Therapeutic itinerary of patients with chronic low-back pain attending outpatient physiotherapy clinic

Objective: to assess therapeutic itinerary of patients with chronic low-back pain. Methods: qualitative study involving the use of an in-depth semi structured interviews were used to collect data on therapeutic itinerary among ten patients with chronic low-back pain who from physiotherapy clinic of a tertiary hospital. Data was analysed using thematic content analysis. Results: emerging themes were as follows: onset of low-back pain, symptoms that initiated the journey for care, steps taken to find pain relief, respondent’s perception on care received, interference of chronic low-back pain with normal life, family and relations, multiple practices in which chronic low-back pain patients are involved, perception of effectiveness of the multiple practices, and hurdles to seeking care. Conclusion: patients with chronic low-back pain take different routes in search of care. Chronic low-back pain markedly altered patients’ life and made them prone to practicing medical pluralism.

Symptom Recovery and Return to Participation Timelines of Patients With Concussion at a Community Physiotherapy Clinic Based on Injury Mechanism

ObjectiveTo compare patient demographics, injury phase (IP; time-to-assessment), total symptom severity score (TSS) changes and return to participation (RTP; cognitive/physical) to mechanism of injury (MOI).BackgroundSecondary concussion prevention includes timely assessment and treatment to decrease TSS and maximize RTP.Design/MethodsOne community physiotherapy clinic. Retrospective chart review (September 1, 2016–August 8, 2018). Two hundred thirty-four patients with concussion (male: n = 85; female: n = 149) from various MOIs. Age groups (years): children 8–12, youth 13–17, young adult 18–29, adult 30–64, senior 65+. IP: acute (<72 hours), subacute (72 hours-2 weeks adults, 72 hours-4 weeks children/youth), persistent (2 weeks-3 months adults, 4 weeks-3 months children/youth), chronic (>3 months). Intervention: multimodal physiotherapy (cervico-vestibular, exertion, education), referral to specialist, psychology and/or neuropsychology. Outcome measures: treatment (number, timeframe) and weeks to recovery (WTR) vs MOI; TSS changes and RTP rates.ResultsAll acute IP had sport MOI, with WTR consistent with current literature. For all others, WTR was longer regardless of age or MOI. MVC and other MOIs were primarily patients in persistent or chronic IP (80% and 71%, respectively). MVC had the longest recovery (12.28 ± 8.21 treatments over 21.03 weeks 95% CI [17.05, 25.01], 44.94 WTR 95% CI [36.38, 53.51]); p < 0.05). Sport MOI received 5.50 ± 3.62 treatments over 7.49 (95% CI [5.59, 9.40]) weeks and 19.07 (95% CI [13.72, 24.42]) WTR. No significant statistical difference was observed between sport and other MOI recovery. TSS decreased in 85% of all patients. Full cognitive RTP was achieved by 75% of patients, and full physical RTP by 68%.ConclusionsConcussion patients experienced symptom and participation recovery, with IP and MOI related to WTR. Treatment/recovery timeframes were longer than previously reported for subacute, persistent, and chronic IPs. These results will inform secondary prevention strategies and knowledge translation underscoring the need for timely assessment and treatment. It also draws attention to RTP in MOIs other than sport.

MANFAAT PEMBERIAN MANUAL TERAPI DAN CODMAN PENDULAR EXERCISE TERHADAP AKTIVITAS FUNGSIONAL PASIEN FROZEN SHOULDER

Background: Frozen shoulder is a joint disorder that causes limited motion of the shoulder joint in all directions of movement, causing both physical and functional problems. This activity aims to see the benefits of manual therapy and pendular codman exercises in increasing the activity of frozen patients at Grandmed Lubuk Pakam Hospital in 2019. Manual therapy methods and codman pendular exercises were given to 24 patients at the Physiotherapy Clinic of Grandmed Lubuk Pakam Hospital. The measuring instrument used to measure the functional activity ability of the shoulder is the index of shoulder pain and disability with the 0% -60% category being improving and 61% -100% being worse. Based on the results obtained during manual therapy and codman pendular exercise, it shows that the ability of the patient's shoulder functional activity has increased. where manual therapy and pendular codman exercise from 16 samples, the ability of shoulder functional activity with a SPADI value of 100% decreased and after manual therapy and pendular codman exercises for 3 times decreased to 12.5% ​​decreased and 87.5% improved. Based on these data it can be neglected that there is an effect of offering manual therapy exercises and pendular codman in increasing the patient's shoulder functional activity by 87.5%

Rehabilitation in Duchenne Muscular Dystrophy: A Case Report

Background: Duchenne muscular dystrophy (DMD) seems to be the most common X-linked muscular dystrophy condition in children marked by proximal muscle weakness and calf hypertrophy and affected mostly in boys. In more than 20 muscular dystrophies the most prevalent form is Duchenne muscular dystrophy. Each 1/3500 male births, the presence of DMD worldwide, indicating that in the UK alone there are approximately 2400 people living with DMD. Assessing improvements in severity, range of motion and functional mobility, implementation of therapies and guidance on positioning are important key factors. Clinical Finding: Mostly in proximal muscles around the hips and shoulders, which are those around the trunk of the body, muscle weakness occurs mainly. In the lower extremities, weakness usually begins proximally, and then passes distally. Symptoms typically begin about the age of 1-3 years. To see the child run and get up off the floor while searching for signs of DMD is necessary. Diagnosis: A very common physical finding in boys with Duchenne's is Gower's Sign. In order to get up, it requires using their hands to 'climb' their legs. It is because of a weakness in the boy's hip muscles, which was seen in this patient in progressive in nature. The proper examination and evaluation the symptoms the child presented to the physiotherapy clinic played an important in reaching to the diagnosis of the condition. Conclusion: Prevent the child from developing contracture, correct posture of the child and maintain quality of life these are important criteria in for the child suffered from Duchenne muscular dystrophy.

A Physiotherapeutic Approach to Musicians' Health – Data From 614 Patients From a Physiotherapy Clinic for Musicians (INAP/O)

Currently, the treatment of musicians is an interprofessional approach. Playing-related health complaints may impact the performance of a musician. In Germany, a medical consulting hour for musicians exists, but those for athletes in sports medicine are not so common. The diagnosing and treatment procedure within the physiotherapy consultation for musicians follows a specific concept-b and requires knowledge of instruments and musician-specific complaints. Based on the consulting hour in a clinic in Osnabrueck, 614 case reports were part of this sample, of which 558 data sets were complete. The focus of the analysis is the instrument and the primary complaint. Also, the type of therapy is characterized, and the amount is calculated. Primary complaints of musicians, in general, are found most frequently in the spine and upper extremity. Musician complaints are different between instruments. Instrumentalists have a significantly higher chance to suffer from a primary complaint in the area of the upper extremity. Furthermore, the groups without an instrument (e.g., singing or dancing) are developing complaints in the anatomical area which they primarily use. Therefore, these types of therapy were used: physiotherapy, manual therapy, and osteopathy with an average of 5.9 treatment units. This study underpinned the importance of musician-specific physiotherapy as a profession to treat musicians. Also, an interdisciplinary approach is necessary to treat all aspects of complaints.

Patients’ Expectations of Physiotherapeutic Treatment for Long-Term Side Effects After Cancer: A Qualitative Study

Objective This study aims to explore the expectations of physiotherapeutic treatment of long-term side effects (LTSEs) after cancer among patients treated in physiotherapy clinics. Methods This a qualitative interview study based on a phenomenological approach. Adult patients with LTSEs after cancer were recruited through The Danish Cancer Society and a private physiotherapy clinic in Denmark. Individual semi-structured interviews were carried out using Microsoft Teams based on an interview guide piloted before the interviews. Interviews were audiotaped and transcribed verbatim. Sampling was conducted with a focus on variation in LTSE. The data were analyzed using Malterud’s principles of systematic text condensation and coded in NVivo 12. Results 2 males and 8 females with an average age of 55.8 years were interviewed for between 40 and 60 minutes from October to November 2020. Four main themes emerged from the interviews 1 : The importance of the physiotherapist’s approach, 2 the benefits of meeting patients with similar symptoms, 3 the importance of receiving knowledge, and 4 patients seeking to maintain their current state more often than aiming to improve their condition. Conclusions Patients consulting a physiotherapy clinic with LTSE after cancer prefer the physiotherapist to have knowledge about cancer and to be emphatic. Furthermore, patients prefer to meet like-minded people and expect support to maintain their current condition rather than improve their condition.

Baropodometric profile of patients assisted in a physiotherapy clinic

Background: Computerized baropodometry, a posturographic recording technique used in the diagnosis and assessment of plantar pressure, which records the pressure points exerted by the body on the plantar surface, is an accurate, objective and quantitative examination. Its record is used in the diagnosis and evaluation of plantar pressure, both in static and dynamic positions. Objective: Analyze the baropodometric profile of patients in a physiotherapy clinic. Methods: A cross-sectional study of documentary character of baropodometry exams registered in the database of a physiotherapy clinic in Teresina (PI), carried out from January 2015 to December 2018. Totaling 193 exams, which include the types of feet, peak plantar pressure and correlation between peak plantar pressure with age, weight, height and BMI. The collected data were analyzed statistically by the software Win Track version 12.0, and presented through tables and figures. In this research, all ethical precepts were carried out in accordance with the resolution of the National Health Council and was approved by the ethics committee. Results: There was a higher prevalence of hollow feet (96.89%), showing a greater occurrence of displacement of the center of gravity posteriorly to the right (46.11%), it was found that there was no satisfactory correlation of anthropometric parameters with peak plantar pressure (p>0.05). Conclusion: It was possible to observe that the examinations evaluated showed a higher prevalence of hollow feet and center of gravity posteriorized to the right. In addition, there was no satisfactory correlation between peak plantar pressure with the variables age, weight, height and BMI.

10 Tests der motorischen Kontrolle bei Patienten mit Rückenschmerzen

Biele C, Möller D, von Piekartz H et al. Validity of Increasing the Number of Motor Control Tests within a Test Battery for Discrimination of Low Back Pain Conditions in People Attending a Physiotherapy Clinic: a Case-Control Study. MJ Open 2019; 25: e032340. doi:10.1136/bmjopen-2019-032340