Effects of the delivery of physiotherapy on the treatment course of elderly fallers presenting to the emergency department: Protocol for a randomized clinical trial.

The use of physiotherapy (PT) in the hospital emergency department (ED) has shown positive results including improvements in patient waiting time, treatment initiation, discharge type, patient outcomes, safety and acceptability of the intervention by medical staffs. These findings originate from studies that primarily focus on musculoskeletal and orthopaedic conditions. Despite a significant number of people visiting the ED, there is a shortage of literature evaluating PT in the ED for elderly populations. The objective of this study is the evaluate the effect of delivering PT in the ED (versus no delivery) in patients aged 75 and over with 'falls' complaints. The main objective is the evaluate the effect on the discharge disposition (discharge home, hospitalization). Secondarily, we will evaluate the effect delivering PT on patient-length of stay, the number of falls at 7 days after admission to the ED, changes between the initial and final medical decision regarding patient orientation, and medical staff satisfaction. This study will follow a prospective longitudinal design involving participants aged 75 years and over. We plan to recruit a total n = 336 patients admitted to the ED with a 'fall' chief complaint. After consent, participants will be randomized into either the 'PT-group' (receiving a prescription and execution of PT within the ED), or to the 'no-PT group' (no delivery of PT within the ED). The PT intervention will involve a standardized assessment of motor capacities using validated clinical examinations, and the delivery of rehabilitative exercises based on individual needs. Outcomes will be recorded from the patient's medical record, and a phone call at 7 days. A questionnaire will be sent to medical staff. The results of this study will help to determine whether PT might be beneficial for the management of this increasing proportion of individuals who come to the ED. Trial registration: (Trial registration number: ClinicalTrials.gov NCT05753319). https://classic.clinicaltrials.gov/ct2/show/NCT05753319.

Impact of the Covid-19 pandemic and lockdowns on the education and mental health of physiotherapy students in France: a descriptive cross-sectional study with national online survey.

OBJECTIVE: To determine the impact of the SARS-CoV-2 (COVID-19) pandemic and lockdowns on the mental health status, training, perceptions of the physiotherapy profession, and career plans of French physiotherapy students. DESIGN: A descriptive cross-sectional study was conducted, representing the first and only survey of its kind, using a national online survey. SUBJECTS: A total of 2678 French physiotherapy students participated in the study. METHODS: Mental health status was assessed using the validated French versions of established depression, anxiety, and insomnia scales. RESULTS: The survey revealed that female sex, age below 21 years, living alone, and having a psychiatric history or COVID-19 risk factors were associated with more severe symptoms of depression, anxiety, and insomnia in the surveyed students. In addition, stress, anxiety, and depression induced by the COVID-19 crisis were linked to apprehension about continuing practical training in physiotherapy. These factors also affected students' perceptions of the profession and the initially envisioned mode of practice, particularly among fifth-year students (odds ratio (OR) = 2.25, 95% confidence interval (95% CI) = (1.69, 2.99), p < 0.001). Notably, the pandemic significantly reduced the desire of these students to pursue a career as physiotherapists (adjusted OR (aOR) 1.41 (1.06, 1.86)). CONCLUSION: French physiotherapy students, especially those in their fifth year, have experienced significant impacts from the COVID-19 pandemic, affecting their mental health, education, perceptions of the physiotherapy profession, and career plans.

Impact of the practice of touch-massage® by a nurse on the anxiety of patients with hematological disorders hospitalized in a sterile environment, a randomized, controlled study.

CONTEXT: In addition to curative care, supportive care is beneficial in managing the anxiety symptoms common in patients in sterile hematology unit. We hypothesize that personal massage can help the patient, particularly in this isolated setting where physical contact is extremely limited. The main objective of this study was to show that anxiety could be reduced after a touch-massage® performed by a nurse trained in this therapy. METHODS: A single-center, randomized, unblinded controlled study in the sterile hematology unit of a French university hospital, validated by an ethics committee. The patients, aged between 18 and 65 years old, and suffering from a serious and progressive hematological pathology, were hospitalized in sterile hematology unit for a minimum of three weeks, patients were randomized into either a group receiving 15-minute touch-massage® sessions or a control group receiving an equivalent amount of quiet time once a week for three weeks. In the treated group, anxiety was assessed before and after each touch-massage® session, using the State-Trait Anxiety Inventory questionnaire with subscale state (STAI-State). In the control group, anxiety was assessed before and after a 15-minute quiet period. For each patient, the difference in the STAI-State score before and after each session (or period) was calculated, the primary endpoint was based on the average of these three differences. Each patient completed the Rosenberg Self-Esteem Questionnaire before the first session and after the last session. RESULTS: Sixty-two patients were randomized. Touch-massage® significantly decreased patient anxiety: a mean decrease in STAI-State scale score of 10.6 [7.65-13.54] was obtained for the massage group (p ≤ 0.001) compared with the control group. The improvement in self-esteem score was not significant. CONCLUSION: This study provides convincing evidence for integrating touch-massage® in the treatment of patients in sterile hematology unit. TRIAL REGISTRATION: NCT02343965.

Evaluation of the impact of non-slip socks on the motor recovery of elderly people in acute care hospitals: Protocol for a randomized, controlled trial study.

BACKGROUND: Older patients often arrive in acute care wards with inappropriate footwear. Hospitals may provide non-slip socks to improve the patients' safety. However, few studies have been conducted on the benefits of non-slip socks. A recent literature review found only two randomized controlled studies that evaluated non-slip socks, but the socks were not the primary focus of the studies. The aim of this study is therefore to specifically evaluate the benefits of non-slip socks on gait in hospitalized older people. METHODS: This open, randomized, controlled trial will include patients aged 75 years and over, hospitalized in an acute medical unit. Patients will be randomized to either remain barefoot or wear non-slip socks throughout their stay. The primary outcome is gait speed, assessed on Day 1 and Day 8. DISCUSSION: This randomized controlled trial should provide clinicians with a scientific rational for the recommendation, or not, of the use of non-slip socks for older patients in acute care hospitals. TRIAL REGISTRATION: https://clinicaltrials.gov/ on May 12, 2021 under the reference: NCT04882696 https://clinicaltrials.gov/ct2/show/NCT04882696.

Assessment of body perception disturbances in complex regional pain syndrome: A systematic review using the COSMIN guideline.

OBJECTIVE: To conduct a systematic review to identify which tools are being used to assess body perception disturbances in Complex Regional Pain Syndrome (CRPS) and to provide an evidence-based recommendation in the selection of an assessment tool, based on measurement properties. DATABASES AND DATA TREATMENT: Five electronic databases (EMBASE, Pubmed, PsycInfo, Science Direct and Web of Science) were searched for English or French written articles, with no time restrictions. All original articles using a body perception assessment tool with adult patients with CRPS were selected, regardless of their design (controlled trials, single case, qualitative study). Two investigators screened abstracts, selected full articles and extracted data independently. RESULTS: Thirty-eight full-text papers were obtained and three main methods to evaluate body perception disturbances were identified: The Bath Body Perception Disturbance Scale, the Neglect-like Symptoms questionnaire adapted from Galer and the patient's body perception description. No full psychometric assessments were found. The Limb Laterality Recognition Task was also used in conjunction with another method. CONCLUSIONS: Three main assessment methods for CRPS body perception disturbances are currently used. Full psychometric evaluation has not been completed for any of the assessment methods. As a consequence, we could not fully apply the COSMIN guideline. To date, there is no agreement concerning the use of a specific questionnaire or scale. The results indicate a need for further research such as psychometric properties of these questionnaires. SIGNIFICANCE: This systematic review identified body perception disturbances assessment methods and their the psychometric properties in order to provide help and guidance to researchers and clinicians to investigate those clinical features.

Translation and validation of the movement imagery questionnaire-3 second French version.

INTRODUCTION: Motor imagery (MI) can be defined as the mental simulation of an action without performing it. Its effectiveness can be substantially influenced by imagery ability, and it is currently accepted that three main modalities are used in MI (kinaesthetic imagery, and internal or external visual imageries). In the context of rehabilitation, MI combined with physical therapy is further known to facilitate functional improvements, and promote cortical reorganization and long-term recovery. This study aimed to test the reproducibility and the validity of constructs (internal consistency and factorial structure) of the Movement Imagery Questionnaire-3 Second French version (MIQ-3Sf). METHOD: The internal consistency as well as the validity of constructs and the test-retest inter-rate reproducibility of the MIQ-3Sf was examined, in 553 participants, for the kinaesthetic and visual items. RESULTS: The composite reliability scores (≥0.92) and the intraclass correlation coefficients (>0.88) for the kinaesthetic, internal visual and external visual imagery subscales revealed satisfactory internal consistency and reproducibility. Moreover, Pearson correlations revealed a strong relationship between the MIQ-3Sf and the MIQ-3f. CONCLUSIONS: /Implications. The MIQ-3Sf can be considered as a valid, reliable and useful questionnaire for examining MI ability in the context of rehabilitation.

Effect of an intensive cervical traction protocol on mid-term disability and pain in patients with cervical radiculopathy: An exploratory, prospective, observational pilot study.

BACKGROUND: Cervical radiculopathy is a relatively common and disabling condition involving local pain in the neck region and pain that radiates into the upper limb. Recent data suggest that cervical traction may effectively reduce disability and pain, with a dose-response relationship. The main aim of this study was therefore to evaluate the mid-term effect of an intensive cervical traction protocol for patients with cervical radiculopathy on disability, and to compare the effects with those reported by non-intensive protocols in the literature. METHODS: We conducted a prospective open observational study of 36 patients referred by their general practitioner for symptoms suggestive of cervical radiculopathy. All patients underwent the same treatment: a 30-minute cervical traction protocol, twice a day, for five consecutive days. The main objective was the evaluation of disability at 3 months. We evaluated at baseline (D1), the end of the protocol (D5) and at mid-term (M3) disability, cervical pain, radiating pain, pain on motor imagery, presence of neuropathic pain and medication consumption. The primary outcome was the proportion of patients for whom the Neck Disability Index improved by more than the minimum clinically important difference of 7 points by M3. RESULTS: Thirty-six patients were included in this study. The Neck Disability Index improved by more than the minimum clinically important difference in 48.3% at M3. Mean Neck Disability Index (p < .001), mean cervical VAS (p < .001), mean radiating VAS (p < .001), and mean VAS for imagined lateral flexion and rotation (p < .002) improved significantly from D1 to D5 and from D1 to M3. Consumption of medication reduced at each time point. The proportion of patients with neuropathic pain reduced from 61.1% at D1 to 33.3% at D5 and 48.3% at M3. CONCLUSION: Disability reduced by more than the minimum clinically important difference in almost half of the participants following the intensive traction protocol. These results are encouraging and suggest that this complex condition can be treated with relatively simple methods.

[Preventing falls among frail elderly patients in acute care: The use of non-slip socks. A systematic literature review]. / Prévention des chutes chez les personnes âgées fragiles hospitalisées en court séjour : utilisation des chaussettes antidérapantes. Une revue systématique de littérature.

INTRODUCTION: Falls among hospitalized frail elderly patients are a worrying, major daily phenomenon. CONTEXT: Inadequate footwear, frequently observed in this population, is one of the main risk factors behind falls. Several hospitals use non-slip socks as a preventive measure. However, in the context of evidence-based medicine, it is important to verify the existence of strong evidence for their effectiveness. OBJECTIVE: The aim of this study is to determine the preventive effectiveness of non-slip socks. METHOD: Five databases were investigated (PubMed, PEDro, Cochrane, ScienceDirect, and Google Scholar). Eligibility criteria were established (using the PICO method), for studies including elderly hospitalized patients. RESULTS: Seven studies were included. Non-slip socks showed a preventive effect in reducing the recurrence of falls (p=0.009) and the prevalence of falls related to urinary incontinence. DISCUSSION: Several studies conclude on the added value of non-slip socks compared to traditional socks or slippers. The limitations inherent in the selected studies are taken into account when drawing conclusions. CONCLUSION: Footwear that is considered safe by therapists and secure by the patient is currently the most recommended option. However, more clinical studies are needed to support our findings.

Prévention des chutes chez les personnes âgées fragiles hospitalisées en court séjour : utilisation des chaussettes antidérapantes. Une revue systématique de littérature.

INTRODUCTION: Falls among hospitalized frail elderly patients are a worrying, major daily phenomenon. CONTEXT: Inadequate footwear, frequently observed in this population, is one of the main risk factors behind falls. Several hospitals use non-slip socks as a preventive measure. However, in the context of evidence-based medicine, it is important to verify the existence of strong evidence for their effectiveness. OBJECTIVE: The aim of this study is to determine the preventive effectiveness of non-slip socks. METHOD: Five databases were investigated (PubMed, PEDro, Cochrane, ScienceDirect, and Google Scholar). Eligibility criteria were established (using the PICO method), for studies including elderly hospitalized patients. RESULTS: Seven studies were included. Non-slip socks showed a preventive effect in reducing the recurrence of falls (p=0.009) and the prevalence of falls related to urinary incontinence. DISCUSSION: Several studies conclude on the added value of non-slip socks compared to traditional socks or slippers. The limitations inherent in the selected studies are taken into account when drawing conclusions. CONCLUSION: Footwear that is considered safe by therapists and secure by the patient is currently the most recommended option. However, more clinical studies are needed to support our findings.

Does the Improvement of Position Sense Following Motor Imagery Practice Vary as a Function of Age and Time of Day?

The effectiveness of motor imagery practice is known to depend on age and on the ability to form motor images. In the same individual, motor imagery quality changes during the day, being better late in the morning for older adults and in the afternoon for younger adults. Does this mean that motor imagery practice should be done at specific time of the day depending on the age of participants to maximize motor learning? To examine whether the effect of motor imagery practice varies as a function of time of day and age, the authors used an arm configuration reproduction task and measured position sense accuracy before and after 135 kinesthetic motor imagery trials. Younger and older participants were randomly assigned to either a morning or an afternoon session. Data showed that the accuracy for reproducing arm configurations improved following imagery practice regardless of time of day for both younger and older adults. Moreover, the authors observed that the position sense was less accurate in the afternoon than in the morning in older participants (before and after motor imagery practice), while performance did not change during the day in younger participants. These results may have practical implications in motor learning and functional rehabilitation programs. They highlight the effectiveness of motor imagery practice for movement accuracy in both younger and older adults regardless of time of day. By contrast, they reveal that the assessment of position sense requires that the time of day be taken into account when practitioners want to report on the older patients' progress without making any mistakes.

Massage can (re-)activate the lower limb sensorimotor representation of older adult inpatients.

Understanding how changes in afferent signal processing may impact the sensorimotor processes is essential for physical therapists whose objective is to actively improve the reorganization of motor function in patients suffering from sensorimotor system disturbance. Because the sensorimotor processes are slowed with the advance in age, we examined whether a single massage session can reactivate the sensorimotor processes of older adult inpatients. Participants were randomly assigned to the experimental (with massage) or control (without massage) groups. Massage was realized on both feet with 7.30 min spent on each foot (Experiment 1), the right foot or the right foot and knee for 10 min (Experiment 2). Body and nonbody mental rotation tasks were used to assess the lower limb motor representation before (pretest), immediately after (Posttest 1) and 24 hr after the massage (Posttest 2). Results showed the positive impact of massage on the body mental rotation task. The activation of the sensorimotor processes can last up to 24 hr depending on the extent of the massaged area. Importantly, the activation of the sensorimotor representation concerned not only the massaged leg but also the contralateral leg. No difference between groups appeared in the nonbody mental rotation task which did not solicit the sensorimotor processes. These results highlighted that peripheral activation via a massage had a specific impact on the sensorimotor processes. Massage is an interesting technique which can help older adult inpatients cope with the slowdown of the signal processing related to advancing age. (PsycINFO Database Record

Influence of circadian rhythms on the temporal features of motor imagery for older adult inpatients.

OBJECTIVE: To examine the circadian modulation on motor imagery quality for older adult inpatients to determine the best time of day to use motor imagery in rehabilitation activities. DESIGN: Time series posttest only. SETTING: Inpatient rehabilitation center. PARTICIPANTS: Participants included older adult inpatients (N=34) who were hospitalized for diverse geriatric or neurogeriatric reasons. They were able to sit without assistance, manipulate objects, and walk 10m in <30 seconds without technical help or with a walking stick. INTERVENTION: None. MAIN OUTCOME MEASURES: The executed and imagined durations of writing and walking movements were recorded 7 times a day (9:15 am-4:45 pm), at times compatible with the hours of rehabilitation activities. Motor imagery quality was evaluated by computing the isochrony index (ie, absolute difference between the average duration of executed and imagined actions) for each trial and each inpatient. The cosinor method was used to analyze the time series for circadian rhythmicity. RESULTS: Imagined movements duration and isochrony index exhibited circadian modulations, whereas no such rhythmic changes appeared for executed movements. Motor imagery quality was better late in the morning, at approximately 10:18 am and 12:10 pm for writing and walking, respectively. CONCLUSIONS: Cognitive and sensorimotor aspects of motor behaviors differed among the older adults. The temporal features of motor imagery showed a clear circadian variation. From a practical perspective, this study offers information on an effective schedule for motor imagery in rehabilitation activities with older adult inpatients.