with best practices. EBP has been adopted and spread worldwide. However, people will not apply it if they do not know, understand, or believe it. Few studies have considered EBP application in Viet Nam. This study explores whether Vietnamese physical therapists’ attitude, knowledge, skills toward EBP and barriers to its use make them ready to implement its practice.MethodsA survey questionnaire was sent directly to physical therapists in governmental healthcare organizations in Ho Chi Minh City, Viet Nam, from July to October, 2017. It consisted of 41 closed- and open-ended questions related to knowledge, attitude, behaviors, frequency of use, and barriers of EBP and the demographic characteristics of participants. Descriptive statistics and significant correlations were determined from Chi-Square statistics or odds ratios between the variables.ResultsThe return rate was 93% (421 out of 453). Eliminated were 40 responses inconsistent with inclusion criteria. The 381 eligible participants were more female (62%) than male, about 53% had vocational degrees, less than 1% had M.S. degrees. Participants reported a positive attitude toward EBP. An incongruity existed between knowledge/ skills of EBP and the frequency of using its 5 steps. English competence was the most critical barrier to applying EBP. The significant associations between attitude and knowledge, and demographical attributes indicated that younger therapists with lower educational degrees had less knowledge of EBP and they rarely employed the application and analytical steps 4 and 5.ConclusionsThe incongruity between knowledge and use of EBP may result from the lack of EBP in academic education. The skills of reading professional articles in the English language and understanding and applying the steps of EBP should be emphasized in academic physical therapy programs. Additionally, policy makers should consider the number of patients a day per physical therapist which impacts EBP use and the quality of healthcare service.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1428-3) contains supplementary material, which is available to authorized users.

Background: Walking is the most common population-wide campaign for health promotion in older people. However, the cutoff threshold for walking steps/day to identify the older people who are at risk of falling is not recommended. Therefore, the objectives were to investigate the association between all possible risk factors including physical performance, physical activity and fall incidence over the six-month in community-dwelling older people who had low-risk of falling and to identify walking threshold (steps/day) for reducing risk of fall. Methods: The older people who aged ≥60 years and had free of falling for 1 year were invited to participate in this study. They lived in five communities in Bangkok Thailand. Demographics and physical performances were collected at baseline. Walking (step/day) and 24-h physical activity (PA) were monitored for 5 consecutive days by the Actical® accelerometer wrapped on non-dominant wrists. The Physical Activity Scale for the Elderly (PASE) questionnaire was used to record activities in the past 7 days by interview. A monthly calendar was used to record fall incidence over the 6 months. Unadjusted and adjusted hazard ratio (HR) with 95% confidence interval (CI) were analyzed using the Cox's proportional hazard regression. The Kaplan Meier curve illustrated the probability to survive from fall over the 6 months. Results: Of 255, 33 older people (12.94%) reported first-fall incidence over the 6 months. Fall incidence density rate was 0.79 per 1000 person-day. Our findings showed that significant association between fall incidence and behavioral risk factors including PASE scores < 100 (HR = 3.53; 95% CI: 1.24-10.04), walking < 5000 steps/day (HR = 3.6; 95% CI: 1.76-7.31) and moderate to vigorous intensity of PA at < 60 min/week (HR = 3.66; 95% CI: 1.12-12.01). Fall incidence were related to the following risk factors: age (HR = 3.54; 95% CI: 1.37-9.11), took polypharmacy/antipsychotics (HR = 4.32; 95% CI: 2.12-8.79), presence of urinary incontinence (HR = 2.87; 95% CI: 1.45-5.68), low functional mobility by Timed Up and Go ≥13.5 s (HR = 6.43; 95% CI: 2.65-15.57). Conclusions: This study proposed walking ≥5000 steps/day as a cutoff threshold to recommend for reducing risk of falling in community-dwelling older people who had low-risk of falling.

Abstract. [Purpose] This study investigated the effects of passive stretching (STR) and strain counter-strain (SCS) techniques in subjects with myofascial pain syndrome (MPS) as measured by a visual analogue scale (VAS), pressure pain threshold (PPT), displacement pain threshold (DPT), active range of motion (AROM), and patients perception of change (PPC).[Subjects] Twenty volunteers with active MPS in the upper trapezius muscle participated in the study.[Methods] The subjects were randomly allocated to either a STR or SCS treatment group. Evaluations were performed at before, immediately, one hour, and one day after treatment. [Results] No significant difference between groups were found. However, there was a significant improvement of VAS an hour after SCS treatment. The improvement seemed to be maintained after treatment. The STR group showed a significant decrease of DPT between immediately and a day after treatment, indicating less tissue compliance.[Conclusion] The SCS treatment helps relieve the pain one hour after treatment in subjects with active MPS.

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