Physiotherapy

SPECIFICNOST FIZIOTERAPIJSKOG PROCESA KOD OBOLJELIH OD URICNOG ARTRITISA Uricni artritis je bolest koju karakterizira hiperuricemija, recicidirajuci napadaji akutnog artritisa, odlaganje mononatrijeva urata u zglob i u tkiva, te stvaranje uratnih kamenaca. Bolest se najcesce javlja između 45. i 54. godine života kod muskaraca i između 55. i 64. godine kod žena. Sinonimi su: giht ; lat. gutta, eng. gout, franc. goutte, njem. gicht, tal. Gotta, te hrvatski ulozi. giht je opisao jos Hipokrat u 5 stoljecu prije Krista. Fizioterapijski proces kod oboljelih od uricnog artritisa obuhvaca subjektivni pregled, objektivni pregled, postupke mjerenje i testove, te primjenu fizioterapijskih procedura s ciljem smanjenja boli, povecanja zglobne mobilnosti, poboljsanja funkcionalnosti, prevencije deformacija, te edukacije bolesnika. Fizikalna procedura izbora koja se primjenjuje u akutnoj fazi bolesti je krioterapija koja se može primjenjivati u tri oblika ; kriokupke, kriooblozi i kriomasaža, te s...

Please cite this article in press as: Katijjahbe MA, et al. Standard restrictive sternal precautions and modified sternal precautions had similar effects in people after cardiac surgery via median sternotomy ('SMART' Trial): a randomised trial.

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Methods: Two surveys were created by the Clinical Reasoning Curricula and Assessment Consortium of the American Council of Academic Physical Therapy. One survey was directed at academic educators and was sent to the 207 Accredited Physical Therapy programs across the United States. The second survey was sent to 4780 credentialed Clinical Instructors (CIs) who were American Physical Therapy Association (APTA) members. Both surveys were distributed electronically with subsequent reminders to complete the survey. Each survey was designed to gather information regarding how clinical reasoning is taught and assessed. Results: Data for the academic survey are representative of forty-six percent of the 207 DPT programs in the country. Data for the clinical educators represent sixteen percent of 4,780 credentialed educators. Only twenty-five percent of academicians reported having a common definition of clinical reasoning in their programs. Ninety-eight percent of academic respondents and ninety-six percent of clinical educators reported using one or more frameworks to teach clinical reasoning. The Guide to Physical Therapist Practice-Patient Client Management and the World Health Organization's International Classification of Functioning, Disability and Health (ICF) were the two most commonly named frameworks by both academic and clinical educators. All academicians and ninety-six percent of clinical educators reported using at least one tool to assess clinical reasoning while most reported using multiple tools. Both cohorts reported using the Clinical Performance Instrument (CPI) as the primary tool to assess clinical reasoning. Clinical educators were asked to rate the level of clinical reasoning skills expected in the clinical experiences in the third professional year. Fifty percent expected students to be at advanced intermediate while forty-two percent expected entry level skills. This is the first attempt at gaining an understanding of how clinical reasoning is taught and assessed in both academic and clinical education in the United States. Results reveal there is great variability in approaches to teaching and assessing clinical reasoning both in the academic and clinical settings. Implications: The surveys highlight the lack of consensus and consistency in how clinical reasoning is taught and assessed in the United States.

A statistically significant main effect of time was found for ankle angular displacement (p = .02). Pairwise comparisons revealed that ankle range of motion was decreased after fatiguing exercise. Statistically significant main effects of group were found for step length (p = .02), step velocity (p = .007). Statistically significant effects of age were found for step velocity (p = .04) and reaction time (p = .007). Age was also found to be significantly correlated with step length (p = .01, r = -.580), step velocity (p = .004, r = -.655), reaction time (p = .002, r = .692), and COP-COM displacement during the landing phase (p = .03, r = -.506). Muscle fatigue had a minor effect on lower extremity joint kinematics during the posterior-directed fall. Between-group differences demonstrated that persons with PD adopted a "stiffening" response relative to healthy older adults. The effect of age played a significant role in the reduction of spatiotemporal parameters of postural control. Implications: Age and acute muscle fatigue have negative consequences on recovery of postural control during reproducible falls in individuals with PD. Physical therapists should be aware of the potential for decreased postural control following acute bouts of intense exercise.

In developed countries, home rehabilitation has been gradually more prevalent. It has perspectives from bio-psychosocial points of view. It includes several treatments, such as exercise, physical therapy, occupational therapy, speech therapy, prosthesis, drug, psychological treatment, nutrition therapy. World Health Organization created the International classification of functioning, disability and health (ICF). The ICF model consists of health and living functions, individuals, and environmental factors, which are important assessment in home rehabilitation. It comprehensively evaluates physical, psychosocial and social problems, and provides integrated medical care and life support as an Interprofessional work (IPW). By IPW, medical staffs can treat patients with satisfactory degree.

Bu çalışmanın amacı kronik böbrek yetmezlikli (KBY) hastaların mizaç ve kişilik özelliklerini ve yaşam kalitesi araştırmaktır. Yöntem: Çalışma grubu Eskişehir Yunus Emre Devlet Hastanesi ve Eskişehir Devlet Hastanesinde 2012-2013 tarihleri arasında hemodiyalize giren KBY tanılı 50 hasta ve 50 sağlıklı kontrol grubundan oluşturulmuştur. Tüm katılımcılardan mizaç ve karakter envanteri (MKE) ve yaşam kalitesi ölçeği (SF-36) 'ni doldurması istendi. Bulgular: MKE' nin alt ölçekleri olan zarardan kaçınma, kendini yönetme, işbirliği yapma toplam puanları hasta ve sağlıklı kontroller arasında anlamlı olarak farklı bulundu (p=0.02, p<0.01, p<0.01, sırasıyla). SF-36 ölçeğinin tüm alt ölçeklerinde de iki grup arasında anlamlı farklılıklar vardı. Sonuç: KBY' li hastaların daha az heyecan duyan, çabuk yorulan, sorumluluk almayan kişilik yapısında olduğu bulunmuştur.

Amac: Bu calismanin amaci kronik bobrek yetmezlikli (KBY) hastalarin mizac ve kisilik ozelliklerini ve yasam kalitesi arastirmaktir . Yontem: Calisma grubu Eskisehir Yunus Emre Devlet Hastanesi ve Eskisehir Devlet Hastanesinde 2012 - 2013 tarihleri arasinda hemodiyalize giren KBY tanili 50 hasta ve 50 saglikli kontrol grubundan olusturulmustur. Tum katilimcilardan mizac ve karakter envanteri (MKE) ve yasam kalitesi olceg i (SF- 36) ‘ni doldurmasi istendi. Bulgular: MKE’ nin alt olcekleri olan zarardan kacinma, kendini yonetme, isbirligi yapma toplam puanlari hasta ve saglikli kontroller arasinda anlamli olarak farkli bulundu (p=0.02, p&lt;0.01, p&lt;0.01, sirasiyla). SF - 36 olceginin tum alt olceklerinde de iki grup arasinda anlamli farkliliklar vardi. Sonuc: KBY’ li hastalarin daha az heyecan duyan, cabuk yorulan, sorumluluk almayan kisilik yapisinda oldugu bulunmustur.

Purpose: To investigate the character temperament properties and life quality of patients with chronic kidney. Materials and Methods: This study was completed with 50 healty people and 50 patient people who undergo hemodialysis and were diagnosid with chronic kidney in Eskisehir Public Hospital in 2012-2013. Participants were asked to filled Temperament and Character Inventory (TCI) and Quality of Life Scale (SF-36). Results: There were found to be significantly differences in total scores of harm avoidance, self directedness and cooperativeness and some subscale scores between patients and controls. There were significantly differences in all subscales of SF-36 between two groups. Conclusion: Patients with chronic kidney disease were found to be personality with less excited, quickly tired and not taking responsibility

The aims of this study were to find out the effects of aerobic exercises on different health related physical fitness variables such as cardio respiratory endurance, flexibility, upper body strength endurance and abdominal strength endurance in adults women. About 32 collage girls (age ranges 21-25yrs) were enrolled as the subject of the study. Two groups were the experimental group, participated in an aerobic exercise programs and the control group. The experimental subjects group was continued for aerobic training for nine month, thrice in a week, 45min. in each time. Due to aerobic training there was no significant change occurs in case of flexibility, upper body strength endurance and abdominal strength endurance. Significant positive changes occurred in case of the cardio respiratory endurance as it was increased due to training. INTRODUCTION &#39;Fitness&#39; is the ability to perform work satisfactorily under specific condition. Physical fitness is the ability to perform musc...

Background: Musculoskeletal symptoms or disorders among dentists have been major concern in recent years. The most frequent injuries occur in spine (neck and back), shoulders, elbow and hands. In order to summarize, the study describes mainly about the prevalence of work related musculoskeletal disorders among dentists, percentage of affection and prevalence of psychosocial aspects among dentists. Aim and objectives: The aim of the study was to find prevalence of musculoskeletal disorders and psychosocial aspects among dentist and among male and female dentists, among age groups (years) of dentists, between right handed and left handed dentists, between four categories of body mass index among dentists, dentists working in private practice, in academics and in both Private practice and academics, under‐ graduate and post‐ graduate level dentists between three categories of clinically experienced dentists between dentists working with assistant and without assistant and to find the p...

BACKGROUND: Lateral epicondylitis is one of the common diseases of the elbow joint. Lateral epicondylitis primarily affects the muscles and soft tissues around the elbow joint. Research has found that the extensor muscles, particularly the extensor carpi radialis brevis (ECRB), are involved in vigorous and repetitive movements of the wrist. Various treatments have been identified, from conservative treatment to surgical treatment, cryotherapy to ergonomic advice, but the results are still inconclusive. OBJECTIVE: The aim of the study is to compare the effectiveness of cyriax mill’s manipulation and deep transverse friction versus the myofascial release technique on pain, grip strength, and functional disability in subjects with lateral epicondylitis. METHOD: 30 patients with lateral epicondylitis between the age of 30 to 45 years were included in the study according to the inclusion criteria, individuals are divided into 2 groups. Group A which was Cyriax physiotherapy and conventio...

Background: Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Patients with Adhesive capsulitis have difficulties in everyday activities (dressing, grooming, and performing overhead reaching activities and so on for a period of several months to several years) and shoulder pain disturbing sleep at night on the affected side. Muscle energy technique helps in increasing shoulder range of motion. MET is unique in its application as the client provides the initial effort while the practitioner facilitates the process. One of the main uses of this method is to normalize joint range, rather than increase flexibility, and techniques can be used on any joints with restricted Range of Motion (ROM) identified during the passive assessment. So the study was done to evaluate the effect of MET on adhesive capsulitis. Aim: This study was desi...

Introduction: Adhesive capsulitis is characterized by a painful, gradual loss of both active and passive glenohumeral motion resulting from progressive fibrosis and ultimate contracture of the glenohumeral joint capsule. Patients with Adhesive capsulitis have difficulties in everyday activities and shoulder pain disturbing sleep at night on the affected side. Aim: This study is designed to evaluate the effect of Muscle Energy Technique on Range of Motion in Adhesive Capsulitis of Shoulder joint. Materials and Methods: An Interventional study was conducted at Out Patient Department of General hospitals in Ahmedabad. The Pre-training outcome of Range Of Motion of External Rotation and Abduction of Shoulder Joint was taken. GROUP A: was given conventional treatment along with Muscle Energy Technique for adhesive capsulitis. Group B: not getting any additional training for adhesive capsulitis other than conventional treatment. The study was conducted for 6 months and treatment was given...

Background: Forward head posture (FHP) described as excessive anterior positioning of the head in relation to a vertical reference line, involving increased cervical spine lordosis (upper cervical spine extended, lower cervical spine flexed) and rounded shoulders with thoracic kyphosis in later stages. Prevalence of forward head posture is high amongst children and adolescents due to excessive use of mobile phones and laptops. But very less studies have been done in India amongst physiotherapy students though their work routine is in prolonged standing position with neck flexed. So, aim of the study is to study the prevalence of FHP amongst population and further progression of this postural abnormality can be prevented. Materials and methodology: 60 participants were recruited according to inclusion and exclusion criteria. Craniovertebral angle were evaluated through photogrammetry method, through Surgimap. Results: In this study 60 students were evaluated, consisting of 40 females...

Family carers play an important role in providing care for frail older Australians. Carers have increased rates of depression, burden and poor physical health compared with non-carers. Physical activity has been shown to improve outcomes; however there is limited research investigating outcomes in older carers and less on physical activity for both the carer and care recipient. Research question: Does a home-based individualised physical activity intervention designed for both the carer and care recipient improve depression severity in older carers? Participants and setting: 273 community-dwelling carers with depressive symptoms and their care recipients will be recruited for a randomised controlled trial. Baseline assessment will consist of functional, psychological, and physical measures and information about service use. Intervention and control: Participants will be randomised to receive either a physical activity program (intervention), a social support program (social control), or usual care (control). The intervention and social control groups will have five home visits over six months. Measurements: All participants will be re-assessed after completion of the program and then six months later to evaluate sustainability of outcomes. The primary outcome measure is the 15-item Geriatric Depression Scale for carers. Secondary outcomes include physical measures for carers and care recipients, carer burden, carer satisfaction, care recipient depression, and cost-effectiveness. All assessors will be blind to group allocation. Discussion: This study has the potential to demonstrate that physical activity interventions can be delivered simultaneously to older carers and care recipients to improve mental and physical outcomes.

La incontinencia urinaria es un problema de salud de alta prevalencia que puede alterar significativamente la calidad de vida. A pesar de ello, los pacientes con incontinencia de orina suelen aceptar sus sintomas durante anos antes de consultar con su medico. Un porcentaje desproporcionadamente alto de aquellos que consultan es remitido al especialista. Aunque la fisiopatologia de la incontinencia urinaria sea compleja, al poseer conocimientos basicos sobre la anatomia y fisiologia del tracto urinario inferior, esta puede ser eficazmente tratada en el marco de la asistencia primaria. En esta revision se describen los recientes hallazgos sobre la neurofisiologia del tracto urinario inferior (TUI), con especial atencion en el papel del sistema nervioso central y del sistema nervioso periferico autonomo y somatico durante el llenado y vaciamiento vesical

Definition of the term diabetes mellitus covers a group of metabolic diseases characterized by elevated blood glucose levels. According to the latest 2016 data from the WHO, 422 million adults are living with diabetes mellitus. Diabetes prevalence is increasing rapidly, because physical inactivity and overweight are risk factors who are increasing too. Complications from diabetes mellitus can be treated with physical modalities. The aim of our research was to assess the knowledge of physiotherapists for treatment of complications from diabetes mellitus with physical medicine. Material and method: We have designed special questionnaire with 30 questions to assess, knowledge for treatment of diabetic food, diabetic ulcer, amputation, and diabetic neuropathy. The data was collected electronically by email. The knowledge was assessed with score: 0-25% poor, 26-50% fair, 51-75%good, 76-100 % excellent. Results: Physiotherapist have had an average score of 40% of the total knowledge, the lowest was about effect of light therapy on diabetic ulcers and treatment of diabetic neuropathy. Discussion: Treatment of diabetes with insulin, is standard in medicine. Physical medicine has important role in prevention of diabetes, with promotion of physical activity. Complications of diabetes decrease quality of life, with many complications affecting circulation, nerves and bones. Researchers are looking for new ways of non-pharmacological treatment of complications. Conclusion: Our medical staff have had, fair knowledge about effect of physical modalities in treatment of complications from diabetes mellitus. Future lectures must contain more attention about this health problem.

Unilateral peripheral facial nerve palsy may have a detectable cause (secondary facial nerve palsy) or may be idiopathic (primary) without an obvious cause (Bell’s palsy). Peripheral facial nerve palsy is diagnosed upon the clinical presentation with weakness of all facial nerve branches, drooping of the brow, incomplete lid closure, drooping of the corner of the mouth, impaired closure of the mouth, dry eye, hyperacusis, impaired taste, or pain around the ear. The aim of our research was to assess the effect of physical therapy treatment and sequelae after palsy. We have made retrospective analyze of 10 patients for sequels, after 1-3 years of palsy and physical therapy treatment with House Brackmann facial nerve grading system. Results: the scale is showing III grade of deficit after palsy. Therapy, particularly of Bell’s palsy, is controversial due to the lack of large, prospective, randomized, and controlled trials. In our medical system patients are treated with physical therap...

Background: Stroke is one of the most important causes of the disability in adults. The chronic motor sequels decrease the functionality capacity of the patients worsening the quality of life. Virtual reality has been proposed as a novel therapeutic tool for motor rehabilitation. Among the virtual reality devices with potential for use in rehabilitation, the Nintendo Wii Fit TM (NWF) stands out as a portable, easyto-use, low-cost alternative that offers good reliability. For this reason, it has been the most used device for rehabilitation. However, few studies have investigated the learning and retention ability of the patients with chronic sequels of stroke in different NWF games. Purpose: To compare the learning and retention of performance improvements after NWF games training in patients with chronic sequels of stroke (CSS) and healthy paired adults. Methods: The experimental group comprised 14 individuals with CSS, 8 male, mean age of 51.71 years (S.D. = 10.43), mean time of Stroke 4.47 years (S.D. = 4.06), 9 left paretic side, whereas control group (CG) comprised 12 healthy paired adults. A total of 10 games were selected on the NWF that elicited slow and fast movements from the center of gravity, associated or otherwise with upper limb movement, and step alternation under different conditions. Games were performed on a platform and guided by visual stimuli projected onto a screen placed from the patient. The training was split into 14 sessions with two sessions given per week. Addionally, there was 1 more session to test the retention, performed 60 days after the end of training. Each session entailed 2 tries at 5 of the 10 games. Results: One 2X8 RM-ANOVA using as factor Groups (CSSG;CG), and training session (s1,s2,s3,s4,s5,s6,s7,RET) as repeated measures for games punctuations showed a significant interaction between the factors for four games (p = .01, ES = .88; p = .0004, ES = .98; p = .02, ES = .83; p = .01, ES = .88). Tukey pos-hoc test (TT) for all of these games showed a significant increase in the punctuation for CG only. There was a significant interaction between the factors for one more games too (p = .0004, ES = .98), but for this game the TT showed a significant increase in punctuations after S6 for CSSG (p = .006, ES = .90), and after S3 for CG (p = .002, ES = .90). For other two games there was a significant effect of group and training session. TT showed there was a significant increase in punctuations regardless of the group, despite the CSG having shown a significant inferior performance in these games. Finally, there was only training session effects for the last one game, i.e. the CSSG showed the same level of performance and learning. Patients with chronic sequels of Stroke were able to improve their performance in the most part of the NWF games and, the most important, to retain the improvements after the training, despite there having showed the inferior performance in comparison with health paired adults. However, the same could not be observed for the other four games. Implications: The NWF games can be a useful tool for rehabilitation of Patients with chronic sequels of Stroke. However, the careful selection of the games is essential to obtain positive results.

Background: According to WHO, Physical Activity (PA) is defined as "Any bodily movements produced by skeletal muscles that requires energy expenditure". Reducing sedentary behavior and promoting regular participation in physical activity among children is the main goal to prevent various health conditions. Health benefits of regular physical exercises are widely acknowledged, yet physical education classes in schools are considered as extracurricular activity. Physical activity is beneficial for overall physical, social and academic performance of children. Aim: To evaluate the relationship between structured physical activity and academic performance among 10-15 year old school children. Methodology: 100 school going children of 6 th , 7 th and 9 th grades (mean age=13.5 years) were randomized and administered a structured physical activity program consisting of 5 minutes of warm-up and cool down and 20 minutes of exercise. The program was given on 3 non-consecutive days for 2 weeks consecutively. For evaluating academic achievement (AA), Wechsler Intelligence Scale for Children (WISC) test; 4 th edition Indian adaptation was administered in addition to the academic grades of the last conducted exam. Results: Results showed larger statistical difference in Picture Completion component of WISC, compared to Picture arrangement, Block design, Object assembly, Coding and Mazes components. Some children also showed improvement in the grades in the subsequent exam/test conducted at school. A structured physical activity program (PA) for school going children may be beneficial in improving the academic performance.

We recently indicated that patient age on its own is not a determinant of quality of allied health care received after an acute stroke. It has not been tested whether other non-age variables influence care decisions made by allied health professionals. This paper explores demographic and stroke-related variables that are putatively associated with the quality of care provided to acute stroke patients by allied health professionals. Methods: Data were retrospectively audited from 300 acute stroke patient records regarding allied health care. Compliance with each of 20 indicators of allied health care quality was established. The influence of various demographic and stroke-related variables on each performance indicator was examined. We undertook a series of analyses using univariate logistic regression models to establish the influence of these variables on care quality. Results: Patient age had a significant correlation with only one process indicator (early mobilization). Seven variables, including stroke severity and level of dependence, were associated with patient age. The majority of these age proxies had significant associations with process indicator compliance. Correlations between non-age variables, in particular stroke severity and comorbidity, suggest the potential for complex confounding relationships between non-age variables and quality of allied health care. Compliance with individual indicators of allied health care was significantly associated with variables other than patient age, and included stroke severity, previous independence, comorbidities, day of admission, stroke unit admission, and length of stay. The inter-relationships between these non-age variables suggest that their influence on quality of care is complex.

This systematic review updates one conducted in 2008 into extended scope practice (ESP) in physiotherapy in orthopedics. Methods: A comprehensive open-ended search was conducted using electronic library databases and Google Scholar to identify any primary study design reporting on physiotherapists working in ESP roles within orthopedic settings. Studies were allocated to the National Health and Medical Research Council hierarchy of evidence, although only studies in levels I, II, or III_1 were critically appraised using a purpose-built critical appraisal tool. Information was extracted on the country of origin, ESP tasks, relevant training, patient types, health, process, and cost measures. Results: 1071 studies were identified, and twelve were included in the review (including diagnostic and evaluative research). The hierarchy of evidence ranged from II to IV, from which only two diagnostic studies met the criteria for critical appraisal. ESP tasks included injection therapy, removing k-wires, and requesting investigations. The education of ESP physiotherapists varied widely, and included formal and informal training. The positive outcomes of ESP initiatives were reported, in diagnostic ability, reduced costs and waiting times, and improved health outcomes. Conclusion: Despite the positive results, the generally low level of evidence and the range of outcome measures reported, constrained clear conclusions regarding the health, process, and cost implications of ESP physiotherapy roles in orthopedic settings. The need for formalized, widely recognized training was highlighted, to give ESP physiotherapy roles credibility.

A labdarúgás a XXI. század egyik legnagyobb fizikai követelményeit támasztó sportági mozgásformája. A nemzetközi szinten versenyző játékosoknak klub-, illetve válogatott szinten egyaránt folyamatosan teljesíteni kell. A versenynaptárból adódóan akár heti két alkalommal is 90 percet kell játszani úgy, hogy közben az átlagos futótávolság több mint 10km. A tanulmány célja, hogy összefoglalja és elemezze azokat a labdarúgó-specifikus nemzetközi kutatásokat, amelyek statisztikai adatokkal alátámasztottan dolgozzák fel a mérkőzéseken teljesített futómennyiséget, illetve annak összetettségét.

Objective. To present Barthel index and FIM in evaluation of the rehabilitation of patients with history of stroke, compare their advantages and disadvantages and explain the importance of properly completed physiotherapy evaluation. Methods and patients. In the introduction I explained someknown facts about stroke, classification of stroke, characterizing symptoms, risk factors important to stroke appearance and rehabilitation after stroke. In the second part, we have informations about Barthel and FIM, two indices that evaluate the level of disability or residual functional capacity of patients with neurological damage. With these two valid indices, shown on the example of patient, we have presented the importance of properly physiotherapy evaluation and inclusion of patients in the rehabilitation process. Results. Barthel index measures only motor function, and FIM measures motor and cognitive functions. Each of them is carefully designed and specific to a particular disease. FIM...

We are currently facing a society of adolescents who are increasingly dependent on technology, in particular the smartphone, and this phenomenon can even lead to limiting situations in which the person's physical wellbeing is called into question. Intensive use of the smartphone may contribute to a decrease in physical activity and generate musculoskeletal symptoms (MMS). To verify the existence of a relationship between the use of the smartphone and: (1) MMS; (2) vigorous, moderate and sedentary physical activity. Methods: An observational, analytical, cross-sectional study was conducted on a sample of 834 adolescents from five schools in the Viseu, Vila Real and Porto regions. Data collection was performed through online questionnaires through the Qualtrics program to make the sociodemographic characterization of the sample and determination of behavioral habits related to health, as well as the use of new technologies. Musculoskeletal symptoms were evaluated through the Portuguese version of the Nordic musculoskeletal questionnaire. (NMQ) and physical activity through the International Questionnaire of Physical Activity (IPAQ). The adolescents who used the smartphone for the most time referred MMS in the cervical (P < 0.001), tho-racic (P = 0.017), lumbar (P < 0.001), shoulders (P < 0.001), wrists/hands (P = 0.003) and knees (P = 0.013). Adolescents who practice more vigorous physical activity (P = 0.023) use less smartphone, and those who have more time in sedentary physical activity (P = 0.008) use it more. Adolescents who spend more time on smartphones refer more MMS. The use of the smartphone is associated with a more sedentary lifestyle, unlike the adolescents who practice vigorous physical activity that give less use to him. The high time of use of smartphones suggests the importance of health promotion campaigns in this population.

Introdução: a dor lombar e dor pélvica são muitas vezes apresentadas como pequenas contrariedades da gravidez, interferindo na qualidade de vida das mulheres grávidas. Objetivo: avaliar a eficácia de diferentes técnicas de fisioterapia no tratamento da dor lombo-pélvica nas mulheres gestantes. Metodologia: a pesquisa computorizada foi realizada nas bases de dados PubMed, PEDro, B-on e na consulta de outras fontes bibliográficas. A qualidade metodológica dos estudos foi analisada segundo a escala Critical Appraisal Skills Programme (CASP). Resultados: foram incluídos 7 estudos, com um total de 1318 participantes. Após a implementação de diferentes técnicas terapêuticas verificou-se uma redução da dor lombar e pélvica nas mulheres gestantes, uma redução das perdas das capacidades físicas e de energia, uma facilitação das atividades, e uma melhoria da vitalidade e do estado emocional. Conclusão: diferentes técnicas de fisioterapia têm um papel importante na redução da dor lombo-pelvica nas mulheres em diferentes estádios gestacionais.

Background: Providing a self-care program appropriate for patient needs in a supportive educative nursing system format could reduce migraine-induced disability. This study was designed to determine the effectiveness of Orem's self-care program on headache related disability in migraine patients. Methods: In this randomized clinical trial, episodic migraine patients with or without aura who signed the informed consent were randomly assigned to two groups (44 patients each). The data collection tools included a demographic questionnaire, the Migraine Disability Assessment (MIDAS) questionnaire, an Orem cognition form, and a self-care checklist. The programs were held as four 30 to 45 minutes training sessions for experimental group. The MIDAS were filled out before and three months after program in two groups. Data were analyzed with SPSS statistical software, version 16 and using chi-square, Mann-Whitney and Wilcoxon tests. Results: There was no statistically significant difference between the two groups in terms of demographic variables (P > 0.05). The mean total MIDAS score in the experimental group, before and after the intervention was 28.1 ± 17.5 and 6.03 ± 4.52, respectively (P = 0.001); and for the control group, it was 37.6 ± 16.4 and 55.6 ± 14.5, respectively (P < 0.001). Also, there was a statistically significant difference in disability indices between the two groups after the intervention (P < 0.001). Conclusion: Self-care program was suitable for needs assessment and provided basis for acquiring positive results in order to decrease disability and saved patient treatment costs.

Background: Providing a self-care program appropriate for patient needs in a supportive educative nursing system format could reduce migraine-induced disability. This study was designed to determine the effectiveness of Orem&#39;s self-care program on headache related disability in migraine patients.

Interprofessional education (IPE) is increasingly recognized as a critical component in preparing healthcare students for collaborative practice. This randomized controlled trial (RCT) aimed to evaluate the impact of an IPE intervention on student collaboration within clinical settings. A total of 120 students from medicine, nursing, pharmacy, and physiotherapy disciplines were randomly assigned to either an intervention group, which participated in a structured IPE program, or a control group, which received standard uniprofessional education. The intervention comprised joint workshops, simulation exercises, and collaborative clinical rotations over 12 weeks. Outcomes were measured using the Readiness for Interprofessional Learning Scale (RIPLS) and the Interprofessional Collaborative Competency Attainment Survey (ICCAS) at baseline and post-intervention. Statistical analysis revealed significant improvements in the intervention group compared to the control group in both RIPLS and ICCAS scores (p < 0.001), indicating enhanced readiness and competency for interprofessional collaboration. These findings suggest that structured IPE interventions can effectively foster collaborative skills among healthcare students, potentially leading to improved patient care outcomes.

Background: Physiotherapists generally accept that electrophysical agents (EPAs) should not be applied directly over, or in the vicinity of cancerous tumours or other malignancies. The idea that EPAs are contraindicated is based upon the theoretical, but rarely proven risk of stimulating malignant cell proliferation and thus tumour growth and/or dissemination. However, a growing body of literature suggests that some electromagnetic and physical energies may be beneficial for use in the treatment of cancerrelated or cancer treatment-related sequelae, and tumours. Objectives: The aim of this narrative review was to collate information on the state of knowledge regarding the application of EPAs in some typical clinical presentations in physiotherapy cancer care; understand whether there is evidence for using EPAs in physiotherapy cancer care; and, how planning might progress to further the evidence in this field. Major findings: Few EPAs have been specifically tested for the capacity to increase tumour growth or dissemination. Evidence exists for the use of some EPAs for symptom control and palliative management of cancer-related or cancer treatment-related symptoms and side effects. Conclusions: Physiotherapists should reconsider the potential use of EPAs in cancer care. Further research will elucidate how best to utilize EPAs in this field of practice. Using some EPAs for tumour treatment could be considered.

Background: In a time of increasing use of eHealth technologies, it is appropriate to consider how these might be used in physiotherapy for improving health outcomes for survivors of cancer. Objectives: The aim of this paper was to understand what technologies are in use in health care and how technologies are being used in cancer care and rehabilitation. Further, to consider the benefits and potential disadvantages of technologies in the field of oncology. Major findings: Two eHealth strategies used for education and intervention were considered: web-based and convergence technologies (the union of web-based and mobile technologies). To date, the use of webbased eHealth technologies for educating survivors of cancer is more advanced than the use of convergence methodologies which may be more suited to health care interventions. The benefits for geographically isolated populations and for information dissemination are evident. A number of challenges remain, in particular the rapid development of interactive technologies, and the reliability of, and secure access to information for intervention trials. Conclusions: The use of eHealth technologies should be incorporated in cancer rehabilitation; however, it is as yet too early to substitute such technologies for traditional methods.

Urinary incontinence (UI) is perceived as a problem that affects older and multiparous women. However, recent studies report that involuntary loss of urine also affects athletes, young and nulliparous. There is controversy over the role of exercise in UI. Thus the purpose of the review is to describe and evaluate scientific evidence concerning the prevalence of UI in female volleyball athletes.The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). The selected databases were PubMed, LILACS, PEDro, Medline, Cochrane, and ScienceDirect. The searches were performed between December 2016 and January 2017. The descriptors and Boolean operators used in the search were as follows: ‘urinary incontinence AND athletes AND volleyball.’ After peer evaluation, 47 studies were identified, and 6 articles were selected for review. The methodological evaluation was based on Strengthening the Reporting of Observational Studies in E...

Muscular Dystrophies merupakan grup penyakit degeneratif progresif yang herediter mengenai otot.Prevalensi muscular dystrophies di dunia pada tahun 2014 adalah 19,8-25,1 dari 100.000 orang.Duchenne muscular dystrophy (DMD) merupakan kelainan bawaan terkait gen X resesif mengenai otot yang hanya diderita oleh laki-laki.DMD merupakan jenis yang terbanyak dan terburuk dari muscular dystrophy dimana terdapat kegagalan pembentukan dystrophin. Seorang pria, Tn. R berusia 25 tahun dengan keluhan utama kelemahan pada seluruh anggota gerak yang semakin memberatsejak 5 tahun yang lalu, kesulitan berjalan dan menaiki anak tangga, kesulitan berdiri dari posisi duduk (Tanda Gower). Pemeriksaan fisik ditemukan raut wajah retrognatik dancalf hypertrophy sedangkan pemeriksaan fungsi vital dalam batas normal.Status neurologis didapatkan penurunan reflek fisiologis sedangkan reflek patologis tidak ditemukan.Pemeriksaan manual muscle testdidapatkan menurunnya kontraksi otot biseps dan triceps. Kekuatan otot ekstremitas superior 4433|3344 dan ekstremitas inferior 4433|3344 dengan fungsi sensoris normal.Terdapat peningkatan enzim creatine kinase diatas normal(35-174 U/L), EMG didapatkan gambaran polifasik dan MUAPs yang kecil, MRI servikal dalam batas normal.Tatalaksana melibatkan fisitoterapi dan kortikosteroid yang dapat menunda perburukan namun tidak menyembuhkan penyakitnya. Kata Kunci: duchenne muscular dystrophy (DMD), herediter,muscular dysthrophies

The knee joint is prone to injury due to its complexity and weight-bearing function. Anterior cruciate ligament (ACL) rupture is a common knee injury with severe complications in the young and physically active population. This study aimed to perform a comparative evaluation of the Lachman, Anterior Drawer, Pivot-shift, and Lever tests in terms of sensitivity and specificity. According to existing research, the Lachman test appears to have the highest overall diagnostic accuracy, and the pivot-shift test has the highest specificity but low sensitivity results. The anterior drawer test has average results in both specificity and sensitivity. However, the Lever test can be successfully used by inexperienced individuals and patients immediately after injury (in the acute state).

The responsibilities of caring for the newborn are affected by factors before, during and immediately after caesarean section. Enhanced recovery after caesarean section (ERAC) enables faster return to preoperative functions and thus, has beneficial effects on the mother and her infant. Authors conducted a systematic review of the literature in January 2025 that involved searching 4 databases for peer-reviewed articles on ERAC protocol and traditional techniques between 2015 and 2024. The year of publication, first author's country, study design, sample size, gestational age, indications for surgery, type of caesarean section and other key findings were extracted from the articles that met the inclusion criteria. The full articles, abstracts, guidelines and conference papers retrieved were 467 with 450 removed for duplications, only abstracts, being guidelines, not meeting our targets and publications outside the stated years. Only 17 articles were included in the review. The primary authors of the included articles originated from 8 countries spanning four (4) continents and 41.2% came from Asia, 23.5% from Africa, and 17.6% each from North America and Europe. Majority (35.3%) of the articles were randomized controlled trials and 29.4% were cohort studies. Interestingly, 88.2% of the articles were published in the last 5 years. Only one study (5.9%) discussed the parental sense of security following discharge from hospital. The socio-demographic variables, past obstetrics, types of caesarean section, gestational age at delivery and type of anaesthesia were factors affecting the success of enhanced recovery after caesarean section and its outcomes.

La fibromialgia provoca un gasto de 10.000 euros por paciente al año 417 Formacion continuada 419 Boletín de la Sociedad Española del Dolor Noticias, Congresos y Cursos 420 Actividad acreditada en base a la encomienda de gestión concedida por los Ministerios de Sanidad y Política Social y Ministerio de Educación al Consejo General de Colegios Oficiales de Médicos con 2,9 CRÉDITOS equivalentes a 12 horas lectivas. www.formacion.elsevier.es/resed * Autor para correspondencia.

This paper examines how transhumanism, which advocates for the enhancement of human capacities through advanced technologies, alters and deepens our understanding of cultural identity, belonging, and maternal embodiment in Megan Hunter's The End We Start From. By reading the text by central terms of Rosi Braidotti, such as the "Nomadic Subject," and Stacie Alaimo, such as the "Transcorporeality" the study reveals that milk, amniotic memory, itself, rising waters establish a network of hydrological force that reconstructs agency: the protagonist is a giver that takes care, climate-refugee as well as an ecological (body) sensor. The broken syntax that painter Hunter employs helps to dissolve the distinction between the body and the world, indicating a maternal ethics of permeability rather than dominance. In the analysis, there are three major interventions: Postpartum Entanglement, where mothers' bodies are entwined with rivers, tidal disasters, and structural remains. Ecological Kinship in kinships involves mother, child, water, debris, and ruins. Nomadic Resilience, where Maternal Futurity is questioned, as an adaptive, non-linear survival, challenging the anthropocentric notion of refuge. By situating Hunter's story within the contexts of climate justice and reproductive labor discourses, this paper will demonstrate that The End We Start From develops a hydrofeminist politics relevant to the intersection of maternal affections and environmental health. The interdisciplinary nature of this inquiry provides significant contributions to environmental humanities and adaptation by showing how literary and filmic forms can express maternal climate ethics in its contribution to the development of ecofeminist posthumanism as a perspective through which human nonhuman inter-dependency can be found during the Anthropocene.

The purpose of the study is to find out whether or not any significant difference found on physical fitness and physiological variables of Athletes in relation to their circuit training. The study was formulated based on the simple random sampling. The samples were collected from the 50 Athletes of APTWR Sports School Boys , ArakuVally, Visakhapatnam district, in the age group of 12-16 years which were considered for the study. Fifty Athletes players have been selected for the study and they have undergone circuit training for 45 days. The pre-test was taken, and then, the post-test was administrated after the systematic training of circuit training. The following test was administrated on Athletes which are physical fitness variables that are speed and agility. Physiological variables pulse rate and breathing holding time. Moreover, it is finally concluded that circuit training have yielded significant differences on the physical fitness and physiological variables of high school Athletes it have scientifically proved better that the Athletes have major role to prove their physical fitness in the performance of the game the physical fitness variables, namely, speed, explosive power, agility, and endurance.

Introdução: A doença renal crônica (DRC) corresponde à redução irreversível da função renal, provoca um grande impacto para a pessoa acometida e suas funcionalidades básicas ficam prejudicadas, resultando em mudanças importantes no seu estilo de vida1. Objetivo: Avaliar o grau de incapacidade e saúde de pacientes com doença renal crônica submetidos à hemodiálise. Metodologia: Trata-se de um estudo de campo, do tipo transversal, com amostra de conveniência, para a avaliação sociodemográfica, clínico funcionais e de desempenho funcional dos pacientes DRC correlacionados ao questionário Word Health Organization Disability Assessment Schedule – WHODAS versão 2.0. Resultados: Os participantes do estudo (n= 59), com predominância de homens (67,79%), e média de idade de 51,75± 00 anos, apresentaram comorbidades associadas à DRC, tendo destaque para hipertensão arterial sistêmica (67,79%) e diabetes mellitus (33,89%). A mobilidade dos pacientes mensuradas pelo Time Up and Go – TUG teste pos...

Background: Excess weight puts a strain on every part of your body. Foot problems in obese adults are most important. The position and function of the foot and ankle affect the stresses transmitted to the knee. Purpose: To measure and to find correlation between leg-heel alignment, tibial torsion and Q angle in normal, overweight and obese individuals. Materials and Methods: 60 normal, overweight and obese subjects were include with mean age 30.6±5.98, 30.9±5.98 and 29.6±4.87 respectively, with each group 20 subjects. Normal subjects with BMI prime between 0.74 to 1.0 were group A, overweight subjects with BMI prime 1.0 to 1.2 were group B and obese subjects with BMI >1.2 were group C. Of each subject leg-heel alignment, tibial torsion and Q angle will be measured using measuring tape, plumb line and goniometer and correlation is studied. Results: Q angle, tibial torsion and leg-heel alignment were statistically analysed amongst normal, overweight and obese using ANOVA and comparison between 2 groups with ANCOVA. Mean Q angle, tibial torsion and leg heel alignment in normal right leg were 17.9, 13.35, 4.7 and for left leg were 18, 14.25, 4.55 respectively. Similarly, in overweight right leg the values were 19.5, 16.5, 5.8 and in left leg were 20, 16.18, 5.35 respectively. Whereas, in obese right leg values were 21.2, 15.5, 6.35 and in left were 22.6,15.5, 6.6 respectively. There was significant difference in Q angle between normal and obese in right (p=0.022); left (p=0.001), In right, tibial torsion between normal and overweight (p=0.001); normal and obese (p=0.031) and in leg-heel alignment significant difference is seen between normal and obese in right (p=0.032). With increase in weight there are changes seen in Q angle, tibial torsion and leg heel alignment.

Background: Excess weight puts a strain on every part of your body. Foot problems in obese adults are most important. The position and function of the foot and ankle affect the stresses transmitted to the knee. Purpose: To measure and to find correlation between leg-heel alignment, tibial torsion and Q angle in normal, overweight and obese individuals. Materials and Methods: 60 normal, overweight and obese subjects were include with mean age 30.6±5.98, 30.9±5.98 and 29.6±4.87 respectively, with each group 20 subjects. Normal subjects with BMI prime between 0.74 to 1.0 were group A, overweight subjects with BMI prime 1.0 to 1.2 were group B and obese subjects with BMI >1.2 were group C. Of each subject leg-heel alignment, tibial torsion and Q angle will be measured using measuring tape, plumb line and goniometer and correlation is studied. Results: Q angle, tibial torsion and leg-heel alignment were statistically analysed amongst normal, overweight and obese using ANOVA and comparison between 2 groups with ANCOVA. Mean Q angle, tibial torsion and leg heel alignment in normal right leg were 17.9, 13.35, 4.7 and for left leg were 18, 14.25, 4.55 respectively. Similarly, in overweight right leg the values were 19.5, 16.5, 5.8 and in left leg were 20, 16.18, 5.35 respectively. Whereas, in obese right leg values were 21.2, 15.5, 6.35 and in left were 22.6,15.5, 6.6 respectively. There was significant difference in Q angle between normal and obese in right (p=0.022); left (p=0.001), In right, tibial torsion between normal and overweight (p=0.001); normal and obese (p=0.031) and in leg-heel alignment significant difference is seen between normal and obese in right (p=0.032). With increase in weight there are changes seen in Q angle, tibial torsion and leg heel alignment.

This study investigates the water quality and fish variety of Bhopal's Upper and Shahpura Lakes, two vital urban freshwater bodies that sustain local livelihoods and biodiversity. Using conventional netting methods, thirteen fish species were identified, including invasive Oreochromis mossambicus and native species like Labeo rohita and Cyprinus carpio. Important physico-chemical characteristics, such as pH, dissolved oxygen (DO), biological oxygen demand (BOD), hardness, alkalinity, and transparency, were measured in water samples taken from various locations. Even though the majority of the values fell below the CPCB/BIS-permissible limits, some regions displayed ecological stress, particularly Upper Lake Site II's raised pH and Shahpura Lake Site II's decreased clarity and pronounced organic odour. To preserve the biological integrity and biodiversity of these lakes, these findings emphasise the critical need for conservation initiatives, pollution control measures, and ongoing environmental monitoring.