Physiotherapist’s approach and treatment preference in the patients of rheumatoid arthritis in Karachi, Pakistan: A cross sectional survey

Objective: To assess the treatment approach of physiotherapists towards patients with Rheumatoid Arthritis. Material & methods: A cross-sectional study was conducted from June to August 2016 among the 116 selected participants who were working in different physical therapy setups of Karachi Pakistan. A self-constructed questionnaire was used among the participants which consist of demographic Characteristics (age, gender, Qualification, and experience). While the Knowledge and utilization related close-ended questions were the 1. Type of exercise (isometrics and isotonic exercise), utilization of manual techniques (use of Maitland peripheral joint mobilization techniques, Cyrix mobilization techniques, Mulligan mobilization techniques & Manual joint distraction). 2. The use of electrotherapy modalities (use of TENS, Ultrasound, Cryotherapy & Heating) & 3. Treatment preference includes (results of manual therapy, electrotherapy or electrotherapy & manual therapy both in combination). Data were analyzed by using Statistical Package for Social Sciences (SPSS) version 21. Results: The majority of physiotherapists (n=71, 61.2%) belong to the age group of 31 to 45 years, and (n=71, 61.2%) were male. After checking the Qualification the majority (n=65, 56%) were Post-graduate and (n=62, 53.2%) were having 7 to 15 years of experience. Among all (n=94, 81%) of physiotherapists were using an isometric type of exercises in the patients with Rheumatoid arthritis. Most of (n=101, 87%) the Physiotherapist was using peripheral joint distraction in patients with Rheumatoid arthritis. The majority (n=109, 93.9%) of physiotherapists were using manual therapy and electrophysical agents in combination among the patients with Rheumatoid arthritis. Conclusion: The physiotherapists who are working in different setups of Karachi were treating the patients of RA by using different techniques of manual therapy along with the combination of electrophysical agents. In electrophysical agents, they were using the tens and heating combination for pain management.

A comparison of efficacy of diclofenac patch and physical therapy techniques in the treatment of patients with myofascial pain disorder of the upper trapezius

Objective: This study was conducted to find the best treatment in treating the patients of myofascial syndrome for this purpose two treatment options were compared to rule out the best option of treatment in minimizing the pain, enhancing the cervical movement and in determining the pressure pain threshold of MTrp. Material and methodology: It was a comparative study. Total 60 patients were randomly allocated to each group of treatment. We compared two treatments, treatment A of 30 patients was physical therapy and 30 patients of treatment B was diclofenac patch. For seven days, these patches were applied three times per day to the MTrP area of the upper trapezius muscle. The fix’s sufficiency and security boundaries were evaluated before it was used (day 0), three days later (day 3), and six days later (day 6). Chi square test was used for checking association of treatments and different attributes of patients. Results: There is significance association was found between demographic characteristics and treatments groups with p-values less than 0.05. There is significance difference effect between both treatments using VAS pain scale and cervical active Rom and PPT of MTRP using p-value less 0.05. These results shows that physical therapy treatment effects are batter as compare to diclofenac patch. Conclusion: Physical therapy techniques and the diclofenac patch have both been shown to be helpful but significant results are shown by Group A in treating trigger points of upper trapezius by normalizing the pathophysiological reasons of trigger points of this region. Physical therapy techniques are more helpful in reducing pain and in achieving cervical movement.

Leisure time physical activity, sedentary behavior and risk of cardiovascular disease and mortality among US Veterans

Background: Cardiovascular Disease (CVD) remains the leading cause of death in the US. Although Physical Activity (PA) has been inversely associated with the risk of CVD, few studies have examined whether sedentary behaviors modify such association. Our goal was to examine associations of leisure time PA with risk of CVD and mortality and the role of sedentary behavior as potential effect modifier among US veterans. Methods: We analyzed self-reported data on leisure time PA, television watching, and time spent on the computer among 438,364 participants of the Veterans Affairs Million Veteran Program from 2011 to 2018. We calculated metabolic equivalent of task-hours per week (MET-h/week) for each person and used electronic health record data to ascertain CVD. Results: Mean age was 64.6 ± 12.6 years and 92% were men. During a mean follow up of 3.3 years, we observed 22,942 new cases of CVD and 48,325 deaths. There was an inverse relation of leisure time PA with CVD and total mortality [HR: 0.96 (0.95-0.97) and 0.91 (0.90-0.92) per 2 MET-h/week increment for CVD and total mortality, respectively]. The associations of PA with both incident CVD and mortality were stronger in participants who spent more time watching television or on computer (all p values for interaction < 0.01). No interaction of PA with time spent on video game was observed (p>0.05). Conclusions: Leisure time PA is inversely associated with risk of CVD and mortality among US veterans and such relations were stronger in participants who spent more time watching television or on computer.