Physiotherapy Practice and Research - Volume 38, issue 2
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Physiotherapy Practice and Research is the Official Journal of
The Irish Society of Chartered Physiotherapists. It is an international, peer-reviewed journal which aims to advance physiotherapy practice and research through scholarly publication. The journal has a clinical focus and publishes material that will improve the evidence base for physiotherapy and assist physiotherapists in the management of their patients. Contemporary physiotherapy practice incorporates a diverse range of activity and the journal aims to support physiotherapists, and publish material, fromall areas of practice, be that the clinical setting, education, research or management.
Physiotherapy Practice and Research welcomes submissions in the form of original research papers, critical reviews (systematic or state-of-the-art papers), case studies, editorials, expert commentaries and book reviews. Letters to the editor are also welcome. The journal will commission focussed or clinical reviews in areas of interest; those planning such reviews should contact the editor in the first instance. Physiotherapy Practice and Research also aims to foster research capacity within the Profession and as such supports and encourages submission from new researchers.
Physiotherapy Practice and Research is a member of and subscribes to the principles of COPE, the Committee on Publication Ethics.
Abstract: BACKGROUND: The current gold standard of balance testing within elite academy football has been shown to be time consuming and contain movement requirements non-specific to football. PURPOSE: To assess the reliability of a new balance protocol for use in elite academy football, due to the difficulty in testing large group sizes and the limited movements patterns with the current gold standard tests. METHODS: Ten participants completed a series of functional jumps, incorporating forward, lateral and vertical movement and landing strategies, with single leg landings. The participants’ jumps were videoed for retrospective analysis as well as…scored in real time by two observers. The subjects balance abilities were graded based on pre-determined criteria derived from the current gold standards of balance testing. Both intra and inter-tester reliability of the functional balance protocol was assessed. MAIN RESULTS: The results show the FBP has ‘excellent’ inter-rater reliability for both real-time analysis and retrospective video analysis, with correlation coefficients ranging from 0.864 to 0.950. CONCLUSIONS: The FBP has excellent intra and inter-rater reliability. The research supplies evidence to suggest that using a functional protocol with an objective fail criteria combining current “gold standard” balance tests, in conjunction with minimal equipment and a short testing duration may be a more appropriate method to test balance.
Abstract: BACKGROUND: Walking difficulty is one of the important neurological consequences after stroke, early prediction of factors related to walking ability may benefit for rehabilitation team to set suitable goals and discharge planning. PURPOSE: This study was performed to identify independent prognostic determinants associated with mobility recovery from ischemic stroke during six months after onset. METHODS: Medical records from first-ever stroke patients who were admitted to the rehabilitation unit were retrospectively reviewed. Baseline characteristics including demographic data, stroke risk factors, motor assessment and stroke-related complications were collected. Outcome measure was ability to walk. To identify clinical…predictors, multivariable risk regression analysis was used for analysis. RESULTS: Of a total 146 stroke survivors, 81 patients (55.5%) could be independent in walking and 65 (45.5%) were non-functional mobility at six months follow-up. Stepwise, multivariable risk regression analysis with generalized linear model demonstrated that follow-up leg score was the strongest independent predictor of walking with risk ratio [RR] of 2.23 (P < 0.01). The association of some stroke-related factors, aphasia and unilateral neglect were found in univariable analysis but revealed no significance from the final model. CONCLUSION: Identification of early predictors associate walking recovery provided meaningful information for stroke care team to consider the amount of care needed and to initiate optimal plan according to realistic goal.
Abstract: BACKGROUND: Pelvic cancers in women are often treated using surgery and radiotherapy alone or in combination. There is evidence that this may result in pelvic floor dysfunctions (PFDs). PURPOSE: This qualitative study aimed to explore the impact of pelvic floor dysfunctions on cancer survivors. METHODS: Survivors of gynaecology or colorectal cancers were invited to participate in this study if they were: more than one year post treatment completion; in remission; and symptomatic of PFD. Semi-stuctured interviews were conducted (n = 12), with questions posed around the impact of PFD symptoms. Interviews were transcribed verbatim and analysed…using thematic analysis. RESULTS: All participants reported lifestyle compromises around planning and control activities. However, this was underpinned by a determination not to allow PFD to abolish social interactions. The degree of acceptance varied: in some cases there was a high level of tolerance and resignation to symptoms. However, there was also intolerance of PFD symptoms, especially bowel control and sexual dysfunction, sometimes expressed by the same individual. Women frequently referred to emotions caused by PFD: frustration, worry, lack of confidence, embarrassment. Some noted effects of their symptoms on intimate and other relationships. Communication with health professionals about PFD was inconsistent. CONCLUSIONS: Symptoms of PFD following successful pelvic cancer treatment can limit female survivors fully engaging in normal life. Alteration in lifestyle activities can accommodate symptoms, but there is consequent emotional impact, and effect on friends and family. There is a reluctance exists to allow symptoms to prevent social interactions altogether.
Keywords: Cancer survivorship, pelvic floor dysfunction, pelvic cancer, gynaecology cancer, colorectal cancer
Abstract: BACKGROUND: Physiotherapy is associated with positive health outcomes and is highly valued among community dwelling people with neurological conditions (pwNC). However, research highlights a deficiency in the quality of physiotherapy services for pwNC in the community setting in Ireland. PURPOSE: The aim of this study was to explore physiotherapists’ views and experiences of physiotherapy service provision for pwNC in primary care with a view to providing a platform of knowledge to assist the development and provision of a high quality physiotherapy service. METHODS: A qualitative study employing semi-structured interviews in four primary care sites in…Ireland was chosen. Purposive sampling was used to recruit 10 primary care physiotherapists. Face to face semi-structured interviews were conducted with each participant. Interviews were audio-recorded and transcribed verbatim, respondent validation was sought and thematic data analysis was conducted on each interview transcript. RESULTS: Physiotherapists identified pwNC as having distinct needs from the general primary care patient population and they reported challenges meeting these needs, resulting in poorer patient outcomes and occupational stress for the physiotherapist. Lack of organisational support from the Health Service Executive (HSE) was the main inhibiting factor and physiotherapy teamwork and line management support were cited as the main factors facilitating the provision of a quality service for people with neurological conditions in primary care. CONCLUSION: Physiotherapists identified a mismatch between their ideal service standard and the practice reality of physiotherapy service provision for pwNC in primary care in Ireland.
Keywords: Physiotherapy, neurological patients, primary health care, qualitative research
Abstract: BACKGROUND: Kinesiophobia, fear of physical movement, is the most common reason for not returning to sport after ACLR. Psychological factors influence recovery after anterior cruciate ligament (ACL) reconstruction (ACLR). Those who undergo ACLR display elevated pain levels as a barrier limiting return to pre-surgical levels of sports performance. To date no study investigating this link has been conducted in an Irish population PURPOSE: To identify individuals who have elevated levels of kinesiophobia after ACLR surgery and ascertain if kinesiophobia was a barrier to return to sport. METHODS: Adults who underwent ACLR in University Hospital during…a three year period were eligible to participate. Individuals who had a previous history of ACL rupture and with concomitant injuries were excluded. The 179 eligible individuals were posted the Tampa Scale of Kinesiophobia (TSK) a demographic questionnaire and information leaflet to invite them to participate in the study. RESULTS: Forty-five participants that met the inclusion criteria were included in the study. The majority of the respondents (78.4%) reported high levels of kinesiophobia. Many (73.7%) returned to sports participation, however only 42.1% and 47.2% returned to pre-injury sports participation and performance respectively. Subjectively kinesiophobia was a key barrier limiting return to pre-injury level of sports participation and performance. CONCLUSIONS: Kinesiophobia appears to be a key barrier preventing return to pre-injury level of sports participation and performance after ACLR.
Abstract: BACKGROUND: Achieving functional independence as early as possible is a major factor in the management of patients following Total Knee Replacement (TKR). The aim of this study was to evaluate the effect of an early mobilisation program for patients after TKR. METHODS: This was a prospective randomised controlled study. Twenty patients were allocated to an early mobilization group who mobilised within 4–6 hours after surgery and another twenty to a control group who followed a standard protocol of mobilising within the 24 hours after the surgery. Primary outcome measures were the length of hospital stay and pain…scores. Secondary outcomes were the active knee range and the timed up and go (TUG) test as a functional measure. RESULTS: Pain in the both groups decreased throughout the period however there was no statistically significant difference between groups (p = 0.614). In addition, no significant change in length of stay was noticed between the groups (p = 0.34). CONCLUSION: The results of this study demonstrate that mobilization within 4–6 hours following TKR does not offer significant advantage over the current standard protocol of mobilizing within 24 hrs of surgery in terms of length of stay, pain or knee range of motion.
Keywords: Early mobility, total knee replacement, rehabilitation, physiotherapy