Physiotherapy for patients with depression:Recent research progress

Depression,a common mental illness,seriously affects the health of individuals and has deleterious effects on society.The prevention and treatment of depression has drawn the attention of many researchers and has become an important social issue.The treatment strategies for depression include drugs,psychotherapy,and physiotherapy.Drug therapy is ineffective in some patients and psychotherapy has treatment limitations.As a reliable adjuvant therapy,physiotherapy compensates for the shortcomings of drug and psychotherapy and effectively reduces the disease recurrence rate.Physiotherapy is more scientific and rigorous,its methods are diverse,and to a certain extent,provides more choices for the treatment of depression.Physiotherapy can relieve symptoms in many ways,such as by improving the levels of neurobiochemical molecules,inhibiting the inflammatory response,regulating the neuroendocrine system,and increasing neuroplasticity.Physiotherapy has biological effects similar to those of antidepressants and may produce a superimposed impact when combined with other treatments.This article summarizes the findings on the use of physiotherapy to treat patients with depression over the past five years.It also discusses several methods of physiotherapy for treating depression from the aspects of clinical effect,mechanism of action,and disadvantages,thereby serving as a reference for the in-depth development of physiotherapy research.

Impact of Action Observation Therapy along with Usual Physiotherapy Intervention of Individual with Alzheimer’s Disease

Alzheimer’s disease (AD) is a neurodegenerative disorder characterized by cognitive impairments in the initial stage, which lead to severe cognitive dysfunction in the later stage. Action observation therapy (AOT) is a multisensory cognitive rehabilitation technique where the patient initially observes the actions and then tries to perform. The study aimed to examine the impact of AOT along with usual physiotherapy interventions to reduce depression, improve cognition and balance of a patient with AD. A 67 years old patient with AD was selected for this study because the patient has been suffering from depression, dementia, and physical dysfunction along with some other health conditions like diabetes and hypertension. Before starting intervention, a baseline assessment was done through the Beck Depression Inventory (BDI) tool, the Mini-Cog Scale, and the Berg Balance Scale (BBS). The patient received 12 sessions of AOT along with usual physiotherapy interventions thrice a week for four weeks, which included 45 minutes of each session. After four weeks of intervention, the patient demonstrated significant improvement in depression, cognition, and balance, whereas the BDI score declined from moderate 21/63 to mild 15/63 level of depression. The Mini-Cog score improved from 2/5 to 4/5, and the BBS score increased from 18/56 to 37/56. It is concluded that AOT along with usual physiotherapy intervention helps to reduce depression, improve cognition and balance of people with AD.

Physiotherapy Management of Rheumatic Diseases

Introduction: Physiotherapy is an integral part of the non-drug treatment strategy for rheumatological conditions. The evidence for its effects is not formal. The objective was to evaluate the impact of physiotherapy in the management of rheumatological disorders. Methods: 6-month case-control study (December 15, 2021 to June 20, 2022) at Ignace Deen University Hospital (Conakry). Patients with rheumatological disease who received drug therapy and physiotherapy were included in the case group. Age- and sex-matched controls had rheumatological conditions, treated without physiotherapy. The evaluation questionnaires were used: WOMAC (osteoarthritis), EIFEL (low back pain), NDI (neck pain), SPADI (shoulder). Patients with heart failure, respiratory failure and/or skin infection were not included. Results: We collected 773 patients (389 cases and 384 controls) with a mean age of 53.8 years ± 12.2 with female predominance (56.8%). Patients were mainly followed for osteoarthritis (65.2%). Rheumatological conditions managed were knee-based (119;30.6%), lumbar spine (220;56.6%), shoulders (27;6.9%) and cervical spine (23;5.9%). For an average duration of 53.4 ± 12.2 minutes per session, patients had benefited from a median of 19 physiotherapy sessions. After 3 months, the baseline mean VAS of 6/10 improved to 2.2 ± 1.6 for cases and 5.7 ± 1.2 for controls. Functional capacity was improved (WOMAC: 41.8 ± 22.7 vs. 18.3 ± 7.3). The satisfaction of patients treated with physiotherapy was 20 times higher than in controls. Conclusion: Physiotherapy performed in the management of rheumatological conditions significantly reduced pain and improved functional capacity.

The Impact of Physiotherapy Interventions on the Elderly Population with Mental Health Conditions at Chainama Hills College Hospital in Zambia. A Pre-Post Single Sample Study Design

Background: Physical functional decline is common among elderly individuals with mental disorders, worsening their symptoms. Physiotherapy interventions have shown some evidence in improving physical function and mental health outcomes in this population. This study aimed to assess the impact of physiotherapy interventions on the elderly with mental health conditions at Chainama Hills College Hospital in Zambia. Methods: A pre-post single sample design was used to track patient progress over six weeks, with 10 physiotherapy sessions. The study population (N = 30) comprised of all elderly individuals with mental health conditions, encompassing both men and women, who were hospitalized during the research period. The Katz Index of Activities of Daily Living and the six-minute walk test were evaluated before and after the intervention. The IBM SPSS version 26 was used to analyze data and results were presented as mean ± SD with a 95% confidence interval. The variables were described in terms of their mean, SD, and range. A significance level of 0.05 was used for a paired T-test to detect changes and multiple logistic regression was used to identify factors associated with mental health. Results: Following the intervention, the percentage of participants achieving full function and independence increased significantly to 96.7% from the initial 73.3%, supported by a 95% CI = [0.82 - 0.99]. There was also a notable decrease in the proportion of individuals experiencing moderate impairment, dropping from 26.7% to just 3.3%, with a corresponding 95% CI = [0.00 - 0.17]. Conclusion: The findings derived from this study illustrate an enhancement in the aspects of participants’ overall health and functional condition, including blood pressure, heart rate, and respiratory rate. Consequently, physiotherapy exercises can be employed as a tactic to ameliorate the functional status and physical well-being of older individuals afflicted with mental disorders in Zambia.

The Effect of Plasma Jet on Bacterial Species and Correlation with Physiotherapy

Introduction: As representatives of prokaryotic beings, bacteria were selected in nature for their very high capacity to adapt to the environment. The human body comprises a vast population of bacteria needed for health maintenance;skin lesions represent a major public health problem involving the nutritional, hospital and illness of the patient. Objective: The objective of this study was to verify the effect of the plasma jet on bacterial species and to correlate it with clinical physiotherapy. Method: This is an in vitro experimental study carried out at FSG University Center. Performed through cultures of bacteria Sthaphylococcus aureus, Pseudomonas aeruginosa and Klebsiella pneumoniae under the effect of plasma jet. Results: As observed all strains were resistant to penicillin, creating no inhibition halo in any of them. In the plates of the bacteria Staphylococcus aureus, in the area where the Plasma Jet was applied there was no microbial growth. In Klebsiella pneumoniae strains microbial growth was achieved in 90 and 120 seconds. Finally, Pseudomonas aeruginosa plates in the 90 seconds were microbial growth compared to the 120 and 180 seconds. Conclusion: It can be concluded that the time of application of the plasma jet has an important role in the antimicrobial action, when compared to Physiotherapy, a new method of treatment for skin lesions may be an option, with the aim of reducing infections and accelerating the process of tissue healing.

Assessment of the 2 Conventional Physiotherapy Sessions Alone versus One Session Associated to Kabat’s Method in the Rehabilitation of Buruli Ulcer Patients (PUB), with Functional Limitations in the District Hospital of Akonolinga, Cameroon

Buruli ulcer (BU) is a chronic, indolent necrotizing disease of the skin and underlying tissues caused by Mycobacterium ulcerans, which may result in functional disability. This disease is the third most frequent infection after leprosy and tuberculosis caused by a mycobacterium. The main objective of this study was to determine comparative effectiveness of conventional physiotherapy alone to its association with Kabat’s method in the management of post-Buruli ulcer functional limitations. This was an interventional randomized, comparative and prospective study. It took place at the district hospital of Akonolinga from the 12th June to 12th September 2016. The study was included, post-Buruli ulcer patients who matched the eligibility criteria, were under treatment in the physiotherapy unit, and who accepted to participate in our study. A questionnaire on the socio-demographic profile of participants, the ulcer localization, the limitation stage, previous medical history and functional mobility assessment scale was administered to the subjects before and after the intervention which lasted for twelve weeks. We had 2 groups: the case group received association of Kabat technique to conventional physiotherapy and the control group received conventional physiotherapy alone. We had 22 patients, 11 patients for the experimental group, 11 patients for the control group. The mean age was 26.18 years, 54.5% of female participation, 68.2% of leg localization, 59.1% patients with severe limitations of functional mobility, and preference for traditional medication 95.5%. After evaluation of efficiency, we concluded that there was no statistically significant difference between the two treatment protocols. Further studies with larger sample size are recommended.

Literature study on clinical treatment of facial paralysis in the last 20 years using Web of Science Comparison between rehabilitation, physiotherapy and acupuncture

BACKGROUND： Facial paralysis is defined as severe or complete loss of facial muscle motor function. OBJECTIVE： The study was undertaken to explore a bibliometric approach to quantitatively assess the research on clinical treatment of facial paralysis using rehabilitation, physiotherapy and acupuncture using Web of Science from 1992 to 2011. DESIGN： Bibliometric approach. DATA RETRIEVAL： A bibliometric analysis based on the publications on Web of Science was performed using key words such as ＂facial paralysis＂, ＂rehabilitation＂, ＂physiotherapy＂ and ＂acupuncture＂. INCLUSIVE CRITERIA： （1） Research articles on the clinical treatment of facial paralysis using acupuncture or physiotherapy （e.g. exercise, electro-stimulation） and other rehabilitation methods; （2） researches on human and animal fundamentals, clinical trials and case reports; （3） Article types： article, review, proceedings paper, note, letter, editorial material, discussion, book chapter. （4） Publication year： 1992-2011 inclusive. Exclusion criteria： （1）Articles on the causes and diagnosis on facial paralysis; （2） Type of articles： correction; （3） Articles from following databases： all databases related to social science and chemical databases in Web of Science. MAIN OUTCOME MEASURES： （1） Overall number of publications; （2） number of publications annually; （3） number of citations received annually; （4） top cited paper; （5） subject categories of publication; （6） the number of countries in which the article is published; （7） distribution of output in journals. RESULTS： Overall population stands at 3 543 research articles addressing the clinical treatment of facial paralysis in Web of Science during the study period. There is also a markedly increase in the number of publications on the subject ＂facial paralysis treatments using rehabilitation＂ during the first decade of the 21 st century, except in 2004 and 2006 when there are perceptible drops in the number of articles published. The only other year during the study period saw such a drop is 1993. Specifically, there are 192 published articles on facial paralysis treated by rehabilitation in the past two decades, far more than the output of physiotherapy treatment. Physiotherapy treatment scored only 25 articles including acupuncture treatment, with over 80% of these written by Chinese researchers and clinicians. Ranked by regions, USA is by far the most productive country in terms of the number of publications on facial paralysis rehabilitation and physiotherapy research. Seeing from another angle, the journals that focus on otolaryngology published the most number of articles in rehabilitation and physiotherapy studies, whereas most acupuncture studies on facial paralysis were published in the alternative and complementary medicine joumals. CONCLUSION： Study of facial paralysis remains an area of active investigation and innovation. Further clinical studies in humans addressing the use of growth factors or stem cells continue to successful facial nerve regeneration.

Outcomes of early physiotherapy in patients with cerebral aneurysms treated by surgical clipping or endovascular embolization

Early physiotherapy was given to 124 patients with ruptured or unruptured cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients were divided into four groups according to their Hunt and Hess grade at admission and aneurysm treatment modality： Group 1,Hunt and Hess grade≤II and surgical clipping;Group 2,Hunt and Hess grade≤II and endovascular embolization;Group 3,Hunt and Hess grade≥III and surgical clipping;Group 4,Hunt and Hess grade≥III and endovascular embolization.Level of consciousness was evaluated using the Glasgow Coma Scale,functional status using the Glasgow Outcome Scale,level of the mobility using the Mobility Scale for acute stroke patients,and independence in activities of daily living using the Barthel Index.After early physiotherapy,the level of consciousness and functional status improved significantly in Groups 1,3,and 4;mobility improved significantly in all groups;and independence in activities of daily living improved significantly in Groups 1 and 3.At discharge, Groups 1 and 2 had better functional status than Groups 3 and 4.Level of consciousness,functional status,mobility and independence in activities of daily living improved after early physiotherapy. These findings suggest that early physiotherapy improved the prognosis of patients with cerebral aneurysms who were treated by surgical clipping or endovascular embolization.Patients with a worse clinical status at presentation had a poorer functional status at discharge.The outcome of physiotherapy was not affected by whether surgical clipping or endovascular embolization was chosen for treatment of the aneurysm.

Corticosteroid injection alone vs additional physiotherapy treatment in early stage frozen shoulders

AIM To investigate the additional value of physiotherapy after a corticosteroid injection in stage one or two idiopathic frozen shoulders(FSs).METHODS A two center, randomized controlled trial was done. Patients with a painful early stage idiopathic FS were eligible for inclusion. After written consent, patients were randomly allocated into two groups. All patients received an ultrasound-guided intra-articular corticosteroid injection. One group underwent additional physiotherapy treatment(PT) and the other group did not(non-PT). The primary outcome measure was the Shoulder Painand Disability Index(SPADI). Secondary outcomes were pain(numeric pain rating scale), range of motion(ROM), quality of life(RAND-36 score), and patient satisfaction. Follow-up was scheduled after 6, 12 and 26 wk.RESULTS Twenty-one patients were included, 11 patients in the non-PT and ten in the PT group, with a mean age of 52 years. Both treatment groups showed a significant improvement at 26 wk for SPADI score(non-PT: P = 0.05, PT: P = 0.03). At the 6 wk follow-up, median SPADI score was significant decreased in the PT group(14 IQR: 6-38) vs the non-PT group(63 IQR: 45-76)(P = 0.01). Pain decreased significantly in both groups but no differences were observed between both treatment groups at any time point, except for night pain at 6 wk in favor of the PT group(P = 0.02). Significant differences in all three ROM directions were observed after 6 wk in favor of the PT group(P ≤ 0.02 for all directions). A significantly greater improvement in abduction(P = 0.03) and external rotation(P = 0.04) was also present in favor of the PT group after 12 wk. RAND-36 scores showed no significant differences in health-related quality of life at all follow-up moments. At 26 wk, both groups did not differ significantly with respect to any of the outcome parameters. No complications were reported in both groups.CONCLUSION Additional physiotherapy after corticosteroid injection improves ROM and functional limitations in early-stage FSs up to the first three months.

Physiotherapy as a Way to Maintain Vaginal Health during Menopause

The majority of women will experience some or most of the menopause symptoms in their life. Thais time in women’s life is associated with a reduction in estrogen levels which leads to physiological changes that affect different organ systems. In the urogenital tract, these changes usually cause vulvar and vaginal atrophy, affecting a vaginal health of women and decreasing their quality of life. Also, there is a reduction in vaginal moisture and loss of tissue elasticity. Besides, other organ systems are involved and they can also negatively impact normal vaginal physiology. These evolutional changes frequently lead to bothersome symptoms that can negatively impact a woman’s vaginal health and the quality of life. The role of pelvic floor physiotherapy is to improve the tone and strength of the muscle fibres in order to achieve the increase of motor units, improve muscle elasticity and to increase the muscle mass which will help to alleviate menopause symptoms.

The Use of Electromagnetic Forces of the Earth in Manual and Physiotherapy

Physiotherapists usually ignore the electric polarization of human bodies that occurs under the influence of the electromagnetic forces of the Earth.This is irrational,since the positive or negative electrification of human tissues has the opposite effect on both their properties and functional activity.How physiotherapists must take into account the polarizing effect of the electromagnetic forces of the Earth when analysing the functional states of the tissues of the human body is shown here.It also shows how these electromagnetic forces can be used by manual and physiotherapists.

Decreasing recurrent bowel obstructions,improving quality of life with physiotherapy:Controlled study

AIM To compare(1) quality of life and(2) rate of recurrent small bowel obstructions(SBO) for patients treated with novel manual physiotherapy vs no treatment. METHODS One hundred and three subjects(age 19-89) with a history of recurrent adhesive SBO were treated with a manual physiotherapy called the Clear Passage Approach(CPA) which focused on decreasing adhesive crosslinking in abdominopelvic viscera. Pre-and post-therapy data measured recurring obstructions and quality of life, using a validated test sent 90 d after therapy. Results were compared to 136 untreated control subjects who underwent the same measurements for subjects who did not receive any therapy, which is the normal course for patients with recurring SBO. Comparison of the groups allowed us to assess changes when the physiotherapy was added as an adjunct treatment for patients with recurring SBO.RESULTS Despite histories of more prior hospitalizations, obstructions, surgeries, and years impacted by bowel issues, the 103 CPA-treated subjects reported a significantly lower rate of repeat SBO than 136 untreated controls(total obstructions P = 0.0003; partial obstructions P = 0.0076). Subjects treated with the therapy demonstrated significant improvements in five of six total domains in the validated Small Bowel Obstruction Questionnaire(SBO-Q). Domains of diet, pain, gastrointestinal symptoms, quality of life(QOL) and pain severity when compared to post CPA treatment were significantly improved(P < 0.0001). The medication domain was not changed in the CPA treated group(P = 0.176).CONCLUSION CPA physical therapy was effective for patients with adhesive SBO with significantly lower recurrence rate, improvement in reported symptoms and overall quality of life of subjects.

The Impact of Lean Six Sigma Practices on Physiotherapy Services Quality at UNRWA Healthcare Centers, Gaza Strip, Palestine

Integrating Lean and Six Sigma found a powerful business tool for the strategy improvement process and saving time is produced. The main aim of this study is to identify the impact of Lean Six Sigma (LSS) practices on physiotherapy service quality at healthcare centers of the United Nations Relief and Works Agency for Palestine Refugees in the Near East (UNRWA), using a descriptive-analytical approach. Data were collected using a questionnaire distributed among 49 physiotherapists working at UNRWA healthcare centers as a census sampling method between July 2016 and August 2017, following the stratified random sampling method. The Statistical Package for Social Science (SPSS) was used to analyze the collected data. The results revealed that there was a statistically significant relationship between Lean Six Sigma (LSS) dimensions and the quality of healthcare services provided in physiotherapy units at the UNRWA healthcare centers. Moreover, the application of Lean Six Sigma dimensions was adopted at 81% of UNRWA healthcare centers. Moreover, the percentage of patients’ satisfaction regarding the quality of healthcare services provided in physiotherapy units was 89%. The study emphasized the effectiveness of Lean Six Sigma dimensions application on the quality healthcare services provided in physiotherapy units at the UNRWA healthcare centers. Furthermore, employee training and reward according to a needs assessment to implement Lean Six Sigma successfully is highly recommended.

Aquatic Physiotherapy and Parkinson’s Disease: Effects on Functional Motor Skills

Parkinson’s Disease (PD) is a progressive disease with motor impairment, and as such requires a multidisciplinary team that includes physiotherapy. Physiotherapy can stimulate learning ability, motor recovery, neuroplasticity and neuroprotection. The aquatic physiotherapy (AP) for PD enables movements to be progressively and safely executed, reducing the risk of falls. Hence, the objective of this study is to analyze the effects of an AP program on the functional motor skills of people with PD. This is a controlled quasi-experimental clinical trial, with blind assessor. The participants were male and female, diagnosed with PD, Hoehn and Yahr stages 1 to 4 and medical certificate for AP. The exclusion criteria were: not presenting independent walking;sensorial deficit;contraindications for attending a heated pool;alterations in levodopa ingestion. The functional assessments conducted on land were: walking speed test;Five Times Sit to Stand Test;Mini BESTest, Unified Parkinson’s Disease Rating Scale (UPDRS) for activities of daily living (ADL);and motor skill parts, evaluated before, after and 4 months after AP. The aquatic assessment was conducted through the Aquatic Functional Assessment Scale (AFAS). The participants were allocated in two groups: Control Group (CG), which did not take part in the pool activities, and Experimental Group (EG), which was submitted to AP, throughout 32 twice-a-week, 50-minute-long appointments. Functional exercises were proposed to respect the principles of specificity and progression regarding complexity in the aquatic activities through aquatic motor skills learning phases. Groups and times were compared statistically. At the end of the study, the EG was composed of 11 participants and the CG 7. There were no differences between the groups at the beginning of the study. A difference was observed between groups for gait speed in evaluation 2;difference between assessment 1 and 2 for GE in the ADL and motor, as well as between assessment 2 and 3 for GE in the motor assessment. CG presented a decline from assessment 1 and 3. In the aquatic assessment, the EG had a statistical difference after the intervention. It was observed that the AP program can modify the aquatic motor skills and the land motor skills of walking speed, the UPDRS ADL and the UPDRS motor.

Effectiveness of Ionic Correction along with Conventional Physiotherapy in Patients Recovering from Stroke: A Case Study

Background and Aims: Brain damage caused by stroke is associated with sensorimotor and/or cognitive impairment, depending on area of brain affected and the severity of attack. The aims of this study were to show the importance of physiotherapy associated with electrolyte and mineral balance through diet correction in patients recovering from stroke. Methods: This is a follow-up study of two patients with stroke followed at Kinshasa International Hospital Center during period from May 16 to July 1, 2020. The first had received physiotherapy with foods for correction of the existing ionic and mineral deficiency and the second had only received pharmacological management with conservative physiotherapy without making a change in diet. Clinical and electrolyte monitoring was performed at regular intervals in both patients. The variables of interest evaluated in both patients were FIM, MOTOR/SENSORY and Ionic balance. Results: The parameters of FIM, motors and sensory functions were improved during follow-up, however they remained disturbed in the control. Na+, Cl﹣, K+, Ca2+, and ionic Ca+ improved from intake to discharge. The biological parameters deteriorated during follow-up in the control. At Day 1, only K+ which was higher in the control than the case. At discharge, a significant drop in K+ control was noted (4.1 vs 3.4);of Na+ (142 vs 125) and of Cl﹣ (109 vs 85). Conclusion: The results show that ionic balance by diet correction associated with physiotherapy is more effective than conventional physiotherapy associated with pharmacological management.

PreEMPT (Preterm Infant Early Intervention for Movement and Participation Trial): The Feasibility of a Novel, Participation-Focused Early Physiotherapy Intervention Supported by Telehealth in Regional Australia—A Protocol

Background: Early intervention is beneficial for improving preterm infant motor and cognitive outcomes in early childhood;however, little is known about whether early intervention can influence a preterm infant’s participation. Additionally, many studies investigating the impact of early intervention for preterm infants have been conducted in large metropolitan centres, leaving preterm infants who reside in regional areas underrepresented in the literature to date. Consequentially, it is not yet known whether there are service delivery models, such as using telehealth as an adjunct to face-to-face intervention, that might cater to the needs of preterm infants residing outside metropolitan centres. PreEMPT (Preterm infant Early intervention for Movement and Participation Trial) is a novel early physiotherapy intervention that has been designed to use a participation goal-directed intervention approach via a mixture of face-to-face clinic sessions and telehealth sessions to improve the motor and participation outcomes of preterm born infants. Methods: This study aims to evaluate the feasibility of PreEMPT using an assessor-blinded, randomised controlled trial to compare PreEMPT to Usual Physiotherapy Care (UPC) for preterm infants residing in a regional Australian hospital catchment area. Twenty-six preterm infants (≤34 + 6 weeks gestational age) will be recruited prior to term corrected age from the special care nursery of a regional hospital. Following informed consent and baseline assessments, infants will be randomly allocated to receive either PreEMPT, a novel participation-focused early physiotherapy intervention delivered weekly for 14 forty-five-minute sessions alternating face-to-face sessions with telehealth into the infant’s home, or UPC, two - three physiotherapy sessions in the 4-month intervention period. Outcome measures relating to infant neuromotor development, motor performance, general development, and parental mental health and well-being will be assessed at 4-, 6- and 8-months corrected age. Feasibility will be evaluated by acceptability (parental satisfaction), demand and practicality (recruitment rate and telehealth session implementation), implementation (attendance at assessment and treatment sessions), and limited efficacy testing (comparing outcomes listed above for infants in PreEMPT and UPC). Discussion: This study will be the first of its kind to use the participation of preterm infants in meaningful life situations as the foundation for intervention delivered via alternating face-to-face clinic sessions with telehealth into the home. The feasibility of this approach will be evaluated and used to inform future iterations of research about PreEMPT’s efficacy for improving preterm infant motor and participation outcomes.

Potential impact of early physiotherapy in the emergency department for non-traumatic neck and back pain

BACKGROUND: Musculoskeletal complaints, especially non-traumatic neck and back pain, are routinely encountered in the emergency department(ED) and lead to ED overcrowding, a burgeoning wait time for physiotherapy and outpatient orthopedic reviews. The study aimed to evaluate the impact of early physiotherapy evaluation and treatment(EPET) vs. standard care(SC) on clinical outcomes for patients presenting to the ED with non-traumatic neck and back pain.METHODS: A retrospective observational study of 125 patients who presented to the ED with non-traumatic neck and back pain with/without peripheral symptoms from July 2010 to February 2011. Neck Disability Index(NDI), Modifi ed Oswestry Low Back Pain Disability Questionnaire(MODI) and 11-point Numeric Pain Rating Scale were used as outcome measures and compared between groups at a mean of 34 days from their initial ED visit.RESULTS: We identifi ed a total of 125 patients. EPET group comprised 62 patients(mean age, 45 years; men, 63%) and SC group comprised 63 patients(mean age, 45 years; men, 43%). The EPET and SC groups received physiotherapy at a median of 4 and 34 days respectively from their fi rst ED visit. EPET patients had signifi cantly lower levels of disability(9.0% vs. 33.4%, Welch t-test, P<0.001) and pain(median value, 1 vs. 4 points, Mann-Whitney U-test, P<0.001) compared with SC patients.CONCLUSION: Early access to physiotherapy in ED was associated with reduced pain and disability levels. EPET protocol can potentially decrease the demand on outpatient orthopedic services, thereby freeing up available resources to treat patients who are more likely to benefi t from it.

Functional physiotherapy method results for the treatment of idiopathic clubfoot

BACKGROUND Idiopathic clubfoot is a congenital deformity of multifactorial etiology.The initial treatment is eminently conservative;one of the methods applied is the Functional physiotherapy method(FPM),which includes different approaches:Robert Debré(RD)and Saint-Vincent-de-Paul(SVP)among them.This method is based on manipulations of the foot,bandages,splints and exercises adapted to the motor development of the child aimed to achieve a plantigrade and functional foot.Our hypothesis was that the SVP method could be more efficient than the RD method in correcting deformities,and would decrease the rate of surgeries.AIM To compare the RD and SVP methods,specifically regarding the improvement accomplished and the frequency of surgery needed to achieve a plantigrade foot.METHODS Retrospective study of 71 idiopathic clubfeet of 46 children born between February 2004 and January 2012,who were evaluated and classified in our hospital according to severity by the Dimeglio-Bensahel scale.We included moderate,severe and very severe feet.Thirty-four feet were treated with the RD method and 37 feet with the SVP method.The outcomes at a minimum of two years were considered as very good(by physiotherapy),good(by percutaneous heel-cord tenotomy),fair(by limited surgery),and poor(by complete surgery).RESULTS Complete release was not required in any case;limited posterior release was done in 23 cases(74%)with the RD method and 9(25%)with the SVP method(P<0.001).The percutaneous heel-cord tenotomy was done in 2 feet treated with the RD method(7%)and 6 feet(17%)treated with the SVP method(P<0.001).Six feet in the RD group(19%)and twenty-one feet(58%)in the SVP group did not require any surgery(P<0.001).CONCLUSION Our study provides evidence of the superiority of the SVP method over the RD method,as a variation of the FPM,for the treatment of idiopathic clubfoot.

Low-intensity Microwave Radiation of Natural Substances for Physiotherapy

The mechanisms of influence of physiotherapy procedures in ozokeriteparaffin therapy are considered in this paper.It is shown that microwave electromagnetic radiation formed by heated ozokerite-paraffin mixture is an important component of physiotherapy procedures.Using the experimental setup developed by the authors,the radiative abilities of ozokerite,paraffin and their mixtures in the microwave range were investigated.It was found that in the process of cooling the ozokerite-paraffin mixture,during the procedure,negative microwave fluxes occur,affecting the inflammatory processes in the patient’s body.The dependences of the microwave radiation level on the composition of the ozokerite-paraffin mixture are investigated.The results of experimental studies allowed us to evaluate the interaction of electromagnetic radiation of ozokerite-paraffin mixtures with human own electromagnetic radiation and to approach the choice of modes of therapeutic interaction more carefully.

Service Evaluation of a New Physiotherapy Management Service for Patients with Chronic Temporomandibular Dysfunction

Aims: This service evaluation explored and reported findings from a new multi-disciplinary service where physiotherapists were incorporated into an orofacial team who managed patients with chronic Temporomandibular Dysfunction (TMD). Methods: We collected data before the physiotherapists’ involvement and on discharge from physiotherapy management. Outcomes were patient-reported pain (numerical rating scale (NRS 0 to 10)), patient specific functional score (PSFS), health-related quality of life (EQ-5D) and range of mandibular depression (mm). Exploratory analyses compared baseline to follow-up scores on discharge from physiotherapy. Results: 79 patients (mean age 40 (SD 18);female 87%) received physiotherapy. At discharge, there was a mean reduction in pain: 2.8 (95% CI 2.0 to 3.6), improvement in function: ﹣4.0 (95% CI ﹣4.7 to ﹣3.3), improvement in health: ﹣0.139 (95% CI ﹣0.196 to ﹣0.082) and increase in mandible depression: ﹣6.6. (95% CI ﹣9.1 to ﹣4.1). Conclusions: The results provide early, exploratory evidence that patients with chronic temporomandibular dysfunction treated by physiotherapists achieve clinically important changes in pain, function and health in the short term.