Research from Low-Income and Middle-Income Countries will Benefit Global Health and the Physiotherapy Profession, but it Requires Support.

Disparities in research publications are common in the physiotherapy and rehabilitation fields.1 A small proportion of published research arises from low-income and middle-income countries (LMICs),1,2 home to 85% of the world's population. Systems-level, institutional-level, and individual-level factors contribute to these disparities. With urgent and unified actions, global health and the standard of physiotherapy research in LMICs can be improved and strengthened. In this editorial, we will discuss the challenges encountered by researchers from LMICs in conducting and publishing high-quality research and propose potential strategies to address these challenges.

Rehabilitative exercise scheduling: Effects on balance, functional movement performance, and pain perception in middle-aged women with knee pain: A randomized controlled trial.

BACKGROUND: The scheduling of clinical rehabilitative exercise should combine best possible delivery of exercise with the most efficient use of time, facilities, equipment, and personnel. However, it is not clear whether distribution of a fixed amount of exercise volume is more efficient over a longer time period in a week (distributed manner) than over a shorter time period in a week (massed manner). OBJECTIVE: To evaluate the effects of distributed versus massed within- and between-session exercise scheduling on balance, exercise performance, and pain perception in middle-aged women with knee pain. PARTICIPANTS: Thirty-four middle-aged female volunteers (mean age ± SD, 56.0 ± 5.2 years old; mean weight ± SD, 66.9 ± 7.6 kg; mean body mass index [BMI] ± SD, 27.7 ± 2.8 kg/m2 ) were randomly assigned to one of the three groups consisting of Rehabilitative Massed Scheduling (RMS); Rehabilitative Distributed Scheduling (RDS); or Control group (CG). MAIN OUTCOME MEASURES: Isometric strength, balance, functional movement performance, and pain perception were assessed at baseline (pre), at week 8 (mid), and 1 week after the full 12 weeks (post) of exercise training or no intervention (CG). RESULTS: Significant improvements in balance, functional movement performance, and pain perception were found after both RDS and RMS after 8 and 12 weeks compared to the control group (p Ë‚ .05). Examination of the net changes (% ∆) between RDS and RMS showed a statistically significant difference only in the right 30-second arm curl records of individuals in the RDS group, which were significantly higher than the RMS group at the post-test (p Ë‚ .05). CONCLUSION: Rehabilitative training providers are advised to distribute the drills of rehabilitative exercise training within and between the sessions of exercise per week only when a positive Bottom-Up Rise Strength Transfer effect (BURST) effect of exercise training is needed. Otherwise, if the whole amount of rehabilitative exercise work is identical the benefit of going five versus three times per week to the rehabilitation centers would be similar.

Composite functional movement screen score predicts injuries in youth volleyball players: a prospective cohort study.

We aimed to investigate whether composite Functional Movement Screen (FMS) test scores can predict musculoskeletal injuries (MSI) in youth volleyball players. 131 national young volleyball players (Males: n = 100, age = 16.5 years, height = 1.787 m, mass = 68.32 kg; Females: n = 31, age = 13.83 years, height = 1.684 m, mass = 65.12 kg) participated in this prospective cohort study. The FMS screen was performed before starting the season. MSI and exposure data were collected during the season via each team's certified athletic trainer. The mean FMS score and standard deviation for all volleyball players was 15.85 ± 3.31. A score of ≤ 14 was positive to predict MSI with specificity of 0.60 and sensitivity of 0.93. The odds ratio for (≤ 14/˃14) was 0.048. The relative risk for being injured was 3.46. Positive likelihood ratio was 2.34, and negative likelihood ratio was 0.11. The findings of this study demonstrated that an FMS score of ≤ 14 is an identifiable risk factor for injury in young volleyball players. The FMS can be used as a pre-season screening test to identify volleyball players who may be predisposed to sustaining MSI during the season ahead.

Runner's health choices questionnaire: female collegiate cross-country runners' perspectives on health and eating.

OBJECTIVE: To assess female collegiate cross-country runners' perspectives regarding sport-related health and the factors impacting eating behaviors. PARTICIPANTS/METHODS: The Runner's Health Choices Questionnaire, a previously validated survey, was electronically distributed to female collegiate cross-country runners. Quantitative descriptive analysis was performed on all questions. RESULTS: A total of 353 female collegiate cross-country runners completed the survey. The most common intrinsic factors that impacted overall diet type were makes you feel healthy, enjoyment of food, and athletic performance enhancement. Extrinsic factors such as practice/race that day, creating a balanced diet, and choices in the cafeteria were the top factors influencing daily meal decisions. Seventy-seven percent of athletes reported that they would be likely to apply information from a healthcare professional if they had access. CONCLUSION: Female cross-country runners appeared willing to apply nutritional information; therefore, it is important that generalized nutrition education with an emphasis on intrinsic and extrinsic factors for food choices be considered for female collegiate cross-country runners.

The acute effect of two massage techniques on functional capability and balance in recreationally trained older adult women: A cross-over study.

With aging comes a reduction in neuromuscular and neuromotor function. Different strategies have been used to mitigate these functional losses. Certain manual therapy techniques and interventions have been explored with regard to their ability to improve functional capability and balance in an older adult population. The purpose of this study was to analyze the acute effects of two massage techniques on functional capability and balance performance in recreationally trained older adult women. Twenty-eight older adult women (66.74 ± 4.61 years) completed three interventions: a) stick massage followed by functional capability and balance performance tests (MMS), b) manual massage followed by functional capability and balance performance tests (MM), c) no MMS or MM (control condition (CC)) - only performed the functional capability and balance performance tests. Functional capability was assessed by four tests that are part of the Senior Fitness Test: the 6-min walk (W6), the chair sit-and-reach (CSR), the 8-foot up-and-go (8FUG), and the 30s-chair stand (30s-CS). Balance was assessed using the Berg Balance Scale (BBS). Significant differences (p < 0.001) were observed between MM and MMS compared to CC among 30s-CS, W6, CSR, and 8FUG. BBS showed a significant difference between MM and CC (p = 0.041). Both MM and MMS demonstrated significant acute improvements in the functional capability of recreationally trained elderly women and may be included in an exercise program.

Computer photogrammetry as a postural assessment in Schwartz-Jampel syndrome: A case report.

The Schwartz-Jampel Syndrome (SJS) is a rare genetic disorder characterized by myotonia and bone dysplasia, which may change the posture. The subject of this case report was a seven-year-old boy diagnosed with SJS and presenting generalized muscle and joints contractures. The purpose of the present case report was to identify postural asymmetries in a patient with SJS through photogrammetry. Postural analysis was conducted using photogrammetry with the Postural Assessment Software (SAPO®). Photogrammetry is a postural assessment system performed through photographic images. These images are acquired by camera and transported to the computer. SAPO® software performs the assessment of this photograph throughout 3D analysis and compares with a predefined protocol. The results of the present case report document several recurrent postural imbalances seen in SJS including myotonia, facial dysmorphism, and skeletal deformities. Thus, even with little evidence in the literature, physical therapy treatment is indicated to increase the functionality of the individual.

Quadriceps foam rolling and rolling massage increases hip flexion and extension passive range-of-motion.

Increases in joint range-of-motion may be beneficial for improving performance and reducing injury risk. This study investigated the effects of different self-massage volumes and modalities on passive hip range-of-motion. Twenty-five recreationally resistance-trained men performed four experimental protocols using a counterbalanced, randomized, and within-subjects design; foam rolling (FR) or roller massage (RM) for 60 or 120-s. Passive hip flexion and extension range-of-motion were measured in a counterbalanced and randomized order via manual goniometry before self-massage (baseline) and immediately, 10-, 20-, and 30-min following each self-massage intervention. Following FR or RM of quadriceps, there was an increase in hip flexion range-of-motion at Post-0 (FR: Δ = 19.28°; RM: Δ = 14.96°), Post-10 (FR: Δ = 13.03°; RM: Δ = 10.40°), and Post-20 (FR: Δ = 6.00°; RM: Δ = 4.64°) for all protocols, but these did not exceed the minimum detectable change at Post-10 for RM60 and RM120, and Post-20 for FR60, FR120, RM60, and RM120. Similarly, hip extension range-of-motion increased at Post-0 (FR: Δ = 8.56°; RM: Δ = 6.56°), Post-10 (FR: Δ = 4.64°; RM: Δ = 3.92°), and Post-20 (FR: Δ = 2.80°; RM: Δ = 1.92°), but did not exceed the minimum detectable change at Post-10 for FR60, RM60, and RM120, and Post-20 for FR60, FR120, RM60, and RM120. In conclusion, both FR and RM increased hip range-of-motion but larger volumes (120- vs. 60-second) and FR produced the greatest increases. These findings have implications for self-massage prescription and implementation, in both rehabilitation and athletic populations.

Posterior Thigh Foam Rolling Increases Knee Extension Fatigue and Passive Shoulder Range-of-Motion.

Monteiro, ER, Costa, PB, Corrêa Neto, VG, Hoogenboom, BJ, Steele, J, and da Silva Novaes, J. Posterior thigh foam rolling increases knee extension fatigue and passive shoulder range-of-motion. J Strength Cond Res 33(4): 987-994, 2019-The purpose of this study was to analyze the acute effects of different foam rolling (FR) volumes on knee extensors fatigue and shoulder passive range-of-motion (PROM). Twelve recreationally active women were recruited for participation in 2 experiments separated by 3 weeks, and the same subjects performed all procedures in each experiment. In experiment 1, subjects performed 3 sets of knee extensions using a predetermined 10 repetition maximum load to momentary concentric failure: control condition (CG) with passive rest and 2 FR conditions for the hamstrings using 2 volumes (60 and 120 seconds; FR60 and FR120, respectively). Experiment 2 consisted of 2 shoulder flexion and extension baseline PROM tests. Following baseline measures, subjects performed a single 60-second bout of FR on the hamstrings. Outcome PROM measures were measured through manual goniometry immediately (post-0), 10 minutes (post-10), 20 minutes (post-20), 30 minutes (post-30), 24 hours (post-24), and 48 hours (post-48) after the intervention to assess the effects on PROM over an extended period. Fatigue index indicated significantly greater fatigue resistance for CG when compared with FR60 (p = 0.035; [INCREMENT]% = 6.49) and FR120 (p = 0.002; [INCREMENT]% = 9.27), and there were no significant differences between FR60 and FR120 (p = 0.513; [INCREMENT]% = 2.78). Shoulder flexion PROM increased in post-0 as compared to baseline 1 (p = 0.002; d = 1.58), baseline 2 (p < 0.001; d = 1.92), and baseline higher measurement (p < 0.001; d = 1.59) and remained increased for post-10 as compared to baseline 2 (p = 0.017; d = 1.55). Shoulder extension PROM increased in post-0 as compared to baseline 1 (p < 0.001; d = 2.61), baseline 2 (p < 0.001; d = 2.83), and baseline higher measurement (p < 0.001; d = 2.59) and remained increased for post-10 as compared to baseline 1 (p < 0.001; d = 1.93), baseline 2 (p < 0.001; d = 2.16), and baseline higher measurement (p < 0.001; d = 1.91) and post-20 as compared to baseline 1 (p = 0.008; d = 1.58), baseline 2 (p = 0.001; d = 1.85), and baseline higher measurement (p = 0.011; d = 1.55). Foam rolling volumes equal to or greater than 60 seconds are detrimental to the ability to continually produce force in the lower extremity and should not be applied to the hamstrings muscle group between sets of knee extensions. PROM results indicate that FR applied to the hamstrings demonstrates an increase in both shoulder flexion and extension PROM. This work may have important clinical (rehabilitation) implications, as it demonstrates global effects of FR on functional outcomes.

THE MOVEMENT SYSTEM IN EDUCATION.

Although many physical therapists have begun to focus on movement and function in clinical practice, a significant number continue to focus on impairments or pathoanatomic models to direct interventions. This paradigm may be driven by the current models used to direct and guide curricula used for physical therapist education. The methods by which students are educated may contribute to a focus on independent systems, rather than viewing the body as a functional whole. Students who enter practice must be able to integrate information across multiple systems that affect a patient or client's movement and function. Such integration must be taught to students and it is the responsibility of those in physical therapist education to embrace and teach the next generation of students this identifying professional paradigm of the movement system. The purpose of this clinical commentary is to describe the current state of the movement system in physical therapy education, suggest strategies for enhancing movement system focus in entry level education, and envision the future of physical therapy education related to the movement system. Contributions by a student author offer depth and perspective to the ideas and suggestions presented. LEVEL OF EVIDENCE: 5.