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1.
BMJ Case Rep ; 14(3)2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33674294

RESUMEN

A woman in her 70s presented to the emergency department with fever, fluctuating cognition and headache. A detailed examination revealed neurological weakness to the lower limbs with atonia and areflexia, leading to a diagnosis of bacterial meningitis, alongside a concurrent COVID-19 infection. The patient required critical care escalation for respiratory support. After stepdown to a rehabilitation ward, she had difficulties communicating due to new aphonia, hearing loss and left third nerve palsy. The team used written communication with the patient, and with this the patient was able to signal neurological deterioration. Another neurological examination noted a different pattern of weakness to the lower limbs, along with new urinary retention, and spinal arachnoiditis was identified. After more than 10 weeks in the hospital, the patient was discharged. Throughout this case, there were multiple handovers between teams and specialties, all of which were underpinned by good communication and examination to achieve the best care.


Asunto(s)
/complicaciones , Meningitis por Escherichia coli/complicaciones , Anciano , Amoxicilina/uso terapéutico , Antibacterianos/uso terapéutico , /terapia , Ceftriaxona/uso terapéutico , Coinfección , Terapia Combinada , Comunicación , Confusión/etiología , Cuidados Críticos , Diagnóstico Diferencial , Femenino , Fiebre/etiología , Cefalea/etiología , Humanos , Meningitis por Escherichia coli/diagnóstico por imagen , Meningitis por Escherichia coli/tratamiento farmacológico , Grupo de Atención al Paciente , Modalidades de Fisioterapia , Relaciones Médico-Paciente , Respiración Artificial , Resultado del Tratamiento
3.
BMJ Open Respir Res ; 8(1)2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33762360

RESUMEN

INTRODUCTION: SARS-CoV-2 has restricted access to face-to-face delivery of pulmonary rehabilitation (PR). Evidence suggests that telehealth-PR is non-inferior to outpatient PR. However, it is unknown whether patients who have been referred to face-to-face programmes can feasibly complete an online-PR programme. METHODS: This service evaluation used a mixed-methods approach to investigate a rapid PR service remodelling using the University of Gloucestershire eLearn Moodle platform. Quantitative baseline demographic and PR outcome data were collected from online-PR participants, and semistructured interviews were completed with PR staff and participants. RESULTS: Twenty-five individuals were eligible from a PR waiting list. Thirteen declined participation and 14 completed PR. Significant pre-post online PR improvements were achieved in 1 min sit-to-stand (CI 2.1 to 9 (p=0.004)), Generalised Anxiety Disorder (CI -0.3 to -2.6 (p=0.023)), Primary Health Questionnaire-9 (CI -0.3 to -5.1 (p=0.029)), Chronic Respiratory Questionnaire dyspnoea (CI 0.5 to 1.3 (p=0.001)), fatigue (CI 0.7 to 2 (p=0.0004)), emotion (CI 0.7 to 1.7 (p=0.0002)), mastery (CI 0.4 to 1.3 (p=0.001)). Interviews indicated that patient PR inclusion was made possible with digital support and a PR introduction session improved participant engagement and safety. Incremental progression of exercise was perceived as more successful online compared with face-to-face PR. However, perceptions were that education sessions were less successful. Online-PR required significant staff time resource. DISCUSSION: Online-PR improves patient outcomes and is feasible and acceptable for individuals referred for face-to-face PR in the context of a requirement for social distancing. Face-to-face programmes can be adapted in a rapid fashion with both staff and participants perceiving benefit. Future pragmatic trials are now warranted comparing online-PR including remote assessments to centre-based PR with suitably matched outcomes, and patient and staff perceptions sought regarding barriers and facilitators of online delivery.


Asunto(s)
Internet , Modalidades de Fisioterapia , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Telerrehabilitación/métodos , Anciano , Anciano de 80 o más Años , Ansiedad/psicología , Asma/fisiopatología , Asma/psicología , Asma/rehabilitación , Depresión/psicología , Tolerancia al Ejercicio , Estudios de Factibilidad , Femenino , Humanos , Enfermedades Pulmonares Intersticiales/fisiopatología , Enfermedades Pulmonares Intersticiales/psicología , Enfermedades Pulmonares Intersticiales/rehabilitación , Masculino , Persona de Mediana Edad , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Enfermedad Pulmonar Obstructiva Crónica/psicología , Calidad de Vida , Resultado del Tratamiento
4.
Anaesthesia ; 76 Suppl 4: 96-107, 2021 Apr.
Artículo en Inglés | MEDLINE | ID: mdl-33682093

RESUMEN

Chronic pelvic pain represents a major public health problem for women and impacts significantly on their quality of life. Yet it is under-researched and a challenge to manage. Women who suffer from chronic pelvic pain frequently describe their healthcare journey as long, via a variety of specialists and frustrating, with their pain often dismissed. Aetiological factors and associations are best conceptualised using the 'three P's' model of predisposing, precipitating and perpetuating factors. This integrates the numerous biological, psychological and social contributors to the complex, multifactorial nature of chronic pelvic pain. Overall management involves analgesia, hormonal therapies, physiotherapy, psychological approaches and lifestyle advice, which like other chronic pain conditions relies on a multidisciplinary team approach delivered by professionals experienced and trained in managing chronic pelvic pain.


Asunto(s)
Dolor Crónico/patología , Analgésicos/uso terapéutico , Dolor Crónico/terapia , Agentes Anticonceptivos Hormonales/uso terapéutico , Epigenómica , Femenino , Humanos , Síndrome del Colon Irritable/patología , Síndrome del Colon Irritable/terapia , Estilo de Vida , Modalidades de Fisioterapia , Vulvodinia/patología , Vulvodinia/terapia
5.
Med J (Ft Sam Houst Tex) ; (PB 8-21-01/02/03): 70-78, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33666915

RESUMEN

COVID-19 is a novel disease with complex primary and secondary health effects that may significantly impact the functional independence and quality of life of patients and their families. While the term "rehabilitation" is often associated with exercise, the interventions employed by rehabilitation professionals in both the inpatient and outpatient setting are much more complex and very relevant in caring for individuals hospitalized with respiratory infections. Since the start of the pandemic, the Department of Rehabilitation at Walter Reed National Military Medical Center has cared for over 85% of the military beneficiaries admitted to the hospital for COVID-19. In addition to providing acute inpatient occupational, physical, and recreational therapy to help maximize each patient's functional independence, the rehabilitation team has also developed a novel program to help facilitate the safe discharge and successful recovery and social reintegration for all patients with COVID-19. Using a holistic approach, a team led by Occupational Therapy has applied a needs-based assessment of each patient and developed an individualized treatment plan, which employs home monitoring, virtual health interventions, peer support, and augmentation to case management and behavioral health care. The overall acceptance and satisfaction of this program by the patients and staff has been excellent, with early evidence to suggest improved quality of life and possible mitigation of long-term complications. This article describes the development and essential elements of this unique rehabilitation program so that other military treatment facilities may consider implementing.


Asunto(s)
/rehabilitación , Personal Militar , Terapia Ocupacional , Modalidades de Fisioterapia , Adulto , Anciano , Anciano de 80 o más Años , Atención Ambulatoria , /psicología , Femenino , Hospitalización , Humanos , Masculino , Persona de Mediana Edad , Recuperación de la Función , Integración Social , Adulto Joven
6.
Niger J Clin Pract ; 24(3): 387-392, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33723113

RESUMEN

Background: Lymphedema of the arm is one of the most common complications following breast cancer surgery. Aims: The primary aim of this study was to evaluate the effects of complex decongestive physical therapy (CDPt) on upper extremity functions, activities of daily living (ADL), and quality of life (QoL), and secondly the effects of the degree of lymphedema on post-treatment differences in older patients with breast cancer-related lymphedema (BCRL). Subjects and Methods: Sixty-eight patients who had BCRL were included between 2015 and 2017. Arm function was evaluated with the Constant-Murley scale, while ADL was measured with the Lawton Instrumental Activities of Daily Living Scale, and QoL was measured with the Lymphedema Functioning, Disability and Health Questionnaire as pre- and post-treatment tests. The patients underwent a CDPt program for 6 weeks. Results: There were statistically significant improvements for all outcome measurements in older patients with Grade 1 and 2 lymphedemas after the treatment (P < 0.001). The Grade 1 patients had a greater difference at mobility, participation in the life and social activities, and their total scores of quality of life had a significance level of P < 0.001. Conclusion: Older patients with Grade 1 BCRL had better mobility, participation in the life, and social activities. CDPt provides enhancement of arm functions, ADL, and QoL in older patients with breast cancer-related lymphedema.


Asunto(s)
Neoplasias de la Mama , Linfedema , Actividades Cotidianas , Anciano , Neoplasias de la Mama/complicaciones , Humanos , Linfedema/etiología , Modalidades de Fisioterapia , Estudios Prospectivos , Calidad de Vida , Resultado del Tratamiento
7.
Undersea Hyperb Med ; 48(1): 53-56, 2021.
Artículo en Inglés | MEDLINE | ID: mdl-33648033

RESUMEN

Paroxysmal autonomic instability syndrome with dystonia (PAISD) is a possible complication that worsens the prognosis of hypoxic-ischemic encephalopathy related to non-fatal drowning. There are case reports of hyperbaric oxygen (HBO2) therapy enhancing recovery in such cases. We report a case of a 5-year-old boy admitted to the Pediatric Intensive Care Unit after a non-fatal drowning. He was transferred under mechanical ventilation and sedation, with hemodynamic instability and hypothermia. On admission he had a Glasgow Coma Score of 6. On the fifth day of admission he presented episodes of dystonia with decerebration posture, diaphoresis, tachycardia and hypertension, sometimes with identified triggers, suggesting PAISD. The episodes were difficult to control; multiple drugs were needed. Electroencephalography showed diffuse slow wave activity, and cranioencephalic magnetic resonance imaging showed hypoxia-related lesions, suggesting hypoxic-ischemic encephalopathy. Early after admission the patient started physiotherapy combined with normobaric oxygen therapy. Subsequently he started HBO2 therapy at 2 atmospheres, with a total of 66 sessions. Dystonia progressively subsided, with gradual discontinuation of therapy. He also showed improvement in spasticity, non-verbal communication and cephalic control. This case highlights the diagnostic and therapeutic challenges of PAISD and the potential benefit of HBO2 therapy, even in the subacute phase, in recovery of hypoxic-ischemic encephalopathy.


Asunto(s)
Ahogamiento , Oxigenación Hiperbárica/métodos , Hipoxia-Isquemia Encefálica/terapia , Preescolar , Estado de Descerebración/etiología , Distonía/etiología , Humanos , Oxigenación Hiperbárica/estadística & datos numéricos , Hipoxia-Isquemia Encefálica/diagnóstico por imagen , Hipoxia-Isquemia Encefálica/etiología , Masculino , Modalidades de Fisioterapia
8.
Ann R Coll Surg Engl ; 103(3): e81-e84, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33645279

RESUMEN

This case discusses an elderly female who presented acutely with compromised profunda femoris pseudoaneurysm and massive haematoma five weeks after dynamic hip screw insertion for a left neck of femur fracture. The only precipitating factor leading to this presentation was ongoing physiotherapy. She was referred from a rehabilitation hospital to the nearest vascular surgical unit for acute and definitive surgical intervention. Post-operatively, she fared incredibly well, regaining her baseline level of functioning. History taking is complex in a patient with dementia. Clinical examination should follow with a focused approach to the site of recent operation and also where complications are likely to manifest when an alteration from baseline cognitive function is noted. This is of course in addition to the complete work up required from a holistic perspective with any acute deterioration. Imaging should be arranged and prompt referral made if a treatable acute cause is identified. It is imperative to involve family and/or next of kin if possible, but this should not impede prompt decision-making in the patient's best interests by the clinical team if delays are likely to occur.


Asunto(s)
Aneurisma Falso/diagnóstico por imagen , Arteria Femoral/diagnóstico por imagen , Fracturas del Cuello Femoral/cirugía , Fijación Interna de Fracturas/rehabilitación , Fracturas por Avulsión/diagnóstico por imagen , Hematoma/diagnóstico por imagen , Hemorragia Posoperatoria/diagnóstico por imagen , Anciano , Aneurisma Falso/cirugía , Tornillos Óseos , Demencia Vascular/complicaciones , Femenino , Arteria Femoral/cirugía , Fracturas del Cuello Femoral/complicaciones , Fracturas por Avulsión/cirugía , Hematoma/complicaciones , Fracturas de Cadera/diagnóstico por imagen , Fracturas de Cadera/cirugía , Humanos , Modalidades de Fisioterapia , Hemorragia Posoperatoria/complicaciones , Hemorragia Posoperatoria/cirugía , Ultrasonografía
9.
Medicine (Baltimore) ; 100(9): e24930, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655957

RESUMEN

BACKGROUND: Rehabilitation training is beneficial for patients with chronic obstructive pulmonary disease (COPD). This study was aimed at evaluating the efficacy of muscle training on dyspnea. METHODS: We used 5 common databases for conducting a meta-analysis included PubMed, the Cochrane Library, Science Direct, Web of Science and Clinical Trials.gov, and eligible randomized controlled trials (RCTs) were included. The main results of include studies were dyspnea of patients who had a clinical diagnosis of COPD measured using Borg score and Medical Research Council (MRC) or modified Medical Research Council (mMRC) scale as the criteria before and after intervention. The intervention measures included respiratory or expiratory muscles or upper limb (UL) or lower limb (LL) training. The mean differences (MD) with the 95% confidence interval (CI) were considered for summary statistics. We also assessed risk of bias using the Cochrane collaboration's tool, and the value of I2 was applied to evaluate the heterogeneity of the trials. RESULTS: Fourteen RCTs with 18 interventions (n = 860 participants) were included. Muscle training significantly improved dyspnea during exercise and in the daily life of patients with COPD (MD, 95% CI: -0.58, -0.84 to -0.32, P  < .0001 and -0.44, -0.65 to -0.24, P  < .0001, respectively). In the subgroup analyses, the trials that used respiratory muscle and UL trainings significantly improved dyspnea during exercise (MD, 95% CI: -0.72, -1.13 to -0.31, P = .0005 and -0.53, -0.91 to -0.15, P = .007, respectively). The studies also showed that the participants in the rehabilitation group, who received respiratory muscle and UL trainings, had a significant improvement of dyspnea in daily life (MD, 95% CI: -0.38, -0.67 to -0.09, P = .01 and -0.51, -0.80 to -0.22, P = .0007, respectively). CONCLUSION: There were some limitations that most of the subjects in this study were patients with moderate to severe COPD and were male, and the training period and duration were different. The analyses revealed that respiratory muscle and UL trainings can improve dyspnea in patients with COPD during exercise and in daily life.


Asunto(s)
Disnea/rehabilitación , Tolerancia al Ejercicio/fisiología , Espiración/fisiología , Modalidades de Fisioterapia , Enfermedad Pulmonar Obstructiva Crónica/rehabilitación , Ensayos Clínicos Controlados Aleatorios como Asunto , Músculos Respiratorios/fisiopatología , Disnea/etiología , Disnea/fisiopatología , Humanos , Enfermedad Pulmonar Obstructiva Crónica/complicaciones , Enfermedad Pulmonar Obstructiva Crónica/fisiopatología , Calidad de Vida
10.
Medicine (Baltimore) ; 100(9): e24931, 2021 Mar 05.
Artículo en Inglés | MEDLINE | ID: mdl-33655958

RESUMEN

ABSTRACT: Although the mutual relationship between ambulation and physical activity (PA) in people with multiple sclerosis (pwMS) has been described in several studies, there is still a lack of detailed information about the way in which specific aspects of the gait cycle are associated with amount and intensity of PA. This study aimed to verify the existence of possible relationships among PA parameters and the spatio-temporal parameters of gait when both are instrumentally assessed.Thirty-one pwMS (17F, 14 M, mean age 52.5, mean Expanded Disability Status Scale (EDSS) score 3.1) were requested to wear a tri-axial accelerometer 24 hours/day for 7 consecutive days and underwent an instrumental gait analysis, performed using an inertial sensor located on the low back, immediately before the PA assessment period. Main spatio-temporal parameters of gait (i.e., gait speed, stride length, cadence and duration of stance, swing, and double support phase) were extracted by processing trunk accelerations. PA was quantified using average number of daily steps and percentage of time spent at different PA intensity, the latter calculated using cut-point sets previously validated for MS. The existence of possible relationships between PA and gait parameters was assessed using Spearman rank correlation coefficient rho.Gait speed and stride length were the parameters with the highest number of significant correlations with PA features. In particular, they were found moderately to largely correlated with number of daily steps (rho 0.62, P< .001), percentage of sedentary activity (rho = -0.44, P < .001) and percentage of moderate-to-vigorous activity (rho = 0.48, P < .001). Small to moderate significant correlations were observed between PA intensity and duration of stance, swing and double support phases.The data obtained suggest that the most relevant determinants associated with higher and more intense levels of PA in free-living conditions are gait speed and stride length. The simultaneous quantitative assessment of gait parameters and PA levels might represent a useful support for physical therapists in tailoring optimized rehabilitative and training interventions.


Asunto(s)
Ejercicio Físico/fisiología , Trastornos Neurológicos de la Marcha/fisiopatología , Marcha/fisiología , Esclerosis Múltiple/complicaciones , Modalidades de Fisioterapia , Adolescente , Adulto , Anciano , Femenino , Estudios de Seguimiento , Análisis de la Marcha , Trastornos Neurológicos de la Marcha/etiología , Trastornos Neurológicos de la Marcha/rehabilitación , Humanos , Masculino , Persona de Mediana Edad , Esclerosis Múltiple/fisiopatología , Esclerosis Múltiple/rehabilitación , Estudios Retrospectivos , Adulto Joven
11.
Sensors (Basel) ; 21(4)2021 Feb 12.
Artículo en Inglés | MEDLINE | ID: mdl-33673097

RESUMEN

Fascial therapy is an effective, yet painful, procedure. Information about pain level is essential for the physiotherapist to adjust the therapy course and avoid potential tissue damage. We have developed a method for automatic pain-related reaction assessment in physiotherapy due to the subjectivity of a self-report. Based on a multimodal data set, we determine the feature vector, including wavelet scattering transforms coefficients. The AdaBoost classification model distinguishes three levels of reaction (no-pain, moderate pain, and severe pain). Because patients vary in pain reactions and pain resistance, our survey assumes a subject-dependent protocol. The results reflect an individual perception of pain in patients. They also show that multiclass evaluation outperforms the binary recognition.


Asunto(s)
Dolor , Modalidades de Fisioterapia , Análisis de Ondículas , Humanos , Dimensión del Dolor
12.
Arthroscopy ; 37(3): 871-872, 2021 03.
Artículo en Inglés | MEDLINE | ID: mdl-33673967

RESUMEN

Gluteal strength improvement is positively correlated with improved outcomes following hip arthroscopy femoroacetabular impingement correction. Arthroscopic femoroacetabular impingement surgery in itself also is correlated with postoperative improvement in gluteal strength. A trial of physical therapy or best conservative care can improve gluteal strength; however, oftentimes this is insufficient treatment. Hip arthroscopy can improve pain and function whilst also improving gluteal strength. When this is conveyed to patients, the additional knowledge can help them buy-in to their treatment regimen.


Asunto(s)
Pinzamiento Femoroacetabular , Artroscopía , Protocolos Clínicos , Pinzamiento Femoroacetabular/cirugía , Humanos , Modalidades de Fisioterapia
13.
Physiother Theory Pract ; 37(3): 389-400, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33678141

RESUMEN

Objective: The objective of this narrative review was to investigate the history of light therapy in hospital settings, with reference to physiotherapy and particularly in an Australian context.Types of articles and search method:a review of available literature was conducted on PubMed, Medline and Google Scholar using keywords light therapy, photobiomodulation, physiotherapy, low-level laser, heliotherapy. Physiotherapy textbooks from Sydney University Library were searched. Historical records were accessed from the San Hospital library. Interviews were conducted with the San Hospital Chief Librarian and a retired former Head Physiotherapist from Royal Prince Alfred Hospital.Summary: Historically, light treatment has been used in both medical and physiotherapy practice. From its roots in ancient Egypt, India, and Greece, through to medieval times, the modern renaissance in 'light as therapy ' was begun by Florence Nightingale who, in the 1850s, advocated the use of clean air and an abundance of sunlight to restore health. Modern light therapy (phototherapy) had a marked uptake in use in medicine in Scandinavia, America, and Australia from 1903, following the pioneering work of Niels Finsen in the late 19th century, which culminated in Dr Finsen receiving the Nobel Prize for Medicine for the treatment of tuberculosis scarring with ultraviolet (UV) light, and treatment of smallpox scarring with red light. Treatment with light, especially UVB light, has been widely applied by physiotherapists in hospitals for dermatological conditions since the 1950s, particularly in Australia, Scandinavia, USA, England and Canada. In parallel, light treatment in hospitals for hyperbilirubinemia was used for neonatal jaundice. Since the 1980s light was also used in the medical specialties of ophthalmology, dermatology, and cardiology. In more recent years in physiotherapy, light was mostly used as an adjunct to the management of orthopedic/rheumatological conditions. Since the 1990s, there has been global use of light, in the form of photobiomodulation for the management of lymphedema, including in supportive cancer care. Photobiomodulation in the form of low-level laser has been used by physiotherapists and pain doctors since the 1990s in the management of chronic pain. The use of light as therapy is exemplified by its use in the San Hospital in Sydney, where light therapy was introduced in 1903 (after Dr. John Harvey Kellogg visited Niels Finsen in Denmark) and is practiced by nurses, physiotherapists and doctors until the present day. The use of light has expanded into new and exciting practices including supportive cancer care, and treatment of depression, oral mucositis, retinopathy of prematurity, and cardiac surgery complications. Light is also being used in the treatment of neurological diseases, such as Parkinson's disease, traumatic brain injury, and multiple sclerosis. The innovative uses of light in physiotherapy treatment would not be possible without the previous experience of successful application of light treatment.Conclusion: Light therapy has had a long tradition in medicine and physiotherapy. Although it has fallen somewhat out of favour over the past decades, there has been a renewed interest using modern techniques in recent times. There has been continuous use of light as a therapy in hospitals in Australia, most particularly the San Hospital in Sydney where it has been in use for almost 120 years.


Asunto(s)
Fototerapia/historia , Modalidades de Fisioterapia/historia , Australia , Historia del Siglo XIX , Historia del Siglo XX , Historia del Siglo XXI , Hospitales , Humanos
14.
Physiother Theory Pract ; 37(3): 432-446, 2021 Mar.
Artículo en Inglés | MEDLINE | ID: mdl-33715579

RESUMEN

Enhancing and facilitating change or optimization of body awareness and movement behaviors have been sustained throughout history as central objectives in physiotherapy. Focus will be on the thoughts and practice of orthopedist Gunder Nielsen Kjølstad (1794-1860). He is, in a Norwegian context, one of the forefathers of physiotherapy. Kjølstad was unique for his time in the sense that he did not limit himself to medicine, but drew on vast array of disciplines, among them philosophy, geometry, physics, and dance. Fundamental to his treatment method was a pedagogy that rested on the active participation of the patient; an approach that stood in stark contrast to the established clinical practices. Through this approach, he developed a treatment for 'crooked backs' which constituted a historic break with the common treatment regimens of the nineteenth century.


Asunto(s)
Ortopedia/historia , Modalidades de Fisioterapia/historia , Fisioterapia/historia , Escoliosis/terapia , Historia del Siglo XVIII , Historia del Siglo XIX , Humanos , Noruega
15.
Artículo en Inglés | MEDLINE | ID: mdl-33530383

RESUMEN

BACKGROUND: the main objective of this study was to analyze the potential short-, medium- and long-term effects of a therapeutic physical exercise (TFE) programme on the functionality of amyotrophic lateral sclerosis (ALS) patients, measured with the Revised Amyotrophic Lateral Sclerosis Functional Scale (ALSFRS-R) scale. METHODS: a systematic review of the PubMed, SCOPUS, Cochrane, Scientific Electronic Library Online (Scielo), Physiotherapy Evidence Database (PEDro), Cumulative Index of Nursing and Allied Health Literature (CINAHL) and Medical Literature Analysis and Retrieval System Online (MEDline) databases was carried out. The information was filtered using the following Medical Subjects Heading (MeSH) terms: "Amyotrophic lateral sclerosis", "Physical Therapy", and "Physical and Rehabilitation Medicine". The internal validity of the selected documents was evaluated using the PEDro scale. The study included clinical trials published in the last 5 years in which one of the interventions was therapeutic physical exercise in patients with ALS, using the ALSFRS-R as the main outcome variable and functional variables as secondary variables. RESULTS: 10 clinical trials were analyzed, with an internal validity of 5-7 points. The TFE groups showed significant short-, medium- and long-term differences, obtaining a mean difference of 5.8 points compared to the 7.6 points obtained by the control groups, at six months, measured with ALSFRS-R. In addition, the participants showed significant improvements in functional abilities in the short, medium and long terms. CONCLUSIONS: Therapeutic physical exercise could contribute to slowing down the deterioration of the musculature of patients with ALS, thus facilitating their performance in activities of daily living, based on the significant differences shown by these individuals in the short, medium and long term both in subjective perception, measured with ALSFRS-R, and functional capacities.


Asunto(s)
Esclerosis Amiotrófica Lateral , Actividades Cotidianas , Esclerosis Amiotrófica Lateral/terapia , Ejercicio Físico , Terapia por Ejercicio , Humanos , Modalidades de Fisioterapia
16.
Artículo en Inglés | MEDLINE | ID: mdl-33567748

RESUMEN

As part of COVID-19 consequences, it has been estimated that 5% of patients affected by this disease will require admission to the intensive care unit (ICU), and physical therapy techniques have been implemented in patients with other conditions admitted to ICU. The aim of the present study is to summarize all the available information about the implementation of physical therapy management in critically ill patients. From three clinical guidelines already published, we performed a search in PubMed, Scopus, ScienceDirect, and CINAHL, including systematic reviews, clinical guidelines, and randomized controlled trials, among others. Data extraction was performed independently by two reviewers. Quality assessment was developed through the AMSTAR-2 tool and PEDro Scale. A narrative synthesis was performed and 29 studies were included. The information extracted has been classified into four folders: ICU environment in COVID-19 (security aspects and management of the patient), respiratory physiotherapy (general indications and contraindications, spontaneously breathing and mechanically ventilated patient approaches), positional treatment, and exercise therapy (safety aspects and progression). The implementation of physiotherapy in patients affected with COVID-19 admitted to the ICU is a necessary strategy that prevents complications and contributes to the stabilization of patients in critical periods, facilitating their recovery.


Asunto(s)
Enfermedad Crítica/rehabilitación , Modalidades de Fisioterapia , Terapia por Ejercicio , Humanos , Unidades de Cuidados Intensivos
17.
Medicine (Baltimore) ; 100(3): e23906, 2021 Jan 22.
Artículo en Inglés | MEDLINE | ID: mdl-33545960

RESUMEN

BACKGROUND: This study will evaluate the clinical effect of vestibular rehabilitation (VR) on benign paroxysmal positional vertigo (BPPV). METHODS: In this study, we will identify relevant trials on the topic published in MEDLINE, EBASE, Web of Science, Cochrane Library, Scopus, CINAHL, CBM, and CNKI from inception to the present. We will also search conference proceedings, thesis/dissertation, ongoing trials in clinical trial registry, and reference lists of included studies. Two researchers will independently carry out record selection, data extraction, and study quality assessment, respectively. Any disagreement will be arbitrated and solved with the help of a third researcher. If necessary, we will conduct random-effects meta-analysis to pool the effect estimates of included trials determined to be acceptable heterogeneity. RESULTS: We will summarize the latest evidence to assess the effect of VR for the treatment of patients with BPPV. CONCLUSION: The findings of this study will help determine whether or not VR is effective in treating BPPV. OSF REGISTRATION: osf.io/k83y5.


Asunto(s)
Vértigo Posicional Paroxístico Benigno/rehabilitación , Posicionamiento del Paciente , Modalidades de Fisioterapia , Humanos , Metaanálisis como Asunto , Ensayos Clínicos Controlados Aleatorios como Asunto , Revisiones Sistemáticas como Asunto , Resultado del Tratamiento
18.
Am J Phys Med Rehabil ; 100(3): 271-275, 2021 03 01.
Artículo en Inglés | MEDLINE | ID: mdl-33595940

RESUMEN

OBJECTIVE: Thoracic outlet syndrome is caused by the compression of blood vessels and nerves leading to the upper limbs; the level of functional discomfort in activities of daily living can be significant. This discomfort has been evaluated using a variety of nonspecific scales, prompting the development a specific self-questionnaire ("Functional Evaluation in Thoracic Outlet Syndrome). Here, the scale's test-retest reliability, sensitivity to change, and criterion validity were assessed. DESIGN: Between May 2015 and July 2017, a total of 37 patients were assessed during an intensive rehabilitation program. The Functional Evaluation in Thoracic Outlet Syndrome self-questionnaire comprises 16 items rated on a 4-point scale: impossible, major discomfort, moderate discomfort, or no difficulty. A total score is then calculated and the usual level of discomfort is rated on a numerical scale. The questionnaire was completed on day (D)1, D2, and the day of discharge. RESULTS: The questionnaire showed very good test-retest reliability, with an overall correlation coefficient above 0.91. The overall score was highly sensitive to change, with a significant median improvement (-5.89) between D1 and discharge (P < 0.001). Of the 16 items, 9 showed significant scalability in their individual sensitivity to change. The criterion validity was moderate: the coefficient for the correlation with the numerical scale was 0.68 on D1 (P < 0.001), 0.55 on D2 (P < 0.001), and 0.69 at discharge (P < 0.001). CONCLUSIONS: The Functional Evaluation in Thoracic Outlet Syndrome self-questionnaire is a quick, simple way of assessing the impact of thoracic outlet syndrome on activities of daily living. The overall score and most of the items displayed good reproducibility and sensitivity to change.


Asunto(s)
Actividades Cotidianas , Evaluación de la Discapacidad , Síndrome del Desfiladero Torácico/fisiopatología , Síndrome del Desfiladero Torácico/rehabilitación , Adulto , Femenino , Humanos , Masculino , Persona de Mediana Edad , Modalidades de Fisioterapia , Reproducibilidad de los Resultados
19.
Artículo en Inglés | MEDLINE | ID: mdl-33572618

RESUMEN

Selective sentinel lymph node biopsy (SLNB) represents a minimally invasive surgery in patients with breast cancer. The purpose of this study was to explore the possible effect of an early physiotherapy intervention for the recovery of the upper limb and the surgical scars after SLNB in comparison with usual care. A total of 40 patients were enrolled in either the control group (n = 20) or the experimental group (n = 20). The intervention group performed an early physiotherapy program based on functional exercises, scar manual therapy, and educational tips. The control group received usual care. Shoulder range of motion (ROM), grip strength, upper limb pain and disability (SPADI), scar recovery (POSAS), myofascial adhesions (MAP-BC), quality of life (EORTCQLA-BR-23) and the presence of axillary web syndrome (AWS) and lymphoedema were assessed at baseline and immediately after intervention. A follow-up period of 6 months was performed for lymphoedema surveillance. Between groups significant differences in favor of the intervention were found for ROM (r = 0.43), grip strength (r = 0.32), SPADI (d = 0.45), POSAS (d = 1.28), MAP-BC (d = 1.82) and EORTCQLQ-BR 23 general function subscale (d = 0.37) (p < 0.05 for all variables). Our results suggest that an early physical therapy program seems to be more effective than usual care in women after SLNB. However, results should be interpreted with caution and future randomized trial with a larger sample size is needed.


Asunto(s)
Neoplasias de la Mama , Biopsia del Ganglio Linfático Centinela , Axila , Neoplasias de la Mama/cirugía , Femenino , Humanos , Escisión del Ganglio Linfático , Modalidades de Fisioterapia , Calidad de Vida
20.
J Orthop Sports Phys Ther ; 51(2): 62, 2021 02.
Artículo en Inglés | MEDLINE | ID: mdl-33522381

RESUMEN

Hip fractures become more common as people age. If they occur when someone is 65 years of age or older, there are a number of things that can ensure a good outcome. Once hip fractures are treated, usually by surgery, rehabilitation begins. This should include physical therapy. The JOSPT published a clinical practice guideline titled "Physical Therapy Management of Older Adults With Hip Fracture" in the February 2021 issue. In this Perspectives for Patients article, we share what the experts found and what it means for you or someone for whom you may be caring. J Orthop Sports Phys Ther 2021;51(2):62. doi:10.2519/jospt.2021.0502.


Asunto(s)
Fracturas de Cadera/terapia , Modalidades de Fisioterapia , Anciano , Humanos , Educación del Paciente como Asunto , Guías de Práctica Clínica como Asunto
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