Effectiveness of Respiratory Muscle Training on Respiratory Muscle Strength, Pulmonary Function, and Respiratory Complications in Stroke Survivors: A Systematic Review of Randomized Controlled Trials.

Background: Stroke is the most common leading cause of mortality and related morbidities worldwide. After stroke, the motor function of extremities and spinal muscles is significantly impairment, but not only this, it also has attributable factors leading to respiratory dysfunction. Nevertheless, to the extent of the authors' knowledge, there is a dearth of conclusive studies which examined the effectiveness of RMT on muscle strength, pulmonary function, and respiratory complications of individuals after stroke. Objective: The purpose of this systematic review was to evaluate the effectiveness of respiratory muscle training on respiratory muscle strength, pulmonary function, and respiratory complications in patients after stroke. Methods: An electronic database search of HINARI, PEDro, PubMed, Cochrane Library and Google scholar was used to identify randomized controlled trials that evaluated the effectiveness of respiratory muscle training in patients with stroke. Articles published from 2010 to 2019 were included. The quality of the articles was assessed using PEDro scale. Articles with abstract only, PEDro scores less than 5, published in non-English language, not freely available articles, and quasi experimental studies were excluded from this study. Results: The literature search yielded a total of 7 articles (6 randomized controlled trials with 1 pilot randomized controlled trial) which met inclusion criteria despite their heterogeneity. The methodological quality of all studies ranged from 6 to 8 in Pedro score. Most of the articles reported a significant increase in respiratory muscle strength, respiratory muscle function, and reduced risk of complications with a p value <0.05. Conclusion: Respiratory muscle training could potentially improve muscle strength and pulmonary functions of subjects after stroke. Thus, it may reduce stroke-related respiratory complications in subjects after stroke. However, further study is warranted with high quality RCTs and pooled synthesis of results.

Extracorporeal shock wave therapy on pain and foot functions in subjects with chronic plantar fasciitis: systematic review of randomized controlled trials.

PURPOSE: The aim of this review was to synthesize current evidence on the efficacy of extracorporeal shock wave therapy on pain, and foot function in subjects with plantar fasciitis. MATERIALS AND METHODS: A comprehensive search of PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus were done to identify randomized controlled trials of extracorporeal shock wave therapy in subjects with plantar fasciitis. PEDro scale was used to evaluate the methodological quality of included trials. Visual Analogue Scale and Foot Function Index were the primary outcome measures of this review. Due to varying of entailed trials, meta-analysis was not carried out. RESULTS: Eleven randomized controlled trials with 658 patients were included. Extracorporeal shock wave therapy exhibited a moderate confirmation to better pain, and foot function of individuals with chronic plantar fasciitis. CONCLUSION: Extracorporeal shock wave therapy could be a promising rehabilitation intervention and might support to improve pain, and foot function of subjects with chronic plantar fasciitis.IMPLICATIONS FOR REHABILITATIONExtracorporeal shock wave therapy (ESWT) exerted beneficial effects on pain and functional outcomes for chronic plantar fasciitis.ESWT could be effectively performed with no side effects.ESWT could be an alternative to the conventional management of chronic plantar fasciitis.

Fear of falling and associated factors among older people living in Bahir Dar City, Amhara, Ethiopia- a cross-sectional study.

BACKGROUND: Fear of falling (FOF) is the most common public health problem, which can lead to loss of confidence, reducing physical and social activities, depression, loss of mobility, increased risk of falls, physical weakness, and strong negative impact on an older people's quality of life. However, studies in developing country were lacking, particularly in the study area. Therefore, the aim of the current study was to fill this gap in the study area in particular and the country in general. The purpose of the current study was to assess the prevalence and associated factors with fear of falling among older people 60 years and older who were living in Bahir Dar city, Ethiopia. METHODS: A community based cross sectional study design was conducted with a total sample size of 527 participants and multistage random sampling technique was used to select the study participants. The fall efficacy scale tool was used to develop the questionnaire. Data were coded, cleaned and entered into SPSS version 23 for analysis. Multi-collinearity and model fitting were checked. In bivariate logistic regression analyses, variables with p-value< 0.25 were considered as potential candidates for multivariable logistic regression analyses. A variable with p-value< 0.05 at 95% CI was considered as statistically significant. Finally, the odds ratio and 95% confidence interval were estimated and interpreted. RESULTS: A total of 481 participants was included in this study. The prevalence of fear of falling among the older people was 59.9% (95% CI; 55.7-64.4). Fear of falling was significantly associated with the following variables:- advanced age (AOR = 4.01, 95% CI; 1.65-9.74), female (AOR = 4.25, 95% CI; 2.25-8.01), lower education level (AOR = 2.77, 95% CI; 1.12-6.82), anxiety [AOR = 9.03, 95% CI; 4.78-17.07), confirmed medical conditions (AOR = 2.01, 95% CI; 1.03-3.91) and walking aids used (AOR = 13.82; 95% CI; 5.21-36.63). CONCLUSIONS: A moderate prevalence of fear of falling was observed. The major associated factors were advanced age, being female, lower educational level, anxiety, confirmed medical conditions and walking aids used. Hence, we recommend the need of rehabilitation programs that enable healthy aging and further rigor research is recommended.

Effect of Ankle Joint Mobilization with Movement on Range of Motion, Balance and Gait Function in Chronic Stroke Survivors: Systematic Review of Randomized Controlled Trials.

BACKGROUND: Ankle joint mobilization with movement has been speculated to be an important intervention for enhancing range of motion, balance, and gait functions in chronic stroke survivors. Nonetheless, there is a scarcity of recent conclusive evidence that evaluates its efficacy in chronic stroke patients. The purpose of this review was to synthesize existing evidence on the efficacy of mobilization with movement therapy on range of motion, balance, and gait performance in subjects after stroke. METHODS: A comprehensive systematic search of literature was performed using the following databases: PubMed/Medline, CINAHL, AMED, PEDro, Cochrane Library, and Scopus. Physiotherapy Evidence Database (PEDro) scale was used to evaluate the methodological quality of included trials. The primary outcome measures of this review were dorsiflexion range of motion (DF-ROM), and Berg balance scale (BBS). This review was reported in accordance with PRISMA statement guidelines. Due to variations in relevant trials, meta-analysis was not carried out. RESULTS AND CONCLUSIONS: Seven randomized controlled trials with a total of 224 subjects were analyzed. Evidence of overall quality was graded from moderate to high. This review found that mobilization with movement therapy could be an alternative rehabilitative intervention for subjects with chronic stroke to increase range of motion, balance, and gait ability. However, the evidence remains preliminary due to the small number of participants. Large-scale RCTs in the future are warranted to investigate the efficacy of mobilization with movement in subgroups of chronic stroke subjects.

Musculoskeletal Disorders and Associated Factors Among Patients with Chronic Kidney Disease Attending at Saint Paul Hospital, Addis Ababa, Ethiopia.

BACKGROUND: Musculoskeletal disorders contributed from chronic kidney disease are increasing worldwide. Musculoskeletal disorders had a significant health burden and are leading causes of co-morbidities, disability and low productivity, which potentially affect individual's functional status and quality of life. PURPOSE: The aim of this study was to assess the prevalence of musculoskeletal disorders and its associated factors among patients with chronic kidney attending in Saint Paul Hospital, Addis Ababa, Ethiopia. PATIENTS AND METHODS: An institution-based cross-sectional study was conducted on 302 enrolled study participants through systematic random sampling techniques. Face-to-face interview, physical examination and chart reviews were used to collect data using semi-structured questionnaire adapted from a standard Nordic Musculoskeletal Questionnaire and other literatures. Data were entered into Epi Info version 7 and exported to SPSS version 23 for analysis. Bivariate logistic regression analysis was employed with a p-value less than 0.25. Finally, those variables having a p-value less than 0.05 with 95% CI in multivariate analysis were taken as statistically significant. RESULTS: The prevalence of musculoskeletal disorders among CKD individuals was found to be 58.6% (95% CI; 53.0, 64.1). Being female (AOR = 0.49; 95% CI 0.26, 0.94), age between 40 and 49 (AOR = 3.34; 95% CI 1.07, 10.44), stage III (AOR = 0.24; 95% CI 0.06, 0.89) and stage IV (AOR = 0.24; 95% CI 0.06, 0.89) chronic kidney disease, having HTN (AOR = 7.47; 95% CI 3.47, 16.06), parathyroid hormone level ≥100 pg/mL (AOR = 0.43; 95% CI 0.21, 0.87), calcium level <8.4 mg/dl (AOR = 5.89; 95% CI 2.66, 13.56) and serum 25 hydroxy vitamin D level <20 ng/mL (AOR = 3.91; 95% CI 1.32, 11.56) were significantly associated with musculoskeletal disorders. CONCLUSION: MSDs were shown to be moderately common in CKD patients. Female gender, age between 40 and 49 yrs, stage III and stage IV CKD, hypertension, higher PTH level, lower calcium level and lower vitamin D level were statistically significant in their association with musculoskeletal disorders.

Effectiveness of Mobilization with Movement on the Management of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials.

Background: Osteoarthritis is becoming a global major cause of pain and functional disability worldwide, especially in the elderly population. Nowadays, evidence shows that mobilization with movement (MWM) has a beneficial effect on knee osteoarthritis subjects. However, its adequacy remains unclear. Objective: To review the best available evidence for the effectiveness of MWMs on pain reduction and functional improvement in patients with knee osteoarthritis. Methods: A comprehensive search of literature was conducted using the following electronic databases: Google Scholar, PubMed, Physiotherapy Evidence Database (PEDro), Science Direct, Cochrane Library, and Scopus. Only randomized controlled trials (RCTs) were included, and the methodological quality of the studies was appraised using the PEDro scale. It was reported according to the guideline of the PRISMA statement. Results: A total of 15 RCTs having 704 participants were included. The present systematic review suggests that there were significant differences between MWM groups and control groups in terms of visual analogue scale (VAS), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) scale, and flexion range of motion. Conclusions: This systematic review demonstrated that MWM was effective to improve pain, range of motion, and functional activities in subjects with knee osteoarthritis.

Effectiveness of Neuromuscular Electrical Stimulation on Post-Stroke Dysphagia: A Systematic Review of Randomized Controlled Trials.

The purpose of this review was to summarize the latest best scientific evidence on the efficacy of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients. A comprehensive systematic search of literature published between November 2014 and May 2020 was performed using the following electronic databases: PubMed/Medline, CINAHL, PEDro, Science Direct, Google Scholar, EMBASE, and Scopus. Only randomized controlled trials (RCT) evaluating the effect of neuromuscular electrical stimulation on swallowing function in dysphagic stroke patients were included. Physiotherapy Evidence Database (PEDro) has been used to evaluate the risk of bias of included trials. This review was reported in accordance with PRISMA statement guideline. The methodological quality of the studies was determined using PEDro scale and GRADE approach. Evidence of overall quality was graded from moderate to high. Eleven RCTs involving 784 patients were analyzed. The primary outcome measures of this review were functional dysphagia scale (FDS) and standard swallowing assessment. This review found neuromuscular electrical stimulation (NMES) coupled with traditional swallowing therapy could be an optional intervention to improve swallowing function after stroke in rehabilitation department.

Prevalence and Associated Factors of Musculoskeletal Disorders Among Cleaners Working at Mekelle University, Ethiopia.

BACKGROUND: Musculoskeletal disorder is a common cause of morbidity, disability, and poor quality-of-life. Its burden among cleaners in developed countries ranges from 56-90%. However, there are a lack of studies in developing countries, particularly in the study area. Thus, the result of this study will help to resolve health problems caused by musculoskeletal disorders among cleaners. PURPOSE: The objective of this study was to identify the prevalence and associated factors of musculoskeletal disorders among cleaners working at Mekelle University. MATERIALS AND METHODS: An institutional-based cross-sectional study was conducted on 270 cleaners. Simple random sampling was used to select the study participants. Data were collected through interview using the standard Nordic Musculoskeletal Questionnaire. Descriptive statistics and bivariate logistic regression were done to identify factors associated with musculoskeletal disorder. In bivariate logistic regression analysis, variables with a P-value<0.25 were modeled to multivariate analysis. Variables with a P-value≤0.05 with 95% confidence interval (CI) in multivariate model were taken as statistically significant. Finally, AOR with 95% CI at a P-value<0.05 was reported. RESULTS: This study found that the prevalence of musculoskeletal disorders among cleaners was 52.3% in the past 12 months and 31.8% in the last 7 days. Time pressure (AOR=3.25, 95% CI=1.08-9.77), work experience (AOR=2.49, 95% CI=1.12-5.52), feeling exhausted (AOR=2.68, 95% CI=1.16-6.20), working hours per day (AOR=3.55, 95% CI=1.54-8.20), awkward posture (AOR=15.71, 95% CI=6.47-38.17), and those who work more than 2 hours in sustaining position (AOR=8.05, 95% CI=2.25-28.85) showed a statistically significant association with musculoskeletal disorder. CONCLUSION: Musculoskeletal disorders were commonly reported among cleaners working at Mekelle University. Time pressure, work experience, feeling exhausted, working hours per day, awkward posture, and working >2 hours in sustaining position were statistically significant in their association with musculoskeletal disorders.

Effectiveness of Action Observation Training on Upper Limb Motor Function in Children with Hemiplegic Cerebral Palsy: A Systematic Review of Randomized Controlled Trials.

The purpose of this review was to evaluate and examine the current best evidence for the effectiveness of action observation therapy on upper limb function rehabilitation in children with hemiplegic cerebral palsy. A comprehensive search of literature published between September 2010 and May 2020 was conducted using the following electronic databases: PubMed, Google Scholar, the Physiotherapy Evidence Database (PEDro), EMBASE, Cochrane library, and Scopus. Only randomized controlled trials evaluating the effect of action observation therapy on upper limb motor function in children with hemiplegic cerebral palsy were included. PEDro scale was used to assess the risk of bias of included trials. This study was reported according to the guideline of the PRISMA statement. The overall methodological quality of the studies was done using the PEDro scale and GRADE approach. The primary outcome measures of this review were the Melbourne Assessment Scale, Assisting Hand Assessment scale to evaluate physical function and structures. Furthermore, the ABILHAND-Kids test, and Box and Block Test primary outcome measures were used to determine the subjects' activities and participation. Nine randomized controlled trials involving 234 participants were analyzed. The overall quality of evidence was rated from moderate to high. This review suggests action observation therapy was found to be a promising intervention for upper limb rehabilitation in children with cerebral palsy.

Effectiveness of Exercise Therapy on Gait Function in Diabetic Peripheral Neuropathy Patients: A Systematic Review of Randomized Controlled Trials.

The purpose of this study was to review the current evidence on the effectiveness of exercise therapy on gait function in patients with diabetic peripheral neuropathy. A comprehensive search of literature published between October 2010 and May 2020 was conducted using the following electronic databases; PubMed, AMED, CINAHL, ScienceDirect, Cochrane Library, PEDro and Google Scholar. Randomized control trials conducted to determine the effectiveness of exercise therapy on gait function in patients with diabetic neuropathy were included in this review. Non-English language published papers were excluded. This review was done in compliance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Data extraction and risk of bias assessment of the studies were carried out independently by two authors. The methodological quality of the studies was evaluated using the PEDro scale and GRADE approach. The overall methodological quality of studies rated from moderate to high. Meta-analysis was not carried out due to the heterogeneity of included trials. The primary outcome measures of gait functions were the six-minute walk test, 10-meter walk test and Tinetti scale. Nine randomized controlled trials with 370 participants were analyzed. Out of them, eight studies proved its effectiveness on gait function on individuals with diabetic peripheral neuropathy. The finding of this study suggested that multi-component exercise therapy consisted of strength, ROM exercise, balance, flexibility and stretching exercises, circuit exercise training, and gait training found to enhance gait function for individuals suffering with diabetic peripheral neuropathy compared to control groups.

Effectiveness of Kinesio Taping on the Management of Knee Osteoarthritis: A Systematic Review of Randomized Controlled Trials.

The purpose of this review was to summarize the current best evidence for the effectiveness of Kinesio Taping in reducing pain and increasing knee function for patients with knee osteoarthritis. A comprehensive search of literature published between 2014 and 2019 was conducted using the following electronic databases: PubMed, Google Scholar, Physiotherapy Evidence Database (PEDro), Science Direct, and Scopus. Only randomized controlled trials evaluating the effect of Kinesio Taping on knee osteoarthritis were included. PEDro was used to assess the risk of bias of included trials. This study was reported according to the guideline of the PRISMA statement. The methodological quality of the studies was done using the PEDro scale and GRADE approach. The overall quality of evidence was rated from moderate to high. Eighteen randomized trials involving 876 patients were included. The present systematic review demonstrated that there were significant differences between Kinesio Taping groups and control groups in terms of visual analog scale (VAS), Western Ontario and MacMaster Universities Osteoarthritis Index (WOMAC) scale and flexion range of motion. Kinesio Taping is effective in improving pain and joint function in patients with knee OA.