Special Issue "Comprehensive Clinical Physiotherapy and Rehabilitation: Version II"

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

Deadline for manuscript submissions: closed (15 April 2022) | Viewed by 18551

Special Issue Editor

Dr. Tadashi Ito
E-Mail 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
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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

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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

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Published Papers (21 papers)

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Article
Direct Effect of Local Cryotherapy on Muscle Stimulation, Pain and Strength in Male Office Workers with Lateral Epicondylitis, Non-Randomized Clinical Trial Study
Healthcare 2022, 10(5), 879; https://doi.org/10.3390/healthcare10050879 - 10 May 2022
Viewed by 246
Abstract
Background: Local cryotherapy (LC) is one of the physiotherapeutic methods used in the conservative treatment of lateral epicondylitis (LE). The aim of the study was to verify the direct effect of a single LC procedure on the clinical symptoms of lateral epicondylitis enthesopathy [...] Read more.
Background: Local cryotherapy (LC) is one of the physiotherapeutic methods used in the conservative treatment of lateral epicondylitis (LE). The aim of the study was to verify the direct effect of a single LC procedure on the clinical symptoms of lateral epicondylitis enthesopathy (pain, pain free grip, PFG) and its effect on the bioelectrical properties of the wrist extensor muscles at rest, on maximal contraction and isometric contraction during fatigue. Methods: The study group was 28 men (35.4 ± 6.13 years) with confirmed unilateral epicondylitis. The performed procedures included the assessment of pain (visual analogue scale, VAS), PFG and ARMS (root-mean-square amplitude) and mean frequencies (MNF) of the sEMG signal before (T0) and after (T1) LC on the side with enthesopathy (ECRE) and without enthesopathy (ECRN/E). Results: There was an increase in the ARMS values of the signals recorded during rest and MVC from the ECR muscles both with and without enthesopathy (p = 0.0001, p = 0.006), an increased PFG after LC only on the side with LE (p < 0.0001) and decreased pain (p < 0.0001). During isometric fatigue contraction, a higher ARMS on both the ECRE side (p < 0.0001) and the ECRN/E side (p < 0.0001) was observed after LC treatment, and a lower MNF was observed on both the ECRN/E side (p < 0.0001) and the ECRE side (p < 0.0001) after LC. Conclusions: LC reduces the pain and increases PFG and muscle excitation expressed by ARMS and seems to delay muscle fatigue. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Effects of Adding Aquatic-to-Land-Based Physiotherapy Programs for Shoulder Joint Position Sense Rehabilitation
Healthcare 2022, 10(2), 332; https://doi.org/10.3390/healthcare10020332 - 09 Feb 2022
Viewed by 456
Abstract
There is limited evidence regarding the effects of aquatic-based physiotherapy on shoulder proprioception following post-traumatic injury to the joint. The main aim of this study was to investigate the effects of additional aquatic-based rehabilitation to a land-based physiotherapy program on shoulder joint position [...] Read more.
There is limited evidence regarding the effects of aquatic-based physiotherapy on shoulder proprioception following post-traumatic injury to the joint. The main aim of this study was to investigate the effects of additional aquatic-based rehabilitation to a land-based physiotherapy program on shoulder joint position sense (JPS) rehabilitation. Forty-four individuals (mean age 44.50 ± 10.11) who had suffered a post-traumatic shoulder injury less than five months previously were pseudo-randomly allocated equally into a control group (9 females, 13 males) and experimental group (6 females, 16 males). Both groups received individualized standard land-based physiotherapy on average for 50 min per session, with five sessions per week for four consecutive weeks. The experimental group received an additional 30 min of personalized aquatic-based therapy during each session. Shoulder JPS was assessed by flexion (60°), extension (25°), abduction (60°), internal rotation (35°) and external rotation (35°) positions prior, halfway through, and after the intervention. Shoulder JPS improved significantly for all positions for both the control group (p < 0.03) and the experimental group (p < 0.01). No significant differences between the control group and the experimental group were found for change in shoulder JPS over time. Our results indicate that shoulder JPS can be significantly improved among individuals with post-traumatic injury to the joint through four weeks of personalized physiotherapy. The addition of aquatic-based exercises to standard land-based therapy did not, however, show significant benefits, and thus cannot be recommended for the improvement of shoulder JPS based on our findings. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
Article
Clinical Experience of High Frequency and Low Frequency TENS in Treatment of Diabetic Neuropathic Pain in Russia
Healthcare 2022, 10(2), 250; https://doi.org/10.3390/healthcare10020250 - 28 Jan 2022
Viewed by 729
Abstract
Background: Transcutaneous electrical nerve stimulation (TENS) is presently one of the main methods of treatment for neuropathic pain in type II diabetes mellitus. The discussion about which TENS frequency is more effective in the treatment of neuropathic pain has been ongoing for many [...] Read more.
Background: Transcutaneous electrical nerve stimulation (TENS) is presently one of the main methods of treatment for neuropathic pain in type II diabetes mellitus. The discussion about which TENS frequency is more effective in the treatment of neuropathic pain has been ongoing for many years. Despite this, the response of different aspects of neuropathic pain to various TENS modalities has not been sufficiently studied. Aim: To analyze changes in characteristics of neuropathic pain depending on the frequency of TENS. Materials and methods: Seventy-five Russian diabetic patients with painful distal axonal neuropathy were enrolled in the study. Patients were assigned to three groups: in the HF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + high-frequency TENS (HF); in the LF TENS group, 25 patients received standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin) + low-frequency TENS (LF); in the control group, 25 patients underwent just standard drug therapy (Alpha-lipoic acid, Pentoxifylline, Vitamin B12, Gabapentin). Pain intensity was calculated before and after treatment with visual analogue scale (VAS), McGill pain questionnaire (MPQ), Douleur Neuropathique 4 Questions (DN4) and Pain Drawing. Results: TENS increased the therapeutic effect of standard drug therapy, in the treatment of neuropathic pain, by 65.9% and prolonged its efficacy by 31% for up to 6 months after treatment. HF TENS had a more pronounced analgesic effect than LF TENS based on VAS (34.7%), sensory (57.6%) MPQ dimensions and DN4 (21%). Affective MPQ dimension with the use of LF TENS was lower than HF TENS by 34.7% immediately after treatment, by 47.3% after 2 months and by 34.8% after 6 months of the follow-up period. Conclusion: There are significant differences between HF and LF TENS based on pain assessment using various pain scales. This reflects the distinctive effects of different TENS modalities on different aspects of neuropathic pain. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Physical Activity Related to Body Muscle Mass Index and Stiffness Index in 7-to-10-Year-Old Girls
Healthcare 2022, 10(2), 197; https://doi.org/10.3390/healthcare10020197 - 20 Jan 2022
Viewed by 375
Abstract
The relationship between moderate-to-vigorous physical activity (MVPA) performance time and body muscle mass and stiffness index in pre-puberty school-aged girls has not been fully elucidated. The effect of sexual maturity on bone mass is more pronounced in girls. This study aimed to clarify [...] Read more.
The relationship between moderate-to-vigorous physical activity (MVPA) performance time and body muscle mass and stiffness index in pre-puberty school-aged girls has not been fully elucidated. The effect of sexual maturity on bone mass is more pronounced in girls. This study aimed to clarify the relationship between MVPA performance time and the above-mentioned factors. This was a prospective, population-based cohort study of 111 girls aged 7–10 years. Data were collected via medical examination, clinical measurements, and questionnaires. Spearman’s ρ analysis was used to determine the association between skeletal muscle mass index (SMI) and stiffness index, muscle strength, and MVPA performance time. Participants who met the recommended MVPA level accounted for only 24.3% (n = 27) of all participating girls (n = 111). The following factors were significantly positively correlated with MVPA level at spearman’s ρ analysis: SMI (r = 0.303, p = 0.001), stiffness index (r = 0.229, p = 0.015), grip strength (r = 0.283, p = 0.003), back muscle strength (r = 0.197, p = 0.038), and standing long jump distance (r = 0.288, p = 0.002). Multiple regression analysis’s results revealed that SMI (β = 0.237; p = 0.024) was associated with MVPA performance time. These results can help school-aged girls to pay adequate attention to having healthy physical activity habits to prevent the decline of skeletal muscle mass, stiffness index, and body muscle strength. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
Article
Relationship between Eccentric-Exercise-Induced Loss in Muscle Function to Muscle Soreness and Tissue Hardness
Healthcare 2022, 10(1), 96; https://doi.org/10.3390/healthcare10010096 - 04 Jan 2022
Cited by 2 | Viewed by 383
Abstract
It is well-known that unusual exercise, especially eccentric contraction (ECC), could cause delayed-onset muscle soreness. However, the factors related to the loss of muscle strength and range of motion (ROM) caused by eccentrically damaged muscle, such as increases in muscle soreness, tissue hardness, [...] Read more.
It is well-known that unusual exercise, especially eccentric contraction (ECC), could cause delayed-onset muscle soreness. However, the factors related to the loss of muscle strength and range of motion (ROM) caused by eccentrically damaged muscle, such as increases in muscle soreness, tissue hardness, and pain threshold, have not been investigated in detail. Thus, this study was conducted to investigate the factors related to the loss of muscle strength and ROM caused by eccentrically damaged muscle in a large sample. Fifty-six sedentary healthy young male volunteers were instructed to perform 60 repetitions of ECC exercise. The outcome variables were measured before and 48 h after the ECC exercise. The results showed that a decrease in ROM was correlated to an increase in tissue hardness, whereas a decrease in muscle strength was correlated to an increase in muscle soreness. Our results suggested that tissue hardness must be controlled for ROM loss, and muscle soreness must be controlled for muscle-strength loss. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Factors Related to Locomotive Syndrome in School-Aged Children in Okazaki: A Cross-Sectional Study
Healthcare 2021, 9(11), 1595; https://doi.org/10.3390/healthcare9111595 - 20 Nov 2021
Viewed by 483
Abstract
The relationship of locomotive syndrome with other physical characteristics and lifestyle habits in children has not been fully elucidated. The aim of this study was to assess the prevalence of children’s locomotive syndrome, and to determine its relationship with the above-mentioned factors. This [...] Read more.
The relationship of locomotive syndrome with other physical characteristics and lifestyle habits in children has not been fully elucidated. The aim of this study was to assess the prevalence of children’s locomotive syndrome, and to determine its relationship with the above-mentioned factors. This was a cross-sectional study of 285 elementary school children who volunteered to participate in a medical checkup for physical function. Data was collected via medical examination, clinical measurements, and questionnaires. A multivariable logistic regression model was used to determine the relationship (odds ratios; ORs) of participants’ characteristics, physical functions, and other outcomes determined by questionnaire on locomotive syndrome. The following factors were related to locomotive syndrome: older age (OR = 1.421, 95% confidence interval [CI] [1.039, 1.945]), male sex (OR = 4.011, 95% CI [2.189, 7.347]), and more time spent watching television per day (OR = 1.281, 95% CI [1.001, 1.640]). These results may assist in the encouragement of children to perform appropriate physical activities and avoid unhealthy lifestyle habits, reducing the occurrence of locomotive syndrome. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Proprioceptive Neuromuscular Facilitation Kinesio Taping Improves Range of Motion of Ankle Dorsiflexion and Balance Ability in Chronic Stroke Patients
Healthcare 2021, 9(11), 1426; https://doi.org/10.3390/healthcare9111426 - 22 Oct 2021
Viewed by 804
Abstract
This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The [...] Read more.
This study aimed to determine the effect of a proprioceptive neuromuscular facilitation (PNF) pattern Kinesio taping (KT) application on the ankle dorsiflexion range of motion (DF-ROM) and balance ability in patients with chronic stroke. This crossover study included 18 patients with stroke. The subjects were randomly assigned to three interventions: barefoot, ankle KT (A-KT), and PNF-KT. The A-KT was applied to the gastrocnemius and tibialis anterior (TA) muscles, and subtalar eversion. The PNF-KT was applied on the extensor hallucis, extensor digitorum, and TA muscles. DR-ROM was measured using the iSen™, a wearable sensor. Balance ability was assessed based on static balance, measured by the Biodex Balance System (BBS), and dynamic balance, measured by the timed up and go (TUG) test and dynamic gait index (DGI). Compared with the barefoot and A-KT interventions, PNF-KT showed significant improvements in the ankle DF-ROM and BBS scores, TUG, and DGI. PNF-KT, for functional muscle synergy, improved the ankle DF-ROM and balance ability in patients with chronic stroke. Therefore, the application of PNF-KT may be a feasible therapeutic method for improving ankle movement and balance in patients with chronic stroke. Additional research is recommended to identify the long-term effects of the PNF-KT. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Self-Reported Walking Difficulty Associated with Stiff-Knee Gait in Japanese Patients with Knee Osteoarthritis: A Preliminary Cross-Sectional Study
Healthcare 2021, 9(10), 1308; https://doi.org/10.3390/healthcare9101308 - 30 Sep 2021
Viewed by 466
Abstract
Background: Individuals with knee osteoarthritis are restricted in their daily activity because of walking difficulty. The purpose of this investigation was to examine the association between self-reported walking difficulty and knee flexion excursion during gait in Japanese patients with knee osteoarthritis. Methods: Twenty-eight [...] Read more.
Background: Individuals with knee osteoarthritis are restricted in their daily activity because of walking difficulty. The purpose of this investigation was to examine the association between self-reported walking difficulty and knee flexion excursion during gait in Japanese patients with knee osteoarthritis. Methods: Twenty-eight patients with knee osteoarthritis participated in this study. Knee flexion excursions in loading response and swing during gait were measured through an inertial measurement unit-based motion capture system. The walking difficulty was assessed by a subitem in the Japanese Knee Osteoarthritis Measure. Pain intensity was assessed by a visual analog scale. Characteristics and gait variables were compared between groups that were determined a priori using the results of the walking difficulty assessment. The relationship between knee flexion excursion during gait and walking difficulty were analyzed using logistic regression. Results: The participants with walking difficulty had significantly small knee flexion excursion in both loading response and swing with large pain. After controlling the effect of pain, only knee flexion excursion in the swing was significantly related to the walking difficulty. Conclusions: This study suggested that the knee flexion excursion in swing during gait is helpful for understanding the walking difficulty experienced in Japanese patients with knee osteoarthritis. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Psychosocial Factors Related to Stroke Patients’ Rehabilitation Motivation: A Scoping Review and Meta-Analysis Focused on South Korea
Healthcare 2021, 9(9), 1211; https://doi.org/10.3390/healthcare9091211 - 14 Sep 2021
Cited by 1 | Viewed by 966
Abstract
The incidence of strokes in individuals in their 30–40 s—who have responsibilities towards their families—has increased. Additionally, many stroke patients suffer from post-stroke disabilities and require rehabilitation. However, especially in younger stroke patients, factors such as financial burden and the inability to be [...] Read more.
The incidence of strokes in individuals in their 30–40 s—who have responsibilities towards their families—has increased. Additionally, many stroke patients suffer from post-stroke disabilities and require rehabilitation. However, especially in younger stroke patients, factors such as financial burden and the inability to be productive lead to depression and thereby, the lack of rehabilitation motivation—which affects their therapeutic outcomes. Therefore, medical interventions alone are not sufficient. This study aimed to identify the psychosocial factors that affect stroke patients’ rehabilitation motivation. Hence, a scoping review was conducted to analyze the research trends across South Korean academic papers and theses, followed by a comprehensive meta-analysis to identify the correlations among the variables. Eighteen factors related to rehabilitation motivation were identified. The internal factors were depression, cognition, self-efficacy, self-esteem, disability acceptance, volition, communication, resilience, empowerment, and uncertainty. The external factors included sleep pattern, quality of life, activities of daily living, physical function, social support, financial burden, disease-related characteristics, and rehabilitation environment. Based on these findings, an intervention model should be developed to provide social support to stroke patients. Moreover, psychological interventions should be developed to enhance the self-efficacy of stroke patients who are undergoing rehabilitation. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Placement Recommendations for Single Kinect-Based Motion Capture System in Unilateral Dynamic Motion Analysis
Healthcare 2021, 9(8), 1076; https://doi.org/10.3390/healthcare9081076 - 21 Aug 2021
Cited by 1 | Viewed by 745
Abstract
Low-cost, portable, and easy-to-use Kinect-based systems achieved great popularity in out-of-the-lab motion analysis. The placement of a Kinect sensor significantly influences the accuracy in measuring kinematic parameters for dynamics tasks. We conducted an experiment to investigate the impact of sensor placement on the [...] Read more.
Low-cost, portable, and easy-to-use Kinect-based systems achieved great popularity in out-of-the-lab motion analysis. The placement of a Kinect sensor significantly influences the accuracy in measuring kinematic parameters for dynamics tasks. We conducted an experiment to investigate the impact of sensor placement on the accuracy of upper limb kinematics during a typical upper limb functional task, the drinking task. Using a 3D motion capture system as the golden standard, we tested twenty-one Kinect positions with three different distances and seven orientations. Upper limb joint angles, including shoulder flexion/extension, shoulder adduction/abduction, shoulder internal/external rotation, and elbow flexion/extension angles, are calculated via our developed Kinect kinematic model and the UWA kinematic model for both the Kinect-based system and the 3D motion capture system. We extracted the angles at the point of the target achieved (PTA). The mean-absolute-error (MEA) with the standard represents the Kinect-based system’s performance. We conducted a two-way repeated measure ANOVA to explore the impacts of distance and orientation on the MEAs for all upper limb angles. There is a significant main effect for orientation. The main effects for distance and the interaction effects do not reach statistical significance. The post hoc test using LSD test for orientation shows that the effect of orientation is joint-dependent and plane-dependent. For a complex task (e.g., drinking), which involves body occlusions, placing a Kinect sensor right in front of a subject is not a good choice. We suggest that place a Kinect sensor at the contralateral side of a subject with the orientation around 30 to 45 for upper limb functional tasks. For all kinds of dynamic tasks, we put forward the following recommendations for the placement of a Kinect sensor. First, set an optimal sensor position for capture, making sure that all investigated joints are visible during the whole task. Second, sensor placement should avoid body occlusion at the maximum extension. Third, if an optimal location cannot be achieved in an out-of-the-lab environment, researchers could put the Kinect sensor at an optimal orientation by trading off the factor of distance. Last, for those need to assess functions of both limbs, the users can relocate the sensor and re-evaluate the functions of the other side once they finish evaluating functions of one side of a subject. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Kinematic Comparison on Lower Limb Kicking Action of Fetuses in Different Gestational Weeks: A Pilot Study
Healthcare 2021, 9(8), 1057; https://doi.org/10.3390/healthcare9081057 - 18 Aug 2021
Cited by 2 | Viewed by 548
Abstract
The fetal movements during different gestational weeks are essential for normal musculoskeletal development. The kinematic characteristics of fetuses with small differences in gestational weeks may be different and important. Ultrasonographic videos of fetal kicking action and plantarflexion action were collected from three healthy [...] Read more.
The fetal movements during different gestational weeks are essential for normal musculoskeletal development. The kinematic characteristics of fetuses with small differences in gestational weeks may be different and important. Ultrasonographic videos of fetal kicking action and plantarflexion action were collected from three healthy pregnant women (24, 27, and 30 gestational weeks) with normal fetal development. The kinematic characteristics, including angular range and angular velocity, were analyzed. These kinematic parameters were measured using simi motion. The final knee angle was found to decrease with progressive gestational weeks. Compared with 24 w, the knee joint angle at 27 w and 30 w was significantly reduced at the end of a kick-type movement (p < 0.01). Except for the mean angular velocity of the knee joint, there were no significant differences in the other conditions. The value at 30 w for mean angular velocity was significantly higher than that at 24 w (p = 0.02). In the ankle joint, no significant differences were observed between different conditions. Therefore, we can conclude that there was no significant difference in the kinematic characteristics of the ankle joint for small gestational age gaps, but there was a significant difference in the knee joint. As the gestation weeks increase, the range of kicking motion tends to decrease. The reason may be that with the increase of gestational weeks, fetal lower limb musculoskeletal development is gradually enhanced; the slower growth rate indicates that development reaches a peak level in weeks 24 to 30. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
The Effect of Simulated Leg-Length Discrepancy on the Dynamic Parameters of the Feet during Gait—Cross-Sectional Research
Healthcare 2021, 9(8), 932; https://doi.org/10.3390/healthcare9080932 - 24 Jul 2021
Cited by 4 | Viewed by 1121
Abstract
Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is [...] Read more.
Background: The effect of Leg-Length Discrepancy (LLD) on dynamic gait parameters has been extensively discussed. Podobarography is the study of foot-to-ground pressure distribution. It has been used to test plantar footprint deviations that could reveal pathology. Purpose: The aim of this study is to determine the effects of simulated LLD on dynamic gait parameters measured with a pressure platform in healthy subjects. Methods: Thirty-seven healthy subjects participated in observational cross-sectional research. A procedure was performed to capture the dynamic parameters of each participant under five different simulated LLD conditions. Support time, mean pressure, and peak pressure measures were registered on three trials for each foot and LLD level per session. An analysis of variance (ANOVA) test for repeated measures was performed to check for differences between the different simulated LLD levels. Results: The stance time of the short leg had no significant changes. The stance time of the long leg increased by 3.51% (p < 0.001), mean pressure of the short leg increased by 1.23% (p = 0.005), and decreased by 5.89% in the long leg (p < 0.001). Peak pressure of the short leg decreased by 2.58% (p = 0.031) and the long leg decreased by 12.11% (p < 0.001). Conclusions: This study demonstrates that increasing LLD causes an asymmetrical foot-loading pattern, with decreased mean and peak pressure on the longer limb, and consequently an overload on the short side. Furthermore, an increasing LLD causes increased stance time on the long leg. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Back Pain Prevalence, Intensity, and Associated Risk Factors among Female Teachers in Slovakia during the COVID-19 Pandemic: A Cross-Sectional Study
Healthcare 2021, 9(7), 860; https://doi.org/10.3390/healthcare9070860 - 07 Jul 2021
Cited by 3 | Viewed by 1424
Abstract
Significant back pain prevalence and intensity are reported in female pedagogues. Due to the COVID-19 pandemic, they have been exposed to remote working conditions, higher psychological demands, and stress. Our objective was to evaluate the back pain prevalence, intensity, and related risk factors [...] Read more.
Significant back pain prevalence and intensity are reported in female pedagogues. Due to the COVID-19 pandemic, they have been exposed to remote working conditions, higher psychological demands, and stress. Our objective was to evaluate the back pain prevalence, intensity, and related risk factors in female teachers from Slovak regions in the context of remote learning during the COVID-19 pandemic. An electronic questionnaire was applied for data collection. A total of 782 adult female teachers (age 43.11 ± 0.36, BMI 34.94 ± 5.94) from primary, secondary, and tertiary schools from Slovak regions were included in the survey. Of these, 74% reported cervical pain, 67% lower back pain, and 60% pain in more than one vertebral region. The highest pain intensities were reported in the following cohorts (pain scale 1–5, 1 = no pain, and 5 = extreme pain): pedagogues from the Presov region (3.74), those working in the special education sector (3.83), those who gave five online classes a week (3.58), those who performed no physical activity (PA, 3.86), pedagogues who did not work in compliance with ergonomic recommendations (3.59), those with moderate or severe stress (3.66), and those who were sitting all or most of the time (3.62). The main risk factors identified were: no PA performed, no compliance with ergonomic recommendations, and stress. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
Article
Understanding Contextual Factors Effects and Their Implications for Italian Physiotherapists: Findings from a National Cross-Sectional Study
Healthcare 2021, 9(6), 689; https://doi.org/10.3390/healthcare9060689 - 07 Jun 2021
Cited by 1 | Viewed by 677
Abstract
An online cross-sectional survey was conducted using Google Docs software. The aim was to understand the management of contextual factors and to identify which are most relevant and which clinicians underestimate. A total of 1250 physiotherapists were chosen from the database of the [...] Read more.
An online cross-sectional survey was conducted using Google Docs software. The aim was to understand the management of contextual factors and to identify which are most relevant and which clinicians underestimate. A total of 1250 physiotherapists were chosen from the database of the Manual Therapists group mailing list (GTM-IFOMPT MO) from July to August 2020. A total of 699 responses were received that were considered valid (56%). Participants (40.83%) identified contextual factors (CFs) as “any element, even involuntary, with which the patient interacts during treatment”. Physiotherapists individually chose the representation of CF with the “therapeutic relationship” (82.9%), followed by “therapeutic setting” (75.8%). This choice differed between participants belonging to different age groups. Participants favor communication strategies (76.93%). More than half (57.88%) pay attention to patient involvement during the course of care; and in response to the patients’ doubts about the use of treatments with limited scientific efficacy, they suggest different medical treatments. The patient’s previous clinical experience is not considered significant and does not influence the choice of treatment. Subsequently, however, the participants reported that they stimulate the patients’ positive expectations of the success of the clinical outcome (45.27%). Knowledge of contextual factors in physiotherapy appears limited and very heterogeneous. Future research could increase the focus on professional development. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Surveying Therapists on Seating Approaches for Patients with Muscular Dystrophy in Japan
Healthcare 2021, 9(6), 631; https://doi.org/10.3390/healthcare9060631 - 25 May 2021
Viewed by 1239
Abstract
Patients with muscular dystrophy (MD) need fitted wheelchairs. This study aimed to ascertain physiotherapists and occupational therapists’ opinions about the current wheelchair seating process for patients with MD in Japan. We identified 266 academic papers published between August 2014 and July 2019 with [...] Read more.
Patients with muscular dystrophy (MD) need fitted wheelchairs. This study aimed to ascertain physiotherapists and occupational therapists’ opinions about the current wheelchair seating process for patients with MD in Japan. We identified 266 academic papers published between August 2014 and July 2019 with the keywords “muscular dystrophy” and either “physiotherapy” or “occupational therapy.” We then sent survey requests to 140 physiotherapists and occupational therapists (who were among the authors of the aforementioned papers), of whom 41 agreed to partake in this study. We found that the time required for each seating was 30–60 min for three types of MD, and the most commonly reported time to trial fitting was 1–3 months. In addition, health insurance reimbursements for seating were considered part of disease-specific rehabilitation in most cases, and most therapists were more or less satisfied with the current seating procedure. Physiotherapists had the highest degree of reflection of their views (wishes) regarding seating, followed by MDs and their families. In Japan, seating has been regarded as a medical practice since 2017. In the future, we would like to investigate the seating concept for individual therapists in detail. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
Article
Therapeutic Efficacy of Transcutaneous Electrical Nerve Stimulation Acupoints on Motor and Neural Recovery of the Affected Upper Extremity in Chronic Stroke: A Sham-Controlled Randomized Clinical Trial
Healthcare 2021, 9(5), 614; https://doi.org/10.3390/healthcare9050614 - 20 May 2021
Viewed by 900
Abstract
Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function [...] Read more.
Inability to use the affected upper extremity (UE) in daily activities is a common complaint in stroke patients. The somatosensory system (central and peripheral) is essential for brain reorganization and plasticity. Neuromuscular electrical stimulation is considered an effective modality for improving UE function in stroke patients. The aim of the current study was to determine the therapeutic effects of transcutaneous electrical nerve stimulation (TENS) acupoints on cortical activity and the motor function of the affected UE in chronic stroke patients. Forty male and female patients diagnosed with stroke agreed to join the study. They were randomly assigned to group 1 (G1) and group 2 (G2). G1 received task-specific training (TST) and sham electrical stimulation while G2 received TST in addition to TENS acupoints. Session duration was 80 min. Both groups received 18 sessions for 6 successive weeks, 3 sessions per week. Evaluation was carried out before and after completion of the treatment program. Outcome measures used were the Fugl-Meyer Assessment of the upper extremity (FMA-UE) and the box and block test (BBT) as measures of the motor function of the affected UE. Brain activity of the motor area (C3) in the ipsilesional hemisphere was measured using a quantitative electroencephalogram (QEEG). The measured parameter was peak frequency. It was noted that the motor function of the affected UE improved significantly post-treatment in both groups, while no significant change was reported in the FMA-UE and BBT scores post-treatment in either G1 or G2. On the other hand, the activity of the motor area C3 improved significantly in G2 only, post-treatment, while G1 showed no significant improvement. There was also significant improvement in the activity of the motor area (C3) in G2 compared to G1 post-treatment. The results of the current study indicate that TST only or combined with TENS acupoints can be considered an effective method for improving motor function of the affected UE in chronic stroke patients, both being equally effective. However, TST combined with TENS acupoints proved better in improving brain plasticity in chronic stroke patients. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Effects of Self RehAbilitation Video Exercises (SAVE) on Functional Restorations in Patients with Subacute Stroke
Healthcare 2021, 9(5), 565; https://doi.org/10.3390/healthcare9050565 - 11 May 2021
Viewed by 779
Abstract
Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve [...] Read more.
Background: Additional exercise therapy has been shown to positively affect acute stroke rehabilitation, which requires an effective method to deliver increased exercise. In this study, we designed a 4-week caregiver-supervised self-exercise program with videos, named “Self rehAbilitation Video Exercises (SAVE)”, to improve the functional outcomes and facilitate early recovery by increasing the continuity of rehabilitation therapy after acute stroke. Methods: This study is a non-randomized trial. Eighty-eight patients were included in an intervention group (SAVE group), who received conventional rehabilitation therapies and an additional self-rehabilitation session by watching bedside exercise videos and continued their own exercises in their rooms for 60 min every day for 4 weeks. Ninety-six patients were included in a control group, who received only conventional rehabilitation therapies. After 4 weeks of hospitalization, both groups assessed several outcome measurements, including the Berg Balance Scale (BBS), Modified Barthel Index (MBI), physical component summary (PCS) and the mental component summary of the Short-Form Survey 36 (SF-36), Mini-Mental State Examination, and Beck Depression Inventory. Results: Differences in BBS, MBI, and PCS components in SF-36 were more statistically significant in the SAVE group than that in the control group (p < 0.05). Patients in the SAVE group showed more significant improvement in BBS, MBI, and PCS components in SF-36 as compared to that in the control group. Conclusions: This evidence-based SAVE intervention can optimize patient recovery after a subacute stroke while keeping the available resources in mind. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Article
Association between Trunk Muscle Strength and Fall Risk in Older Men and Women with Lumbar Spondylosis
Healthcare 2021, 9(5), 521; https://doi.org/10.3390/healthcare9050521 - 29 Apr 2021
Viewed by 1573
Abstract
Various factors significantly affect the risk of falls among older adults with lumbar spondylosis. However, the relationship between falls and trunk muscle strength in older men is poorly explored. Thus, we aimed to investigate the relationship between back muscle strength and fall risk [...] Read more.
Various factors significantly affect the risk of falls among older adults with lumbar spondylosis. However, the relationship between falls and trunk muscle strength in older men is poorly explored. Thus, we aimed to investigate the relationship between back muscle strength and fall risk in older men and women with lumbar spondylosis. Based on self-reported fall scores, 39 outpatients were classified into two groups. Back and abdominal muscle strength, among other data, were compared between the two groups. Spearman’s rank correlation analysis was used to assess the relationship between fall scores and selected variables. Back (r = −0.491, p = 0.002) and abdominal muscle strength (r = −0.415, p = 0.009) were related to the fall score. Furthermore, back and abdominal muscle strength were related to the fall score in women with a high risk of falls, whereas back muscle strength, erector spinae, and lumbar multifidus cross-sectional areas, and visual analog scale were related to the fall score in men with a high risk of falling. Back muscle strength and fall scores may be useful to assess the risk of falls in older patients with lumbar spondylosis. However, evaluating this relationship may require separate sex-specific analyses. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
Article
Anxiety, Difficulties, and Coping of Infertile Women
Healthcare 2021, 9(4), 466; https://doi.org/10.3390/healthcare9040466 - 15 Apr 2021
Cited by 3 | Viewed by 912
Abstract
The present study aims to highlight how women perceive and adapt to infertility difficulties. To better understand the difficulties that women diagnosed with infertility are experiencing, the study explores this concept in correlation with anxiety and coping. 240 women with fertility problems from [...] Read more.
The present study aims to highlight how women perceive and adapt to infertility difficulties. To better understand the difficulties that women diagnosed with infertility are experiencing, the study explores this concept in correlation with anxiety and coping. 240 women with fertility problems from various parts of Romania completed the State-Trait Anxiety Inventory (STAI-Form Y), Brief COPE and the scale “Difficulties With Infertility and Its Treatment.” Statistical analyzes showed that women who were at the beginning of treatment obtained higher scores on the anxiety [F(2,237) = 4.76, p = 0.009] and on the difficulties scale [F(2,237) = 3.53, p = 0.031], compared to participants who resorted to repeated fertilization procedures. It is important to emphasize that there is a significant positive correlation between the perception of infertility difficulties and coping, and also between difficulties and state anxiety. Regarding the relationship between state anxiety and coping, there were significant positive associations between maladaptive coping strategies and state anxiety, while adaptive strategies were negatively associated with state anxiety. In addition, regarding coping strategies, venting and self-blame occurred predominantly in women who know that the cause of infertility is female-related. These findings draws attention to the fact that infertile women live this experience at very high levels of anxiety, using quite a few adaptive coping mechanisms. These results highlight the need to investigate ways to reduce anxiety and optimizing adaptive coping strategies. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)

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Case Report
An Evaluation of the Effectiveness of Ibuprofen and Manual Therapy in Young Women with Dysmenorrhea—A Pilot Study
Healthcare 2021, 9(6), 617; https://doi.org/10.3390/healthcare9060617 - 21 May 2021
Cited by 2 | Viewed by 1534
Abstract
The aim of the study was to evaluate the effect of manual therapy and the use of ibuprofen on the severity of dysmenorrhea and changes in the level of sex hormones in young women with dysmenorrhea. Material and methods: The study included [...] Read more.
The aim of the study was to evaluate the effect of manual therapy and the use of ibuprofen on the severity of dysmenorrhea and changes in the level of sex hormones in young women with dysmenorrhea. Material and methods: The study included six women, aged 22 ± 2 years, with primary dysmenorrhea (PD). A physiotherapist examined the tenderness and flexibility of the muscles. The patients were subjected to a gynecological and physiotherapeutic examination; the concentrations of progesterone and 17-beta-estradiol were also determined. In subgroup A (n = 3), manual therapy was performed 3 × 45 min; in subgroup B (n = 3), the patients received ibuprofen 3 × 400 mg/day. Results: In subgroup A, all patients showed a decrease in the level of progesterone and an increase in the concentration of estradiol. In subgroup B, the concentration of progesterone and 17-beta estradiol decreased in two subjects. In subgroup A, manual therapy reduced the severity of headache, back pain, diarrhea, fatigue, and PMS. In subgroup B, the use of ibuprofen only alleviated back pain and fatigue. Moreover, in subgroup A, after the application of manual therapy, improvement in flexibility and pain relief of the examined muscles was demonstrated. On the other hand, in subgroup B, no improvement in flexibility or reduction in muscle soreness was found in patients who took ibuprofen. Conclusions: Manual therapy may reduce menstrual pain in women with dysmenorrhea. However, the results need to be confirmed in studies conducted on a larger group of patients with dysmenorrhea. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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Case Report
Inversion Table Fall Injury, the Phantom Menace: Three Case Reports on Cervical Spinal Cord Injury
Healthcare 2021, 9(5), 492; https://doi.org/10.3390/healthcare9050492 - 22 Apr 2021
Cited by 1 | Viewed by 919
Abstract
Background: An inversion device, which is used to suspend one’s body and perform traction therapy, was introduced as an inversion table under the name of “Geokkuri” in South Korea. Fall injuries while hanging on inversion tables are among the most devastating spine injuries, [...] Read more.
Background: An inversion device, which is used to suspend one’s body and perform traction therapy, was introduced as an inversion table under the name of “Geokkuri” in South Korea. Fall injuries while hanging on inversion tables are among the most devastating spine injuries, as the likelihood of severe neurological sequelae such as tetraplegia increases. However, its enormous danger has been overlooked and this devastating injury has become a common clinical entity over time. The limited number of studies reported imply the lack of interest of researchers in these injuries. We reviewed three cases of spinal cord injury sustained on inversion tables in different environments and report the potential danger associated with the use of inversion tables to facilitate a safer exercise environment. Full article
(This article belongs to the Special Issue Comprehensive Clinical Physiotherapy and Rehabilitation: Version II)
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