Academy Library and Information Service Current Awareness Bulletin - Physiotherapy May 2021
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Academy Library and Information Service
Current Awareness Bulletin – Physiotherapy
May 2021
This Current Awareness Bulletin is produced by Academy Library and Information Service GWH staff with a
range of resources to support practice. It will include recently published systematic reviews, research articles
and details of library resources.
You may be able to access some articles if you have an OpenAthens account. Click on the logo above to register.
For further information or support, please contact the Academy Library on 01793 604596 or email:
gwh.alis@nhs.net.
Resources
BMJ Best Practice uses the latest evidence-based research, guidelines and expert opinion to offer step-by-
step guidance on diagnosis, prognosis, treatment and prevention.
DynaMed study summaries provide brief and clinically oriented descriptions of clinical research studies,
placed in context within the clinical framework. Key elements of a DynaMed study summary include the
study conclusion, level of evidence rating, study type, reference, and study details.
Trip is a clinical search engine designed to allow users to quickly and easily find and use high-quality
research evidence to support their practice and/or care. As well as research evidence we also allow
clinicians to search across other content types including images, videos, patient information leaflets,
educational courses and news.
Systematic Reviews
Austrian Institute of Health Technology Assessment
Robotics and functional electrical stimulation for stroke rehabilitation (2021)
Goetz, G., Walter, M., Wohlhöfner, K., Wittenberg, H., Saal, S., Stephan, K.M. and Dohle, C.
Available online at this link
Post-stroke patients often suffer from a hemiparesis affecting the functional abilities of lower and/or upper
extremities. Improving walking and everyday activities are therefore important rehabilitation goals for these
patients. Robotic assisted rehabilitation (RAR) and functional electrostimulation (FES) can, among others, be
used as a supplement to conventional rehabilitation in post-stroke patients. The purpose of this report was
to evaluate whether there is an additional clinical benefit of using RAR or FES in stroke rehabilitation when
compared to standard rehabilitation alone.Effective Health Care Program
Standardized Library of Lumbar Spondylolisthesis Outcome Measures (2021)
Available online at this link
Significant variation exists in both the types and definitions of outcome measures used in patient registries,
even within the same clinical area. This variation reduces the utility of registries, making it difficult to
compare, link, and aggregate data across the spectrum of clinical care and reporting. To address these
limitations, the Agency for Healthcare Research and Quality (AHRQ) developed the Outcome Measures
Framework (OMF), a conceptual model for classifying outcomes that are relevant to patients and providers
across most conditions; it is intended to serve as a content model for developing harmonized outcome
measures for specific clinical areas.
Original Research
1. A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A
Global Response to COVID-19.
Freeman-Sanderson Amy Archives of physical medicine and rehabilitation 2021;102(5):835-842.
Objective: To identify core practices for workforce management of communication and swallowing functions in coronavirus disease
2019 (COVID-19) positive patients within the intensive care unit (ICU).; Design: A modified Delphi methodology was used, with 3
electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey
statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the
ICU were included.; Setting: Electronic modified Delphi process.; Participants: Speech-language pathologists (SLPs) (N=35) from 6
continents representing 12 countries.; Interventions: Not applicable.; Main Outcome Measures: The main outcome was consensus
agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly
agree). Prioritization rank order of statements in a fourth round was also conducted.; Results: SLPs with a median of 15 years of ICU
experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the
third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance.; Conclusions: A set of global
consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19
pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation,
resourcing and training, and the management of communication and swallowing functions. These statements support and provide
direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic. (Copyright ©
2021. Published by Elsevier Inc.)
Available online at this link
2. A rehabilitation programme focussing on pelvic floor muscle training for persistent lumbopelvic pain after childbirth: A
randomized controlled trial.
Wang Hui Journal of rehabilitation medicine 2021;53(4):1.
OBJECTIVETo evaluate the effects of a rehabilitation programme for lumbopelvic pain after childbirth.METHODSWomen with
lumbopelvic pain 3 months postpartum were included in a randomized controlled trial. Patients in the intervention group (n = 48)
received pelvic floor muscle training combined with neuromuscular electrical stimulation of the paraspinal muscles for 12 weeks, while
patients in the control group (n = 48) received neuromuscular electrical stimulation for 12 weeks. Outcomes were measured with the
Triple Numerical Pain Rating Scale (NPRS), Modified Oswestry Disability Questionnaire (MODQ) and Short-Form Health Survey-36 (SF-
36).RESULTSThe NPRS score was significantly better in the intervention group at 12 weeks compared with the control group (p = 0.000).
The MODQ score was significantly better at 6 and 12 weeks compared with the control group (p = 0.009 and p = 0.015, respectively).
The mean value of the Physical Components Summary of the SF-36, was significantly better in the intervention group at 6 weeks
(p = 0.000) and 12 weeks (p = 0.000) compared with the control group, but there was no significant improvement in Mental
Components Summary of the SF-36.CONCLUSIONA postpartum programme for women with lumbopelvic pain is feasible and improves
the physical domain of quality of life.
Available online at this link
3. Age, rehabilitation and surgery characteristics are re-injury risk factors for adolescents following anterior cruciate ligament
reconstruction.
Law Mallory A. Physical Therapy in Sport 2021;49:196-203.
To examine the effect of age on post-ACLR rehabilitative outcomes and identify surgical/rehabilitative characteristics as ACL re-injury
risk factors in adolescents. Cohort study. Children's hospital. 273 adolescents with first-time ACLR. Demographics, injury history,
surgery, and outcomes documented during post-ACLR physical therapy (PT) sessions were extracted from medical records. Effects of
age on outcomes were examined using multivariate regression. ACL re-injury risk factors were identified using survival analysis with
Cox regression. Re-injury was recorded in 47 patients (17.2%) with a median follow-up time of 3.1 years and median re-injury time of
13.4 months post-surgery. Younger age (Hazard-Ratio, HR = 1.264 per year decrease; P = 0.005), receiving surgery within 1 month post-
injury (HR = 3.378 vs. >3 months; P = 0.012), starting PT within 3 days post-surgery (HR = 3.068; P = 0.022), and decreased number of PT
sessions (HR = 1.118 per 3-session decrease; P = 0.010) increased re-injury risk. Although age was associated with re-injury risk, age was
not associated with any outcome (P > 0.059). Adolescents who are younger, receive surgery and post-surgery PT sooner, or attendfewer PT sessions may be at an increased re-injury risk. Younger patients achieved similar outcomes despite elevated re-injury risk.
Current discharge criteria are inadequate in identifying high re-injury risk patients. • Adolescent patients who are younger had a higher
ACL re-injury risk. • However, similar rehabilitative outcomes and progression across all youth patients. • Need sensitive discharge
criteria to identity high re-injury risk youth patients. • Getting ACLR or PT sooner or attending less PT also led to a higher re-injury risk.
• Structured rehabilitation/PT post-ACLR is critical in preventing ACL re-injury.
Available online at this link
4. Assessment of Studies Evaluating Spinal Manipulative Therapy and Infectious Disease and Immune System Outcomes: A
Systematic Review.
Chow Ngai JAMA network open 2021;4(4):e215493.
Importance: Claims that spinal manipulative therapy (SMT) can improve immune function have increased substantially during the
COVID-19 pandemic and may have contributed to the rapid spread of both accurate and inaccurate information (referred to as an
infodemic by the World Health Organization).; Objective: To identify, appraise, and synthesize the scientific literature on the efficacy
and effectiveness of SMT in preventing the development of infectious disease or improving disease-specific outcomes in patients with
infectious disease and to examine the association between SMT and selected immunological, endocrine, and other physiological
biomarkers.; Evidence Review: A literature search of MEDLINE, the Cumulative Index to Nursing and Allied Health Literature, the Index
to Chiropractic Literature, the Cochrane Central Register of Controlled Trials, and Embase was conducted from inception to April 15,
2020. Randomized clinical trials and cohort studies were included. Eligible studies were critically appraised, and evidence with high and
acceptable quality was synthesized using the Synthesis Without Meta-Analysis guideline.; Findings: A total of 2593 records were
retrieved; after exclusions, 50 full-text articles were screened, and 16 articles reporting the findings of 13 studies comprising 795
participants were critically appraised. The literature search found no clinical studies that investigated the efficacy or effectiveness of
SMT in preventing the development of infectious disease or improving disease-specific outcomes among patients with infectious
disease. Eight articles reporting the results of 6 high- and acceptable-quality RCTs comprising 529 participants investigated the effect of
SMT on biomarkers. Spinal manipulative therapy was not associated with changes in lymphocyte levels or physiological markers among
patients with low back pain or participants who were asymptomatic compared with sham manipulation, a lecture series, and
venipuncture control groups. Spinal manipulative therapy was associated with short-term changes in selected immunological
biomarkers among asymptomatic participants compared with sham manipulation, a lecture series, and venipuncture control groups.;
Conclusions and Relevance: In this systematic review of 13 studies, no clinical evidence was found to support or refute claims that SMT
was efficacious or effective in changing immune system outcomes. Although there were limited preliminary data from basic scientific
studies suggesting that SMT may be associated with short-term changes in immunological and endocrine biomarkers, the clinical
relevance of these findings is unknown. Given the lack of evidence that SMT is associated with the prevention of infectious diseases or
improvements in immune function, further studies should be completed before claims of efficacy or effectiveness are made.
Available online at this link
5. Core Stability Exercises in Addition to Usual Care Physiotherapy Improve Stability and Balance After Stroke: A Systematic
Review and Meta-analysis.
Gamble Kate Archives of physical medicine and rehabilitation 2021;102(4):762-775.
Objective: To systematically review the effect of core stability exercises in addition to usual care physiotherapy on patient outcomes
after stroke.; Data Sources: Cumulative Index to Nursing and Allied Health, MEDLINE, Physiotherapy Evidence Database (PEDro),
PubMed, and EMBASE were searched to November 2018.; Study Selection: Eleven randomized controlled trials that compared usual
care physiotherapy with usual care physiotherapy with additional core stability exercises in people with stroke were included. The
initial search yielded 1876 studies.; Data Extraction: Two independent reviewers applied inclusion and exclusion criteria and extracted
data on methodological quality using the PEDro scale, participant characteristics, intervention details, outcome measures, and results.;
Data Synthesis: Postintervention means and SDs were pooled to calculate either the standardized mean difference (SMD) or the mean
difference (MD) and 95% CIs using a random-effects model and inverse variance methods. There was moderate quality evidence to
suggest the addition of core stability exercises to usual care physiotherapy improved trunk control (SMD, 0.94; 95% CI, 0.44-1.44; I 2
=69%), functional dynamic balance (SMD, 1.23; 95% CI, 0.5-1.97; I 2 =71%), and walking speed (MD, 0.27m/s; 95% CI, 0.01-0.52; I 2
=40%) in people with acute and chronic stroke. No significant effect was found when assessing functional ambulation categories or the
timed Up and Go test, and mixed results were found for global functioning.; Conclusions: The addition of core stability exercises to
usual care physiotherapy after stroke may lead to improved trunk control and dynamic balance. Therefore, core stability exercises
should be included in rehabilitation if improvements in these domains will help clients achieve their goals. Future trials should consider
incorporating outcomes of body kinematics during functional tasks to assess movement quality and assess participation outcomes.
(Copyright © 2020 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.)
Available online at this link
6. COVID-19 and hand surgery: the perspective of an Italian hand therapist.
Vigliarolo D. Hand surgery & rehabilitation 2021;40(2):208.
Available online at this link
7. Decision-Making on Referral to Primary Care Physiotherapy After Inpatient Stroke Rehabilitation.
Geerars Marieke Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association
2021;30(5):105667.
Objective: This study aimed to acquire insight into the decision-making processes of healthcare professionals concerning referral to
primary care physiotherapy at the time of discharge from inpatient stroke rehabilitation.; Design: A generic qualitative study using aninductive thematic analysis was performed. Semi-structured interviews were conducted following an interview guide.; Setting:
Secondary care centers in the Netherlands: neurology departments of nine hospitals and (geriatric) rehabilitation centers.; Participants:
Nineteen healthcare professionals (physiotherapists, specialist in geriatric medicine, physiatrist, physician assistant) participated in the
study. All were involved in the decision for referral to primary care physiotherapy.; Results: During the inpatient period, healthcare
professionals gather information to form a complete picture of the stroke survivor as a basis for decision-making. The decision on
referral is influenced by personal factors and home environment of the stroke survivor, organizational factors within the care setting,
and the intuition and feeling of social responsibility of the individual healthcare professional.; Conclusions: After inpatient
rehabilitation, many elements are considered that may influence referral to primary care physiotherapy. Presently, there is no
consensus concerning referrals. The final decision depends on the individual physiotherapist and care setting. Healthcare professionals
mentioned the importance of movement behavior, although there is no consensus if secondary prevention is a primary task of the
physiotherapist. More research is needed to identify risk factors for functional decline in order to develop a referral policy that
addresses primary care physiotherapy to the right group of stroke survivors. (Copyright © 2021 The Author(s). Published by Elsevier
Inc. All rights reserved.)
Available online at this link
8. Does pain neuroscience education improve pain knowledge, beliefs and attitudes in undergraduate physiotherapy
students?
Saracoglu Ismail Physiotherapy research international : the journal for researchers and clinicians in physical therapy
2021;26(2):e1898.
Background: To evaluate the effect of a brief pain neuroscience education (PNE) session on physiotherapy students' knowledge of pain
and their beliefs and attitudes about the treatment of patients with chronic low back pain.; Methods: This study was a single-center,
cross-sectional study including 205 physiotherapy undergraduate students. The participants completed the Neurophysiology of Pain
Questionnaire (NPQ) and Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT). They then received a 70-min neuroscience
education session covering the mechanisms and biopsychosocial aspects of chronic low back pain. The questionnaires were
readministered immediately after the educational session and at 6 months posteducation.; Results: Our analysis included data from
156 participants (mean age: 20.9 ± 2.51, 69.8% women) who completed the questionnaires pre-, post-, and 6 months after the
educational session. To assess the effect of the education on the scores of the questionnaires, a repeated-measures ANOVA was
conducted. There was a significant interaction observed for NPQ over time (p = 0.00; η 2 = 0.654), for PABS-PT factor 1(p < 0.001;
η2 = 0.50) and for PABS-PT factor 2 over time (p = 0.02; η 2 = 0.04) CONCLUSION: This study showed that a 70-min session of PNE
improves the level of pain knowledge in undergraduate physiotherapy students and influences their beliefs and attitudes concerning
chronic low back pain. These findings suggest that adding PNE to the curricula of physiotherapy and rehabilitation programs may be
beneficial. (© 2021 John Wiley & Sons Ltd.)
Available online at this link
9. Double-Blind Randomized Trial on the Efficacy of the Forced Prolonged Position for Treatment of Lateral Canal Benign
Paroxysmal Positional Vertigo.
Mandalà Marco The Laryngoscope 2021;131(4):E1296-E1300.
Objectives/hypothesis: The need for class I and II studies on the efficacy of liberatory maneuvers in the treatment of lateral canal
benign paroxysmal positional vertigo (LC-BPPV) motivated the present double-blind randomized trial on the short-term efficacy of the
forced prolonged position (FPP).; Study Design: Double-blind, randomized controlled trial.; Methods: Two hundred twenty-one patients
with unilateral LC-BPPV met the inclusion criteria for a multicentric study. Patients were randomly assigned to treatment by FPP (116
subjects) or sham treatment (105 subjects). Subjects were followed up at 24 hours with the supine roll test by blinded examiners.;
Results: Among the sample, 67.4% and 32.6% of the patients showed respectively geotropic and apogeotropic variant of LC-BPPV. At
the 24-hour follow-up, the effectiveness of FFP compared to the sham maneuver was, respectively, 57.8% versus 12.4% (P < .0001) in
the total sample, 76.9% versus 11.3% (P < .0001) in the geotropic variant group, and 60.5% versus 17.6% (P = .0003) in the apogeotropic
variant group, including resolution or transformation to geotropic variant.; Conclusions: FPP proved highly effective compared to the
sham maneuver. The present class 2 study of the efficacy of the FPP changes the level of recommendation of the method for treating
LC-BPPV into a strong one.; Level of Evidence: 2 Laryngoscope, 131:E1296-E1300, 2021. (© 2020 American Laryngological, Rhinological
and Otological Society Inc, "The Triological Society" and American Laryngological Association (ALA).)
Available online at this link
10. Early mobilization and physical exercise in patients with COVID-19: A narrative literature review.
Wittmer Veronica Lourenço Complementary therapies in clinical practice 2021;43:101364.
BACKGROUNDCurrently, little is known about early mobilization and exercise in individuals with COVID-19.OBJECTIVETo describe the
indication and safety of early mobilization and exercises in mild to severe COVID-19 patients and to investigate the use of
telerehabilitation to deliver exercise programs to these patients.METHODSThis narrative literature review was conducted performing a
comprehensive search of databases.RESULTS32 articles met the established criteria and the main findings were summarized and
described, including indication, contraindication and recommendation for early rehabilitation and exercises
prescription.CONCLUSIONSThe literature suggests that early mobilization and physical exercise are beneficial for individuals with
COVID-19. However, much of what has been published is based on expert opinion due to a lack of randomized trials, which are needed.
Available online at this link
11. Effect of a Novel Perturbation-Based Pinch Task Training on Sensorimotor Performance of Upper Extremity for Patients
With Chronic Stroke: A Pilot Randomized Controlled Trial.Hsu Hsiu-Yun Archives of Physical Medicine & Rehabilitation 2021;102(5):811-818. To investigate the effects of perturbation-based pinch task training on the sensorimotor performance of the upper extremities of patients with chronic stroke via a novel vibrotactile therapy system. A single-blinded randomized controlled trial. A university hospital. Patients with chronic stroke (N=19) randomly assigned into either an experimental group or a control group completed the study. In addition to 10 minutes of traditional sensorimotor facilitation, each participant in the experimental group received 20 minutes of perturbation-based pinch task training in each treatment session, and the controls received 20 minutes of task-specific motor training twice a week for 6 weeks. The scores for the primary outcome, Semmes-Weinstein monofilament (SWM), and those for the secondary outcomes, Fugl-Meyer Assessment (FMA), amount of use, quality of movement (QOM) on the Motor Activity Log (MAL) scale, and box and block test (BBT), were recorded. All outcome measures were recorded at pretreatment, post treatment, and 12-week follow-up. There were statistically significant between-group differences in the training-induced improvements revealed in the SWM results (P =.04) immediately after training and in the BBT results (P =.05) at the 12-week follow-up. The changes in muscle tone and in the QOM, SWM, and BBT scores indicated statistically significant improvements after 12 sessions of treatment for the experimental group. For the control group, a significant statistical improvement was found in the wrist (P
15. Efficacy of exercise rehabilitation program accompanied by experiential music for recovery of aphasia in single
cerebrovascular accidents: a randomized controlled trial.
Aravantinou-Fatorou Katerina Irish journal of medical science 2021;190(2):771-778.
BACKGROUNDThe current study aims to evaluate the effects of daily traditional experiential music listening for clinical recovery of
post-stroke aphasia.METHODSThis was a prospective randomized trial with seventy-nine stroke survivors who suffered from post-
stroke aphasia. All patients underwent a neuropsychological evaluation, at time = 0 during the admission at the rehabilitation structure
(baseline), and 6 months post-stroke. All cases received standard treatment for stroke and post-stroke aphasia in terms of medical care
and rehabilitation. Furthermore, patients were randomized to receive either standard care only or standard care with daily traditional
experiential music listening. Computer tomography perfusion and neurological examination were assessed to all patients. Recovery
was measured by the score at Aachener Aphasie Test.RESULTSThe statistically significant differences between the control group (CG)
and the rest of the patients were the clinical characteristics (hemiparesis) (p = 0.002), the cerebral blood flow in affected areas
(p = 0.000), and the Mini-Mental Test (mMT) (p = 0.000). Only group and mMT were independent predictor factors for recovery,
according to multivariate analysis odd ratio (ΟR) (95% confidence interval) 0.022 (0.009-0.435) and 0.658 (0.142-0.224)
respectively.CONCLUSIONSThe results of this study are promising and suggest that an enriched sound environment is beneficial for
patients with post-stroke aphasia since the recovery rate is higher when standard care was combined with daily music listening.
Available online at this link
16. Feasibility, safety and effectiveness of a pilot 16-week home-based, impact exercise intervention in postmenopausal
women with low bone mineral density.
Ng C.-A Osteoporosis international : a journal established as result of cooperation between the European Foundation for
Osteoporosis and the National Osteoporosis Foundation of the USA 2021;32(5):893-905.
The feasibility and efficacy of home-based, impact exercise are unclear. This pilot impact exercise intervention was feasible and safe,
and improved bone health and physical function in postmenopausal women with low bone density. Appropriately designed
randomised controlled trials are now required to determine whether such interventions can reduce fracture risk.INTRODUCTIONThe
feasibility and efficacy of impact exercise in postmenopausal women with low bone mineral density (BMD) are unclear. We aimed to
determine adherence, safety and changes in BMD, bone microarchitecture and physical function following a pilot home-based, impact
exercise intervention in postmenopausal women with low BMD.METHODSFifty community-dwelling postmenopausal women with
BMD T-scores < - 1.0 participated in 16 weeks of home-based impact exercise progressively increasing to 50 multi-directional unilateral
hops on each leg daily. Bone density and structure were assessed by lumbar spine and hip dual-energy X-ray absorptiometry (DXA), 3D
modelling (3D-SHAPER) of hip DXA scans and distal tibial high-resolution peripheral quantitative computed tomography scans. Physical
performance was assessed by repeated chair stand time and stair climb time.RESULTSForty-four women (mean ± SD age 64.5 ± 7.5
years) completed the intervention, with adherence of 85.3 ± 17.3%. Reasons for withdrawal were related soreness (n = 2), unrelated
injury (n = 1) and loss of interest (n = 3). Femoral neck areal BMD increased by 1.13 ± 3.76% (p = 0.048). Trabecular volumetric BMD
(vBMD) increased at the total hip (2.27 ± 7.03%; p = 0.038) and femoral neck increased (3.20 ± 5.39%; p < 0.001). Distal tibia total
vBMD increased by 0.32 ± 0.88% (p = 0.032) and cortical cross-sectional area increased by 0.55 ± 1.54% (p = 0.034). Chair stand and
stair climb time improved by 2.34 ± 1.88 s (p < 0.001) and 0.27 ± 0.49 s (p < 0.001), respectively.CONCLUSIONA 16-week home-based,
impact exercise was feasible and may be effective in improving femoral neck areal BMD, total hip and distal tibial vBMD and physical
function in postmenopausal women. Appropriately designed randomised controlled trials are now required to determine whether such
interventions can reduce fracture risk in older populations.
Available online at this link
17. Hip Arthroscopy Versus Physical Therapy for the Treatment of Symptomatic Acetabular Labral Tears in Patients Older Than
40 Years: A Randomized Controlled Trial.
Martin Scott D. The American journal of sports medicine 2021;49(5):1199-1208.
Background: Previous observational studies have suggested poor results of arthroscopic surgery for the treatment of acetabular labral
tears in patients older than 40 years.; Purpose: To compare hip arthroscopy versus nonoperative management for symptomatic labral
tears in patients older than 40 years who have limited radiographic osteoarthritis.; Study Design: Randomized controlled trial; Level of
evidence, 1.; Methods: In this single-surgeon, parallel randomized controlled trial, patients older than 40 years who had symptomatic,
MRI-confirmed labral tears and limited radiographic osteoarthritis (Tönnis grades 0-2) were randomized 1:1 to arthroscopic surgery
with postoperative physical therapy (SPT) or physical therapy alone (PTA) using an electronic randomization program. PTA patients who
achieved unsatisfactory improvement were permitted to cross over to SPT after completing ≥14 weeks of physical therapy. The primary
outcomes were International Hip Outcome Tool (iHOT-33) and modified Harris Hip Score (mHHS) at 12 months after randomization,
and secondary outcomes included other patient-reported outcome measures and the visual analog scale. Outcomes were assessed at
baseline and at 3, 6, and 12 months after randomization. Primary analysis was performed on an intention-to-treat basis using linear
mixed-effect models. Sensitivity analyses included modified as-treated analysis and treatment-failure analysis. Due to infeasibility,
patients and health care providers were both unblinded.; Results: The study enrolled 90 patients (46 [51.1%] SPT; 44 [48.9%] PTA); of
these, 81 patients (42 [51.9%] SPT; 39 (48.1%) PTA) completed 12-month follow-up. A total of 28 of the 44 PTA patients crossed over to
SPT within the study period (63.6% crossover). Intention-to-treat analysis revealed significantly greater iHOT-33 scores (+12.11; P =
.007) and mHHS scores (+6.99 points; P = .04) in the SPT group than the PTA group at 12 months. Modified as-treated analysis revealed
that these differences exceeded the minimal clinically important difference of 10.0 points (SPT-PTA iHOT-33, +11.95) and 8.0 points
(SPT-PTA mHHS, +9.76), respectively.; Conclusion: In patients older than 40 years with limited osteoarthritis, arthroscopic acetabular
labral repair with postoperative physical therapy led to better outcomes than physical therapy alone. Thus, age over 40 years should
not be considered a contraindication to arthroscopic acetabular labral repair.; Registration: NCT03909178 (ClinicalTrials.gov identifier).
Available online at this link18. Home-based exercise programmes improve physical fitness of healthy older adults: A PRISMA-compliant systematic review
and meta-analysis with relevance for COVID-19.
Chaabene H. Ageing research reviews 2021;67:101265.
This systematic review and meta-analysis aimed to examine the effects of home-based exercise programmes on measures of physical-
fitness in healthy older adults. Seventeen randomized-controlled trials were included with a total of 1,477 participants. Results
indicated small effects of home-based training on muscle strength (between-study standardised-mean-difference [SMD] = 0.30),
muscle power (SMD = 0.43), muscular endurance (SMD = 0.28), and balance (SMD = 0.28). We found no statistically significant effects
for single-mode strength vs. multimodal training (e.g., combined balance, strength, and flexibility exercises) on measures of muscle
strength and balance. Single-mode strength training had moderate effects on muscle strength (SMD = 0.51) and balance (SMD = 0.65)
while multimodal training had no statistically significant effects on muscle strength and balance. Irrespective of the training type, >3
weekly sessions produced larger effects on muscle strength (SMD = 0.45) and balance (SMD = 0.37) compared with ≤3 weekly sessions
(muscle strength: SMD = 0.28; balance: SMD = 0.24). For session-duration, only ≤30 min per-session produced small effects on muscle
strength (SMD = 0.35) and balance (SMD = 0.34). No statistically significant differences were observed between all independently-
computed single-training factors. Home-based exercise appears effective to improve components of health- (i.e., muscle strength and
muscular endurance) and skill-related (i.e., muscle power, balance) physical-fitness. Therefore, in times of restricted physical activity
due to pandemics, home-based exercises constitute an alternative to counteract physical inactivity and preserve/improve the health
and fitness of healthy older adults aged 65-to-83 years.
Available online at this link
19. Impact of COVID-19 on hand surgery in Italy: A comparison between the Northern and the Southern regions.
Toia F. Hand surgery & rehabilitation 2021;40(2):139-144.
The aims of this study were to evaluate the impact of the COVID-19 pandemic on emergency and elective hand surgery in four Italian
regions that had either a high (Lombardy and Piemonte) or a low (Sicilia and Puglia) COVID-19 case load to discuss problems and to
elaborate strategies to improve treatment pathways. A panel of hand surgeons from these different regions compared and discussed
data from the centers they work in. The COVID-19 pandemic had an enormous impact on both elective and emergency surgery in Italy,
not only in highly affected regions but also - and paradoxically even at a higher extent - in regions with a low COVID-19 case load. A
durable and flexible redesign of hand surgery activities should be promoted, while changing and hopefully increasing human resources
and enhancing administrative support. Telematics must also be implemented, especially for delivering rehabilitation therapy.
(Copyright © 2020. Published by Elsevier Masson SAS.)
Available online at this link
20. Intensive pulmonary rehabilitation in a pediatric lung transplantation patient: A case report.
Choi Eun Jung Medicine 2021;100(17):1.
BACKGROUNDThe pediatric lung transplant is a very important treatment for patients with end-stage lung diseae, and pulmonary
rehabilitation (PR) is also an important factor in determining the prognosis. However, there is no much literature available on
pulmonary rehabilitation in pediatric patients' post lung transplant. Through this case report, we would like to present our intensive PR
program for pediatric patients' post-lung transplant.PATIENT CONCERNSThe 10-year-old boy's breathing before receiving a lung
transplant continued to deteriorate and he eventually became dependent on a wheelchair.DIAGNOSISHe was diagnosed with infantile
acute lymphoblastic leukemia at 6 months of age. At the age of one year, he underwent allogeneic bone marrow transplantation, but
was diagnosed with post-transplantation bronchiolitis obliterans (PTBO) two months later. He had a lung transplant at the age of
10.INTERVENTIONSHe was hospitalized and received an initial assessment. This assessment included functional, cognitive, and
psychological evaluations. He additionally completed PR exercises twice daily for two weeks. After discharge, he continued to
participate in an outpatient-based PR program for three months. During the outpatient phase, PR exercises were performed once
weekly, in addition to home-based cognitive training.OUTCOMESOur intensive post-lung PR program improved our patient's exercise
capacity, lung function, and quality of life. As a comprehensive rehabilitation service, our program also included a cognitive training
component.CONCLUSIONWe describe an intensive PR program tailored to pediatric patients' post-lung transplant. The program was
feasible and resulted in improvements in functional exercise capacity, lung function, and quality of life. Future research into our
method is necessary for continued improvement of this novel program.
Available online at this link
21. Learning about health promotion through behavior change: a novel qualitative study of physiotherapy students
incorporating applied intervention and reflection.
Barradell Sarah Physiotherapy theory and practice 2021;37(4):497-506.
Introduction and Aim : A broader definition of health, and an increase in lifestyle-related health conditions, have necessitated a change
in physiotherapy practice. As a result, what entry-level students learn about health and wellbeing for 21 st century needs is receiving
more attention. The aim of this study was to explore what entry-level physiotherapy students learned experientially about health
promotion and behavior change by working with a peer to reciprocally prescribe and receive a six-week health promotion program.
Method : Thematic analysis of an assessment task that students submitted as part of their enrolment in a second-year physiotherapy
subject. Results : Analysis revealed three themes: 1) physiotherapist's contribution to the health and wellbeing of others; 2) needing to
understand determinants of health to collaboratively facilitate behavior change; and 3) benefits of experiential activities to learn about
professional/personal roles. Discussion : Students demonstrated understanding of the complexity and challenges associated with being
a practitioner. The assessment task gave students an authentic learning experience to navigate factors such as establishing personal
interests, negotiating goals, and addressing motivation. Furthermore, it highlighted that opportunities may exist for students toparticipate in, and learn from, practice-relevant situations outside of clinical placements.
Available online at this link
22. Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education and active physiotherapy-A randomized
controlled trial.
Dragesund Tove Physiotherapy research international : the journal for researchers and clinicians in physical therapy
2021;26(2):e1891.
Background and Purpose: Norwegian Psychomotor Physiotherapy (NPMP) has been an established treatment approach for more than
50 years, mostly in the Scandinavian countries, usually applied to patients with widespread and long-lasting musculoskeletal pain
and/or psychosomatic disorders. Few studies have investigated the outcomes of NPMP, and no randomized clinical trials (RCT) with a
comparing treatment group have systematically been tried out on individuals.; Methods: This is a pragmatic, single-blinded RCT where
128 participants with long-lasting widespread musculoskeletal pain and/or pain located to the neck and shoulders were block
randomized to NPMP or Cognitive Patient Education combined with active individualized physiotherapy (COPE-PT). Intention-to-treat
with linear mixed models were used to estimate the group differences in treatment effects. The outcomes at 3, 6, and 12 months
follow-up were pain intensity, function, anxiety and depression, quality of life, sleep, fear of movement, and subjective health
complaints. Risk profile (Örebro) was examined at 3 and 6 months. All participants underwent physical tests at baseline and 6 months.;
Results: One-year data were available for 66.4% of the original participants. Calculated with intention-to-treat analysis, at 3 months
statistically significant differences were found in favor of COPE-PT for pain, anxiety and depression, quality of life-physical dimension,
risk profile and fear of movement. At 6 months, statistically significant differences in favor of COPE-PT were found for anxiety and
depression, and sleep. At 12 months, the improvements were still statistically significant for anxiety, depression and sleep. Both groups
improved, but no statistically significant differences were found between the groups on the physical tests at 6 months.; Conclusions:
COPE-PT, which is targeted towards pain-coping and increasing activity, contribute to more improvements than NPMP. (© 2020 John
Wiley & Sons Ltd.)
Available online at this link
23. Physical exercise and prevention of falls. Effects of a Pilates training method compared with a general physical activity
program: A randomized controlled trial.
Patti Antonino Medicine 2021;100(13):e25289.
Introduction: Falls are the leading cause of injury-related mortality and morbidity in the elderly. Physical activity plays a key role in the
prevention of falls and stimulates postural control. The aim of this study was to compare a general physical activity program for the
elderly with a Pilates program to evaluate the effects on balance and on reducing the risk of falling.; Materials and Methods: Forty-six
subjects were enrolled in this study, but only 41 were included in the study. The subjects were divided into 2 groups: Pilates group (P-
G) and a group following a nonspecific program of physical activity (Pa-G). Each subject underwent the hand grip test, Berg balance
scale test, and posturographic analysis.; Results: Spearman correlation coefficient showed correlations between the following
parameters: BBS versus hand grip test (r = 0.68); BBS versus ellipse surface area (r = -0.75). There were significant differences between
groups after the exercise program: both groups showed an improvement in performance but the P-G recorded significantly better
results than the Pa-G.; Discussion and Conclusions: This study confirmed that physical activity improves both balance and strength.
However, our data show that Pilates has a greater effect on these physical abilities than a general physical activity program. (Copyright
© 2021 the Author(s). Published by Wolters Kluwer Health, Inc.)
Available online at this link
24. Physical Therapy, Occupational Therapy, and Speech Language Pathology in the Emergency Department: Specialty Consult
Services to Enhance the Care of Older Adults.
Pontius Elizabeth A. Emergency medicine clinics of North America 2021;39(2):419-427.
The rehab services of Physical Therapy, Occupational Therapy, and Speech Language Pathology (PT/OT/SLP) are areas of emerging
practice in the emergency department (ED). These specialty consult services can provide ED physicians with valuable, nuanced
assessments for the older adults that will assist in determining a safe discharge plan. PT and OT interventions in the ED have been
shown to decrease hospital admissions and readmissions, increase patient satisfaction, and decrease cost. Rehab specialists provide
physicians with an expanded scope of management options that can greatly enhance the care of patients in the ED. (Copyright © 2021
Elsevier Inc. All rights reserved.)
Available online at this link
25. Physiotherapeutic assessment and management of chronic pelvic pain syndrome: A case report.
Burzynski Bartlomiej Medicine 2021;100(15):e25525.
Introduction: Chronic pelvic pain syndrome is difficult for the diagnosis and therapy and that means the patient attending the physician
or physiotherapist may present various symptoms. There are no guidelines concern physiotherapy diagnosis and treatment of chronic
pelvic pain syndrome. This study presents the physiotherapeutic assessment and management in men with pelvic pain symptoms.;
Patient Concerns: Forty-six-year-old man attended the physiotherapy consulting room due to symptoms of pain in the perineum, lower
abdomen, urethra, and scrotum for a year. Earlier, the patient had consulted a urologist who made a diagnosis of cystitis and
prescribed medications that did not get results.; Diagnosis: Ultrasound imaging and manual inspection (per rectum) of the pelvic floor
was conducted by physiotherapist. Also, the abdominal and lower extremities muscles were assessed. Patient reported pain symptoms
during examination of the musculus ischiocavernosus, puboanalis, pubococcygeus, iliococcygeus, coccygeus, and canalis pudentalis seu
Alcocki.; Interventions: The patient was given physiotherapeutic interventions consisting in the manual therapy of the lumbopelvic hip
complex and the manual therapy per rectum.; Outcomes: During 10th session of the physiotherapeutic treatment, patient reportedimprovement in pain symptoms. A month later, patient reported total alleviation of the pain symptoms during control visit.;
Conclusion: Therapy of chronic pelvic pain syndrome is a process that involves application of different therapies and different
approaches. Functional and structural assessment and also therapy conducted by physiotherapist is becoming an integral part of
urology and represents 1 possible conservative treatment form. (Copyright © 2021 the Author(s). Published by Wolters Kluwer Health,
Inc.)
Available online at this link
26. Physiotherapy in Haiti: A qualitative study exploring local clinicians' perspectives.
Bessette Jennifer Physiotherapy research international : the journal for researchers and clinicians in physical therapy
2021;26(2):e1890.
Background and Purpose: The physiotherapy profession in Haiti has seen many changes since the earthquake in 2010, due to the
increased number of Haitians living with permanent impairments. The earthquake sparked a significant humanitarian response.
Research shows that the response focused mainly on providing short-term rehabilitation services without sustained efforts to develop
sustainable rehabilitation services. A decade later, little is known about the state of the Haitian physiotherapy profession. The purpose
of this study was to explore the perspectives of Haitian physiotherapy professionals regarding the current state of the profession in
terms of strengths, weaknesses, opportunities and threats.; Methods: We used a qualitative exploratory descriptive design. This study
consisted of two phases: (1) a survey to identify potential interview participants, and identify preliminary themes to be explored in the
follow-up interviews, and (2) a series of semi-structured qualitative interviews. We performed a thematic analysis of the interview
transcripts.; Results: Four physiotherapists and one rehabilitation technician participated in the interviews. Six interrelated themes
emerged, each having a systemic impact on the development of physiotherapy and rehabilitation services in Haiti: (1) physiotherapy as
an emerging field, (2) government funding and planning of physiotherapy services, (3) accessibility to physiotherapy services, (4)
relationship with doctors, (5) international collaboration, and (6) Haitian physiotherapy associations.; Conclusion: This study highlights
the ongoing efforts of local physiotherapy associations in advocating for the profession in Haiti, which has become one of the
profession's main strengths. The lack of government funding and service planning was considered a significant barrier to overcome, as
was the aftermath of the earthquake's emergency response. Future international efforts could focus on supporting local physiotherapy
associations and organisations in their endeavours to develop sustainable rehabilitation services. (© 2020 John Wiley & Sons Ltd.)
Available online at this link
27. Physiotherapy: an active, transformational, and authentic career choice.
Harman Katherine Physiotherapy theory and practice 2021;37(5):594-607.
Background : This paper arises from a larger study exploring early professional socialization across five professions: physiotherapy,
nursing; dentistry; pharmacy; and medicine. Purpose : To explore the process of physiotherapy student professional identity
development and the evolution of expectations and views of interprofessional practice in the first year of their program. Methods :
One-on-one interviews at three time points: after being accepted into the physiotherapy program and before classes began (T1; n =
12); after term one (T2; n=9) and on completion of year one (T3; n = 7). Analyses employed narrative methodology, guided by
anticipatory socialization and professional identity theories. Results : At T1, participants described their path towards physiotherapy,
indicating career satisfaction as the core of their choice. Expectations of practice aligned with the normative social positioning of the
profession. T2 and T3 interviews revealed that their pre-entry conceptualization of practice was both challenged and positively
reinforced, leading them either to being satisfied with, or questioning their choice. Clinical placements created the most meaningful
opportunities to understand their roles both as individual professionals and members of a collaborative team. Conclusion : Findings
revealed the complex process of professional socialization in physiotherapy students with implications for admissions and formal and
IPE curricula.
Available online at this link
28. Positive expiratory pressure in postoperative cardiac patients in intensive care: A randomized controlled trial.
Pieczkoski Suzimara Monteiro Clinical Rehabilitation 2021;35(5):681-691.
Objective: To evaluate effectiveness of positive expiratory pressure blow-bottle device compared to expiratory positive airway pressure
and conventional physiotherapy on pulmonary function in postoperative cardiac surgery patients in intensive care unit. Design: A
randomized controlled trial. Settings: Tertiary care. Subjects: 48 patients (16 in each group; aged 64.5 ± 9.1 years, 38 male) submitted
to cardiac surgery. Interventions: Patients were randomized into conventional physiotherapy (G1), positive expiratory pressure blow-
bottle device (G2) or expiratory positive airway pressure, both associated with conventional physiotherapy (G3). G2 and G3 performed
three sets of 10 repetitions in each session for each technique. Main measures: Pulmonary function (primary); respiratory muscle
strength, radiological changes, pulmonary complications, length of intensive care unit and hospital stay (secondary) assessed
preoperatively and on the 3rd postoperative day. Results: Pulmonary function (except for forced expiratory volume in one second/
forced vital capacity % predicted) and respiratory muscle strength showed significant reduction from the preoperative to the 3rd
postoperative in all groups (P < 0.001), with no difference between groups (P > 0.05). Regarding radiological changes, length of
intensive care unit stay and length of hospital stay, there was no significant difference between groups (P > 0.05). Conclusion: Both
positive expiratory pressure techniques associated with conventional physiotherapy were similar, but there was no difference
regarding the use of positive expiratory pressure compared to conventional physiotherapy. Clinical Trial Registration Number:
NCT03639974. https://clinicaltrials.gov/ct2/show/NCT03639974
Available online at this link
29. Potentiating Effects of Accentuated Eccentric Loading Are Dependent Upon Relative Strength.
Merrigan Justin J. Journal of strength and conditioning research 2021;35(5):1208-1216.ABSTRACTMerrigan, JJ, Tufano, JJ, and Jones, MT. Potentiating effects of accentuated eccentric loading are dependent upon relative
strength. J Strength Cond Res 35(5): 1208-1216, 2021-The purpose was to evaluate the acute effects of accentuated eccentric loading
(AEL) on bench press velocity and subsequent perceived effort (ratings of perceived exertion [RPE]) and soreness. Resistance-trained
men (n = 8) and women (n = 2) completed 4 sets of 5 bench press repetitions with AEL and traditional loading (TL) using concentric
loads of 50% (AEL50, TL50) and 65% (AEL65, TL65) 1-repetition maximum (1RM). Throughout each TL set, the eccentric load remained
identical to the concentric. Variable resistance during the first repetition of AEL equaled 120% 1RM. Hierarchical Linear Modeling was
used to evaluate differences between AEL and TL (p < 0.05). For the first repetition, AEL50 and AEL65 resulted in slower eccentric and
concentric velocities. The increasing slope of eccentric and concentric velocity across repetitions was greater during AEL50 and AEL65
compared with TL50 and TL65, respectively (p < 0.05). As an individual's strength increased, AEL50 resulted in slower eccentric velocity
and faster concentric velocity than TL50. The AEL65 resulted in faster concentric velocity than TL65 (p < 0.05). Mean protocol
comparisons revealed trivial to small effects between AEL and TL. There were no differences in RPE or soreness between protocols with
soreness ratings remaining unchanged from baseline (1.80 ± 0.20 AU; p < 0.05). Overall, AEL was not effective for increasing concentric
velocity during the bench press with current loading protocols. Yet, stronger individuals may exhibit increases in concentric velocity
from AEL, which may be a result of different pacing strategies employed during the eccentric phase. Furthermore, when using the
current AEL protocols, eccentric intensities were increased with no greater RPE or soreness.
Available online at this link
30. Rehabilitation strategies of Flemish physical therapists before and after anterior cruciate ligament reconstruction: An
online survey.
Dingenen Bart Physical Therapy in Sport 2021;49:68-76.
The primary objective of the study was to investigate rehabilitation strategies of Flemish physical therapists before and after anterior
cruciate ligament (ACL) reconstruction. Secondly, we aimed to investigate physical therapists' preferences on continuing education and
evaluate their self-rated confidence and competence when treating patients before and after ACL reconstruction. Survey-based study.
Online survey platform. Flemish physical therapists (n = 283). The online survey consisted of a combination of 40 open- and closed-
ended questions, divided across 5 sections: (1) participant demographics and clinical practice information, (2) patient population
information, (3) continued education practices, (4) rehabilitation strategies, and (5) physical therapist self-rated confidence and
competence to treat patients with ACL reconstruction. A wide variability in rehabilitation strategies were found across the whole ACL
rehabilitation continuum, which were in general not in line with best available evidence. Nevertheless, the overall self-rated confidence
and competence of physical therapists treating patients before and after ACL reconstruction were high. Our findings indicate a need to
improve rehabilitation practices before and after ACL reconstruction. Advanced research dissemination and implementation are
required to achieve better rehabilitation outcomes. A wide variability in rehabilitation strategies before and after ACLR was found.
Responses regarding clinical practice did not agree with best available evidence. The overall self-rated confidence and competence of
physical therapists were high. ACL rehabilitation practices need to improve.
Available online at this link
31. Role of Physiotherapy in Hospice Care of Patients with Advanced Cancer: A Systematic Review.
Vira Prina American Journal of Hospice & Palliative Medicine 2021;38(5):503-511.
Objective: To review the role of physiotherapy and its effects in hospice care of patients with advanced cancer. Methods: A
comprehensive literature search was performed in PubMed, Scopus, Web of Science, CINAHL and PEDro. The search strategy was
devised, articles were screened, and 2 independent reviewers conducted data extraction. Eligible studies were methodologically
assessed for quality rating using modified Downs and Black's checklist. The extracted data was summarized according to site/stage of
cancer, details of intervention, outcome measures and the results. Result: The total number of screened articles were 2102, out of
which 9 were identified as suitable for the purposes of comprehensive review. The studies included exercise therapy, massage therapy,
relaxation therapy, compression bandaging and use of TENS as the various physiotherapy interventions under consideration. Studies
were generally of low to moderate quality. A broad range of outcomes were employed including physical symptoms like loss of
function, pain, fatigue, edema, sleep disturbances and quality of life. The findings of the studies supported the benefits of the
interventions. Conclusion: A structured exercise protocol, massage therapy, TENS and compression bandaging are useful in alleviating
the symptoms experienced by patients with advanced cancer in hospice care. The reduced symptom burden has reflected as an
improvement in their quality of life. However, there is a further need for high quality studies to strengthen the findings of this review.
Available online at this link
32. Telemedicine for Musculoskeletal Rehabilitation and Orthopedic Postoperative Rehabilitation.
Phuphanich Melissa E. Physical medicine and rehabilitation clinics of North America 2021;32(2):319-353.
Telehealth visits result in high-quality care, with high patient and provider satisfaction. Strong evidence suggests that virtual physical
therapy is noninferior to conventional face-to-face physical therapy for a variety of musculoskeletal disorders. Postoperative
telerehabilitation has a strong positive effect on clinical outcomes, and the increased intensity telerehabilitation programs offer is a
promising option for patients. Studies demonstrate effective virtual postoperative management. The novel coronavirus disease 2019
pandemic has led to improved reimbursement for telehealth visits and accelerated widespread implementation of telemedicine. This
article establishes experience and evidence-based practice guidelines for conducting telemedicine visits, with emphasis on the virtual
physical examination. (Published by Elsevier Inc.)
Available online at this link
33. Telerehabilitation for Pain Management.
Nanda Udai Physical medicine and rehabilitation clinics of North America 2021;32(2):355-372.You can also read
