scholarly journals Incorporating patient preferences into osteoarthritis treatment

2021 ◽  
Vol 36 (4) ◽  
pp. 577-586
Author(s):  
Yeşim Gökçe Kutsal ◽  
Sibel Eyigör ◽  
Sevilay Karahan ◽  
Rezzan Günaydın ◽  
Jale İrdesel ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Side Effects ◽  
Physical Therapy Modalities ◽  
Treatment Modalities ◽  
Easy Access ◽  
Oral Drugs ◽  
Therapy Program ◽  
Home Based ◽  
Physical Therapy Program

Objectives: This study aims to identify the relationship between treatment modalities and the patients’ preferences in osteoarthritis (OA) treatment and identify the related factors. Patients and methods: This multi-center, cross-sectional study included a total of 305 patients with OA (66 males, 239 females; mean age: 66.4±9.7 years; range, 38 to 90 years) between July 2019 and January 2020. Data including demographic and clinical characteristics of the patients were recorded using a structured questionnaire. Results: The mostly common involvement sites were knee joints, lumbar, and cervical regions, respectively. Prior to the study, the treatment modalities which were prescribed to patients were oral drugs (79.7%), topical drugs (73.8%), home-based exercise program (62.6%), and physical therapy (outpatient) (61.3%). Of the recommended remedy, 89.2% were prescribed by physiatrists, 24.6% by orthopedists, 5.6% by family practitioners, 2.6% by neurosurgeons, and 1.6% by algologists. The most beneficial treatments (to whom) were inpatient physical therapy program (47%), oral drugs (41%), home-based exercise programs (24.9%) according to patients’ perspective. According to patient preferences, nearly half of the patients preferred outpatient physical therapy program (45.9%), oral drugs (33.1%), inpatient physical therapy (20%), and home-based exercises (18%). The most common reasons for their preferences were previous benefits from treatment (54.4%), long-term effects (38%), easy access to treatment (33.1%) and concerns about side effects (28.9%). The mostly common reasons for their preferences were previous benefits from the treatment (54.4%), long-term positive effects of physical therapy (38%), easy access to the treatment (33.1%) and concerns about side effects of drugs (28.9%). Conclusion: Besides medical regimen, the results of this study showed that the patients preferred outpatient and inpatient physical therapy modalities, and home-based exercises programs. In the light of these findings, initiation of a new prescription (e.g., drugs or physical therapy modalities) in OA patients, previous treatment modalities, and approaches are suggested to be carefully reviewed by the clinician to anticipate and improve the adherence behavior to the new treatment.

scholarly journals Timing of Supervised Physical Therapy after Hindfoot Fractures

2017 ◽  
Vol 2 (3) ◽  
pp. 2473011417S0000
Author(s):  
Stephanie Albin ◽  
Drew Van Boerum ◽  
James Morgan ◽  
Shane Koppenhaver
Keyword(s):  
Physical Therapy ◽  
Clinical Outcomes ◽  
Manual Therapy ◽  
Foot And Ankle ◽  
Therapeutic Exercise ◽  
Therapy Program ◽  
Surgical Fixation ◽  
Physical Therapy Program

Category: Ankle, Hindfoot Introduction/Purpose: Fractures to the hindfoot, including the talus and calcaneus, have devastating long-term functional outcomes. To date, no randomized trials have been done assessing the best time to initiate physical therapy after surgical fixation of these fractures. The purpose of this study is to assess whether initiating a supervised physical therapy program including therapeutic exercise and manual therapy two weeks post-operatively (EARLY) versus seven weeks post-operatively (LATE) in patients following surgical fixation for these fractures results in differences in clinical outcomes. The secondary purpose of this study is to assess what factors predict outcomes after these hindfoot fractures. Methods: Fifty patients between the ages of 18-70 years having undergone an open reduction internal fixation (ORIF) of the calcaneus or talus were recruited to participate from two foot and ankle fellowship-trained orthopedic surgeons. Subjects were randomly assigned to initiate formal physical therapy starting within 2 weeks post-operatively (EARLY) (n=26) or 8 weeks post-operatively (LATE) (n=24). Treatment for both groups consisted of impairment based manual therapy and therapeutic exercise. The lower extremity functional scale (LEFS), the American Orthopeadic Foot and Ankle Society (AOFAS) hindfoot scale, range of motion (ROM), pain and girth measurements to assess swelling were the outcome measures for this study. Subjects in both groups were seen for a total of 10 visits. All subjects underwent follow-up assessments at 3 months, 6 months, and 12 months post-operatively. Between-group differences were analyzed using ANCOVAs with baseline scores as covariates. Regression was used to assess factors predicting patients’ self-reported outcomes. Results: Results demonstrated no significant differences between the groups at any time point (3, 6 or 12 months) for the LEFS (p=0.637) or the AOFAS (p=0.634). No significant differences existed between the two groups for active ROM (p=0.106) or swelling (p=0.389). Subjects in both groups demonstrated improved AOFAS scores from baseline to one year follow-up by 26 points (p=0.00); however, most of the change occurred within the first 6 months post-operatively with only a 1.722 (95% CI -3.63 to 7.08) change between 6 to 12 month follow-up visits. Baseline anxiety (as measured by the Beck Anxiety Questionnaire) significantly predicted LEFS scores at both the 6 month and 12 month follow-up periods (r= -0.55, p=0.0015 and r= -0.53, p=0.007). Conclusion: This study did not demonstrate that initiating early supervised physical therapy (within 2 weeks after surgical fixation) improves self-reported outcomes for patients after surgical fixation of a hindfoot fracture as assessed by the LEFS, the AOFAS hindfoot scores, or clinical outcomes such as ROM or swelling compared to patients initiating a formal physical therapy program seven weeks after surgery. Although, many these patients typically have less than ideal clinical outcomes, it is possible that addressing other factors such as anxiety may help improve long-term outcomes.

The Tecar Therapy to Support Sports Traumatology

2019 ◽  
pp. 69-74
Author(s):  
Neonila-Gabriela Ștefan ◽  
Raluca-Anca Tănasă ◽  
Cristina-Elena Moraru
Keyword(s):  
Physical Therapy ◽  
Side Effects ◽  
Sports Medicine ◽  
Recovery Process ◽  
Time Limit ◽  
Advanced Technology ◽  
Therapy Program ◽  
Boomerang Effect ◽  
Physical Therapy Program ◽  
Sports Traumatology

The Tecar therapy is evidence of the way in which advanced technology can be used in sports medicine, for the rehabilitation of traumas. The TECAR technology is not painful, invasive or hard to tolerate, without side effects, with a time limit and several sessions being assimilated within the recovery process. The purpose of this paper is to use this therapyin sports traumatology. The subjects of the research were two athletes practicing performance handball with left inguinal ligamentous and muscular sprain and epicondylitis of the higher limb. After applying the Tecar therapy and the physical therapy program, we have noted a favourable recovery of the two athletes. This study confirms the efficiency of this therapy in the recovery of sportstraumas. Whereas this technology is beneficial, with visible results, its use without physical therapy can create a “boomerang effect”.

scholarly journals Protocol for a home-based integrated physical therapy program to reduce falls and improve mobility in people with Parkinson’s disease

BMC Neurology ◽  
2012 ◽  
Vol 12 (1) ◽  
Author(s):  
Meg E Morris ◽  
Clarissa Martin ◽  
Jennifer L McGinley ◽  
Frances E Huxham ◽  
Hylton B Menz ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Physical Therapy ◽  
Therapy Program ◽  
Home Based ◽  
Physical Therapy Program

scholarly journals Effectiveness of a home-based physical therapy program in patients with chronic low back pain

2015 ◽  
Vol 8 (15) ◽  
pp. 12-16
Author(s):  
Elena Sîrbu
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Chronic Low Back Pain ◽  
Low Back ◽  
Therapy Program ◽  
Home Based ◽  
Number Of Patients ◽  
Inflammatory Drugs ◽  
Physical Therapy Program

Abstract Aim: To demonstrate the effectiveness of a home-based physical therapy program on pain, spine mobility and quality of daily activities in patients with chronic low back pain (CLBP). We also want to show that patients who undergo this program decreased their intake in analgesic and anti-inflammatory drugs. Methods: 18 patients with chronic low back pain were assessed with the following tests: VAS pain scale, Schober’s test and Rolland-Morris questionnaire. Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAID) consumption was recorded. Over a period of six months all subjects participated in a 45 minutes home-based physical therapy program, three times per week. Before starting this intervention all patients were instructed and exercises were demonstrated in front of them by a physical therapist. Moreover, they received written brochures in order to exercise correctly at home. Follow-up examinations took place at baseline and six months later. Results: We obtained significant differences between pre- and post-intervention assessments of pain (p=0.001), lumbar flexion (p=0.0001) and functional status (p=0.0005) in our group. Moreover, the number of patients who were taken analgesics decreased from 7 (39%) to 5 patients (28%). Likewise the number of patients who were taken anti-inflammatory drugs decreased from 11 (61%) to 8 (44%). Conclusion: The home-based rehabilitation program was effective in improving the ranges of active lumbar flexion and in decreasing the physical disability caused by low back pain, as well as in reducing the levels of pain. We note that a larger number of patients have given up to the intake of NSAIDs comparative to those who have given up to analgesics.

Low frequency transcranial magnetic stimulation in subacute ischemic stroke: Number of sessions that altered cortical excitability

2020 ◽  
Vol 47 (4) ◽  
pp. 427-434
Author(s):  
Mohammed S. El-Tamawy ◽  
Moshera H. Darwish ◽  
Saly H. Elkholy ◽  
Engy BadrEldin S. Moustafa ◽  
Shimaa T. Abulkassem ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Transcranial Magnetic Stimulation ◽  
Physical Therapy ◽  
Upper Limb ◽  
Magnetic Stimulation ◽  
Cortical Excitability ◽  
Low Frequency ◽  
Cortical Reorganization ◽  
Therapy Program ◽  
Physical Therapy Program

BACKGROUND: Cortical reorganization between both cerebral hemispheres plays an important role in regaining the affected upper extremity motor function post-stroke. OBJECTIVES: The purpose of the current study was to investigate the recommended number of contra-lesion low frequency repetitive transcranial magnetic stimulation (LF-rTMS) sessions that could enhance cortical reorganization post-stroke. METHODS: Forty patients with right hemiparetic subacute ischemic stroke with an age range between 50–65 yrs were randomly assigned into two equal groups: control (GA) and study (GB) groups. Both groups were treated with a selected physical therapy program for the upper limb. Sham and real contra-lesion LF-rTMS was conducted for both groups daily for two consecutive weeks. Sequential changes of cortical excitability were calculated by the end of each session. RESULTS: The significant enhancement in the cortical excitability was observed at the fourth session in favor of the study group (GB). Sequential rate of change in cortical excitability was significant for the first eight sessions. From the ninth session onwards, no difference could be detected between groups. CONCLUSION: The pattern of recovery after stroke is extensive and not all factors could be controlled. Application of LF-rTMS in conjugation with a selected physical therapy program for the upper limb from four to eight sessions seems to be efficient.

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