Exploring the delivery of remote physiotherapy during the COVID-19 pandemic: UK wide service evaluation.

INTRODUCTION: During the Coronavirus (Covid-19) pandemic, physiotherapists changed rapidly to working remotely. Research demonstrates the benefits of remote physiotherapy, but little is known about its implementation in practice. PURPOSE: Explore the take-up and delivery of remote physiotherapy during the pandemic in the United Kingdom. METHODS: Sequential mixed methods evaluation with physiotherapists leading remote physiotherapy delivery. Two-stage approach included online survey (2020) and semi-structured interviews with documentary/data analysis (2021). RESULTS: There were 1620 physiotherapists who completed the survey. The most used devices were telephone (n = 942,71.0%) and the AttendAnywhere platform (n = 511, 38.5%). Remote consultations were frequently used for initial assessment (n = 1105, 83%), screening/triage (n = 882, 67%), or to review, monitor, and progress treatment (n = 982-1004, 74%-76%). Qualitative survey responses reflected respondents' response to COVID-19 and delivery of remote physiotherapy. Twelve remote physiotherapy leads were then purposively sampled across clinical areas. Three main themes emerged from interviews: response to Covid-19, delivery of remote physiotherapy, and future of remote physiotherapy. CONCLUSION: Remote physiotherapy was safe, feasible, and acceptable for those who accessed it. There were patients for which it was deemed unsuitable across clinical areas. In practice, it should be combined with in-person consultation based on patients' needs/preferences. Further research should explore post-pandemic maintenance of remote delivery.

The use of technology to support lifestyle interventions in knee osteoarthritis: A scoping review.

Introduction: Technological tools that promote the adoption of physical activity to increase individuals' functional ability in knee osteoarthritis (OA) are desired to support lifestyle interventions. However, there is little consensus as to the current use of such supportive interventions for knee OA. The aim of this scoping review is therefore to provide an overview on the current use of technology within lifestyle interventions for individuals with knee OA. Methods: Scoping review as per PRISMA guidance. Structured search of Cochrane Central Register for Controlled Trials, ELSEVIER, IEEExplore, GOOGLE Scholar, MEDLINE, PEDRO, PUBMED, WEB OF SCIENCE from 2010 to 2020 inclusive. Hits were screened by title and abstract and then full text review based on pre-defined criteria. Results were synthesised and pooled by theme for reporting. Results: 2508 papers were identified, and following review, 78 studies included. Papers included interventions for individuals with knee osteoarthritis (n â€‹= â€‹31), total or partial knee arthroplasty (n â€‹= â€‹20) and developmental work in healthy controls (n â€‹= â€‹27). Of the 78 studies, 47 were carried out in laboratory settings and 31 in the field. The identified themes included Movement measurement (n â€‹= â€‹24), Tele-rehabilitation (n â€‹= â€‹22), Biofeedback (n â€‹= â€‹20), Directly applied interventions (n â€‹= â€‹3), Virtual or augmented reality (n â€‹= â€‹5) and Machine learning (n â€‹= â€‹4). Conclusions: The predominant current use of technology in OA lifestyle interventions is through well-established telecommunication and commercially available activity, joint angle and loading based measurement devices, while integrating new advanced technologies seems a longer-term goal. There is great potential for the engineering and clinical community to use technology to develop systems that offer real-time feedback to patients and clinician as part of rehabilitative interventions to inform treatment.

On Extremal Graphs of Degree Distance Index by Using Edge-Grafting Transformations Method.

BACKGROUND: Topological indices have numerous implementations in chemistry, biology and a lot of other areas. It is a real number associated with a graph, which provides information about its physical and chemical properties and their correlations. For a connected graph H, the degree distance DD index is defined as DD(H) = Σ{h1,h2}⊆V(H) [degH(h1)+degH (h2)]dh (h1,h2), where degH (h1)is the degree of vertex h1 and dH (h1,h2) is the distance between h1 and h2 in the graph H. AIM AND OBJECTIVE: In this article, we characterize some extremal trees with respect to degree distance index which has a lot of applications in theoretical and computational chemistry. MATERIALS AND METHODS: A novel method of edge-grafting transformations is used. We discuss the behavior of DD index under four edge-grafting transformations Results: With the help of those transformations, we derive some extremal trees under certain parameters, including pendant vertices, diameter, matching and domination numbers. Some extremal trees for this graph invariant are also characterized Conclusion: It is shown that balanced spider approaches to the smallest DD index among trees having given fixed leaves. The tree Cn,d has the smallest DD index, among all trees of diameter d. It is also proved that the matching number and domination numbers are equal for trees having a minimum DD index.

Patient and clinician experiences and opinions of the use of a novel home use medical device in the treatment of peripheral vascular disease - a qualitative study.

BACKGROUND: Peripheral vascular diseases have a significant impact on functional quality of life. Previous research has demonstrated the complex, limiting and costly economic implications of these conditions such as lower limb ulceration chronicity and ischaemic amputation. These complex, limb and life threatening conditions demand the development of novel interventions with objective research as part of that development. Hence, a novel intermittent negative pressure medical device in the form of a wearable boot (FlowOx™) was developed. As part of the development process, this study aimed to explore patient and clinician opinions of the boot. METHODS: A qualitative approach was used to collect patient and clinician experiences in Norway. An advisory group informed the semi-structured questions used in seven patient interviews and one clinician focus group (n = 5). The data were recorded digitally and transcribed verbatim. Patient and clinician data were analysed as distinct groups using a thematic process. RESULTS: Data analysis resulted in five themes from the patients which gave insight into; the impact of the disease process; practicalities of using the boot, positive experiences of use; perceived outcomes; reflecting on use. Six themes were created from the clinicians. These gave insight into; ideal outcomes and how to measure them; ways to potentially use the boot; using research in healthcare; positives of the device; observed effects and next steps; potential improvements to the device. CONCLUSION: This study provides insight into the experiences and opinions of FlowOx™. Patients and clinicians were positive about the device due to its ease of use. Those patients with peripheral arterial disease experienced significantly more benefit, especially for ischaemic ulceration than those with a chronic venous condition. Clinicians placed value on the patient reported outcomes in the treatment decision-making process. This preliminary study into experiences of FlowOx™ use provides valuable feedback that will inform design modification and ongoing research into implementation points and prospective user groups. FlowOx™ demonstrates potential as a conservative therapy offering users a convenient, home use, self-care management solution for improving symptomatic peripheral arterial disease and quality of life.