Effect of Eutony, Holistic Gymnastics and Pilates on hamstring flexibility and back pain in pre-adolescent girls: Randomized clinical trial.

OBJECTIVE: This study aimed to evaluate the effects of Eutony, Holistic Gymnastics, and Pilates on hamstring flexibility and back pain in pre-adolescent girls. METHODS: This randomized prospective quantitative clinical trial compared the effects of Eutony, Holistic Gymnastics, and Pilates on hamstring flexibility and back pain. The sample consisted of 80 pre-adolescent girls aged 10-13 years and divided into three groups: Eutony, with 26 girls; Holistic Gymnastics, 27 girls; and Pilates, 27 girls. The participants underwent ten 1-h weekly interventions. Hamstring flexibility was evaluated using fingertip-to-floor, sit-and-reach, and hip angle tests; back pain was evaluated using the Body Posture Evaluation Instrument questionnaire and the way they carried their backpack by the Layout for Assessing Dynamic Posture. Descriptive statistical analysis, analysis of variance, and Kruskal-Wallis test were performed at a 5 % significance level (p < 0.05). RESULTS: The three body practices increased hamstring flexibility in all fingertip-to-floor (7.77 cm), hip angle (5.58°), and sit-and-reach evaluations (9.07 cm). Before the intervention, 66.25 % of participants complained of back pain. After the intervention, only 37.50 % continued with the complaint. Moreover, 25 % of pre-adolescent girls started to carry their school backpack correctly. CONCLUSION: Eutony, Holistic Gymnastics, and Pilates increased hamstring flexibility, reduced back pain complaints, and incentivized the girls to carry the school backpack correctly. REGISTRY OF CLINICAL TRIALS: Brazilian Registry of Clinical Trials ReBEC (RBR-25w6kk).

Comparative efficacy of acupuncture, venesection, and physical therapy on chronic low back pain outcomes: a randomized clinical trial.

Objective: Chronic low back pain (CLBP) imposes considerable financial and social burden with poor response to medical and surgical treatments. Alternatively, acupuncture and venesection(Fasd) are traditionally used to alleviate nociceptive and musculoskeletal pains. This study aimed to evaluate the effectiveness and the safety of acupuncture and venesection on CLBP and patient functionality. Methods: The current study was a single-blinded, randomized clinical trial with balanced allocation, conducted in the Department of Physical Medicine & Rehabilitation Medicine, in 2022. One hundred five CLBP patients who had no back pain-attributable structural or major diseases were randomly allocated into three parallel arms and received either physical therapy (PTG), acupuncture (APG), or venesection (VSG). Pain severity and functional aspects were evaluated using the visual analogue scale (VAS) and Oswestry disability index (ODI) during the study. VAS and ODI scores were defined as the primary outcomes. Results: Ninety-five patients were reviewed in the final analysis (PTG=33, APG=30, VSG=31). Demographic data showed equal group distribution. Statistical analysis showed all procedures had reduced VAS score immediately after the first session, after the last session, and after follow-up; however, APG and VSG values were significantly lower (P<0.05). Pain reduction results in follow-up period were more sustainable in APG and VSG as compared to PTG (P<0.01). ODI results revealed global improvement after the last session of the treatment in all groups, while APG had more significant results (P<0.05). During the follow-up period, ODI still tended to decrease in VSG, non-significantly increased in APG, and significantly increased in PTG. Only two patients reported fainting after receiving venesection. Conclusion: Considering the pain and functional scores, both acupuncture and venesection can reproduce reliable results. Acupuncture and venesection both have sustained effects on pain and daily function of the patients even after treatment termination, while physical therapy had more relapse in pain and functional limitations.

Comparison of High-intensity Laser Therapy with Extracorporeal Shock Wave Therapy in the Treatment of Patients with Plantar Fasciitis: A Double-blind Randomized Clinical Trial.

Background: The most common cause of heel pain is plantar fasciitis (PF). Although conservative treatments relieve pain in more than 90% of patients, it may remain painful in some cases. This study aimed to compare High-intensity Laser Therapy (HILT) with Extracorporeal Shock Wave Therapy (ESWT) in patients with PF. Methods: In this double-blinded randomized clinical trial (conducted in Yazd, Iran, from May 2020 to March 2021), patients were classified into two groups, including the ESWT and HILT, using online randomization. Nine sessions, three times a week for 3 weeks, were the treatment period in both groups. Visual Analogue Score (VAS), Heel Tenderness Index (HTI), and the SF36 questionnaire were compared and analyzed statistically at the beginning and 9 months after treatment. Results: 38 patients (19 in each group) completed the study. Results showed that pain and patient satisfaction improved significantly 3 months after treatment. The VAS and HTI decreased 3 months after treatment in both groups, which was statistically significant (P<0.001). The SF36 score in both groups increased 3 months after treatment, and this increase was statistically significant (P<0.001). Although the two modalities were effective based on VAS, HTI, and SF36, a significant statistical difference was observed between them (P=0.03, P=0.006, P=0.002, respectively), and the HILT was more effective. Conclusion: ESWT and HILT decrease pain and increase patient satisfaction in PF. Besides, both methods are non-invasive and safe. However, there is a significant difference between them, and HILT is more effective. Trial registration number: IRCT20210913052465N1.

Innovative Use of Mouth Props/Bite Blocks in Postoperative Mouth Opening Exercises.

Context: Postoperative jaw physiotherapy in the form of mouth opening exercises is an integral part of surgical treatment in oral submucous fibrosis and temporomandibular joint ankylosis. The literature has outlined multiple physical therapy modalities and modifications to aid in assisted mouth-opening exercises. Purpose: To overcome shortcomings associated with the use of conventional devices, the authors describe an innovative use and modification of a prefabricated soft silicone bite block/mouth prop as an adjunct to the devices to aid in achieving optimal mouth opening.

Rehabilitation interventions to modify physical frailty in adults before lung transplantation: a systematic review protocol.

INTRODUCTION: Lung transplantation is the gold-standard treatment for end-stage lung disease for a small group of patients meeting strict acceptance criteria after optimal medical management has failed. Physical frailty is prevalent in lung transplant candidates and has been linked to worse outcomes both on the waiting list and postoperatively. Exercise has been proven to be beneficial in optimising exercise capacity and quality of life in lung transplant candidates, but its impact on physical frailty is unknown. This review aims to assess the effectiveness of exercise interventions in modifying physical frailty for adults awaiting lung transplantation. METHODS AND ANALYSIS: This protocol was prospectively registered on the PROSPERO database. We will search four databases plus trial registries to identify primary studies of adult candidates for lung transplantation undertaking exercise interventions and assessing outcomes pertaining to physical frailty. Studies must include at least 10 participants. Article screening will be performed by two researchers independently at each stage. Extraction will be performed by one reviewer and checked by a second. The risk of bias in studies will be assessed by two independent reviewers using tools appropriate for the research design of each study; where appropriate, we will use Cochrane Risk of Bias 2 or ROBINS-I. At each stage of the review process, discrepancies will be resolved through a consensus or consultation with a third reviewer. Meta-analyses of frailty outcomes will be performed if possible and appropriate as will prespecified subgroup and sensitivity analyses. Where we are unable to perform meta-analysis, we will conduct narrative synthesis following Synthesis without Meta-analysis guidance. The review will be reported using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses checklist. ETHICS AND DISSEMINATION: No ethical issues are predicted due to the nature of this study. Dissemination will occur via conference abstracts, professional networks, peer-reviewed journals and patient support groups. PROSPERO REGISTRATION NUMBER: CRD42022363730.

Clinical and cost-effectiveness of individualised (early) patient-directed rehabilitation versus standard rehabilitation after surgical repair of the rotator cuff of the shoulder: protocol for a multicentre, randomised controlled trial with integrated Quintet Recruitment Intervention (RaCeR 2).

INTRODUCTION: Despite the high number of operations and surgical advancement, rehabilitation after rotator cuff repair has not progressed for over 20 years. The traditional cautious approach might be contributing to suboptimal outcomes. Our aim is to assess whether individualised (early) patient-directed rehabilitation results in less shoulder pain and disability at 12 weeks after surgical repair of full-thickness tears of the rotator cuff compared with current standard (delayed) rehabilitation. METHODS AND ANALYSIS: The rehabilitation after rotator cuff repair (RaCeR 2) study is a pragmatic multicentre, open-label, randomised controlled trial with internal pilot phase. It has a parallel group design with 1:1 allocation ratio, full health economic evaluation and quintet recruitment intervention. Adults awaiting arthroscopic surgical repair of a full-thickness tear are eligible to participate. On completion of surgery, 638 participants will be randomised. The intervention (individualised early patient-directed rehabilitation) includes advice to the patient to remove their sling as soon as they feel able, gradually begin using their arm as they feel able and a specific exercise programme. Sling removal and movement is progressed by the patient over time according to agreed goals and within their own pain and tolerance. The comparator (standard rehabilitation) includes advice to the patient to wear the sling for at least 4 weeks and only to remove while eating, washing, dressing or performing specific exercises. Progression is according to specific timeframes rather than as the patient feels able. The primary outcome measure is the Shoulder Pain and Disability Index total score at 12-week postrandomisation. The trial timeline is 56 months in total, from September 2022. TRIAL REGISTRATION NUMBER: ISRCTN11499185.

Current updates relating to treatment for interstitial cystitis/bladder pain syndrome: systematic review and network meta-analysis.

BACKGROUND: Despite the publication of several meta-analyses regarding the efficacy of certain therapies in helping individuals with interstitial cystitis (IC) / bladder pain syndrome (BPS), these have not provided a comprehensive review of therapeutic strategies. The study aimed to determine the efficacy of various therapies for IC/BPS and identify potential moderating factors using randomized controlled trials (RCTs). METHODS: We queried the PubMed, Cochrane, and Embase databases to identify prospective RCTs using inclusion criteria: 1) patients diagnosed with IC, 2) interventions included relevant treatments, 3) comparisons were a specified control or placebo, 4) outcomes were mean differences for individual symptoms and structured questionnaires. The pairwise meta-analysis and network meta-analysis (NMA) were performed to compare the treatments used in IC/BPS. Hedges' g standardized mean differences (SMDs) were used for improvement in all outcomes using random-effects models. Efficacy outcomes included individual symptoms such as pain, frequency, urgency, and nocturia, as well as structured questionnaires measuring IC/BPS symptoms. RESULTS: A comprehensive literature search was conducted which identified 70 RCTs with 3,651 patients. The analysis revealed that certain treatments, such as instillation and intravesical injection, showed statistically significant improvements in pain and urgency compared to control or placebo groups in traditional pairwise meta-analysis. However, no specific treatment demonstrated significant improvement in all outcomes measured in the NMA. The results of moderator analyses to explore influential variables indicated that increasing age was associated with increased nocturia, while longer follow-up periods were associated with decreased frequency. CONCLUSION: This systematic review and meta-analysis provide insights into the efficacy of various treatments for IC. Current research suggests that a combination of therapies may have a positive clinical outcome for patients with IC, despite the fact that treatment for this condition is not straightforward. TRIAL REGISTRATION: PROSPERO CRD42022384024.

Using reference equations to standardise incremental shuttle walk test performance in children and young people with chronic conditions and facilitate the evaluation of exercise capacity and disease severity.

AIMS: The aim was to evaluate whether standardised exercise performance during the incremental shuttle walk test (ISWT) can be used to assess disease severity in children and young people (CYP) with chronic conditions, through (1) identifying the most appropriate paediatric normative reference equation for the ISWT, (2) assessing how well CYP with haemophilia and cystic fibrosis (CF) perform against the values predicted by the best fit reference equation and (3) evaluating the association between standardised ISWT performance and disease severity. METHODS: A cross-sectional analysis was carried out using existing data from two independent studies (2018-2019) at paediatric hospitals in London,UK. CYP with haemophilia (n=35) and CF (n=134) aged 5-18 years were included. Published reference equations for standardising ISWT were evaluated through a comparison of populations, and Bland-Altman analysis was used to assess the level of agreement between distances predicted by each equation. Associations between ISWT and disease severity were assessed with linear regression. RESULTS: Three relevant reference equations were identified for the ISWT that standardised performance based on age, sex and body mass index (Vardhan, Lanza, Pinho). A systematic proportional bias of standardised ISWT was observed in all equations, most pronounced with Vardhan and Lanza; the male Pinho equation was identified as most appropriate. On average, CYP with CF and haemophilia performed worse than predicted by the Pihno equation, although the range was wide. Standardised ISWT, and not ISWT distance alone, was significantly associated with forced expiratory volume in 1 s in CYP with CF. Standardised ISWT in CYP with haemophilia was slightly associated with haemophilia joint health score, but this was not significant. CONCLUSIONS: ISWT performance may be useful in a clinic to identify those with worsening disease, but only when performance is standardised against a healthy reference population. The development of validated global reference equations is necessary for more robust assessment.

Evidence-informed and consensus-based statements about SAFEty of Physical Agent Modalities Practice in physiotherapy and rehabilitation medicine (SAFE PAMP): a national Delphi of healthcare scientific societies.

OBJECTIVE: A shared consensus on the safety about physical agent modalities (PAMs) practice in physiotherapy and rehabilitation is lacking. We aimed to develop evidence-informed and consensus-based statements about the safety of PAMs. STUDY DESIGN AND SETTING: A RAND-modified Delphi Rounds' survey was used to reach a consensus. We established a steering committee of the Italian Association of Physiotherapy (Associazione Italiana di Fisioterapia) to identify areas and questions for developing statements about the safety of the most commonly used PAMs in physiotherapy and rehabilitation. We invited 28 National Scientific and Technical Societies, including forensics and lay members, as a multidisciplinary and multiprofessional panel of experts to evaluate the nine proposed statements and formulate additional inputs. The level of agreement was measured using a 9-point Likert scale, with consensus in the Delphi Rounds assessed using the rating proportion with a threshold of 75%. RESULTS: Overall, 17 (61%) out of 28 scientific and technical societies participated, involving their most representative members. The panel of experts mainly consisted of clinicians (88%) with expertise in musculoskeletal (47%), pelvic floor (24%), neurological (18%) and lymphatic (6%) disorders with a median experience of 30 years (IQR=17-36). Two Delphi rounds were necessary to reach a consensus. The final approved criteria list comprised nine statements about the safety of nine PAMs (ie, electrical stimulation neuromodulation, extracorporeal shock wave therapy, laser therapy, electromagnetic therapy, diathermy, hot thermal agents, cryotherapy and therapeutic ultrasound) in adult patients with a general note about populations subgroups. CONCLUSIONS: The resulting consensus-based statements inform patients, healthcare professionals and policy-makers regarding the safe application of PAMs in physiotherapy and rehabilitation practice. Future research is needed to extend this consensus on paediatric and frail populations, such as immunocompromised patients.

Perioperative experiences of patients with high pain catastrophizing and knee arthroplasty after receiving or not preoperative physiotherapy: Qualitative study.

BACKGROUND: Among the risk factors studied for persistent pain after total knee arthroplasty (TKA), pain catastrophizing stands out above the others. In this regard, preoperative interventions based on pain neuroscience education or multimodal physiotherapy have been shown to be effective in reducing pain catastrophizing. OBJECTIVES: The present qualitative study aims to explore the perioperative experiences of high pain catastrophizing participants undergoing total knee arthroplasty surgery. Comparisons will be made between those who received, and those who did not receive a preoperative physiotherapy intervention. METHODS: Based on the purposive sampling approach, participants from a randomized controlled trial were selected. In total, 14 persons participated in face-to-face semi-structured interviews. RESULTS: Following a thematic analysis, the results were divided into two themes: 1) The preoperative experiences of patients with symptomatic knee arthroplasty, covering aspects related to health, functioning, cognition, and behaviour; and 2) The perioperative TKA rehabilitation process, illustrating differing experiences between individuals who received the preoperative physiotherapy interventions and those who did not. CONCLUSIONS: While participants who received no preoperative physiotherapy intervention showed limited coping strategies during post-surgery rehabilitation and the same cognitions as before (hypervigilance, rumination, or avoidance of activities), those participants who received the preoperative physiotherapy showed abilities to cope with their pain, felt empowered and were involved in their rehabilitation.

First mobilisation after abdominal and cardiothoracic surgery: when is it actually performed? A national, multicentre, cross-sectional study.

OBJECTIVES: Knowledge of clinical practice regarding mobilisation after surgery is lacking. This study therefore aimed to reveal current mobilisation routines after abdominal and cardiothoracic surgery and to identify factors associated with mobilisation within 6 hours postoperatively. DESIGN: A prospective observational national multicentre study. SETTING: 18 different hospitals in Sweden. PARTICIPANTS: 1492 adult patients undergoing abdominal and cardiothoracic surgery with duration of anaesthesia>2 hours. PRIMARY AND SECONDARY OUTCOMES: Primary outcome was time to first postoperative mobilisation. Secondary outcomes were the type and duration of the first mobilisation. Data were analysed using multivariate logistic regression and general structural equation modelling, and data are presented as ORs with 95% CIs. RESULTS: Among the included patients, 52% were mobilised to at least sitting on the edge of the bed within 6 hours, 70% within 12 hours and 96% within 24 hours. Besides sitting on the edge of the bed, 76% stood up by the bed and 22% were walking away from the bedside the first time they were mobilised. Patients undergoing major upper abdominal surgery required the longest time before mobilisation with an average time of 11 hours post surgery. Factors associated with increased likelihood of mobilisation within 6 hours of surgery were daytime arrival at the postoperative recovery unit (OR: 5.13, 95% CI: 2.16 to 12.18), anaesthesia <4 hours (OR: 1.68, 95% CI: 1.17 to 2.40) and American Society of Anaesthesiologists (ASA) classification 1-2, (OR: 1.63, 95% CI: 1.13 to 2.36). CONCLUSIONS: In total, 96% if the patients were mobilised within 24 hours after surgery and 52% within 6 hours. Daytime arrival at the postoperative recovery unit, low ASA classification and shorter duration of anaesthesia were associated with a shorter time to mobilisation. TRIAL REGISTRATION NUMBER: FoU, Forskning och Utveckling in VGR, Vastra Gotaland Region (Id:275357) and Clinical Trials (NCT04729634).

HIP fracture Supplemental Therapy to Enhance Recovery (HIPSTER): a protocol for a randomised controlled trial.

INTRODUCTION: Hip fractures result in substantial health impacts for patients and costs to health systems. Many patients require prolonged hospital stays and up to 60% do not regain their prefracture level of mobility within 1 year. Physical rehabilitation plays a key role in regaining physical function and independence; however, there are no recommendations regarding the optimal intensity. This study aims to compare the clinical efficacy and cost-effectiveness of early intensive in-hospital physiotherapy compared with usual care in patients who have had surgery following a hip fracture. METHODS AND ANALYSIS: This two-arm randomised, controlled, assessor-blinded trial will recruit 620 participants who have had surgery following a hip fracture from eight hospitals. Participants will be randomised 1:1 to receive usual care (physiotherapy according to usual practice at the site) or intensive physiotherapy in the hospital over the first 7 days following surgery (two additional sessions per day, one delivered by a physiotherapist and the other by an allied health assistant). The primary outcome is the total hospital length of stay, measured from the date of hospital admission to the date of hospital discharge, including both acute and subacute hospital days. Secondary outcomes are functional mobility, health-related quality of life, concerns about falling, discharge destination, proportion of patients remaining in hospital at 30 days, return to preadmission mobility and residence at 120 days and adverse events. Twelve months of follow-up will capture data on healthcare utilisation. A cost-effectiveness evaluation will be undertaken, and a process evaluation will document barriers and facilitators to implementation. ETHICS AND DISSEMINATION: The Alfred Hospital Ethics Committee has approved this protocol. The trial findings will be published in peer-reviewed journals, submitted for presentation at conferences and disseminated to patients and carers. TRIAL REGISTRATION NUMBER: ACTRN12622001442796.

Efficacy of photobiomodulation therapy combined with mobile health education in patients with head and neck cancer suffering from chronic xerostomia after radiotherapy: protocol for a three-arm, randomised, placebo-controlled, double-blinded study.

INTRODUCTION: The role of photobiomodulation (PBM) therapy for oral tissue damage induced by cancer treatment is currently unclear, and there is low-quality to moderate-quality evidence supporting the use of this approach for treating xerostomia and/or hyposalivation. Consequently, patients with head and neck cancer increasingly turn to basic oral hygiene to alleviate salivary gland dysfunction, and their adherence can be improved by mobile health (mHealth) education. The primary objective of this study will be to analyse the effects of different doses of PBM therapy (7.5 J/cm2 vs 3 J/cm2) plus mHealth education on quality of life (QoL), oral health, salivary secretion and salivary gland ultrasound assessment at postintervention and at the 6-month follow-up in patients with head and neck cancer after radiotherapy compared with those in control group. METHODS AND ANALYSIS: A prospective, three-arm, randomised, placebo-controlled, double-blinded study will be conducted among patients with head and neck cancer suffering from chronic xerostomia. A total of 20 patients per arm will be included and randomly assigned to receive 7.5 J/cm2 of PBM, 3 J/cm2 of PBM or placebo therapy. PBM therapy will be applied during 24 sessions at 22 points extra and intraorally two times per week for 3 months, combined with a mobile application (https://www.laxer.es). The assessments will be recorded at the beginning of the study, at postintervention and at the 6-month follow-up. The primary outcomes will be QoL, oral health, salivary secretion and salivary gland ultrasound. The pain pressure threshold, functional performance, mood and sleep quality will be secondary indicators. ETHICS AND DISSEMINATION: This study received ethics approval from the Andalusian Biomedical Research Ethics Portal (2402-N-21 CEIM/CEI Provincial de Granada) according to the Declaration of Helsinki for Biomedical Research. The results of this study will be presented at national and international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov NCT05106608.

Efficacy of a physiotherapy, yoga and patient education programme for patients with breast cancer and hormone therapy-induced pain: a multicentre randomised study protocol (SKYPE 2).

INTRODUCTION: Osteoarticular pain is experienced by approximately 50% of patients with breast cancer under hormone therapy and can increase the risk of therapy discontinuation. Among complementary therapies, yoga has shown efficacy regarding reduction of fatigue, anxiety, pain due to hormone therapy and inflammation. Personalised patient education programmes increase engagement and motivation, and induce effective behavioural changes. The SKYPE programme, an integrated intervention combining physiotherapy, yoga and patient education, showed promising efficacy on hormone therapy-induced pain in a previous pilot study. In this study, we hypothesised that using theory-based patient education favour learning and practising 15 min of at-home yoga every day to decrease hormone therapy-induced pain. METHODS AND ANALYSIS: This multicentre randomised study will assess the efficacy of the SKYPE programme on pain reduction compared with standard care in patients with breast cancer reporting osteoarticular pain due to hormone therapy. Main secondary objectives will describe pain evolution and characteristics, patient adhesion to yoga sessions and home practice, forward flexibility, quality of life, fatigue, anxiety and compliance to hormone therapy. Patients in the intervention group will participate in 1 weekly educational yoga session of 90 min for 6 weeks, supervised by physiotherapists (period 1). They will also perform daily at-home 15 min yoga sessions for 12 weeks, the total duration of the intervention (periods 1 and 2). Pain will be evaluated during physiotherapy check-ups at baseline (T0), at 6 weeks (T1) and at 12 weeks (T2). ETHICS AND DISSEMINATION: This study was approved by the ethics committee (CPP Ile de France 8 on 22 June 2020). The results will be disseminated to patients and healthcare professionals, and published in a peer-reviewed journal. TRIAL REGISTRATION NUMBER: NCT04457895.

Pelvic Floor Therapy and Initial Interventions for Pelvic Floor Dysfunction in Gynecologic Malignancies.

PURPOSE OF REVIEW: This review provides evidence-based updates for the first-line management approaches for pelvic floor disorders in patients with gynecologic malignancies, as well as important provider considerations when referring for pelvic floor physical therapy. RECENT FINDINGS: Currently, there is strong evidence to recommend pelvic floor muscle training as initial treatment for urinary incontinence and for pelvic organ prolapse; some evidence to recommend a more targeted pelvic floor muscle training program for fecal incontinence; and mostly expertise-based evidence to recommend vaginal gels or estrogen to aid with dyspareunia causing sexual dysfunction. More research is greatly needed to understand the role of overactive pelvic floor muscles in survivors with chronic pelvic pain and the treatment of post-radiation pelvic complications such as vaginal stenosis and cystitis. While pelvic floor disorders are common concerns in gynecologic cancer survivors, there are evidence-based initial noninvasive treatment approaches that can provide relief for many individuals.

Muscle strength in patients hospitalized for COVID-19 / Força muscular em pacientes hospitalizados por COVID-19

Abstract Introduction Complications arising from hospitalization due to COVID-19 have great impact on the physical health of individuals. One of the consequences that deserves attention is muscle weakness, which can be influenced by several factors, generating consequences that may need rehabilitation. Objective To relate the degree of peripheral and respiratory muscle strength to sociodemographic, clinical, and hospitalization variables close to discharge after hospitalization due to COVID-19. Methods This cross-sectional study analyzed data for 52 patients hospitalized for COVID-19 who were interviewed close to discharge to determine sociodemographic and clinical profiles and underwent muscle strength testing. Peripheral muscle strength was evaluated using the Medical Research Council scale, and respiratory strength was determined according to maximum inspiratory and expiratory pressure measured with a vacuometer. Hospitalization data were collected from patient medical records. Results Peripheral strength was reduced in 53.9% of the sample, and the related variables (p < 0.05) were age, weight, cancer, high blood pressure, physical therapy, and number of physiotherapy sessions. Inspiratory force was reduced by 50% of individuals and expiratory force in 60% individuals, and these reductions were related (p < 0.05) to sex, high blood pressure, age, and weight. Conclusion Close to COVID-19 hospital discharge, over 50% of patients exhibited peripheral and respiratory muscle weakness, associated with advanced age, hypertension, and low weight. Those with peripheral weakness received more physiotherapy and had more oncological diseases, while respiratory weakness was more common in men. This underscores the importance of preventive measures and post-hospitalization rehabili-tation programs, including physiotherapy, for muscle strength recovery.

Resumo Introdução As complicações decorrentes da hospitalização por COVID-19 têm grande impacto na saúde física dos indivíduos. Uma das consequências que merece atenção é a fraqueza muscular, que pode ser influenciada por diversos fatores, ge-rando consequências que podem necessitar de reabilitação. Objetivo Relacionar o grau de força muscular periférica e respiratória com variáveis sociodemográficas, clínicas e de internação próximo à alta após internação por COVID-19. Métodos Este estudo transversal analisou dados de 52 pa-cientes hospitalizados por COVID-19 que foram entrevistados próximo à alta para determinar perfis sociodemográficos e clínicos e que foram submetidos a testes de força muscular. A força muscular periférica foi avaliada pela escala do Medical Research Council, e a força respiratória foi determinada de acordo com a pressão inspiratória e expiratória máxima medida com vacuômetro. Os dados de internação foram coletados dos prontuários dos pacientes. Resultados A força periférica esteve reduzida em 53,9% da amostra e as variáveis relacionadas (p < 0,05) foram idade, peso, câncer, hipertensão, fisioterapia e número de sessões de fisioterapia. A força inspiratória foi reduzida em 50% dos indivíduos e a força expiratória em 60% dos indivíduos, e essas reduções foram relacionadas (p < 0,05) ao sexo, pressão arterial elevada, idade e peso. Conclusão Próximo à alta hospitalar da COVID-19, mais de 50% dos pacien-tes apresentavam fraqueza muscular periférica e respiratória associada à idade avançada, hipertensão e baixo peso. Aqueles com fraqueza periférica receberam mais fisioterapia e tiveram mais doenças oncológicas, enquanto a fraqueza respiratória foi mais comum em homens. Isto ressalta a importância de medidas preventivas e programas de reabilitação pós-hospitalização, incluindo fisioterapia, para a recuperação da força muscular.

Effects of low-level laser therapy on acupuncture points on knee pain and function in knee osteoarthritis

SUMMARY OBJECTIVE: Knee osteoarthritis is a common and disabling disease. We aimed to examine the effect of low-level laser therapy in addition to routine physical therapy modalities (transcutaneous electrical stimulation, superficial heating modality of infrared, ultrasound, and exercise) on the functional status and pain in knee osteoarthritis. METHODS: Patients with knee osteoarthritis (n=71) who underwent physical therapy (transcutaneous electrical stimulation, infrared, ultrasound, exercise therapy, and low-level laser therapy) were retrospectively screened. Patients who received low-level laser therapy on acupuncture points, transcutaneous electrical stimulation, infrared, ultrasound, and exercise were included in the low-level laser therapy (+) (n=35), and patients who received only transcutaneous electrical stimulation, ultrasound, infrared, and exercise were included in the low-level laser therapy (-) group (n=36). The Visual Analog Scale for activity pain, Lysholm Knee Scoring Scale, and walking and stair climbing tests were used before and after treatment obtained from patient files. RESULTS: The post-treatment Visual Analog Scale activity score and walking and stair climbing test results were statistically significantly lower in the low-level laser therapy (+) group than in the low-level laser therapy (-) group. There was no significant difference in post-treatment Lysholm Knee Scoring Scale scores between the two groups. In both groups, the Visual Analog Scale activity, Lysholm Knee Scoring Scale, and walking and stair climbing test scores statistically significantly decreased after treatment. CONCLUSION: Knee osteoarthritis increases with aging and creates significant functional limitations. low-level laser therapy with routine physiotherapy contributed to the improvement in the pain and functional status of the patients with knee osteoarthritis. Low-level laser therapy can be recommended in osteoarthritis treatment guidelines with the support of further studies, which is an easy-to-apply, effective, and reliable method.

Modelo para avaliação da efetividade da atuação fisioterapêutica na atenção básica / Model for evaluating the effectiveness of physiotherapeutic activities in primary care

RESUMO A pesquisa objetivou elaborar um modelo para avaliação da efetividade da atuação fisioterapêutica na atenção básica. O modelo foi elaborado com base na literatura, em entrevistas com experts envolvidos na atuação fisioterapêutica na Atenção Básica à Saúde e conferência de consenso para validação com especialistas. A matriz avaliativa proposta é composta por três dimensões - ações assistenciais, de gestão e de promoção de saúde - e nove indicadores. Esse modelo proposto será posteriormente aplicado para verificar sua aplicabilidade, necessidade de ajustes e possibilidade de replicação em diferentes contextos.

ABSTRACT The research aimed to develop a model to evaluate the effectiveness of physiotherapeutic activities in primary care. The model was elaborated based on the literature, through interviews with experts involved in physiotherapeutic activities in Primary Health Care and a consensus conference for validation with specialists. The proposed evaluation matrix is composed of three dimensions - care, management and health promotion actions - and nine indicators. This proposed model will be later applied to verify its applicability, the need for adjustments and the possibility of replication in different contexts.