| || |
Latest PhysioForum Posts
Physical Function Post Hip Replacement Surgery Improved By Walking Skills Program.
Monday 03 June 2013 - 01:13:15 | International Physiotherapy News
Researchers in Norway report that patients who receive walking skills training following total hip arthroplasty for osteoarthritis show improved unction. The physical therapy program displayed a positive effect on walking distance and stair climbing which continued 12 months following hip replacement surgery. Results of the study appear in Arthritis Care & Research, a journal published by Wiley-Blackwell on behalf of the American College of Rheumatology (ACR).
Osteoarthritis (OA) is a joint disease where loss of cartilage in affected joints such as the knees, hips, fingers or spine causes pain and stiffness that can be disabling. In some cases, the only treatment option for OA is total replacement of the joint, known as arthroplasty. The World Health Organization (WHO) estimates that 10% of men and 18% of women 60 years of age and older suffer from OA. In the U.S., the National Hospital Discharge Survey reported that 230,000 Americans had hip replacement surgery in 2007.
Previous research reported pain relief, a return to daily functioning, and maintaining an active lifestyle to be high priorities for hip replacement patients. Yet despite improvements in pain and mobility following surgery, several studies have shown patients with hip replacements had more walking impairment compared to healthy peers, and displayed poorer hip flexibility and muscle strength in their affected hip. "Physical therapy, particularly exercises that increase strength and improve walking, is a major component of patient rehabilitation following hip arthroplasty," said Kristi Elisabeth Heiberg, a Ph.D. candidate at the University of Oslo in Norway and lead author of the current study.
To investigate the effects of a walking skills training program on walking, stair-climbing, balance, physical function, and pain, the research team recruited participants undergoing total hip arthroplasty at two hospitals in the Oslo area. Patients were enrolled consecutively from October 2008 through March 2010, with 68 patients randomized to either a training group (35) or in the control group (33). Participants had a mean age of 66 years, with 35 women and 33 men taking part in the study. Participants in the training group engaged in 12 sessions that were led by a physical therapist twice a week. Each 70 minute session was solely performed in weight-bearing positions and included physical activities such as sitting to standing, walking over obstacles, walking with turns, and climbing stairs. The aim of the training program was to improve patients' flexibility, strength, coordination, balance, and walking endurance following surgery.
Results show those who took part in the walking program displayed significant improvement in physical performance measures and self-reported physical functioning at five months following surgery compared to the control group. Compared to baseline measures (3 months post surgery), 66% of subjects in the training group and 15% in the control group improved their walking distance to 164 feet (50 meters) or more by the fifth month following hip replacement surgery. At 12 months post surgery the training group showed greater improvement in walking distance and stair climbing abilities than the control.
"The training program was well tolerated by patients and no complications were reports," concludes Ms. Heiberg. "Our findings suggest physical rehabilitation helps improve mobility and function in patients who received hip replacements."
Sourced from: [link]
Physiotherapy Assessment By Telemedicine Approach Is Effective In Low Back Pain.
Sunday 26 May 2013 - 03:23:53 | International Physiotherapy News
A study in the May 15 issue of Spine reports that a new "telerehabilitation" approach lets physical therapists assess patients with low back pain (LBP) over the Internet, with good accuracy compared with face-to-face examinations. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.
Taking advantage of Skype and other widely-used services may make telerehabilitation a more feasible alternative to in-person clinic visits, according to the new research by Prof. Manuel Arroyo-Morales and colleagues of University of Granada, Spain. They believe their results "give preliminary support to the implementation of web-based LBP assessment systems using video recordings that can be evaluated by different therapists." Can Back Pain Assessments Be Performed Over the Internet?
The researchers designed and evaluated a web-based telerehabilitation system for performing routine clinical assessments of patients with LBP. The telerehabilitation setup operated across a low-bandwidth Internet connection between two personal computers equipped with webcams. The system included the popular Skype videoconferencing service, allowing the patient and physical therapist could see and talk to each other in real time. The therapist guided the patient in performing specific movements, and captured video clips for analysis using video motion analysis software (Kinovea). The therapist and patient were also able to complete standard back pain questionnaires using the web-based system.
Fifteen patients with chronic LBP underwent two assessments in random order: once face-to-face and once using the telerehabilitation setup. Accuracy was assessed by comparing the results of telerehabilitation assessment with those of in-person assessment. The results showed good agreement between the two evaluations, supporting the use of telerehabilitation for clinical assessment of LBP. There was good correlation for measures made on video motion analysis, such as spine mobility and back muscle endurance; as well as questionnaire-based assessments such as disability, pain, and health-related quality of life. Skype and Other Tools Make Telerehabilitation More FeasibleThe telerehabilitation setup showed consistent results for the same therapist at different times (intra-rater reliability) as well as for assessment by independent therapists (inter-rater reliability).
There is growing interest in Internet-based systems for assessment of patients with musculoskeletal disorders. Telerehabilitation approaches could be especially valuable for patient in rural or remote areas, who don't have easy access to healthcare providers. In the past, the use of telerehabilitation was limited by high equipment costs. The new study shows the successful use of telerehabilitation using widely available and familiar technology, including the use of free software such as Skype.
The telerehabilitation system evaluated in the new study may be useful in assessing patients with the very common problem of LBP, showing good agreement with the results of face-to-face assessment. However, there are still some factors limiting more widespread use—including the need for "potentially unwieldy" security software to protect patient privacy. Prof. Arroyo-Morales and coauthors also note that many patients who would otherwise have been eligible for the study weren't included because of a lack of familiarity and experience with computers. The researchers call for further studies in larger groups of patients—focusing on those who don't have easy access to in-person evaluations.
Copied from: [link]