Special Issue "Comprehensive Clinical Physiotherapy and Rehabilitation"

A special issue of Healthcare (ISSN 2227-9032). This special issue belongs to the section "Nursing".

Deadline for manuscript submissions: 25 March 2021.

Special Issue Editor

Dr. Tadashi Ito
Website
Guest Editor
Three-Dimensional Motion Analysis Room, Aichi Prefectural Mikawa Aoitori Medical and Rehabilitation Center for Developmental Disabilities, Okazaki 444-0002, Japan
Interests: physiotherapy treatment; physiotherapy exercise; physical function; motion analysis; gait analysis; biomechanics; geriatric rehabilitation; stroke rehabilitation; physiotherapy children; muscle training; motor control; prevention; health promotion; healthcare; proprioception; balance control; rehabilitation medicine; community health; rehabilitation engineering; low back pain; pain; pain rehabilitation

Special Issue Information

Dear Colleagues,

In order to improve a patient’s physical ability, effective physiotherapy treatment and an assessment of comprehensive physiotherapy appear to be important. Thus, proper understanding of clinical factors along with adequate physiotherapy has become a critical component of any comprehensive rehabilitation. In addition, the accurate assessment of physical function can lead to the early detection and prevention of disease. Therefore, it is critically important that physiotherapists constantly develop their knowledge and techniques. This Special Issue aims to serve as a global forum for the discussion of all aspects of motion analysis, physiotherapy, and rehabilitation studies including evaluation, treatment, and prevention.

Dr. Tadashi Ito
Guest Editor

Manuscript Submission Information

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Keywords

  • physiotherapy
  • rehabilitation
  • gait analysis
  • muscle training
  • motor control
  • physical medicine
  • comprehensive clinical medicine
  • prevention
  • healthcare
  • biomechanics
  • physical function
  • posture
  • falls
  • low back pain

Published Papers (20 papers)

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Open AccessArticle
Disparities in Service and Clinical Outcomes in State-Wide Advanced Practice Physiotherapist-Led Services
Healthcare 2021, 9(3), 278; https://doi.org/10.3390/healthcare9030278 - 03 Mar 2021
Abstract
Abstract: This study explored variations in the primary service and clinical outcomes of a state-wide advanced practice physiotherapist-led service embedded in public medical specialist orthopaedic and neurosurgical outpatient services across Queensland, Australia. An audit of the service database over a six-year period was [...] Read more.
Abstract: This study explored variations in the primary service and clinical outcomes of a state-wide advanced practice physiotherapist-led service embedded in public medical specialist orthopaedic and neurosurgical outpatient services across Queensland, Australia. An audit of the service database over a six-year period was taken from 18 service facilities. The primary service and clinical outcomes were described. Variations in these outcomes between facilities were explored with a regression analysis adjusting for known patient- and service-related characteristics. The findings showed substantial positive impacts of the advanced practice model across all facilities, with 69.4% of patients discharged without a need for medical specialist review (primary service outcome), consistent with 68.9% of patients reporting clinically important improvements in their condition (primary clinical outcome). However, 15 facilities significantly varied from the state average for the primary service outcome (despite only three facilities varying in the primary clinical outcome). While this disparity in the primary service outcomes appears to be influenced by potentially modifiable differences in the service-related processes between facilities, these process differences only explained part of the variation. This study described the subsequent development of a new, more comprehensive set of service evaluation metrics to better inform future service planning. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessArticle
Short-Term Effect of Kinesio Taping of Lower-Leg Proprioceptive Neuromuscular Facilitation Pattern on Gait Parameter and Dynamic Balance in Chronic Stroke with Foot Drop
Healthcare 2021, 9(3), 271; https://doi.org/10.3390/healthcare9030271 - 03 Mar 2021
Abstract
The aim of this study is to identify the effectiveness of proprioceptive neuromuscular facilitation (PNF) leg Kinesio taping on gait parameters and dynamic balance in chronic stroke patients with foot drop. A total 22 chronic stroke patients were randomly assigned to experimental (n [...] Read more.
The aim of this study is to identify the effectiveness of proprioceptive neuromuscular facilitation (PNF) leg Kinesio taping on gait parameters and dynamic balance in chronic stroke patients with foot drop. A total 22 chronic stroke patients were randomly assigned to experimental (n = 11) and control groups (n = 11). All subjects underwent conventional therapy and gait training for 50 min. The experimental group additionally received KT of tibialis anterior muscle (TA) and hamstring muscles according to the PNF pattern. The control group received KT of only TA. The primary outcome measures that the gait parameter are gait velocity, cadence, step length, and stride length. Dynamic balance was measured by the timed up-and-go test (TUG) time and activity-specific balance confidence scale (ABC) as the secondary outcomes. All of the measurements were performed baseline and 24 h after intervention. Our results showed that the experimental group showed significant improvements in gait velocity, cadence, step length, stride length and TUG, and ABC score compared with the control group. We conclude that the short term effect of application of lower-leg KT according to the PNF pattern increased the gait ability and dynamic balance of chronic stroke patients with foot drop. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Prolonged Running Using Bionic Footwear Influences Lower Limb Biomechanics
Healthcare 2021, 9(2), 236; https://doi.org/10.3390/healthcare9020236 - 23 Feb 2021
Viewed by 130
Abstract
The running biomechanics of unstable shoes have been well investigated, however, little is known about how traditional neutral shoes in combination with unstable design elements and scientifically (bionic) designed shoes influence prolonged running biomechanics. The purpose of this study was to investigate biomechanical [...] Read more.
The running biomechanics of unstable shoes have been well investigated, however, little is known about how traditional neutral shoes in combination with unstable design elements and scientifically (bionic) designed shoes influence prolonged running biomechanics. The purpose of this study was to investigate biomechanical changes for a typical 5 km run and how footwear technology may affect outcomes. Sixteen healthy male recreational heel strike runners participated in this study, and completed two prolonged running sessions (neutral shoe session and bionic shoe session), with 7 to 10 days interval between sessions. A two-way repeated-measures analysis of variance (ANOVA, shoe × time) was conducted to determine any differences in joint biomechanics. Main effects for shoe type were observed at the ankle, knee and hip joints during the stance phase. In particular, decreased range of motion (ROM) was observed using the bionic shoes for all three joints, and the joint moments also had significant changes except for the frontal plane of the hip. Main effects for time were also observed at the ankle, knee and hip joints. The ROM of the sagittal plane in the knee and hip decreased post-5 km running. The reduction of ankle dorsiflexion, hip flexion, hip adduction and hip internal rotation angles were observed post-5 km running, as well as the increase of ankle eversion and external rotation, knee adduction and internal rotation angles. The kinetics also exhibited significant differences between pre-5 km running and post-5 km running. The interaction effects only existed in the ROM of the hip sagittal plane, hip adduction angle and hip internal rotation angle. The results suggested that bionic shoes could be beneficial for strengthening muscle control, enhancing postural stability and proprioceptive ability. Footwear personalization could be a solution that benefits runners, reduces injury risk and improves running performance. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Postural Sway in Older Patients with Sagittal Imbalance and Young Adults during Local Vibratory Proprioceptive Stimulation
Healthcare 2021, 9(2), 210; https://doi.org/10.3390/healthcare9020210 - 15 Feb 2021
Viewed by 268
Abstract
This study aimed to assess differences in somatosensory control strategies between older patients with sagittal imbalance and young adults during postural tasks. The center of pressure displacement in 27 older patients with sagittal imbalance and 27 young adults was determined upon standing blindfolded [...] Read more.
This study aimed to assess differences in somatosensory control strategies between older patients with sagittal imbalance and young adults during postural tasks. The center of pressure displacement in 27 older patients with sagittal imbalance and 27 young adults was determined upon standing blindfolded on a balance board. Vibratory stimulation at 56 to 100 Hz was applied bilaterally to the gastrocnemius and soleus muscles (GS) and lumbar multifidus to evaluate the contributions of proprioceptive signals to postural control. Data of older patients and young adults were compared using the Mann–Whitney U-test or independent sample t-tests. Compared with the young adults, the older patients were significantly more reliant on the GS (p < 0.005) for their postural control and showed a higher relative proprioceptive weighting ratio (RPW) (p = 0.038). The postural strategy adopted by the older patients depended on the level of proprioceptive stimulation applied to the GS, and the postural control strategy of the ankle correlated with RPW. Overall, this study identifies RPW as a novel measure of postural strategy in older patients with sagittal imbalance and provides an understanding of strategies used to maintain balance, which may assist in developing preventative measures to reduce the risk of falls. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
The Effect of Virtual Reality Exercise Program on Sitting Balance Ability of Spinal Cord Injury Patients
Healthcare 2021, 9(2), 183; https://doi.org/10.3390/healthcare9020183 - 09 Feb 2021
Viewed by 292
Abstract
(1) Background: Virtual reality (VR) is a useful device for rehabilitation therapy. The purpose of this study was to examine the effect of virtual reality exercise program on sitting balance with spinal cord injury; (2) Methods: 20 subjects who selected on the basis [...] Read more.
(1) Background: Virtual reality (VR) is a useful device for rehabilitation therapy. The purpose of this study was to examine the effect of virtual reality exercise program on sitting balance with spinal cord injury; (2) Methods: 20 subjects who selected on the basis of the screening criteria were divided into the experimental group (n = 10) who underwent the virtual reality exercise program and rehabilitation therapy and the control group (n = 10) who underwent a regular sitting balance training program and a regular rehabilitation therapy. Each intervention consisted of a 30-min session a day, three times a week, for eight weeks. In order to measure functions of the sitting balance, FSA (force sensitive application) and LOS (limit of stability) were used before and after the treatment intervention; (3) Results: We found significant differences for the FSA, LOS between pre-test and post-test in the 2 groups; (4) Conclusions: The findings of this study suggest that virtual reality exercise program can be applied as a useful approach for spinal cord injury patients. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Validation of Clinical Characteristics and Effectiveness of Pulmonary Rehabilitation in a COPD Population with Discrepancy between Exercise Tolerance and FEV1
Healthcare 2021, 9(1), 53; https://doi.org/10.3390/healthcare9010053 - 06 Jan 2021
Viewed by 463
Abstract
This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking [...] Read more.
This study’s objective was to examine the characteristics of patients with chronic obstructive pulmonary disease (COPD) presenting with various exercise tolerance levels. A total of 235 patients with stable COPD were classified into 4 groups: (1) LoFlo + HiEx—patients with a six-minute walking distance (6MWD) ≥350 m and percentage of predicted forced expiratory volume in 1 s (%FEV1.0) <50%; (2) HiFlo + HiEx—patients with a 6MWD ≥350 m and a %FEV1.0 ≥50%; (3) LoFlo + LoEx—patients with a 6MWD < 350 m and %FEV1.0 < 50%; and (4) HiFlo + LoEx—patients with a 6MWD <350 m and %FEV1.0 ≥ 50%. Aspects of physical ability in the HiFlo + LoEx group were significantly lower than those in the HiFlo + HiEx group. The HiFlo + LoEx group was characterized by a history of hospitalization for respiratory illness within the past year, treatment with at-home oxygen therapy, and lacking daily exercise habits. Following three months of pulmonary rehabilitation, the LoFlo + HiEx group significantly improved in the modified Medical Research Council dyspnea score, maximum gait speed, and 6MWD, while the HiFlo + LoEx group significantly improved in the percentage of maximal expiratory pressure, maximum gait speed, 6MWD, incremental shuttle walking distance, and St. George’s Respiratory Questionnaire score. The HiFlo + LoEx group had the greatest effect of three-month pulmonary rehabilitation compared to other groups. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Severity, Progress, and Related Factors of Mood Disorders in Patients with Coronary Artery Disease: A Retrospective Study
Healthcare 2020, 8(4), 568; https://doi.org/10.3390/healthcare8040568 - 16 Dec 2020
Viewed by 431
Abstract
Patients with coronary artery disease (CAD) are more likely to experience depression and anxiety, which, in turn, are risk factors for CAD. The Beck depression inventory (BDI) and Beck anxiety inventory (BAI) were applied for mood evaluation during hospitalization and again 3 months [...] Read more.
Patients with coronary artery disease (CAD) are more likely to experience depression and anxiety, which, in turn, are risk factors for CAD. The Beck depression inventory (BDI) and Beck anxiety inventory (BAI) were applied for mood evaluation during hospitalization and again 3 months after discharge in 118 patients with CAD, and cardiopulmonary exercise tests were conducted in the outpatient department. Of the patients diagnosed with CAD, 40 (33.9%) had depressive moods, and 51 (43.2%) had anxious moods. A family history of CAD, low Korean activity scale index (KASI), and use of beta-blockers were independent factors causing depressive mood, while lower left ventricular ejection fraction (LVEF) and low KASI score were independent factors causing anxious mood. A considerable number of patients (35.7% with depressive mood and 25.0% with anxious mood) still had emotional problems after 3 months of discharge. The change values of BDI were associated with lower LVEF and longer hospital stay, while those of BAI was associated with a longer hospital stay. Since some patients had depressive and anxious moods after three months of discharge, evaluating and treating them are essential. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
The Effect of Spinal Manipulation on the Electrophysiological and Metabolic Properties of the Tibialis Anterior Muscle
Healthcare 2020, 8(4), 548; https://doi.org/10.3390/healthcare8040548 - 10 Dec 2020
Cited by 1 | Viewed by 793
Abstract
There is growing evidence showing that spinal manipulation increases muscle strength in healthy individuals as well as in people with some musculoskeletal and neurological disorders. However, the underlying mechanism by which spinal manipulation changes muscle strength is less clear. This study aimed to [...] Read more.
There is growing evidence showing that spinal manipulation increases muscle strength in healthy individuals as well as in people with some musculoskeletal and neurological disorders. However, the underlying mechanism by which spinal manipulation changes muscle strength is less clear. This study aimed to assess the effects of a single spinal manipulation session on the electrophysiological and metabolic properties of the tibialis anterior (TA) muscle. Maximum voluntary contractions (MVC) of the ankle dorsiflexors, high-density electromyography (HDsEMG), intramuscular EMG, and near-infrared spectroscopy (NIRS) were recorded from the TA muscle in 25 participants with low level recurring spinal dysfunction using a randomized controlled crossover design. The following outcomes: motor unit discharge rate (MUDR), strength (force at MVC), muscle conduction velocity (CV), relative changes in oxy- and deoxyhemoglobin were assessed pre and post a spinal manipulation intervention and passive movement control. Repeated measures ANOVA was used to assess within and between-group differences. Following the spinal manipulation intervention, there was a significant increase in MVC (p = 0.02; avg 18.87 ± 28.35%) and a significant increase in CV in both the isometric steady-state (10% of MVC) contractions (p < 0.01; avg 22.11 ± 11.69%) and during the isometric ramp (10% of MVC) contractions (p < 0.01; avg 4.52 ± 4.58%) compared to the control intervention. There were no other significant findings. The observed TA strength and CV increase, without changes in MUDR, suggests that the strength changes observed following spinal manipulation are, in part, due to increased recruitment of larger, higher threshold motor units. Further research needs to investigate the longer term and potential functional effects of spinal manipulation in various patients who may benefit from improved muscle function and greater motor unit recruitment. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Gender Medicine and Physiotherapy: A Need for Education. Findings from an Italian National Survey
Healthcare 2020, 8(4), 516; https://doi.org/10.3390/healthcare8040516 - 27 Nov 2020
Viewed by 549
Abstract
Background: Gender medicine permeates all sectors of medicine, from prevention to treatment and rehabilitation; it aims to customize the care path, ensuring equity in the access to health care system services. It is unclear to what extent physiotherapists’ treatment choices align with gender [...] Read more.
Background: Gender medicine permeates all sectors of medicine, from prevention to treatment and rehabilitation; it aims to customize the care path, ensuring equity in the access to health care system services. It is unclear to what extent physiotherapists’ treatment choices align with gender medicine principles. The aim of this survey is to detect the need of Italian physiotherapists to deepen knowledge in gender medicine. Materials and methods: An 18-item survey assessed the characteristics of responders about knowledge of gender medicine. An online survey was performed in 2020 using SurveyMonkey Software. Data were analyzed by statistical regression. Results: A total of 617 physiotherapists voluntarily participated in the study (53.84% of the target population). The majority of responders (68.4%) declared having general information about gender medicine, but 55.43% of them claimed to have heard of it but did not know properly what gender medicine was about; 92.38% of the physiotherapists believed that they needed training to acquire knowledge in gender medicine. Conclusions: Gender equity matters for health. Moderate knowledge of gender medicine’ principles and modest application of these findings were used in clinical practice of physiotherapy. Physiotherapists declared that they need training in gender medicine. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessFeature PaperArticle
Effects of Muscle Strengthening around the Hip on Pain, Physical Function, and Gait in Elderly Patients with Total Knee Arthroplasty: A Randomized Controlled Trial
Healthcare 2020, 8(4), 489; https://doi.org/10.3390/healthcare8040489 - 17 Nov 2020
Viewed by 470
Abstract
Background: Functional limitations may still remain even after a patient completes a traditional quadriceps-based rehabilitative program after total knee arthroplasty. Based on studies reporting that patients with knee osteoarthritis have muscle weakness around the hip joint after total knee arthroplasty, we investigated [...] Read more.
Background: Functional limitations may still remain even after a patient completes a traditional quadriceps-based rehabilitative program after total knee arthroplasty. Based on studies reporting that patients with knee osteoarthritis have muscle weakness around the hip joint after total knee arthroplasty, we investigated whether strengthening the hip muscles can reduce pain and improve the physical function and gait of patients who underwent total knee arthroplasty. Methods: Patients were randomly divided into three groups: hip, quadriceps, and control. The hip group (n = 19) completed an extensor, adductor, and external muscle strengthening exercise program. The quadriceps group (n = 20) completed a quadriceps strengthening exercise program. The control group (n = 16) completed an active range of motion exercises. Therapy was conducted thrice weekly for 12 weeks. Pain and function items from the Western Ontario and McMaster Universities Osteoarthritis Index, Alternate Step Test, Five Times Sit to Stand Test, and Single Leg Stance Test were performed to assess pain and physical function. In the gait analysis, stride, single-stance (%), double-stance (%), and gait speed were measured. Data were collected at baseline and at 4, 8, and 12 weeks after the intervention. Results: The hip group showed more significant improvements in pain and performance on the Alternate Step Test and Single Leg Stance Test than the quadriceps and control groups. In the gait analysis, the hip group showed the largest improvements in single stance and double stance. Conclusions: In conclusion, a 12-week hip muscle strengthening exercise program effectively improves the physical function and gait of patients who have undergone total knee arthroplasty. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
The Relationship between Technology Use and Physical Activity among Typically-Developing Children
Healthcare 2020, 8(4), 488; https://doi.org/10.3390/healthcare8040488 - 17 Nov 2020
Cited by 1 | Viewed by 487
Abstract
Objectives: This study aimed to investigate the relationship between technology use and physical activity level and to measure the association between sociodemographic characteristics of the participants, technology use, and physical activity level among Saudi children. Materials and Methods: This cross-sectional study was conducted [...] Read more.
Objectives: This study aimed to investigate the relationship between technology use and physical activity level and to measure the association between sociodemographic characteristics of the participants, technology use, and physical activity level among Saudi children. Materials and Methods: This cross-sectional study was conducted among 458 parents of typically-developing Saudi children (6–12 years). A translated validated questionnaire used for data collection consisted of three parts: Children’s Physical Activity Questionnaire (CPAQ), Questionnaire on the Impact of Technology on Children (used to investigate the impact of technology on children’s physical activity) and sociodemographic questions (e.g, children’s age and sex, age, educational level, marital status of parents and monthly income). Data were analyzed using Pearson correlation and Mann-Whitney U test to assess the relationship between technology use and physical activity level. A chi-squared test was used to assess the relationship between technology use and sociodemographic variables. Statistical significance was set at p < 0.05. Results: Mean age of the sampled children was (8.44 ± 2.07). Data analysis revealed that high use of technology was significantly associated with low level of activity. Pearson’s correlation analysis showed a negative relationship between a high level of activity and technology use (r = −0.138, p = 0.047). Ownership of a device was significantly associated with higher technology time consumption. Regression analysis revealed that age of the child, educational level of the parents, screen time use, and owning electrical devices significantly predicted the level of practicing physical activity among children of sampled parents (p < 0.05). Conclusions: practicing inadequate physical activity among children could be influenced by educational level of parents, screen time use, and owning electrical devices. Therefore, parental involvement is required to reduce time of exposure to technology screens among children. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessArticle
Standing Up from a Chair with an Asymmetrical Initial Foot Position Decreases Trunk and Masticatory Muscle Activities in Healthy Young Men
Healthcare 2020, 8(4), 480; https://doi.org/10.3390/healthcare8040480 - 12 Nov 2020
Viewed by 278
Abstract
This study aimed to identify the activation of lower extremity, trunk, and masticatory muscle and trunk kinematics of the initial foot position during the sit-to-stand (STS) movement. Sixteen young men participated in this cross-sectional pilot study and performed STS using both symmetrical and [...] Read more.
This study aimed to identify the activation of lower extremity, trunk, and masticatory muscle and trunk kinematics of the initial foot position during the sit-to-stand (STS) movement. Sixteen young men participated in this cross-sectional pilot study and performed STS using both symmetrical and asymmetrical foot positions. Activation of the tibialis anterior (TA), gastrocnemius lateral head (GA), rectus femoris (RF), biceps femoris (BF), rectus abdominis, erector spinae (ES), sternocleidomastoid (SCM), upper trapezius (UT), temporalis (TE), and masseter muscles in the dominant side was determined. For trunk kinematics, head and trunk velocities, front-back (For-Back) and mediolateral (Med-Lat) weight translation rates, and trunk inclination were measured. GA, TA, BF, and RF activation significantly increased, whereas ES, SCM, UT, and TE activation significantly decreased when using the asymmetrical foot position. Head velocity, For-Back, Med-Lat, and trunk inclination were also significantly decreased. In conclusion, the asymmetrical foot position increases muscle activation in the lower extremities and decreases trunk inclination. In addition, ES, UT, and TE muscle activity decreases at the initial asymmetrical foot position. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessArticle
Knowledge, Attitude, and Barriers to Telerehabilitation-Based Physical Therapy Practice in Saudi Arabia
Healthcare 2020, 8(4), 460; https://doi.org/10.3390/healthcare8040460 - 04 Nov 2020
Viewed by 820
Abstract
(1) Telerehabilitation (TR) is a part of telemedicine involved in providing rehabilitation services to people in remote locations. TR in physical therapy in the kingdom of Saudi Arabia is still in its infancy and its implementation may pose different challenges in the physical [...] Read more.
(1) Telerehabilitation (TR) is a part of telemedicine involved in providing rehabilitation services to people in remote locations. TR in physical therapy in the kingdom of Saudi Arabia is still in its infancy and its implementation may pose different challenges in the physical therapy settings. The purpose of this nation-wide survey is to explore physiotherapists (PTs) knowledge, attitudes, and barriers towards implementation of TR in physical therapy settings; (2) Methods: A 14 item questionnaire was developed and mailed to PTs working in hospitals and rehabilitation centers across 13 provinces in Saudi Arabia; (3) Results: 347 PTs responded. Results are as follows: 58.8% (n = 204) of PTs reported that they had sufficient knowledge about TR. About31.7% (n = 110) of PTs reported that their hospital and rehabilitation center had installed TR, yet only 19.9% (n = 69) utilized the TR facility. Image-based TR was more frequently used (n = 33) as compared to sensor-based TR (n = 29) and virtual reality TR (n = 10).The main barriers were technical issues and cost related to implement TR in physical therapy settings; and (4) Conclusions: There is a relatively high number of PTs with self-reported knowledge about TR, however facilities and usage were limited. The main barriers were technical issues, staff skills, and the high cost involved in the introduction of TR in the PT-based health care settings. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
The Importance of Optimal Gaze Direction on Deep Neck Flexor Activation in Chronic Neck Pain
Healthcare 2020, 8(4), 449; https://doi.org/10.3390/healthcare8040449 - 01 Nov 2020
Viewed by 433
Abstract
Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing [...] Read more.
Chronic neck pain (CNP) patients have weak deep neck flexors (DNF) and a hyperactive sternocleidomastoid (SCM). The cranio-cervical flexion test (CCFT) promotes activation of the DNF and decreases activity of the SCM, promoting pain recovery, but research suggests SCM activation increases with increasing gaze direction. We aimed to investigate how DNF and SCM activation varies according to gaze direction in the CCFT, and to prescribe the appropriate gaze direction for CNP. Twenty-eight CNP subjects had their maximum strength pressure level determined by CCFT for strength (20–~30 mmHg) and at each of the measured pressures, DNF and SCM thickness in each of four gaze directions (0°, 20°, 40°, and 60°) was measured by ultrasound imaging. The DNF to SCM ratio varied significantly according to gaze direction (p < 0.05), with gaze directions of 20° and 0° being significantly different from 40° (p < 0.05). Although there was no significant difference in DNF activation according to gaze direction, there was in SCM activation (p < 0.05), with SCM 60° significantly different from SCM 20° and SCM 40° (p < 0.05). In order to increase DNF activation efficiency during the CCFT, SCM activation should be controlled, and a gaze direction below 20° is the most efficient. This can inform DNF training of CNP patients in a clinical environment. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Effects of Virtual Reality-Based Rehabilitation on Upper Extremity Function among Children with Cerebral Palsy
Healthcare 2020, 8(4), 391; https://doi.org/10.3390/healthcare8040391 - 10 Oct 2020
Viewed by 732
Abstract
Background: Deterioration in upper extremity function has been a common problem among children with cerebral palsy (CP). The present study evaluated the effects of virtual reality (VR)-based rehabilitation combined with conventional occupational therapy (COT) on upper extremity function and caregiver assistance among children [...] Read more.
Background: Deterioration in upper extremity function has been a common problem among children with cerebral palsy (CP). The present study evaluated the effects of virtual reality (VR)-based rehabilitation combined with conventional occupational therapy (COT) on upper extremity function and caregiver assistance among children with CP. Methods: Medical records of 17 children with CP who regularly participated in a rehabilitation program at Samsung Changwon Hospital were retrospectively reviewed. Ten children received VR-based rehabilitation, which utilized RAPAEL Smart Kids and video games combined with COT. Seven children received COT alone, which was provided by a trained occupational therapist and focused on their upper extremities. Clinical outcomes were determined using the Quality of Upper Extremity Skills Test (QUEST) and Pediatric Evaluation of Disability Inventory (PEDI), which were administered before and 8 weeks after the first intervention session. Results: The smart glove (SG) group showed significant improvements in all QUEST domains and five PEDI domains (p < 0.05), whereas the COT group showed a significant change only in total QUEST scores. A comparison between both groups revealed that the SG group had significantly greater improvements in five QUEST domains and two PEDI domains (p < 0.05). Conclusions: Our results suggest that VR-based rehabilitation combined with COT may improve the upper extremity functions and decrease caregiver burden among children with CP. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Knowledge, Attitude and Implementation of Evidence-Based Practice among Physiotherapists Working in the Kingdom of Saudi Arabia: A Cross-Sectional Survey
Healthcare 2020, 8(3), 354; https://doi.org/10.3390/healthcare8030354 - 22 Sep 2020
Viewed by 677
Abstract
The current study aimed to investigate knowledge, attitudes, and implementation of evidence-based practice among physiotherapists working in Saudi Arabia. A sample of physiotherapists working in various outpatient settings in Saudi Arabia participated in this survey. Sixty-four therapists (30 females, 34 males) completed a [...] Read more.
The current study aimed to investigate knowledge, attitudes, and implementation of evidence-based practice among physiotherapists working in Saudi Arabia. A sample of physiotherapists working in various outpatient settings in Saudi Arabia participated in this survey. Sixty-four therapists (30 females, 34 males) completed a 28-item survey questionnaire. Approximately half of the participants indicated that evidence-based practice was useful and important for clinical practice. About 60% of the participants reported that they have adopted the evidence-based practice on a regular basis. Participants who had a membership in a physiotherapy organization and had advanced degrees showed more positive attitudes (t = −2.31, p = 0.02 and t = −2.15, p = 0.04, respectively) and greater levels of knowledge (t = −2.32, p = 0.02 and t = −3.86, p = 0.001, respectively) regarding evidence-based practice terminology. Furthermore, place of training (trained overseas) was associated with a positive attitude towards literature findings (t = 2.26, p = 0.03). The results of this study demonstrated that participants reported that evidence-based practice had not been extensively implemented, despite positive attitudes regarding its implementation among physiotherapists practicing in Saudi Arabia. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessArticle
Effects of Thoracic Mobilization and Extension Exercise on Thoracic Alignment and Shoulder Function in Patients with Subacromial Impingement Syndrome: A Randomized Controlled Pilot Study
Healthcare 2020, 8(3), 316; https://doi.org/10.3390/healthcare8030316 - 02 Sep 2020
Viewed by 1156
Abstract
Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned [...] Read more.
Introduction: Thoracic kyphosis commonly occurs in subacromial impingement syndrome. This pilot study investigated the effect of thoracic joint mobilization and extension exercise on improving thoracic alignment and shoulder function. Methods: In total, 30 patients with subacromial impingement syndrome were recruited and randomly assigned to three groups, the joint mobilization group (n = 10), exercise group (n = 10), and combination group (n = 10). After four weeks of treatment, the measured outcomes included thoracic kyphosis using a manual inclinometer; pectoralis major (PM) and upper trapezius (UT) muscle tone and stiffness using the MyotonPRO®; affected side passive range of motion (ROM) using the goniometer (flexion, abduction, medial rotation, and lateral rotation); and shoulder pain and disability index (SPADI). Results: All three groups had significant improvements in all variables (p < 0.05). Thoracic kyphosis; UT muscle tone; and flexion, medial rotation, and lateral rotation ROM and SPADI were all significantly improved in the combination group compared to the mobilization and exercise groups (p < 0.05). Conclusions: The combination therapy of thoracic mobilization and extension exercise can be regarded as a promising method to improve thoracic alignment and shoulder function in patients with subacromial impingement syndrome. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
Open AccessArticle
Correlation between Lung Function and Functional Movement in Healthy Adults
Healthcare 2020, 8(3), 276; https://doi.org/10.3390/healthcare8030276 - 16 Aug 2020
Viewed by 795
Abstract
It is difficult to determine whether lung function improves by simple abdominal strengthening exercises, and studies on the correlation of lung function and functional movement are insufficient. Therefore; we aimed to identify the correlation between lung function and functional movement. We recruited 204 [...] Read more.
It is difficult to determine whether lung function improves by simple abdominal strengthening exercises, and studies on the correlation of lung function and functional movement are insufficient. Therefore; we aimed to identify the correlation between lung function and functional movement. We recruited 204 healthy adults and measured their forced vital capacity; forced expiratory volume in 1 s, maximum voluntary ventilation, maximum expiratory pressure (MEP), and maximum inspiratory pressure (MIP). We also extracted data obtained during functional movements. Differences between lung function and functional movement by gender were determined using independent sample t-tests, while the relationship between lung function and functional movement variables were analyzed using Pearson′s correlation coefficient. Significant gender-based differences between lung function and functional movement, a negative correlation between MIP and inline lunge, and a significantly positive correlation between MIP and trunk stability push-up occurred in males. In females, a positive correlation occurred between MEP and hurdle step, MIP and deep squat, and MIP and hurdle step. Aspects of lung function (MEP and MIP) showed correlations with functional movements. The results showed that lung function and functional movement were correlated, confirming that there is a relationship between lung function and functional movement in healthy adults. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessArticle
Guidelines for the Evaluation of Cardiorespiratory Physiotherapy in Stroke Patients
Healthcare 2020, 8(3), 222; https://doi.org/10.3390/healthcare8030222 - 22 Jul 2020
Viewed by 877
Abstract
Evaluation of stroke patients is prioritized over therapeutic interventions to restore cardiorespiratory capacity. This study aimed to develop a clinically applicable guideline to evaluate cardiorespiratory physiotherapy in stroke patients based on a literature review and a modified Delphi survey. The literature search included [...] Read more.
Evaluation of stroke patients is prioritized over therapeutic interventions to restore cardiorespiratory capacity. This study aimed to develop a clinically applicable guideline to evaluate cardiorespiratory physiotherapy in stroke patients based on a literature review and a modified Delphi survey. The literature search included 13,498 articles in PubMed, EMBASE, CINAHL, and Cochrane Library electronic databases. We surveyed previous articles between January 2010 and June 2019. After the option elimination process, a total of 27 documents were selected and analyzed (draft: 18, modified Delphi survey: 9). The results of this research are roughly divided into two categories. First, 31 draft items were extracted, and a modified Delphi survey questionnaire was created from a literature review. Second, an expert was asked to make two modified Delphi surveys and to modify, delete, and supplement the entries in the statistical analysis at each level to finalize the steps to 20 items. The guidelines developed in this study reflect the selective use of cardiorespiratory physiotherapy evaluation methods in the clinical setting, based on the health status of individual patients. Moreover, the guidelines may help physiotherapists make informed decisions based on expert knowledge, thereby playing a crucial role in the patient-centered treatment planning process. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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Open AccessCase Report
The Otteroo: A Case Series Exploring Its Potential to Support Physical Therapy Intervention in Infants with or at Risk for Developmental Delay
Healthcare 2021, 9(2), 109; https://doi.org/10.3390/healthcare9020109 - 21 Jan 2021
Viewed by 375
Abstract
The objective of this case series was to examine the potential of the Otteroo as a tool to support physical therapy intervention in infants with or at risk for developmental disability. The Otteroo is a float with potential for use in aquatic therapy [...] Read more.
The objective of this case series was to examine the potential of the Otteroo as a tool to support physical therapy intervention in infants with or at risk for developmental disability. The Otteroo is a float with potential for use in aquatic therapy sessions or as part of a home exercise program. By tracking the amount of use and caregiver perception of the child’s response, we aimed to generate an understanding of the Otteroo’s potential as a family-based adjunct to physical therapy. Four children at risk of developmental delay participated in this study. The Otteroo was provided for four weeks, with recommendations for use. We used an activity log to track usage and collected survey data of caregiver perception of the child’s response. Activity logs showed that use ranged from 3–7 interactions and a total of 40–99.5 min (x¯ = 54.88, SD = 29.75). The survey responses varied as to whether caregivers perceived their children enjoyed the experience. Future research should focus on finding effective methods of encouraging Otteroo use if efficacy of an intervention is to be tested. This initial work provides a foundation for future efficacy research with the Otteroo in children with or at risk for developmental delay. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation)
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