Archives of Physiotherapy and Rehabilitation
Archives of Physiotherapy and Rehabilitation is an open access peer-reviewed journal publishes papers in the core topics like Physiotherapy and Rehabilitation. Archives of Physiotherapy and Rehabilitation welcome articles in all areas related to Physiotherapy, Stroke Physiotherapy, Injury and Medicine, Exercise Whiplash Injury, Sports Injuries, Rehabilitation, Stroke Rehabilitation, Whiplash Injury, Myofascial Pain, Neuro Rehabilitation, Addiction Rehabilitation, Cardiac Rehabilitation, Physical Therapy Medicine, Pulmonary Rehabilitation, on quarterly basis.
Ultrasound-Guided Cryoneuroablation as a Treatment for Post-Amputation Neuroma in a Pediatric Patient
Introduction: Post-amputation pain is a frequent and limiting complication, especially in pediatric patients. Stump neuromas represent a common cause of refractory neuropathic pain, with few effective therapeutic options available. Objective: To describe the use of ultrasound-guided cryoneuroablation as a minimally invasive alternative for the treatment of painful post-amputation neuroma in a pediatric patient. <o:p></o:p>Methods: A 10-year-old girl with left transtibial amputation due to meningococcal sepsis and severe neuropathic pain (VAS 8/10) secondary to a tibial nerve neuroma, refractory to conventional treatment. Ultrasound-guided cryoneuroablation of the tibial nerve was performed under general anesthesia. <o:p></o:p>Results: The procedure was completed without complications, achieving pain reduction to VAS 1/10 and full functional recovery within two weeks. <o:p></o:p>Conclusions: Ultrasound-guided cryoneuroablation is a safe, effective, and minimally invasive technique for the management of painful post-amputation neuroma in the pediatric population, providing novel evidence in this understudied group.
Copyright (c) 2026 Archives of Physiotherapy and Rehabilitation
Early Detection of Microvascular Ischemia Through Cardiopulmonary Exercise Testing in a Cardiac Rehabilitation Program
Introduction: Cardiopulmonary exercise testing (CPET) is an exercise test that integrally evaluates cardiovascular, respiratory, and metabolic responses to physical effort, allowing an accurate assessment of functional capacity and ventilatory efficiency. It is characterized by high sensitivity and specificity, as well as the ability to detect myocardial ischemic alterations at an early stage, even before they become evident through conventional imaging techniques. In this context, its application during cardiac rehabilitation programs may provide relevant information for the diagnosis and safe management of patients with suspected coronary microvascular disease. The aim of this clinical case is to highlight the usefulness and feasibility of CPET for the early detection of microvascular ischemia in the setting of cardiac rehabilitation. Clinical observation: We present the case of a 54-year-old woman referred to cardiac rehabilitation with a diagnosis of non-obstructive apical hypertrophic cardiomyopathy and recurrent atrial fibrillation. The patient reported dyspnea with mild exertion, corresponding to New York Heart Association (NYHA) functional class III, as well as occasional chest pain. An initial evaluation using CPET revealed severe functional limitation, classified as Weber class C, together with significant ventilatory impairment (Arena class 4), which justified the indication for a structured cardiac rehabilitation program. After completion of the program, a repeat CPET demonstrated objective criteria of myocardial ischemia according to Belardinelli. Conclusions: This case highlights the usefulness of CPET for the early detection of microvascular myocardial ischemia in patients without a prior diagnosis based on conventional testing. Moreover, CPET is reinforced as a fundamental tool for designing individualized training programs, optimizing functional capacity, and ensuring patient safety during cardiac rehabilitation.
Cross Cultural Adaptation and Validation of the Portuguese Version of the Community Service Attitudes Scale
The Community Service Attitudes Scale (CSAS) is a 46-item measure designed to assess students' attitudes towards community service in higher education. The study aimed to cross-culturally adapt and validate the CSAS to European Portuguese. The CSAS was translated into Portuguese and back-translated, content validation was performed by a review committee, and a pretest was completed by 30 undergraduate students. To assess content/face validity, reliability and stability participants were recruited from January to April 2023 at a higher health school. They completed an online questionnaire (Google Forms) on two occasions, one week apart. Ninety-five undergraduate health students completed the scale. 59.4% females and 40.6% males, age 21.04 (±1.79), 57.3% without previous community experience. Cronbach's alpha was greater than .80 for all dimensions of the instrument, the CSAS total score (.97) and the CSAS subscales (ranging from .88 to .95), indicating very good internal consistency. The intraclass correlation coefficient (ICC) obtained between test-retest, the total CSAS ICC was .96 and the ICC subscales ranged from .86 to .94, confirming good reliability. The Portuguese version of the CSAS (CSAS_P) is a valid and reliable instrument to assess university students' involvement and attitudes towards community service.
Women Health Physiotherapy Rehabilitation in Community Based Education
Introduction: Being male or female greatly influences health outcomes, shaped by both biological factors and gender related distinctions. Physiotherapy in women's health has progressed significantly since its origins in early 20th century. Gaps in women's health and physiotherapy rehabilitation within community settings pose a major obstacle to achieving better long term health outcomes. The aim of the study is to investigate the perspectives of patients and medical staff on women health physiotherapy rehabilitation in Community Based Education (CBE). Methodology: This study utilized a qualitative descriptive approach to examine the results of implementing a physiotherapy CBE model in women's health, incorporating perspectives from both patients and Primary Health Care (PHC) professionals. The study was conducted at the Al Gosi Centre, Omdurman, Sudan. Data collection involved conducting interviews with eight health professionals and organizing group discussions to gather feedback and reports from 15 women receiving healthcare services. Data analysis focused on transforming interviews and discussion group sessions into comprehensive transcripts and deriving analytical themes from the results. All ethical confederations have been obtained. Results: Most patients view Women's Health Physiotherapy Rehabilitation within CBE as a traditional treatment approach that involves exercises and massage. A smaller group describes it as a therapy incorporating a relaxation machine. Overall, patients perceived the intervention positively, noting increased awareness of harmful behaviors, a general improvement in functional levels, and, for some, a reduction in symptoms. However, most of the staff demonstrated limited knowledge about Women's Health Physiotherapy Rehabilitation within CBE, often assuming it focuses solely on orthopedic cases. Staff members also highlighted several challenges in implementing the rehabilitation program, such as insufficient medication supplies, inadequate laboratory resources, a lack of specialized personnel, and limited facilities and equipment. Conclusion: The study revealed a lack of awareness among patients and staff regarding women's health physiotherapy rehabilitation in CBE. There is a clear need to educate physiotherapy students, women’s health patients, and medical staff about the significance of such rehabilitation.
Prevalence of Upper Cross Syndrome and Pre-Presbyopic Symptoms Among Handloom Cluster of West Bengal
Background: The repetitive and posture-intensive nature of handloom work imposes significant physical strain, leading to various occupational health issues. This study explores the incidence of Upper Cross Syndrome (UCS) and pre-presbyopic symptoms among West Bengal handloom workers and examines their interrelation. Materials & Methods: In this cross-sectional study, 400 handloom workers from different West Bengal clusters participated. The Neck Disability Index (NDI), REEDCO Posture Score (RPS), and Numeric Pain Rating Scale (NPRS) were used to evaluate the prevalence of UCS. For pre-presbyopic symptoms, visual tests like Monocular Estimation Method (MEM) and Near Visual Acuity (NVA). The data were analyzed using SPSS 23.0 software. Results: Among 400 handloom workers, most reported neck pain, postural dysfunction, and mild to moderate neck disability, with males more affected. Pain (NPRS) correlated negatively with posture (REEDCO, r = –0.71) and positively with disability (NDI, r = 0.599). Common findings included muscle tightness and weakness in the neck and shoulder girdle, with restricted cervical and shoulder movements. Workers aged 30–39 years showed early presbyopia (p < 0.01) linked to reduced near vision and higher MEM values.
A Review on Digital Divide and Its Impact on Physiotherapy Delivery in Rural Settings
Digital physiotherapy has been evidenced to be an effective and practical way of delivering physiotherapy services to individuals, principally those with inadequate access to traditional in-person care. However, the assistances of digital physiotherapy are not evenly distributed. Rural areas are disproportionately affected by these disparities due to deprived network coverage area, limited affordability of electronic devices, lower educational levels, awareness of telerehabilitation and limited exposure to digital health interventions. The goal of this review is to evaluate and synthesize existing literature on the digital divide and what impact the digital divide has on physiotherapy service delivery in rural areas. In doing so, this review will identify the main barriers, implementers, and gaps in research, with the goal of informing clinical practice, guiding future research, and supporting policy initiatives designed to promote the equitable access of digital physiotherapy services delivered in rural settings.
Wet Cupping (Hijama) as a Non-Pharmacological Approach for the Management of Musculoskeletal Pain and Inflammation
Background: Musculoskeletal pain is a leading cause of chronic disability and functional limitation. Due to limitations and adverse effects associated with long-term pharmacological therapy, non-pharmacological interventions such as wet cupping (Hijama) are increasingly being explored for pain and inflammation management. Objective: To evaluate clinical effectiveness, inflammatory response, and safety of wet cupping (Hijama) in patients with musculoskeletal pain. Methods: A cross-sectional study was conducted among 180 patients with musculoskeletal pain between March 2025 and June 2025. Pain severity was assessed using the Visual Analogue Scale (VAS), and functional outcome in knee osteoarthritis was evaluated using the KOOS score. Inflammatory markers (CRP, ESR, serum uric acid) and biochemical safety parameters (ALT, AST, ALP, hemoglobin) were measured at baseline and after four weeks of wet cupping therapy. Paired statistical tests were applied to compare pre- and post-treatment values. Multivariable linear regression analysis was performed to identify predictors of pain reduction. Results: A significant reduction in pain severity was observed across all musculoskeletal conditions following wet cupping therapy. Mean VAS scores decreased significantly in cervical spondylosis (7.8 ± 0.9 to 3.9 ± 0.8), low back pain (7.6 ± 0.8 to 4.0 ± 0.7), frozen shoulder (7.7 ± 0.7 to 3.8 ± 0.6), and sciatic pain (8.1 ± 0.6 to 4.1 ± 0.8) (p < 0.001 for all). Functional improvement was demonstrated by a significant increase in KOOS scores among knee osteoarthritis patients (48.2 ± 4.1 to 66.8 ± 3.2, p < 0.001). Inflammatory markers showed significant improvement, with CRP levels decreasing from 3.6 ± 1.1 mg/L to 2.7 ± 0.9 mg/L and ESR from 29.4 ± 8.2 mm/hr to 21.6 ± 7.1 mm/hr (p < 0.001 for both). Serum uric acid levels demonstrated a non-significant reduction (5.8 ± 1.0 to 5.6 ± 0.9 mg/dL; p = 0.08). Biochemical parameters including ALT, AST, and ALP showed mild but statistically significant reductions (p < 0.05), while hemoglobin levels remained unchanged, indicating good safety and tolerability. Multivariable regression analysis identified baseline CRP (β = 0.44, p < 0.001), duration of pain (β = 0.38, p < 0.001), male gender (β = 0.31, p = 0.002), and age (β = 0.02, p = 0.01) as independent predictors of pain reduction following wet cupping therapy. Conclusion: Wet cupping (Hijama) is an effective and well-tolerated non-pharmacological intervention for musculoskeletal pain, demonstrating significant improvement in pain severity, functional outcomes, and inflammatory markers.
Methods and Safety of Exercise Testing in Older Adults: A Narrative Review
For almost fifty years, clinical exercise testing has been a mainstay of cardiovascular evaluation, especially for ischemic heart disease (IHD) diagnosis, functional assessment, and prognostic stratification. Exercise testing for older adults has become more crucial in both clinical and preventive healthcare settings due to the world's rapidly growing senior population. However, aging is linked to progressive physiological changes, a higher burden of comorbidities, frailty, and functional limitations, all of which call for more stringent safety precautions, protocols, and testing modalities. The methods, indications, contraindications, risk stratification, protocol selection, and safety principles of exercise testing in older adults are all thoroughly examined in this narrative review. Submaximal, functional, and field-based evaluations, as well as customized protocol design, are given special attention.
Low Inter-rater Reliability of Active Hand Joint Range of Motion Measurements When Assessing Hand Function in a Clinical Setting
Background: Hand physiotherapists typically rely on goniometers for manual joint angle assessments, a process that is not only time-consuming but also susceptible to significant variability between therapists, which can lead to inconsistent evaluations, complicating the accurate tracking of a patient’s progress. Inter-rater reliability tests are crucial in determining whether these standard assessment tools need to be improved or replaced, to achieve more accurate assessments and ultimately enhance the quality of patient care. Methods: Participants in the study included five patients hospitalized in the hand department due to movement restrictions and five experienced hand physiotherapists. Following a standardized protocol, flexion and extension of all finger joints were measured, along with other thumb and wrist movements, using identical goniometers and a finger ruler to assess fingernail palm distance (FPD) and fingernail table distance (FNTD). Each joint measurement was performed once by each of the five therapists to evaluate inter-rater reliability. Results: Results indicate varied inter-rater reliability, with 37.2% of measurements showing poor agreement (ICC < 0.5), 30.2% moderate agreement (0.5 ≤ ICC < 0.75), and 4.7% excellent agreement (ICC ≥ 0.9). Conclusions: Findings underscore the need for improved measurement instruments in clinical settings, suggesting potential benefits from sensor gloves or other electrically based devices to enhance reliability and accuracy in ROM assessments.
Recovering Facial Function 18 Months Post Vestibular Schwannoma Excision: A Neuro-Rehabilitative Case Study
Introduction: Vestibular schwannoma, or acoustic neuroma, is a benign tumor that affects the eighth cranial nerve, which often results in hearing loss, tinnitus, and balance issues. Surgical removal can lead to post-operative complications such as facial nerve palsy that can significantly impact a patient's quality of life. Case description: This case study presents the rehabilitation of a 51-year-old female who developed right-sided facial palsy following a right retromastoid suboccipital craniotomy. Eighteen months post-surgery, she sought rehabilitation with complaints of facial asymmetry, difficulty in speech, chewing, swallowing, and incomplete eye closure. Intervention: A tailored rehabilitation program was implemented, which included neuromuscular re-education, facial PNF exercises, mirror biofeedback, faradic stimulation, facial taping, and postural care. The patient also received interventions for tremor management and lower limb strengthening. Outcome: Within four weeks, she demonstrated improvements in facial symmetry, eye closure and functional facial expressions, which was also evidenced by improved scores on the Sunnybrook Facial Grading System. Conclusion: This case highlights the effectiveness of targeted physiotherapy in post-surgical facial palsy rehabilitation after the removal of vestibular schwannoma. A multidisciplinary approach that combines neuromuscular re-education, electrotherapy, and functional training can accelerate recovery and enhance the patient’s overall quality of life.
The Effect of an Exercise Therapy Program on Physical Function in Patients Undergoing a Haematopoietic Progenitor Cell Transplantation: An Observational Study
Purpose: To observe the effect of a exercise therapy (ET) program on the physical capacity of patients undergoing a haematopoietic stem cell transplant (HSCT) 3 months after said intervention. Methods: An observational study was carried out in patients who underwent a HSCT between September 2020 and August 2021. Patients were assessed before admission and 3 months after the transplant. The 30-second chair to stand test (30CST) was used to measure lower body resistance, and the timed up and go (TUG) was employed to assess functional mobility and detect balance and coordination problems. During admission, the patients completed the ET program developed at the hospital and based on the guidelines for ET after a HSCT from the Spanish Group for Transplantation and Cellular Therapy (GETH-TC). Results: 34 patients were included. Three months after the HSCT, a decrease both in the number of 30CST repetitions from 11.58 ± 4.09 to 10.94 ± 3.54 (p < 0.0001) and in the time to perform the TUG from 9.86 ± 5.56 to 8.65 ± 3.30 seconds (p < 0.0001) was recorded. Conclusions: An ET program starting with conditioning for a HSCT is safe, can improve coordination and balance, and serves to help mitigate the loss of muscle strength these patients tend to experience because of disease, the transplant process, and prolonged inactivity.
Medical Staff and Physiotherapy Role in Total Knee Replacement.
Introduction A Total Knee Replacement (TKR) is a surgical operation in which artifcial material is used to replace the damaged knee joint. Total knee arthroplasty is regarded as one of the most economically efficient and reliably successful surgical procedures conducted in the field of orthopedics. Globally, TKR is becoming more common and over 700,000 TKR arthroplasties were carried out in the United States (USA) in the year of 2012 only1. In Sudan, there is a significant rise in the number of TKR surgeries. Patient-reported outcomes are shown to improve dramatically with respect to pain relief, functional restoration, and improved quality of life (QoL). Medical personnel, including physiotherapists, have a close teamwork relationship when it comes to TKR rehabilitation. The purpose of this study is to ascertain medical personnel's perception toward physiotherapy's role in treating TKR. Methodology The viewpoint of medical staff regarding the role of physiotherapy in controlling TKRwas ascertained using a crosssectional survey utilizing questionnaires. A total of 60 medical personnel involved in the care of TKR patients at Shurg Alneel Hospital and the Military Hospital in Khartoum, Sudan, which were chosen for this study. The data were analyzed using version 31 of the Statistical Package for the Social Sciences (SPSS). All ethical considerations have been acquired. Results There were 33% of the participants perceive strengthening exercises as the role of physiotherapy in TKR. Majority (50%) of participants strongly agree that physiotherapy plays a significant role in the treatment of TKR. There were 67% of participants who strongly agree with the inclusion of physiotherapists in the rehabilitation team for TKR. Majority (83%) of participants experience effective communication with physiotherapists within the rehabilitation team. Conclusion Among the few physiotherapists, considerable efforts are being made in the rehabilitation program for TKR with other medical staff.
Copyright (c) 2025 Archives of Physiotherapy and Rehabilitation
Sciatica: Correlation Between Nerve Conduction and Lipid Profile
Sciatica is a common neuropathic pain condition, most often resulting from lumbar disc herniation and characterized by radiating pain along the sciatic nerve pathway. Although mechanical compression of the nerve root is a well-recognized cause, growing evidence suggests that systemic metabolic factors particularly dyslipidemia may accelerate intervertebral disc degeneration, impair vascular supply, and heighten nerve inflammation. Elevated total cholesterol, LDL-C, and triglycerides have been linked to greater risk of disc herniation and may directly influence nerve function; however, their relationship with nerve conduction parameters in sciatica remains unclear. This study aims to examine the correlation between serum lipid profiles and nerve conduction parameters in individuals with sciatica. A cross-sectional, frequency-matched case control design was employed. Serum lipid levels, including total cholesterol, triglycerides, LDL-C, and HDL-C, were assessed and compared between sciatica patients and matched controls. Nerve conduction studies of the tibial and peroneal nerves evaluated conduction velocity, latency, and amplitude. Correlation analyses were conducted to explore associations between lipid abnormalities and electrophysiological outcomes. Preliminary results demonstrate significantly reduced nerve conduction velocities in sciatica patients. Higher levels of total cholesterol, LDL-C, and triglycerides showed a negative correlation with conduction velocity and amplitude, suggesting metabolic dysregulation may exacerbate neural impairment beyond mechanical compression. These findings highlight the potential contribution of dyslipidemia to sciatic nerve dysfunction. Incorporating metabolic assessment into sciatica evaluation may improve diagnostic accuracy and guide targeted therapies. Further research is warranted to determine whether lipid-lowering interventions can enhance nerve recovery and reduce symptom severity.
The inter-rater and intra-rater reliability for measures of passive rotation of the cervical spine with a big protractor. A pre-study with a doll before performing the study with infants
Infants with congenital muscular torticollis (CMT) often have some degree of limited rotation in the cervical spine toward the affected side. Measurement of passive range of motion (PROM) is an essential part of the examination. The aim of this study was to look for inter-rater and intra-rater reliability for measures of PROM in cervical rotation with a big protractor. Method: Three physical therapists (PT) and one pediatric nurse participated in the evaluation of intra-rater and inter-rater reliability for PROM measurements of cervical rotation with a protractor. Three dolls were used instead of infants to exclude an unwillingness in infants that likely would restrain repeated measurements. The study was carried out in two parts, part I with a doll in real time and part II with photographs of three dolls in different positions. Results: Both the intra-rater and inter-rater intraclass correlation coefficient (ICC) was >0.9. Inter-rater reliability was high for both the experienced and less experienced evaluators, it was however highest for the more experienced PT. Conclusion: The reliability of measuring passive cervical rotation with a protractor was high in both intra-rater and inter-rater measurements regardless of short or long experience as a PT.
Adolescents/Adults with Neglected Congenital Muscular Torticollis. Case Description: An Adolescent with Problems Due to Neglected CMT
The aim is to describe an adolescent with neglected Congenital Muscular Torticollis (CMT) and to discuss some difficulties for adolescents/adults with neglected CMT. Even though CMT is mostly discovered in infanthood, some individuals do not get treatment in time. For older children/adolescents/adults with a visual muscular cord tightness in the sternocleidomastoid muscle, surgery is mostly a requisite for physical therapy to work. Surgery for CMT is nothing new but there seems to be a lack of knowledge about it, especially for older children, adolescents, and adults. When CMT is not treated, the head remains tilted toward the affected side, there is restricted motion in the neck, often an elevated shoulder on the affected side, some lateral shift of the head, pain, and facial asymmetry. Early surgery is preferable. However, adults with neglected CMT can benefit from surgery; they can get increased neck motion, a straight head position, less pain and better well-being. Surgery should be offered regardless of age as it can make an important difference to the individual. In the described case an adolescent with considerable effects of neglected CMT felt that she had gained a new life after surgery.
The Role of Repetitive Peripheral Magnetic Stimulation in Reducing Contractures and Enhancing Joint Function Among Elderly Residents of Skilled Nursing Facility: A Pilot Study
Background: Contractures are a common issue in geriatric patients, particularly in nursing facilities, where prolonged immobility can reduce joint mobility and function. These conditions, characterized by tightness in muscles, tendons, or skin, impact quality of life and complicate caregiving. Repetitive Peripheral Magnetic Stimulation (RPMS) therapy is a promising non-invasive treatment for healing, reducing inflammation, and improving joint function, potentially aiding elderly patients in skilled nursing facilities. Methods: This study employed an ABA design (baseline-treatment-baseline) to assess the effects of combined RPMS and Passive Range of Motion (PROM) therapy on knee contractures in elderly patients. Twelve participants (mean age 83.3 ± 5.2 years; 4 males, 8 females) were recruited into a study protocol consisting of 3 phases: Phase A1 (RPMS+PROM), Phase B (PROM), and Phase A2 (RPMS+PROM). The primary goal was to assess knee range of motion (ROM) improvements, with mobility changes as a secondary focus. ROM data were collected at baseline and after each phase using a goniometer. Results: No participant experienced a decline in knee ROM after completing the treatment program, although some showed slight fluctuations during individual phases. The average improvement across both limbs was 20°, with statistically significant changes observed in the dominant limb after Phase B and in both limbs following Phase A2, compared to baseline. Conclusions: RPMS therapy combined with PROM exercises showed promise for improving knee ROM. However, variability in outcomes highlights the need for personalized treatment plans. Future research should explore factors that contribute to sustained improvements and refine protocols for long-term benefits.
Effect of Inspiratory Muscle Training on Respiratory Muscle in Patients Undergoing Open Heart Surgery
Background: Patients undergoing open-heart surgery (OHS) are at risk of postoperative pulmonary complications and decreased functional capacity (FC) of the lungs. Respiratory muscle training (RMT) is reported to be effective in improving respiratory muscles strengthening (RMS) and FC. Aim: To investigate the effects of RMT on the respiratory muscles of patients undergoing OHS. Design: A randomized controlled trial Setting: Thammasat University Hospital Population: Patients undergoing OHS. Methods: Fifty-eight patients who underwent OHS were randomly assigned to two groups: 29 in the control group (CG) and 29 in the training group (TG). The patients in the TG underwent physical therapy program and RMT using a breath trainer. Patients in the CG underwent physical therapy only. The maximum inspiratory pressure (MIP), maximum expiratory pressure (MEP) and 6-minute walk test (6MWT) were assessed pre- and post-operatively. Results: The TG had significant increase in MIP (46.70±24.98 vs. 61.40±28.46 cmH2O, P<0.001), MEP (40.06±22.83 vs. 62.30±22.64 cmH2O, P<0.001) and 6-MWT (172.73±88.11 vs. 208.26±89.42 m, P=0.013). The CG had significant decrease in MIP (42.23±20.26 vs. 23.46±9.94 cmH2O, P<0.001), MEP (35.90±24.35 vs. 23.10±15.03 cmH2O, P=0.002) and 6MWT (150.83±91.79 vs. 76.6±67.67 m, P<0.001). Conclusion: RMT effectively improved RMS and FC in patients undergoing OHS.
Copyright (c) 2024 Archives of Physiotherapy and Rehabilitation
Physiotherapy Interventions for Back Pain Management
Back pain is a widespread condition that affects a significant portion of the global population, leading to substantial physical and psychological distress. Physiotherapy has become an essential component in the management of back pain, employing a variety of techniques aimed at alleviating symptoms, enhancing mobility, and preventing recurrence. This review article examines key physiotherapy techniques, including manual therapy, exercise therapy, postural training, modalities, and patient education. Manual therapy techniques, such as spinal manipulation, have been shown to provide immediate relief, while exercise therapy focuses on strengthening core muscles and improving flexibility. Postural training addresses ergonomic factors that contribute to pain, and various modalities, including heat and electrical stimulation, can complement other treatments. Education and self-management strategies empower patients to take an active role in their recovery. Overall, a tailored physiotherapy approach can significantly improve outcomes for individuals suffering from back pain, enhancing their quality of life and functional abilities. Continued research is essential to further refine these techniques and optimize treatment strategies.
Copyright (c) 2023 Archives of Physiotherapy and Rehabilitation
Efficacy of Structured Grip Strengthening Exercise Program to Improve Activity Limitations in Patients with Breast Cancer-Related Lymphedema
Background: Breast cancer is one of the most common cancers found in India. Breast cancer-related lymphedema is a complication found in women who undergo mastectomy and radiation. It causes upper limb disability leading to reduced hand function and grip strength. There is limited research for finding out the efficacy of exercises to improve hand functions and strength. Therefore, this study aims to find out the effect of grip strengthening exercises in women with breast cancer-related lymphedema with reduced hand grip strength. Method: The study was conducted on 30 women with lymphedema having reduced hand grip strength. The nature and purpose of the study were explained and a consent form was filled out by the participants. The participants were assessed and then they were given simple exercises to perform for 4 weeks. After the 4 weeks, the participants were reassessed and statistical analysis was done to find out the results. Results: There was a significant increase in hand grip strength of the affected arm as compared to the hand grip strength assessed before the treatment. The study also shows that activities of daily living were performed with more ease after the treatment. Conclusion: According to the results, hand functions and strength improves with exercise. Thus, reduced hand grip strength in women with lymphedema can be improved by including grip strengthening exercises. It can also be used with other therapeutic interventions for better treatment outcomes.
Copyright (c) 2022 Archives of Physiotherapy and Rehabilitation
Prevalence of Urinary Incontinence and Impact on Quality of Life: Observational Study in a Higher Education Institution
Introduction: Urinary incontinence is more common in women due to anatomical reasons, as well as births and pregnancies, that weaken the perineal muscles, negatively influencing quality of life. Objective: To identify the prevalence of UI among women in an academic environment and, among incontinents, to assess the impact of incontinence on quality of life. Materials and methods: Observational and cross-sectional study with a sample of women linked to a higher education institution. For data collection, an online questionnaire was made available to volunteers via Google Forms to be answered anonymously. Results: 63 women were interviewed with a prevalence of urinary incontinence of 36.5% among respondents. Among incontinents, there was mild incontinence in 78.2% and moderate in 21.7% and negative impact on personal relationships in 47.8% of them. Conclusion: The results of the present study showed a prevalence of UI equal to 36.5% among women inserted in an academic environment. This percentage can be considered high due to the average age of the sample and the context in which these women are inserted. Regarding the impact of urinary losses on quality of life, almost half of the incontinent sample reported that the losses interfere with personal life. Despite this, they perceived their health status positively.
Copyright (c) 2021 Archives of Physiotherapy and Rehabilitation
Does Esoteric Connective Tissue Therapy ( ECTT) have Efficacy and Long Term Benefits Treating People with Chronic Musculoskeletal Pain
Background: There has been so much research on chronic low back pain globally without any definitive model that reduces the pain levels permanently over time. At best there are medical management models including medication, exercise, relaxation techniques and counseling. For the last 20 years there has been an increasing interest in the quality, nature and role of the body’s connective tissue (CT) with physical therapists, osteopaths, anatomy specialists, orthopeadic and plastic surgeons in America and Europe. The working hypothesis is that CT may have a very important role in our body’s vitality and in chronic pain conditions. Recent research has shown the CT changes from being naturally fluid in nature to thickened and less fluid/flexible with physical strain and significant emotional strain. (Helene Langevin MD NCCIH (USA)– Fascia Researcher, Carla Stecco MD Professor of Anatomy, University of Padova (Italy) and Dr Jean-Claude Guimberteau – hand surgeon, (France). Dr Guimberteau has taken videos of the sliding/ gliding nature of CT in patients having open hand surgery that have changed the way surgeons view CT. He has been looking to answer the unanswered question : How does the CT function in the body? He has stated ‘ The more we research the connective tissue the more we will understand it, this opens the door to new therapies’. I have been working with a new therapy : Esoteric Connective Tissue Therapy (ECTT ) for 20 years especially with people with complex chronic pain conditions. I propose that the CT is the overlooked key that if supported to heal and return to a more fluid state will help reduce the severity and impact of chronic low back pain.
Permanent Makeup in Areolopapillary Complex Reconstruction: A Case Study
Introduction: Oncoreconstructive plastic surgery represents a major advance for the quality of life of women with breast cancer and the reconstruction of the nipple areola complex (NAC) is the last step in the process of a new breast creation. GOAL. To present, through a case report, the results of Permanent makeup for PAC reconstruction in satisfaction, self-esteem and quality of life. Materials and Methods: Case study of a 47-year-old volunteer who underwent unilateral PAC reconstruction through Permanent makeup performed in a single procedure. Comparative visual assessment (before and immediately after Permanent makeup images) and satisfaction of the procedure and its impact on self-esteem and quality of life were assessed using a structured questionnaire. Results: The comparative evaluation of the images showed that after the procedure the neomama aspect was closer to the anatomical model. The volunteer reported satisfaction with Permanent makeup, stated that the procedure is safe and effective and approximates the aspect of the neomama to the original breast, with positive repercussions on sexual health, self-image and quality of life. Conclusion: The Permanent makeup of the NAC showed a positive and important aesthetic difference in the new breast with favorable repercussions on the patient's satisfaction, self-esteem and quality of life.
Copyright (c) 2020 Archives of Physiotherapy and Rehabilitation
Prevalence and Associated Factors of Flat Feet among Patients with Hypertension; Findings from a Cross Sectional Study Carried Out at a Tertiary Care Hospital in Sri Lanka
Background: Hypertension is considered a risk factor for flat feet as it causes posterior tibial tendon dysfunction. The objectives of this study were to identify the prevalence and associated factors of flat feet among patients with hypertension. Methods: A cross sectional study with systematic sampling was done in three selected hypertension clinics at the National Hospital of Sri Lanka. Patients with hypertension above 40 years of age with no other recognized risk factors were enrolled. Socio-demographic details and clinical information were collected using a pre-tested interviewer administered questionnaire. Arch index was obtained by a static footprint on the Harris mat. Body weight and height were measured using standard instruments. Body Mass Index was calculated. Descriptive statistics, Independent t- test, Chi-square test and Pearson correlation were used for data analysis. Results: Of the 403 participants enrolled, 53.8% were females. The mean arch index of right and left sides were 0.26883 ± 0.3477 and 0.26993 ± 0.03484 respectively. Overall prevalence of flat feet was 51.6%; it was right sided in 32% and left sided in 37.7%. Higher Body Mass Index was associated with presence of flat feet (p=0.001) and arch index (p<0.001). There was no significant association with gender or duration of hypertension. Conclusions: Prevalence of flat feet among patients with hypertension seems to be greater than reported in non-hypertensive individuals with otherwise similar characteristics. Increasing body mass index even below the threshold of 30 kg/m2 seems to be associated with higher risk.
Effect of the Rehabilitation Program on the Lower Limbs Function after Anterior Cruciate Ligament Reconstruction Surgery: Case Series from Sudan, Khartoum, 2018-2019
Objectives: To assess the effect of the rehabilitation program on the lower limbs function after anterior cruciate ligament reconstruction surgery. Design: A case- series hospital-based study. Setting: The study was conducted in Khartoum state at the Safana physiotherapy and rehabilitation complex at the East Nile Model Hospital from the first of January 2018 to the thirty first of December 2019. Participants: 13 participants were studied with ACL injuries, aged from 15 to 45 years. Main outcome measures: The data was collected using the Lower Extremity Functional scale, it comprises 20 items, each item has a score of 5-points (0-4). Results: Revealed that 9 participants out of 13 had a bad scores before the rehabilitation program and the rest 4 had good scores. After the completion of the program 8 participants had good scores while 5 had bad scores. There is a significant statistical association between the scale scores before and after the rehabilitation (p-value 0.001) and between the participants’ age and the scale scores after the rehabilitation (p-value 0.001). There is also a significant statistical association between the number of sessions and the scores after the rehabilitation (p-value 0.001). Conclusion: The results revealed the beneficial and crucial role of the rehabilitation program in the lower limbs function restoration.
A Clinical Review on Low Dose Short Wave Diathermy Therapy as a Physical Antibiotic on Covid-19 Pneumonia
COVID-19 pandemic mostly affects respiratory system resulting in cough, sputum production, dyspnoea, hypoxemia as in pneumonia. Currently, 5 % of COVID-19 cases require admission to ICU due to respiratory distress. The global current treatment options mostly followed for ARDS due to COVID-19 pneumonia include high flow nasal canula (HFNC), non-invasive ventilation (NIV), mechanical ventilation with lower tidal volumes and continuous positive airway pressure (CPAP). There is high risk of aerosol dispersion during these techniques provoking the risk of cross infection, as most of the COVID-19 hospitals are not having negative pressure isolation rooms. There is also an acute shortage of mechanical ventilators globally. Short Wave Diathermy is a physical therapy antibiotic which has antimicrobial effects, possessing the capacity to reduce cyanosis, pain, dyspnoea, cardiac embarrassment and induces restful sleep. Short wave diathermy with acute precautionary measures could be beneficial in reducing the temperature, improving circulation, reducing respiratory rate, grunt and Pain.
The Effect of Pre-Warm-Up Actions on Flexibility and Jumping Ability in Soccer Players
A series of exercises with the use or not various instruments is applied before soccer players warm-up. The aim of this study was to examine the effect of these exercises in combination with classic soccer warm-up on ROM and jumping ability performance. Sixteen (n=16) semi-professional soccer players executed two warm-up protocols. The control protocol (CONTROL) was the classic soccer warm-up and the experimental one (EXPER) included pre-warm-up actions using foam rolling, static stretching, neuromuscular control exercises on unstable surfaces and muscle activation exercises accompanied by the classic warm-up of soccer players. The participants executed hip flexion Range of Motion (ROM) measurement and two Countermovement Jump with Arm Swing (CMJAS). Two-Way ANOVA revealed significant main effect of “time” on ROM (p<0.05) in both protocols, but no differences on CMJAS (p=0.10). Results show that pre-warm-up actions do not add further benefit in performance in ROM and CMJAS in relation to classic soccer warm-up.
Effectiveness of Passive Chest Physiotherapy in Prevention of Ventilator Associated Pneumonia in Sepsis
Background: Around 19 million cases of sepsis are reported annually, with 5 million deaths are estimated to be recorded in middle and low income countries due to sepsis. Ventilator Associated Pneumonia is most common risk factor associated with sepsis. Passive chest physiotherapy involves various techniques including Percussions, Compression and Manual Hyperinflation Technique for external manipulation; they basically dislodge chest secretions by applying kinetic energy to chest wall. Objective: To evaluate effectiveness of passive chest physiotherapy in prevention of ventilator associated pneumonia in sepsis. Methodology: This was a Quasi Experimental Study conducted in Liaquat National Hospital from February October with non probability convenient based sampling. Total 60 intubated patients diagnosed with sepsis on the basis of American college of chest physicians and society of critical care principle or conditions that could lead to sepsis like impaired immune system, infection, renal failure, burn, Urinary Tract Infection,exposure to invasive devices were included in this study. Excluded were those with pulmonary embolism, pulmonary edema, clotting disorders, osteoporosis of ribs, lung contusion,emphysema, Intracranial pressure greater than 20mmHg, hemodynamically unstable patients, cardiac problems, skin infections . Ethical Approval was taken from Institutional Review Board of Liaquat National School Of Physiotherapy. Passive chest physiotherapy was administered to patient twice daily (11:00 am and 3:30 pm) in 10 days. Patients were given standard care as per ICU protocol in the form of nursing, pharmacology as prescribed by physician/Surgeon throughout intervention period. Acute Physiology, Age, Chronic Health Evaluation II (APACHE II) and Clinical Pulmonary Infection Scoring (CPIS) were used as assessment tools. Data was analyzed using spss 22.0.<b
Potential Role of Zeolites in Rehabilitation of Cancer Patients
Abstract not available in the source database.
Benefits of Robot-Assisted Rehabilitation in Stroke Patients: A Follow up Study
Background: Stroke is found as leading cause of death in the world. Yet, the consequences of stroke spread beyond patient mortality and thus the post-stroke care to reduce patients’ dependency relies on rehabilitation. Purpose: To quantify the benefits of robotic tilt table rehabilitation on improving the quality of living and ga- ining functional independence in stroke patients. Methods: A total of 63 stroke patients (age 50.8 ± 6.86 years) were assigned for 30 days of robotic tilt table rehabilitation on Erigo tilt-table. NIHSS, MMSE, Modified Ashworth Scale, QOL and muscle strength (affected upper and lower limb) outcomes were assessed at baseline (day 0), after (day 30) intervention and on 90th day of follow up. Results: Patients had shown a significant improvement in all the variables with time. Conclusion: The robot-assisted training along with home-exercise program is found to be effective in rehabilitation of stroke patients.
Effect of Functional Electrical Stimulation on Erectile Dysfunction in Post –Stroke Survivors- A Randomized Cinical Control Trail
Background: Stroke often affect sexual health in a negative way. The common sexual dysfunction amongst stroke survivors are decreased libido, impaired erectile and ejaculatory functions, decreased vaginal lubrications, impaired ego, self-esteem, and depression. Objective: To find the effectiveness of Functional electrical stimulation on improving erectile function in Post-stroke patients. Methods: It is a single - blinded randomized controlled trail, 486 hemiplegic patients from a 1st stroke admitted into the Hospital were screened for the study of whom 180 patients full filled the inclusion criteria and were randomly divided into two groups. 120 patients completed the study. Functional electrical stimulation group was given functional electrical stimulation, for a period of 4 weeks with 4 sessions per week with 15 min each session. After the intervention, the patients were trained for pelvic floor and home exercises. Conventional Physiotherapy group was given pelvic floor and home exercises. The erectile dysfunction was measured by International Index of Erectile Function and erectile function was measured by erectile hardness. Results: The mean of differences between Preintervention and postintervention IIEF in FES group is 8.85 SD +/-3.16 and that of Conventional Physio. group is 5.13 SD +/- 3.92. With‘t’ value 4.53, the test is significant at p<0.05, which indicates the results are statistically significant. The mean of differences between Preintervention and postintervention EHS in FES group is 1.63 SD +/-1.28 and that of Conventional Physio. group is 0.77 SD +/- 0.87. With‘t’ value 4.34, the test is significant at p<0.05, which indicates the results are statistically significant. The magnitude of the experiment effect revealed large effect (Cohen’s d >0.7). Conclusion: We conclude from this study that Functional electrical stimulation improves erectile function in stroke survivors and is a treatment of choice for erectile dysfunction in post-stroke patients.