Physiotherapy Practice and Research - Volume 43, issue 1
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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: Respiratory physiotherapy is a core area of practice, but little is known about pre-qualification physiotherapy curricula across institutions. The purpose of this study was to identify and categorise the pre-qualification content of respiratory physiotherapy curricula across the island of Ireland. METHODS: This cross-sectional survey was conducted remotely and eight respiratory module coordinators/teaching leads participated. Respiratory physiotherapy curricular topics and assessment details from each participating institution were documented. Curricular topics were then grouped and categorised into discrete broader curricular topic areas by agreement. A representative from each higher education institution rated the curricular topic from their programme as…‘foundation’, ‘core’, ‘not essential but desirable’ or ‘broadly relevant’. Assessment strategies for each programme were documented. RESULTS: From 246 individual topics, seven broad category areas were generated which were operationally defined and divided into 41 content topics. Of the content topics 18 out of 41 (44%) topics were unanimously rated as core to the respiratory module by each participating programme. A diverse range of assessment strategies were employed across programmes with all including written and practical components. CONCLUSION: Between programmes and institutions, there was a reasonably high degree of overlap of the respiratory physiotherapy topic areas which are delivered within or outside of core respiratory modules. Content appears to be broadly standardised and appears to support the preparedness of graduates for practice in this area. The identification of ‘core’ respiratory topics in this study may be useful for the design of new respiratory physiotherapy modules or ongoing curricular review.
Abstract: BACKGROUND & PURPOSE: Pulmonary fibrosis (PF) is a debilitating, incurable disease. Strategies to optimise health-related quality of life and minimise symptom impact are advocated. Available treatment options such as pulmonary rehabilitation have been severely disrupted due to COVID-19. This feasibility study explored the clinical efficacy and acceptability of an online singing and breathing retraining programme (SingStrong) for people with PF. METHODS: The weekly online programme conducted over 12 weeks was comprised of 45-minute classes of mindfulness, breathing retraining, vocal exercises and singing conducted by a trained vocal coach. People with PF were invited to participate and sessions were…recorded for non-attenders. Demographic data were collected, and the St Georges Respiratory Questionnaire (SGRQ) and Idiopathic PF Patient Reported Outcome measure (IPF-PROM) were administered. The questionnaire also invited participants to provide feedback on the utility, enjoyability and main pros/cons of the intervention. Participation in the research element of the programme was not required to attend the weekly classes. RESULTS: Of 24 participants recruited, data from 15 (mean (Standard Deviation) age of 66 (8.7); male: n = 8) who completed both pre and post-intervention questionnaires were analysed. Statistically significant improvements were recorded in the IPF-PROM (p = 0.019) and self-reported quality of life (p = 0.028). Class attendance by study participants and the broader PF group cumulatively, increased from 14 to 25 participants between weeks 1 and 12. Qualitatively, strong satisfaction with classes and improved efficacy in self-management of lung health, in particular breathlessness, were reported. CONCLUSIONS: Singing and breathing retraining interventions may endow biopsychosocial benefits for people with PF, in the presence of modest objective clinical gains. Singing programmes are popular and may provide helpful adjuncts to existing clinical strategies such as pulmonary rehabilitation.
Keywords: Pulmonary Fibrosis, Singing for lung health, Online rehabilitation, SingStrong
Abstract: BACKGROUND: Lung transplantation (LTx) is an established treatment option for patients with end-stage lung diseases. Nevertheless, exercise intolerance, respiratory muscle function impairment, functional disability, and peripheral muscle weakness often persist following LTx. PURPOSE: To examine the effectiveness of a pulmonary rehabilitation (PR) program and home-based inspiratory muscle training (IMT) alone or in combination, in post lung transplantation (LTx) patients. METHODS: In a prospective pilot study a sample of 22 patients who had undergone LTx 4–18 months prior, were randomized to groups of PR alone, or combined with home-based IMT, or IMT alone, for six months: four…months in the intervention program and two months of follow-up. Inspiratory muscle strength was assessed by measuring the maximal inspiratory pressure (MIP). RESULTS: There was a statistically significant increase in MIP values as well as in the 6-min-walk-test, only in the PR combined with home-based IMT, and IMT exercise groups. From baseline after 2- and 4-months intervention and at 6-months at follow-up, there was a statistically significant correlation between MIP and Maximum Voluntary Ventilation (MVV) values. CONCLUSIONS: Pulmonary rehabilitation (PR) program combined with inspiratory muscle training (IMT) or home-based IMT alone, in post lung transplantation patients, seems to be the best exercise combination for achieving the optimal effect, in inspiratory muscle strength and exercise capacity, with evidence for long-term benefits. Patients should be encouraged to participate in a PR program that includes home-based IMT exercise, especially in times of restricted mobility, as currently due to the COVID-19 pandemic.
Abstract: AIM: To determine the effects of a structured, moderate-intensity, early cardiac rehabilitation (CR) program on physical function and psychological wellbeing in patients following aortic root replacement. MATERIALS AND METHODS: Patients were randomly assigned to either an 8-week (24 sessions) cardiac rehabilitation (CR) program, 4 to 6 weeks after aortic root replacement using the Bentall procedure, or to an age- and sex-matched control group undertaking no structured exercise. Physical function (via exercise treadmill test (ETT)) and psychological wellbeing (assessed via DASS-21 and SF36) were assessed before and following 8-weeks of CR. RESULTS: 30 patients (15 in the…control (mean age: 37±10 years) and 15 in the intervention group (mean age: 38±11 years)) completed the 8-week CR programme and no adverse events were reported over the intervention period. In the CR group, all sub-components of the SF-36 and DASS-21 increased (all P < 0.05), showing an overall improvement in psychological wellbeing following the intervention. Distance walked on the ETT (improved significantly following 8-weeks of CR (490±167 m v 659±141 m; Λ improvement = 169 m; P < 0.05). There were no changes in physical function and psychological wellbeing in the controls (P > 0.05). A significant group-by-time interaction effect was evident for physical function and all sub-components of the SF-36 and DASS-21 (all P < 0.05) highlighting significant improvements in outcomes in the CR group compared to controls. CONCLUSIONS: This small sample, aerobic-based, moderate-intensity CR is safe and effective, and can be tolerated only 4–6 weeks after complex aortic root replacement surgery.
Abstract: BACKGROUND: Little is known about predictors of activity participation that are objectively measured in cardiac rehabilitation (CR) graduates. This prospective observational study aimed to determine the predictors of objectively measured activity participation among adults with chronic cardiac conditions who have completed Phase II CR. METHODS: Twenty-five adults with chronic cardiac conditions graduating from traditional CR program participated in the study. The outcome variable was an activity participation level measured by light-to-vigorous intensity physical activity (LVPA) minutes using ActiGraph GT9X Link accelerometer after CR discharge. Covariates were collected at the discharge from CR, and outcome variables were collected at…1 month, 3 months, and 9 months post CR discharge. RESULTS: Gender, standardized LVPA at CR discharge, body mass index, and motivation for physical activity and leisure were significantly associated with the activity participation levels at 1 month, 3 months, and/or 9 months post CR discharge. Gender, standardized LVPA at CR discharge, highest education completed, and depressive symptoms significantly predicted the activity participation levels at 1 month (R2 = 0.69, p < 0.001), 3 months (R2 = 0.65, p < 0.001), and/or 9 months (R2 = 0.80, p < 0.001) post CR discharge. Female CR participants who were more active, had more than high school education, and showed more depressive symptoms at CR discharge were more likely to be active post CR. CONCLUSIONS: CR participants may benefit from individualized approach to plan their days post CR and application-focused and education-level sensitive sessions to understand the importance of activity participation maintenance post CR.
Abstract: BACKGROUND: After cardiac surgery, various pulmonary complications develop which require specific care. These complications affect pulmonary functions and can lengthen the hospital stay of patients, causing increased hospital costs and becoming an important cause of morbidity and mortality. OBJECTIVES: To investigate the short-term effect of inspiratory muscle training on pulmonary function after mitral valve replacement. METHODS: A sample of Thirty five patients (35.5±3.29 years) who underwent mitral valve replacement. Spirometric parameters were measured before and after intervention including forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and ratio of forced expiratory volume…in the first second to forced vital capacity (FEV1/FVC). All participants had received postoperative Inspiratory muscle training (IMT) from the first day in the inpatient unit after discharge from intensive care unit till hospital discharge. Paired t -test was used to investigate differences between means of pulmonary function measures (P < 0.05). Effect size was calculated and post hoc power analysis was performed. RESULTS: After one week of postoperative IMT there was a statistically significant improvement in the studied spirometric parameters (FVC, FEV1, FEV1/FVC) (p = 0.01). All studied spirometric parameters showed very large effect size (d >0.8). The post hoc power analysis revealed that the study power was more than 90%. CONCLUSION: One week of post-operative IMT may have a beneficial short-term effect in improving pulmonary functions after mitral valve replacement.
Abstract: INTRODUCTION: Joint hypermobility (JH) is a term used to define active or passive joint range of motion that is beyond normal range, accounting for age, sex, and ethnicity. Symptomatic hypermobility is a term that can be used when symptoms are thought to be associated with JH. Children and young people with symptomatic hypermobility complain of musculoskeletal symptoms but also may report symptoms from other domains including gastrointestinal, cardiovascular, psychological, and urogenital. Many of these symptoms are not included in formal diagnostic criteria yet may impact negatively on their quality of life. The pattern of these symptoms may change with age.…PURPOSE: To map the literature on clinical characteristics of symptomatic hypermobility in an age and developmental context, to improve our understanding and assist in the clinical assessment of children and young people with symptomatic hypermobility. METHODS: This systematic scoping review will be conducted in accordance with the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews (PRISMA-ScR) methodology. Studies that include children and young people from birth to 24 years with a confirmed diagnosis of symptomatic hypermobility, HSD or hEDS using internationally recognised criteria or equivalent diagnoses will be included. Data extraction and analysis will be undertaken using an iterative process. DISCUSSION: Mapping and synthesis of the data will be carried out and gaps and limitations in the literature will be acknowledged. Results will be disseminated in a peer reviewed journal. The search strategy will be made available publicly for transparency.
Keywords: Symptomatic hypermobility, children, young people, clinical characteristics
Abstract: INTRODUCTION: The aim of this study was to investigate the association between gait parameters, gross motor function and physical activity (PA) in young people with cerebral palsy (CP). METHODS: Thirty-eight adolescents aged between 10–19 years with spastic CP in GMFCS levels I-III (mean [standard deviation] age 13.7 [2.4 ] yr; 53%female) were included in this cross-sectional study. Hip, knee and ankle joint excursion and stance time was assessed using 3D gait analysis. Self-selected walking speed was assessed during a timed 10 m overground walk and treadmill walking. Gross motor function was assessed using dimensions D and E of the Gross…Motor Function Measure (GMFM-66). Moderate-to-vigorous PA, light PA and step-count were assessed using an accelerometer. Linear regression was used to examine associations. RESULTS: After adjusting for age, sex and GMFCS level, percentage stance time was associated with dimension E of the GMFM-66 (β= –0.29, 95%CI –0.54 to –0.05). There was no evidence that any other gait parameters were associated with GMFM-66 dimensions D or E. There was also no evidence that gait parameters or GMFM-66 dimensions D or E were associated with step-count or time in PA after adjusting for age, sex and GMFCS level. DISCUSSION: The findings provide an insight into the complexity of the relationship between gait quality or ability at the impairment level, function as measured in a controlled environment, and the performance of habitual PA, which is essential for health among children with CP.