Physiotherapy Practice and Research - Volume 39, 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: Frozen Shoulder remains one of the most misunderstood pathologies to affect the shoulder joint. Frozen Shoulder is characterised by pain, loss of active and passive range of motion especially in flexion and external rotation with normal radiological findings undergoing three stages of presentation: initial pain, stiffness and near full resolution with time. Current treatment options include manual physiotherapy techniques, injection therapy, manipulation under anaesthetic and surgical release of shoulder capsule. Presently there remains a paucity of significant research supporting the sole use of any of these techniques in the treatment of frozen shoulder. Future studies should incorporate larger subject populations…with closely related symptoms and be multicentred across a larger geographical area.
Abstract: BACKGROUND: The Star Excursion Balance Test (SEBT) is a common clinical test that can provide information about dynamic movement, but does not reflect movement quality or postural-control strategies, and does not report kinematics of the lower limb. PURPOSE: To assess the dynamic postural control of healthy subjects using inertial measurement units (IMUs) and clinical SEBT scores to determine the effect of knee bracing and taping. METHODS: Twenty-four healthy individuals performed the SEBT under three randomised conditions (patellar bracing, patellar taping, and control condition (no intervention). Clinical SEBT scores were recorded and normalised to leg length and…angular velocities were measured using IMUs during SEBT. Composite scores were calculated as the sum of clinical scores in each direction divided by three. Descriptive statistics (mean±sd) were calculated for each variable and repeated measures ANOVA were used to identify differences between limb (dominant, non-dominant) and condition. MAIN RESULTS: Compared to the control condition, bracing and taping significantly improved dynamic postural control in the sagittal plane by 6% (1.5–10.5%) P = 0.011 and 8% (2.9–13%) P = 0.004 respectively. Bracing significantly improved coronal plane stability compared to the control condition by 9% (3.8–14.1%) P = 0.002, and taping by 7% (1.6–12.6%) P = 0.013. SEBT scores revealed small but statistically significant differences (P < 0.05) between conditions in the anterior, posteromedial and composite scores, all showing a difference of between 1-2%. PRINCIPAL CONCLUSIONS: Patellar soft bracing and taping can improve dynamic postural stability during SEBT. It is possible to detect clinically important changes in lower limb stability from angular velocity using IMUs.
Keywords: Star excursion balance test, inertial measurement unit, reaction brace, McConnell tape
Abstract: PURPOSE: The aim of this analytical observation cohort study was to establish the effectiveness of the GAA15 (Gaelic Athletic Association 15) in reducing lower extremity injury rates (IR) in adolescent males playing hurling at post primary school level during one season. METHODS: A sample of 516 male subjects (mean age 15.9 years±SD 1.9), were recruited from fourteen post primary schools. Seven schools participated in the intervention group with equal group numbers in the control group. The intervention group implemented an injury prevention programme namely the GAA15 before training and matches. The control group adopted their normal warm-up behaviour…prior to matches and training. RESULTS: Control group participants sustained lower extremity training IRs of 15.83/1000 hrs (95% CI 9.4–22.3) compared to 8.78/1000 hrs (95% CI 5.2–12.4) in the intervention group (p = 0.063). Match lower extremity IRs of 36.32/1000 hrs (95% CI 21.1–51.5) were reported for the control group, with 25.62/1000 hrs (95% CI 16.9–34.4) reported for the intervention group participants (p = 0.230). Hurling lower extremity IRs were reduced by between 30% to 45% in the intervention group when compared to the respective control groups. CONCLUSIONS: Following this investigation, it can be concluded that the implementation of the GAA15 is effective in reducing lower extremity injury rates in adolescent males participating in hurling when compared to a matched control group.
Abstract: PURPOSE: The primary aim of this study was to determine the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of kinesiology tape (KT) and usual care versus usual care alone in the treatment of breast lymphoedema (BLE). METHODS: Fourteen participants with BLE were randomly assigned to either the KT and usual care group or usual care alone group. Both groups received three sessions of manual lymphatic drainage (MLD) once per week for three weeks, with the KT group additionally wearing the KT for two seven-day periods in between MLD sessions. Safety and acceptability of…the KT were assessed by recording adverse events, skin changes and compliance with KT. Outcomes included were: ease of recruitment, attrition and acceptability of KT, percentage breast tissue water, patient-reported breast heaviness/fullness, breast discomfort and breast redness. RESULTS: Recruitment for this study was an average of 2.8 participants per month. There were no dropouts from either group. No adverse events or major skin side effects were recorded in either group. Minor skin redness was the most common dermal change (n = 5). Compliance with KT was excellent. Percentage tissue water in the worst affected breast quadrant reduced, on average, by 15.14% and 10.43% in both the KT group and the usual care group respectively. CONCLUSION: This feasibility RCT into the use of KT in BLE has shown that recruitment to a larger scale RCT is feasible. It has been demonstrated that KT is a safe and acceptable intervention with no adverse events and minor dermal changes. A large, multi-centred RCT is now necessary to accurately assess the effect of KT in BLE.
Keywords: Breast lymphoedema, breast oedema, kinesiology tape, Moisture MeterD Compact
Abstract: BACKGROUND: Wrist-Worn Activity Monitors (WWAMs) are low-cost, user-friendly devices which have become popular for monitoring physical activity. Their reliability and validity need investigation for accurate physical activity monitoring. We examined between-sessions and inter-device reliability of the WWAMs. In addition, we examined the criteria-related validity of the WWAMs against two gold standards, an Ankle-Worn Activity monitor (AWAM) and video. METHODS: Twenty volunteers participated in two sessions, one week apart. In each session, participants walked on a treadmill for five minutes at each of the three speeds: 0.89 m/s (slow),1.12 m/s (moderate) and 1.33 m/s (fast). Total step counts at each speed were…obtained using one AWAM (stepWatch), three-WWAMs (Fitbit Flex) and video. The Intraclass Correlation Coefficient (ICC) was calculated to determine the reliability and validity of the WWAMs. RESULTS: The WWAMs exhibited moderate to excellent between-sessions reliability (ICC = 0.69–0.90). The WWAMs demonstrated excellent inter-device reliability at each speed across both sessions (ICC = 0.91–0.98). The criteria-related validity of WWAMs compared to the AWAM, and video recording showed moderate to excellent agreement (ICC = 0.67–0.85) at each speed. CONCLUSIONS: WWAMs recorded steps consistently between-sessions and between-devices for treadmill walking among healthy adults at each speed but exhibited limited agreement for recording steps at each speed compared to AWAM and video.
Abstract: BACKGROUND: Immediate rehabilitation is increasingly used for tendon injuries, but complete single-leg heel raise recovery after injury remains uncommon. PURPOSE: This study primarily determined if immediate versus traditional rehabilitation resulted in better single-leg heel raise recovery against the physiological reference, and compared performance recovery against the non-injured limb. The study also explored if clinical parameters at 4, 8, and 12 weeks post-tenorrhaphy are predictors of more single-leg heel raises at week 12 in recreational soccer players. METHOD: Twenty-six amateur soccer players (43.2±10.1 years-old, BMI 29.5±3.9 kg/m2 ) underwent rehabilitation using early or traditional rehabilitation following Dresden tenorrhaphy…of the Achilles tendon. The main outcome was the single-leg heel raise repetitions. RESULTS: Immediate rehabilitation resulted in significantly more single-leg heel raises than traditional rehabilitation (p < 0.001). Performance capacity compared to the physiological reference was significantly greater for immediate rehabilitation (p < 0.001) but significantly lower for traditional rehabilitation (p < 0.001). Only immediate rehabilitation recovered single-leg heel raise capacity as compared to the non-injured limb (p = 0.217). The beta coefficients for weight and dorsiflexion range of motion at week 12 were respectively – 0.81±0.25 and 1.86±0.61. CONCLUSIONS Immediate AT tenorrhaphy rehabilitation more quickly recovers reference values and approximates non-injured-limb values for single-leg heel raise capacity after a 12-week physical therapy program. Dorsiflexion range of motion at week 12 and weight were predictors for more single-leg heel raise repetitions at week 12.
Abstract: BACKGROUND AND PURPOSE: Nonspecific neck pain (NS-NP) which is described as neck pain without specific underlying disease is the most common neck pain presentation. This study aimed to compare the influence of the Mulligan sustained apophyseal glides (SNAG’s) with exercise, versus myofascial release (MFR) with exercise, on pain, neck range of motion (ROM), and functional disability in people with NS-NP. METHODS: A single blinded randomized control trial was used. Seventy participants with NS-NP were allocated randomly into three groups, the SNAG’s group received SNAG’s with exercise, the MFR group received MFR with exercise and the control group received…exercise only. The selected exercises included strengthening exercises, stretching of the posterior neck muscles, and neck straightening exercises. The total treatment included 12 sessions, 3 sessions per week for 4 consecutive weeks. Pain, neck ROM and neck function was assessed prior to the first treatment and at the end of the 4-week trial. RESULTS: There were statistically significant, time-by-group effects (mixed-design MANOVA) on pain, neck ROM and NDI for all groups (P < 0.0001). SNAG’s with exercise and MFR with exercise yielded significant reduction in pain and neck disability, and increase in neck ROM. Control group reported lesser reduction in pain and neck disability, and lesser increase in neck ROM. CONCLUSION: SNAG’s with exercise and MFR with exercise offered short-term statistically significant improvements in pain, neck ROM and functional disability in NS-NP. However, there is need to ascertain the long-term effects of these treatment approaches, before any further clinical recommendations can be made.
Abstract: PURPOSE: This study aimed to investigate the effects on the pulmonary function in women with post-mastectomy syndrome during different 48-week individualised physical rehabilitation programs. METHODS: The participants of this study were 115 breast cancer patients with late symptoms of post-mastectomy syndrome who completed intervention and 50 healthy women (control group). Women had undergone surgical treatment and adjuvant radiation therapy for breast cancer. Women with post-mastectomy syndrome were enrolled for the first individualised program (first main group, MG1 , n = 45), for the second individualised program (second main group, MG2 , n = 40) and for the third individualised program (third…main group, MG3 , n = 30). The first program included aqua aerobics (aqua jogging, aqua building, aqua stretching), conditional swimming, and recreational aerobics; the second program included conditional swimming and Pilates exercises; the third program included yoga-based exercises and stretching. RESULTS: It was found that most of the spirometry parameters steadily improved in all groups during a 48-week individualised physical rehabilitation programs. After that period of training the individualised program for women of the first main group came to have an advantageous effect on all the indicators of respiratory function (p < 0.05– p < 0.001) as compared with the healthy women, except for the expiratory reserve volume, and maximal voluntary ventilation, which were not statistically significant. CONCLUSIONS: Our findings showed that individualized physical rehabilitation programs had a positive effect on pulmonary function in women with post-mastectomy of all groups.
Keywords: Pulmonary function, rehabilitation, breast cancer, mastectomy
Abstract: Dry needling is an invasive procedure using solid filament needles to treat myofascial pain and dysfunction. It is becoming a widely used adjunct to traditional physiotherapy treatment. Despite its rate of growth there still remains questions marks over the effectiveness of dry needling and its potential to cause adverse events. Recent reviews largely agree that there is an improvement in the patient’s pain and range of motion in the short term when compared to no treatment, but evidence remains inconclusive for long term effects. Dry needling is an invasive therapy and clinicians need to have an appropriate…indication for providing dry needling therapy while also determining whether the therapy will place the patient under any unacceptable risk of adverse events. One paper found the rate of mild adverse events to be as high as19.18%. The most common adverse events experienced were bleeding, bruising and pain during or following treatment. To minimise the risk of adverse events treating clinicians should receive appropriate training and certification to provide dry needling therapies. This commentary aims to present the most current evidence surrounding dry needling effectiveness, safety profile and the need for appropriate levels of professional competence.
Keywords: Dry needling, trigger points, myofascial pain, adverse