Fear of movement and other associated factors in older patients with total knee arthroplasty.

BACKGROUND: Kinesiophobia is an important risk factor for functional activities of patients in the early stage following total knee arthroplasty (TKA). AIMS: This study aimed to investigate the relationship between fear of movement and associated factors in older patients in the late stage after TKA. METHODS: The study included 45 older patients (mean age:70.11 ± 0.90 years) with knee osteoarthritis who underwent TKA. Kinesiophobia was assessed with the Tampa Scale of Kinesiophobia (TSK). Pain and strength in the quadriceps femoris (QF) muscle were assessed by the Visual Analog Scale and hand-held dynamometer, respectively. Functional level was determined using the 30-s sit-to-stand test (STS) and 10-m walking test. RESULTS: There were correlations between TSK and QF muscle strength (r = -0.538, p < 0.001), activity pain level (r = 0.489, p = 0.001), and 30-s STS (r = -0.306, p = 0.041). There were no correlations between TSK and age (r = 0.207, p = 0.172) and 10-m walking test (r = 0.112, p = 0.465). CONCLUSIONS: Increased pain and decreased QF muscle strength and functional level on STS were related with fear of movement in TKA patients. It was concluded that kinesiophobia of older patients with TKA must be considered during the assessment and rehabilitation program in the late stage after TKA.

Vagus nerve stimulation for the treatment of epilepsy: things to note on the protocols, the effects and the mechanisms of action.

Epilepsy is a chronic brain disorder that is characterized by repetitive un-triggered seizures that occur severally within 24 h or more. Non-pharmacological methods for the management of epilepsy were discussed. The non-pharmacological methods include the vagus nerve stimulation (VNS) which is subdivided into invasive and non-invasive techniques. For the non-invasive techniques, the auricular VNS, stimulation of the cervical branch of vagus nerve in the neck, manual massage of the neck, and respiratory vagal nerve stimulation were discussed. Similarly, the stimulation parameters used and the mechanisms of actions through which VNS improves seizures were also discussed. Use of VNS to reduce seizure frequency has come a long way. However, considering the cost and side effects of the invasive method, non-invasive techniques should be given a renewed attention. In particular, respiratory vagal nerve stimulation should be considered. In doing this, the patients should for instance carry out slow-deep breathing exercise 6 to 8 times every 3 h during the waking hours. Slow-deep breathing can be carried out by the patients on their own; therefore this can serve as a form of self-management.HIGHLIGHTSEpilepsy can interfere with the patients' ability to carry out their daily activities and ultimately affect their quality of life.Medications are used to manage epilepsy; but they often have their serious side effects.Vagus nerve stimulation (VNS) is gaining ground especially in the management of refractory epilepsy.The VNS is administered through either the invasive or the non-invasive methodsThe invasive method of VNS like the medication has potential side effects, and can be costly.The non-invasive method includes auricular VNS, stimulation of the neck muscles and skin and respiratory vagal nerve stimulation via slow-deep breathing exercises.The respiratory vagal nerve stimulation via slow-deep breathing exercises seems easy to administer even by the patients themselves.Consequently, it is our opinion that patients with epilepsy be made to carry out slow-deep breathing exercise 6-8 times every 3 h during the waking hours.

Pain coping strategies and related factors including demographics, pain characteristics, functional mobility in postmenopausal women with chronic musculoskeletal pain.

This cross-sectional study investigated pain coping strategies and their relationship to demographic and clinical characteristics in postmenopausal women (PMWs) with chronic musculoskeletal pain (CMSP). PmW (n = 60) who presented to receive physiotherapy from a rehabilitation center participated. McGill Pain Questionnaire (MPQ) was used to assess pain intensity and characteristics, Pain Coping Inventory (PCI) was used to assess strategies of coping with pain, and Timed Up and Go-Test (TUG) was used to assess functional mobility. Data were analyzed using descriptive analyses, paired-samples t-test, independent-samples t-test, Mann Whitney U-test, one-way ANOVA, and Pearson's correlation analysis. There was no significant difference in terms of marital status, educational status, and exercise habits between the participants' statuses of using active and passive strategies of coping with pain. Younger women (50-59 years of age) preferred active strategies more than passive strategies to cope with pain (p = .047). There were significant differences among the age groups in terms of "pain transformation" subdomain of active strategies (p = .007) and "sensory" subdomain of MPQ (p = .053). Strategies of coping with pain and functional mobility of participants were not significantly related (p > .05). Results indicated that age is a significant factor in coping with pain and pain characteristics. Healthcare providers should consider PmW's preferences and experiences with pain management when recommending pain management strategies.

Are the physical activity habits of Turkish physiotherapists associated with their physical activity promotion and counseling?

Background: Physiotherapists (PTs) must be role models and convincing promoters of physical activity (PA). Objective: This cross-sectional study aimed to determine whether Turkish PTs' PA promotion and counseling practices are associated with their own PA habits. Method: An open-access survey was distributed to 2,619 PTs via e-mail to collect information about the PTs' PA habits; their knowledge, role perception, confidence, perceived barriers and feasibility in PA promotion; and their counseling practices. During the year that the survey was online, 421 (16.1%) PTs responded. The PTs were divided into two groups: physically active PTs (engaged in at least one type of PA) and inactive PTs. Chi-square test of independence was used for data analysis. Results: Knowledge of PA did not differ between the groups (p>0.05). Physically active PTs had higher role perception (except in one item) and greater confidence in PA promotion than inactive PTs (p<0.05). Except for one barrier, engagement in PA was not associated with perceived barriers or feasibility in PA promotion (p>0.05). Significantly more physically active PTs suggested PA to 10 or more patients/month [25.2% (n=40), vs. 13.5% (n=26); p=0.005] and suggested at least one type of PA [78.7% (n=137) vs. 59.2% (n=141); p=0.000]. PTs who engaged in vigorous-intensity PA and strength training were significantly more likely to suggest these types of PA than PTs who did not [44.1% (n=15) vs. 10.4% (20); p=0.000 and 91.1% (n=113) vs. 83.2% (n=154); p=0.047, respectively]. Conclusion: This study demonstrated that physically active PTs had higher role perception and confidence, and more actively promoted PA in their counseling practice.

Consideration of prevention and management of long-term consequences of post-acute respiratory distress syndrome in patients with COVID-19.

This manuscript provides support for physical therapists to focus on the long-term, as well as the short-term, consequences of acute respiratory distress syndrome (ARDS) associated with COVID-19. Since late November 2019, COVID-19 has become a global health pandemic and threat. Although most people have no or mild symptoms, COVID-19 spreads aggressively and can lead to ARDS rapidly in a proportion of individuals. The evidence supports that gas exchange and countering the negative effects of bed rest and immobility are priorities in severely affected patients admitted to the intensive care unit (ICU). However, in recent years, research has focused on poor long-term functional outcomes in patients with ARDS, often associated with ICU-acquired weakness, deconditioning, and myopathies and neuropathies. In addition to physical therapists providing respiratory support in the ICU, the literature unequivocally supports the view that early intervention for ICU management of patients with ARDS secondary to COVID-19 needs to focus on reducing contributors to impaired long-term function, with direct attention paid to preventing or managing ICU-acquired weakness, deconditioning, and myopathies and neuropathies, in conjunction with respiratory care.

Is Guillain-Barré Syndrome Associated With COVID-19 Infection? A Systemic Review of the Evidence.

Background: There is emerging evidence that Guillain-Barré syndrome (GBS) may be associated with coronavirus disease 2019 (COVID-19) infection. The aim of this review was to investigate the strength of the evidence. Method: The review was registered in PROSPERO (CDR42020184822). Three electronic databases, MEDLINE, PubMed, and Web of Science, and three preprint servers, MedRvix, ChemRvix, and BioRvix, were searched from December 2019 to 24th September 2020. Studies were included if they were on COVID-19 and of any design. Articles that are reviews or opinion were excluded. The selection process was carried out using EndNote and Rayyan software. The main outcomes in the study were study design, sample size, sex, age, overall GBS symptoms, other COVID-19 symptoms, comorbidity, timing between infection and the onset of neurological symptoms, CT, MRI, and EMG results. Methodological quality of the studies was assessed using the McMaster Critical Review Form. The collected data was analyzed using qualitative synthesis. Findings: Fifty-one high-quality studies (mostly) consisting of 83 patients were included in the study. All of the patients (except in a very few) in the included studies had confirmed diagnosis of COVID-19. Similarly, the diagnosis of GBS was based on standard clinical, electrophysiological, and cerebrospinal fluid (CSF) criteria. Conclusion: GBS may be associated with COVID-19, and therefore, testing for COVID-19 is recommended in patients presenting with GBS during this pandemic.

Relationship between self-reported and performance-based tests in assessment of patients with total hip arthroplasty.

PURPOSE: The aim of our study was to investigate the relationship between self-reported and performance-based tests in the assessment of patients with total hip arthroplasty (THA). METHODS: Ninety four patients (35 males, 59 females) were included in the study with mean age 57.1 ± 14.6 years. Patients performed four performance tests (Timed "Up & Go" Test, Sit to Stand Test, Self-paced Walk Test and Stair Test) and two self-reported measurements (Harris Hip Score [HHS] and SF-36 [36-Item Short Form Health Survey]) were preferred to assess patients. RESULTS: There were varying correlations between performance tests and subscales of the SF-36 including physical function, energy/fatigue, pain, general health. Strong correlation was found between HHS and Timed "Up and Go"( r = -0.59, p < 0.001), self-paced walk test ( r = -0.58, p < 0.001). Moderate correlation was found between HHS and sit to stand test ( r = -0.406, p < 0.001), stair test ( r = 0.32, p < 0.001). CONCLUSIONS: There were especially moderate-to-strong correlations between self-reported measurements and performance-based tests in the evaluation of patients with THA. Therefore, outcomes assessment after THA may include self-reported measurements or performance-based tests.