Comparison of the outcomes of two different exercise programs on frozen shoulder.

OBJECTIVES: The aim of the study was to compare the effects of two different exercise programs on pain, range of motion (ROM), and functional results in frozen shoulder. METHODS: Twenty-two female and 7 male patients [mean age 52.1 years (range 38-65 years)] were randomly allocated into two groups: 14 in the first group and 15 in the second group. The patients were treated for 6 weeks (30 sessions) at hospital under the supervision of physical therapist. Both groups were treated with transcutaneous electrical nerve stimulation, cold pack, and nonsteroidal antiinflammatory drugs; and were given glenohumeral ROM exercises. The scapulothoracic exercises were performed only by the second group. Functional results were assessed using the modified Constant score, pain was assessed using visual analog scale (VAS), and ROM was measured with a goniometer. Assessments were performed before treatment and repeated at 6 and 12 weeks of treatment. RESULTS: In both groups, the Constant score and ROM were increased, and VAS was decreased at the end of 6 and 12 weeks. The modified Constant score was not significantly different between the groups before and after treatment. VAS score was better in the second group at 6 weeks (p<0.01). Improvement in ROM was significantly better in the second group at 12 weeks (p=0.005). CONCLUSION: In addition to glenohumeral ROM exercises, scapulothoracic exercises contribute to decreasing pain and increasing ROM in patients with frozen shoulder.

Higiene de manos de los fisioterapeutas: prevención de infecciones nosocomiales / Hand hygiene in physiotherapists: prevention of nosocomial infections

Introducción: se entiende por infección nosocomial aquella que se adquiere en el hospital y que no estaba presente ni en período de incubación cuando el paciente ingresó. Las infecciones nosocomiales producen una alta morbimortalidad en los pacientes e incrementan los costes relacionados con los cuidados sanitarios. En una unidad de fisioterapia, se produce un aumento en el número de sesiones de tratamiento, y una limitación de la mejora funcional conseguida tras la finalización de éste.Objetivo: destacar la importancia de la correcta higiene de manos, tanto por su alta eficacia como por su bajo coste, como medida de prevención de la transmisión de microorganismos patógenos.Material y métodose realiza una búsqueda bibliográfica en las bases de datos de PubMed, PEDro y en The Cochrane Library.Conclusiones: la desinfección higiénica de manos con soluciones hidroalcohólicas es la más efectiva para reducir la contaminación bacteriana de las manos(AU)

Introduction:Nosocomial infection is defined as that acquired in the hospital that was not present in either the incubation stage or on admission. Nosocomial infection causes high morbidity and mortality in patients and an increase in health care costs. This causes a rise in the number of treatment sessions and places a limitation on the functional improvement achieved after its completion in a physiotherapy unit.Objective: To draw attention on the importance of appropriate hand hygiene due to its high effectiveness as well as its low cost in order to prevent transmission of pathogenic microorganisms.Material and methodA research of the literature was carried out through PubMed, PEDro, and The Cochrane library.Conclusions: Hand disinfection with an alcohol-based solution is the most effective measure to remove bacterial hand contamination(AU)

Organización de la actividad asistencial del fisioterapeuta en salas de Atención Primaria / Organization of care activity of the physiotherapist in primary care sites

Objetivo: conocer el tiempo dedicado a la actividad asistencial en salas de fisioterapia del Área de Gestión Sanitaria Norte de Almería. Métodos: estudio observacional descriptivo de la actividad asistencial realizada en tres salas de fisioterapia de las Zonas Básicas de Salud de Serón, Albox y Los Vélez durante el mes de febrero de 2006. Se cuantificó el tiempo dedicado a las distintas actividades asistenciales en dichas salas. Se diferenció por actividad asistencial efectiva (tratamiento individual, grupal y tratamiento domiciliario), actividades de formación y tareas de organización, según indica la Guía de Procedimientos de Fisioterapia en Atención Primaria. Se cuantificaron también otras actividades no incluidas en la cartera de servicios del fisioterapeuta. Resultados: del total del tiempo trabajado durante el mes de febrero en las tres Zonas Básicas de Salud (18 días), el mayor porcentaje correspondió a la actividad asistencial efectiva con un 86,37% de la jornada laboral (aproximadamente 6 horas diarias). Para actividades organizativas el porcentaje de tiempo dedicado diariamente fue del 6,89%. El tiempo dedicado a las actividades no incluidas en la cartera de servicios fue de 6,74%. Conclusiones: se ha encontrado que tanto las actividades realizadas por el fisioterapeuta como los tiempos empleados para las mismas no se corresponden en general con lo recomendado, siendo el tratamiento individual el que mayoritariamente ocupa la jornada laboral. Se dedica tiempo a actividades que no son propias del fisioterapeuta de Atención Primaria y que sería más conveniente utilizar en actividades formativas, de prevención y promoción de la salud(AU)

Objective: Know the time dedicated to care activity in the physiotherapy rooms of the North Health Care Management Area of Almeria.Methods: Observational, descriptive study of the care activity performed in threephysiotherapy sites of the Basic Health Zones of Seron, Albox and los Velez during themonth of February 2006. Time dedicated to the different care activities in said sites wasquantified. It was differentiated by real care activity (individual and group treatment andhome treatment), training activities and organization tasks as indicated by thePhysiotherapy Procedures Guidelines in Primary Care. Other activities not included inthe list of physiotherapeutic services were also quantified.Results: The greatest percentage of time worked during the month of February in thethree Basic Health Zones (18 days) corresponded to real care activity, this accounting for86.37% of the work day (approximately 6 hours daily). The percentage of time dedicated toorganizational activities daily was 6.89%. Time dedicated to activities not included in thelist of services was 6.74%.Conclusions: It was found that both the activities performed by the physiotherapist andthe times used for them do not correspond in general with that recommended, individualtreatment being that which mostly occupies the work day. Time is dedicated to activitiesthat are not characteristic of the primary care physiotherapist and that could be betterused in training activities, prevention activities and health promotion activities(AU)

Analysis of ultraviolet phototherapy and photochemotherapy resources in Ireland.

BACKGROUND: Ultraviolet (UV) phototherapy is widely used and very successful in the treatment of skin conditions. As such a safe and efficient service is essential. At present, there are no standard Irish guidelines regarding the operation, calibration or inspection of UV equipment nor is there an Irish policy on staff/patient safety or training issues. AIM: To survey all known phototherapy centres in Ireland. METHODS: A postal questionnaire was sent to all known phototherapy centres in Ireland addressed to the consultant dermatologist or the physiotherapist-in-charge. It was divided into six sections: Instrumentation, Quality Assurance, UV meters, equipment maintenance, patient/staff safety and training. Comments on current practice were invited. Non-respondents were contacted by telephone, in some cases the survey was mailed a second time. RESULTS: This study demonstrated a substantial quantity of suboptimal equipment in use and a lack of consensus regarding quality assurance inspection and UV meter calibration frequency. CONCLUSIONS: Guidelines must be established for calibration of UV equipment and standardisation of phototherapy protocols in Ireland.

Two sources of contamination of a hydrotherapy pool by environmental organisms.

As a result of occasional water discolouration, the hydrotherapy pool of a large teaching hospital was monitored for free and combined chlorine, alkalinity, calcium hardness, total dissolved solids and cyanuric acid levels together with bacteriological analysis. The hose pipe supplying the pool and the dual water pumps were also examined as potential sources of bacterial contamination. The pool water yielded high counts of Pseudomonas vesicularis, Pseudomonas aeruginosa, and CDC Group IV C2, even in the presence of adequate levels of free chlorine. This was found to be due to high concentrations of cyanuric acid which resulted in a 'chlorine lock'. The source of the P. vesicularis and CDC Group IV C2 was found to be the pool hose and this problem was alleviated by flushing it with water each day before use. The source of the P. aeruginosa was the pool pumps, and was eradicated by regularly shock dosing them with 6-8 ppm of free chlorine.

Infection control in hydrotherapy.

Bacteria which flourish in untreated whirlpool and hubbard tank water may cause disease in people who are elderly, debilitated, or on antibiotics. This study compared various bactericidal agents in order to find the most economical, convenient and effective way to prevent infection occurring in patients undergoing hydrotherapy. Samples of water from a hubbard tank and two whirlpool baths were tested for colony count and culture before, during and after use, while regular patient loads and cleaning procedures were in effect. A germicidal detergent, an iodophor, and two chlorine agents were tried in succession. Acceptability to patients, effectiveness against bacteria, cost, and ease of handling were compared. The germicidal detergent only killed some bacteria and was very foamy. The iodophor was expensive and stained the tanks. Household bleach was unreliable in its effect hard to handle, and produced many complaints of "chlorine" smell. Stabilized granular chlorine treatment of the water provided an excellent infection control method for the physiotherapy department in this study.