Physiotherapy Practice and Research - Volume 44, 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: INTRODUCTION: The Covid-19 pandemic provided a research opportunity to explore online group exercise programmes in larger numbers while restrictions on group gatherings were in place. An online survey was conducted with Irish Physiotherapists to ascertain their views on online group exercise programmes and the methods they employed to conduct their online classes in order to guide Physiotherapists with future care delivery. METHODS: A mixed-methods design was employed using a cross-sectional national online survey of Physiotherapists in Ireland. The survey collected both qualitative and quantitative data. Descriptive statistics were used to summarise the ordinal and continuous data and free-text…responses were analysed using conventional content analysis. RESULTS: In total, 81 Physiotherapists completed the surveys. The majority of Physiotherapists (62%) feel a blended or hybrid model is the best option for the future. Convenience and decreased travel were cited as the main advantages of online classes. Physiotherapists cited in-person classes as being of higher teaching quality with improved safety and social interaction. Physiotherapists indicated that very little staff or technological resources were needed for their online classes and serious adverse events during the classes were extremely infrequent. CONCLUSION: Online group exercise programmes were well received by Physiotherapists, although the majority of those questioned believe a mixture of both online and in person exercise classes should be offered going forward.
Keywords: Physiotherapy, telehealth, rehabilitation, group exercise
Abstract: PURPOSE: To develop a fidelity score for the Stratified Vocational Advice Intervention (SVAI), and to evaluate associations between level of fidelity to the SVAI and number of sick leave days and work ability at six months follow-up in workers on sick leave due to musculoskeletal disorders (MSDs). METHODS: The SVAI was provided by physiotherapists (PTs) who documented delivery in individual participant logs. A fidelity score was developed based on the number of follow-up sessions held, core questions documented, and a written action plan. Data were extracted from the logs and fidelity to the SVAI was categorised as “fully…delivered", “partially delivered, or “not delivered” based on predetermined criteria. The number of sick leave days was calculated from registry data, and work ability was assessed using a question from the Work Ability Index on current work ability compared with the lifetime best (0–10). RESULTS: 148 SVAI logs were available for fidelity evaluation (87%). The SVAI was fully delivered to 87 (56%) participants and partially delivered to 61 (39%) participants. There was no statistically significant association between level of fidelity and sick leave days (B = 5.8, 95% confidence interval (CI) –6.2, 17.7, p = 0.34) or work ability (B = –0.2, 95% CI –1.4, 1.1, p = 0.77). CONCLUSION: A three-category fidelity score was developed and the SVAI was generally delivered according to protocol. There were no statistically significant associations between level of fidelity and number of sick leave days or work ability in participants at six months follow-up.
Keywords: Fidelity, vocational rehabilitation, musculoskeletal disorders, sick leave, return to work
Abstract: PURPOSE: The aims of the study were two-fold 1) to explore the treatment modalities musculoskeletal physiotherapists are utilising and the underlying reasons why and 2) report current continuing professional development (CPD) practises and their perceived effectiveness. METHODS: Using a cross-sectional questionnaire, musculoskeletal physiotherapists in the United Kingdom (UK) were invited to complete an online survey. The survey captured respondents’ professional characteristics and their main reason for selecting a range of treatments sub-grouped into three broad categories; Manual Therapy, Treatment Modalities and Education Based Approaches. Respondents were asked to report their CPD practises and their perceived effectiveness. Data was…converted into proportions with lower and upper limits of the 95% confidence interval (CI). Likert scale questions were treated as numeric variables with the mean and standard deviation (SD) calculated for combined responses. RESULTS: Of the 414 responders, 408 were eligible for analyses. The most common reason for treatment selection, based upon a combined total of 9792 responses across all treatment modalities, was content taught in ‘entry-level training’ (n = 2010, 20.5%, 85% CI 20 to 21), followed by ‘practice related courses or CPD events’ (n = 1241, 12.7%, 95% CI 12 to 13). ‘Self-reflection’ was the most common form of CPD (n = 404). All forms of CPD were considered ‘effective’ for developing knowledge and skills except ‘clinical audit’ and ‘journal clubs’ which were rated as ‘indifferent’ by respondents. CONCLUSIONS: Treatment technique depends heavily on skills taught in entry-level training. Despite research articles amongst the most utilised forms of CPD, a disconnect exists in its implementation as the main driver of treatment selection. A wide range of CPD activities were undertaken by participants and rated as ‘effective’ for acquiring and applying physiotherapy related skills.
Keywords: Musculoskeletal, physiotherapy, survey, professional, development
Abstract: BACKGROUND: Sacroiliac Joint Dysfunction (SIJD) may be observed in 13% to 30% people with idiopathic low back pain (LBP). Latissimus dorsi (LD) muscle works by stabilizing the SIJ, providing a pathway for force transmission through the thoraco lumbar fascia. Literature has shown that muscles can change their activation pattern in response to pain, altering motor control. However, to date, there have been no studies evaluating the EMG activity of LD in people with SIJD while lifting a load, this could guide for a better understanding about how muscle activation occurs in this group of patients. AIM: To evaluate…and compare activation of LD in people with LBP, SIJD and without LBP in load lifting. METHODS: One hundred fourteen people were evaluated and divided into 3 groups: LBP, SIJD and Control group. EMG signals were recorded from LD while the subjects lifted a load in a symmetrical posture. Subjects started in an upright position, grasped the box from the floor and returned to the initial position with flexed elbows. Root Mean Square (RMS) amplitude and latency were calculated. The Kruskal-Wallis and the post hoc Dunn’s tests were used to compare groups. RESULTS: Results showed that left LD in SIJD group is activated 26.21% more than in the control group and 23.98% than the LBP group (p = 0.02). Besides, right LD has a delayed onset in SIJD by 0.68 ms compare with the control group and 0.29 ms with LBP group (p = 0.03). CONCLUSION: In a specific group of individuals with SIJD, alterations in LD muscle activation, could be evidenced by an increased RMS amplitude which is accompanied with a delay in activation in the opposite side during lifting a load in a symmetrical posture.
Keywords: Low back pain, sacroiliac joint dysfunction, electromyography, latissimus dorsi
Abstract: OBJECTIVE: Given the poor functional outcomes associated with contraversive pushing after stroke and lack of evidence guiding physical therapy interventions, the PUSH (Prioritizing Upright, Standing, and Higher-level stepping activities) Strategy was designed to address unmet needs. The aim of this paper is to describe the clinical application of the PUSH Strategy delivered during the physical therapy plan of care within inpatient rehabilitation. METHODS: The PUSH Strategy was applied during clinical practice in a large, urban inpatient rehabilitation hospital for patients demonstrating contraversive pushing after stroke with the goals to (1) reduce contraversive pushing, (2) contribute to facilitation of…a community discharge, and (3) improve functional outcomes. Subsequently, outcomes [Burke Lateropulsion Scale (BLS), discharge disposition, and the Mobility and Walk portions of the Continuity Assessment and Record Evaluation (CARE) Tool] were collected at admission and discharge to assess patient progress. RESULTS: Between 2018 and 2020, 11 patients participated in the PUSH Strategy with 73% of patients achieving all three Strategy goals. On average, patients saw improvement in pushing [admit, 7.73 ± 3.3 (moderate pushing); discharge, 1.55 ± 2.4 (no pushing)] and function (admit mobility, 9.9 ± 4.4; discharge, 21.5 ± 5.3 and admit walking 8.1 ± 0.3, discharge 9.6 ± 2.7) during their inpatient rehabilitation stay. Nine were discharged to the community (82%). CONCLUSIONS: The PUSH Strategy was successfully applied for patients with post-stroke contraversive pushing during inpatient rehabilitation. Overall, patients demonstrated reduced pushing and improved functional outcomes during their rehabilitation and most were discharged to a community setting.
Abstract: BACKGROUND: Proprioception is the awareness of the position, movement, and muscular force generated by the body and its musculoskeletal parts, and is an important somatosensory impairment to assess in people with stroke. We know that rehabilitation clinicians self-report to assess proprioception in approximately two-thirds of people with stroke. What we do not know is what type of assessments are used, or the true frequency of their use in clinical practice. This study aimed to provide a preliminary description of the type and frequency of proprioception assessment used by clinicians working in stroke rehabilitation in Australia, and their knowledge about proprioception…impairment. METHODS: We surveyed Australian physiotherapists and occupational therapists who were involved in the rehabilitation of people with stroke. The online cross-sectional survey ran from March to October 2020. While they were blind to the aims of the study, respondents answered questions about clinical decision-making in a case study of a person with stroke and proprioception impairment. Then, they were asked questions about proprioception. RESULTS: There was a total of 165 survey responses, of which 58 contained complete datasets suitable for analysis. Only 55% (n = 32) of respondents selected an assessment of proprioception for the person described in the case study. The majority of respondents defined proprioception to be the sense of joint / limb (n = 38, 65.5%) or body (n = 27, 46.6%) position and used ‘eyeball’ judgements of limb matching accuracy (56%, n = 33) as an assessment. CONCLUSIONS: These preliminary data suggest that proprioception is likely under-assessed in stroke rehabilitation and that clinicians understand proprioception to be the sense of joint position and movement, but lack awareness of other proprioceptive senses, such as the sense of muscle force. These factors may reduce the ability of clinicians to rehabilitate proprioception impairment in people with stroke.
Abstract: INTRODUCTION: Although the five-times-sit-to-stand test (FTSST) is commonly used to analyse functional capacity, in older adults with mild cognitive impairment (MCI), many activities of daily living, such as walking while holding objects, require the simultaneous performance of motor and motor tasks. Hence, the FTSST with a secondary task has been introduced, though there is a lack of evidence on its validity and reliability. This study aimed to examine the concurrent validity and reliability of the FTSST with a dual task in older adults with MCI. METHODS: Twenty-eight older adults with MCI participated in the study. All participants performed…the FTSST, FTSST with a dual task and Timed Up and Go (TUG) test. The concurrent validity of the FTSST with a dual task was established with the TUG. RESULTS: Moderate concurrent validity was found between the FTSST with a dual task and the TUG, with Pearson’s r = 0.59 (p < 0.001). The FTSST with a dual task exhibited good intra-rater (ICC 3,2 = 0.99) and inter-rater (ICC 2,2 = 0.99) reliability. The standard error of measurement and minimal detectable change of the intra- and inter-rater reliability of the FTSST with a dual task were 0.22 and 0.18, respectively. CONCLUSION: This study showed a significant correlation between the FTSST both with and without a dual task and the TUG as well as good inter- and intra-rater reliability when used in older adults with MCI. These findings support using these tests as outcome measures in older adults with MCI.