Knowledge, attitude and practice of physiotherapists about lymphedema: A Turkish perspective.

BACKGROUND: Physiotherapists are important members of the healthcare team in the management of lymphedema. Therefore, the level of knowledge and awareness of physiotherapists on this disease is substantial. This study was planned to investigate knowledge, attitude, and practice of physiotherapists about lymphedema in Turkey. METHOD: This study was a qualitative, prospective, and cross-sectional research. Data were collected with the web-survey which consisted of the demographical characteristics information, evaluation of their own knowledge and practice in lymphedema management, and current knowledge of physiotherapists about lymphedema based on the current literature. RESULTS: Two hundred seventy-four physiotherapists (174 Female: 100 Male; mean age: 29.87 ± 6.9 years) completed the web-survey. From 274 physiotherapists, 52.60% of them had no education about lymphedema, 13.90% of them had never seen any patient with lymphedema, and 57.70% of them had not taken part in the management of a patient with lymphedema. 71.90% of the physiotherapists did not think they have enough knowledge about lymphedema. It was identified that physiotherapists' general and risk factors knowledge about lymphedema was sufficient. However, physiotherapists showed a lack of knowledge on the evaluation, treatment, and recommendations for lymphedema. CONCLUSION: Physiotherapists' education and experience in lymphedema management are crucial as they are important members of the multidisciplinary team. To raise qualified physiotherapists in this field, from undergraduate education, special training programs about lymphedema should be added to their lifelong learning process.

The effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease: A systematic review and meta-analysis of systematic reviews.

BACKGROUND: The aim of the study was to evaluate the effect of Tai Chi on functional mobility, balance and falls in Parkinson's disease. MATERIALS AND METHODS: A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses up to the end of October 2021. 601 studies were identified, and 16 of them were included in our study. RESULTS: According to our meta-analysis; there was a significant effect of Tai Chi on balance (SMD, -0.777 95% CI -0.921 to -0.633; p = 0.000), functional mobility (SMD, -0.719 95% CI -0.944 to -0.494; p = 0.000), and falls (SMD, -0.456 95% CI -0.668 to -0.245; p = 0.000) in PD. CONCLUSION: Our systematic review and meta-analysis found significant effects of Tai Chi on functional mobility, balance and falls in patients with PD.

The effect of Tai Chi and Qigong on health-related quality of life in Parkinson's disease: a systematic review and meta-analysis of systematic reviews.

The overall aim of the treatment in Parkinson's disease is to optimize functional independence, safety, well-being and thereby health-related quality of life. Tai Chi and Qigong are widely used exercises in Parkinson's disease, but there is insufficient evidence to support or refute the efficacy of Tai Chi and Qigong, especially on health-related quality of life in patients with Parkinson's disease. The aim of this study was to conduct a systematic review and a meta-analysis from the systematic reviews that evaluate the effectiveness of Tai Chi and Qigong on health-related quality of life in Parkinson's disease. A comprehensive literature search was conducted to identify the systematic reviews and meta-analyses by using Cochrane Library, MEDLINE, PubMed, etc., databases up to the end of November 2018. From 1504 articles, seven fulfilled the inclusion criteria and were included in our study. Five of the included systematic reviews were about Tai Chi, and two of them were about both Tai Chi and Qigong. According to our meta-analysis, there was no significant effect of Tai Chi and Qigong on health-related quality of life in patients with Parkinson's disease, when compared to the control group (standardized mean difference -0.166, 95% confidence interval -0.676 to 0.344; P = 0.523). In conclusion, our systematic review and meta-analysis showed no significant effect of Tai Chi and Qigong statistically on health-related quality of life in patients with Parkinson's disease, but the small effect size in our study favoured the potential benefit of Tai Chi and Qigong on health-related quality of life in Parkinson's disease.

The clinical and urodynamic results of a 3-month percutaneous posterior tibial nerve stimulation treatment in patients with multiple sclerosis-related neurogenic bladder dysfunction.

AIM: The aim of this study was to investigate the effect of PTNS after 12 weeks, on the urodynamic findings in the Multiple Sclerosis (MS) patients with neurogenic detrusor overactivity (NDO). METHODS: A total of 19 MS patients with NDO were enrolled in the study. Urodynamic studies before and after 12 weeks PTNS were performed. PTNS was applied unilaterally from the medial malleolus and posterior to the edge of the tibia by using charge-compensated 200 micros pulses with a pulse rate of 20 Hz, weekly, during 3 months. The effects of PTNS on urodynamic variables were compared of baseline and after PTNS data in MS patients. RESULTS: Mean volume at the first involuntary detrusor contraction (1st IDCV) on standard cystometry was 124.2+/-37.6 ml, while it was 217.5+/-66.4 mL after PTNS. Mean maximum cystometric capacity (MCC) on standard cystometry was 199.7+/-29.3 mL, while it was 266.8+/-36.9 mL after stimulation. The improvements in the 1st IDCV and MCC were statistically significant after stimulation. Mean P(detmax) at first involuntary detrusor contraction, maximal detrusor pressure at maximum cystometric capacity, detrusor pressure at maximal flow (P(detQmax)) and maximal flow rate (Q(max)) were statistically significant after PTNS for 12 weeks. CONCLUSIONS: These results have demonstrated that PTNS is effective to suppress NDO in MS patients after PTNS. Although long-term efficacy of PTNS is known, the findings showed prominent improvements on the clinical and urodynamic outcome, we think that the use of PTNS for DO in MS patients will be promising in clinical practice in the future.