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Physiotherapy [JOURNAL]

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The use of creative case studies to explore non-verbal and non-ambulant children and young people's well-being.

Pickering DM, Gill P, Reagon C

Physiotherapy · 2024 Jun · PMID 38244485 · Publisher ↗

BACKGROUND AND PURPOSE: The aim of this paper is to describe and critically analyse creative research methods, exploring how these can offer ways to enable non-verbal and non-ambulant children and young people with cereb... BACKGROUND AND PURPOSE: The aim of this paper is to describe and critically analyse creative research methods, exploring how these can offer ways to enable non-verbal and non-ambulant children and young people with cerebral palsy, to express their views about their well-being. The context of this research explored their choices for recreational activities, seeking to understand how their level of participation impacted upon their well-being. METHODS: A qualitative comparative case study design was chosen comprising of two interviews, using photographs and diaries to elicit discussion, supported by observations. These observations provided evidence of well-being indicators that were interpreted by the researcher, alongside their parents. Seven participants volunteered, aged nine to sixteen years. Data were analysed utilising Braun and Clark's six stages. Firstly, each case's data sources were coded, themes identified, then across cases comparisons, arriving at three final themes. Triangulation of data sources which made up each case, enhanced the trustworthiness in this study. RESULTS: Observations were key to providing insight into their well-being. Interpretation of this rich data, supported by their parents, revealed that the participants could self-advocate, as shown by their intentional behaviours, to choose their level of participation. DISCUSSION: The researcher's ability to be creative in the data collection methods is original in physiotherapy. It was important to work in partnership with parents, to ensure the correct interpretation of their intentional behaviours from the observations. The diaries and photographs added a unique contribution to knowledge, which enabled the non-verbal participants inclusion, empowering them to express their well-being. STUDY REGISTRATION: This study is registered with the International Study + Clinical Trials Network Register (ISRCTN) Number:42717948. CONTRIBUTION OF PAPER.

The National Suspected Cauda Equina Syndrome Pathway: implications for physiotherapists.

Williams JT, Lister H, Fakouri B … +1 more , Panchmatia JR

Physiotherapy · 2024 Mar · PMID 38244418 · Publisher ↗

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Development of a clinical practice guideline for physiotherapy management of adults invasively ventilated with community-acquired pneumonia.

van der Lee L, Patman S, Hill AM

Physiotherapy · 2024 Mar · PMID 38244417 · Publisher ↗

BACKGROUND AND SETTING: Patients hospitalised with community-acquired pneumonia (CAP) are frequently admitted to an intensive care unit (ICU) for invasive mechanical ventilation and receive treatment by physiotherapists.... BACKGROUND AND SETTING: Patients hospitalised with community-acquired pneumonia (CAP) are frequently admitted to an intensive care unit (ICU) for invasive mechanical ventilation and receive treatment by physiotherapists. However, clinical physiotherapy practice is variable for this ICU cohort. OBJECTIVES: To develop a clinical practice guideline for physiotherapy management of adults invasively ventilated with CAP using the best available evidence. METHODS: Guideline development using evidence synthesis according to the GRADE and JBI approaches, incorporating findings from four preceding phases of a mixed-methods research program: systematic review and meta-analysis, national survey of Australian ICU physiotherapy practice, e-Delphi study to determine expert consensus, and multidisciplinary peer-review of the expert consensus statements by senior ICU clinicians to determine validity and applicability of the statements for translation into practice. RESULTS: The guideline comprises 26 recommendations, encompassing physiotherapy assessment, patient selection and prioritisation, and treatment. Physiotherapy treatment covers domains of humidification, patient positioning, hyperinflation techniques, manual chest wall techniques, normal saline instillation, active treatment, and mobilisation. Recommendations are rated as strong or conditional based on JBI criteria, and certainty of evidence according to GRADE. Considerations for practice are provided within the guideline to enhance clarity and practicality, particularly for conditional recommendations where evidence is limited or conflicting. CONCLUSION: This guideline, based on the best available evidence for clinical physiotherapy practice for adults invasively ventilated with CAP, is intended to support clinicians with clinical decision making. Further research is required to evaluate guideline implementation into clinical practice, and incorporate the values and preferences of ICU patients and their families. CONTRIBUTION OF PAPER.

The provision and impact of rehabilitation provided by physiotherapists in children and young people with congenital heart disease following cardiac surgery: a scoping review.

Clarke SL, Milburn NC, Menzies JC … +1 more , Drury NE

Physiotherapy · 2024 Mar · PMID 38241942 · Publisher ↗

INTRODUCTION: Children with congenital heart disease (CHD) are at risk of delayed motor development with increased risk for those requiring cardiac surgical intervention. We conducted a scoping review to identify the pro... INTRODUCTION: Children with congenital heart disease (CHD) are at risk of delayed motor development with increased risk for those requiring cardiac surgical intervention. We conducted a scoping review to identify the provision and impact of physiotherapy-delivered rehabilitation in children and young people with CHD following cardiac surgery. METHODS: CINAHL, EMBASE, PUBMED, AHMED, EMCARE, Cochrane Database of Systematic Reviews, NHS Evidence databases were searched (2000-2022). Included studies were published in full, in English and reported the use of physiotherapy in CHD (participants 0-18years) post-surgical procedure. Articles were screened by title and abstract and through full-text review with results structured in accordance with the PAGER framework and PRISMA- ScR checklist. RESULTS: Seven full text peer reviewed papers published 2014-2021 were identified from 5747 papers screened. Included papers were predominantly non-randomised cohort studies with a sample size of between one and 247. Study participants ranged from eight days to 16 years, with a variety of congenital heart defects and surgical procedures. The provision of physiotherapy varied with a range of rehabilitation formats and physiotherapeutic interventions utilised. Physiotherapy provision appeared to have a positive impact on functional/ developmental outcomes and muscle strength. DISCUSSION: Assessing the impact and provision of physiotherapy in CHD post-surgical intervention is challenging based on the published literature, due to small sample sizes, lack of control groups, heterogeneous demographics and variable intervention and formats delivered. Further research is required to identify the optimum format of physiotherapy provision and establish the potential impact of physiotherapy delivered rehabilitation on motor function and development. CONTRIBUTION OF THE PAPER.

Normative values and prediction equations for the modified incremental step test in healthy adults aged 18-83 years.

Amaral DP, José A, Correia NS … +2 more , Furlanetto KC, Dal Corso S

Physiotherapy · 2024 Mar · PMID 38241941 · Publisher ↗

OBJECTIVE: To establish normative values and reference equations for predicting the number of steps and oxygen consumption (VO) from the modified incremental step test (MIST) in healthy adults aged 18-83 years. DESIGN: P... OBJECTIVE: To establish normative values and reference equations for predicting the number of steps and oxygen consumption (VO) from the modified incremental step test (MIST) in healthy adults aged 18-83 years. DESIGN: Prospective observational study. PARTICIPANTS: One hundred and ninety-four healthy adults aged 18-83 years with normal spirometry. SETTINGS: Exercise physiology laboratory of a university. METHODS: Participants underwent two MISTs (30 minutes apart). The MIST was performed on a 20-cm-high step using an externally paced rhythm imposed by audible signals, starting with 10 steps per minute and with constant increments of 1 step every 30 seconds. MAIN OUTCOMES: Number of steps and VO obtained from MIST. RESULTS: Normative values were provided for males and females for each age group. The following equations were determined: number of steps = 675.113 + (66.165*sex, 0 female and 1 male) - (5.353*age) - (6.593*body mass index) (R² =0.44, P < 0.001); VO = 0.106 + (0.216*sex, 0 female and 1 male) - (0.008*age [years]) + (0.021*weight [kilograms]) + (0.001*number of steps) (R² =0.80, P < 0.001). CONCLUSION: Normative values and prediction equations are proposed for the number of steps and VO which can be used to interpret performance on the MIST in individuals with different health conditions. These equations now need validation in other samples.

Physiotherapy for people with dementia: a Call to Action for the development of clinical guidelines.

Evans CJ, van den Berg MEL, Lewis LK

Physiotherapy · 2024 Mar · PMID 38241940 · Publisher ↗

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Response to Comments on: "The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis".

Xie YH, Liao MX, Lam FMH … +3 more , Gu YM, Liao LR, Pang MYC

Physiotherapy · 2024 Mar · PMID 38238204 · Publisher ↗

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Maximum tolerable daily dose of mirror movement therapy ankle exercises after stroke: an early phase dose screening study.

Bajuaifer S, Grey MJ, Hancock NJ … +2 more , Chandler E, Pomeroy VM

Physiotherapy · 2024 Mar · PMID 38237263 · Publisher ↗

BACKGROUND: Mirror movement therapy may reduce lower limb motor impairment after stroke. The dose is unknown. OBJECTIVE: identify the maximum tolerable dose a day (MTD) of lower limb mirror movement therapy DESIGN: 3 + 3... BACKGROUND: Mirror movement therapy may reduce lower limb motor impairment after stroke. The dose is unknown. OBJECTIVE: identify the maximum tolerable dose a day (MTD) of lower limb mirror movement therapy DESIGN: 3 + 3 cohort rule-based, dose escalation/de-escalation study. After undertaking baseline measures participants performed mirror movement therapy for 14 consecutive days. Participants then undertook outcome measures. Cohort One trained for 15 minutes daily. Subsequent cohorts exercised at a dose set according to pre-set rules and the modified Fibonacci sequence. The study stopped when the difference between set doses for consecutive cohorts was 10% or less. SETTING: Participants' homes (intervention) and a movement analysis laboratory (measures). PARTICIPANTS: Adults discharged from statutory stroke rehabilitation services. INTERVENTION: Mirror movement therapy ankle exercises. OUTCOME MEASURES: Motricity Index (primary) and bilateral time symmetry from movement onset to peak activation of Tibialis Anterior muscles during standardised sit-to-stand (secondary). RESULTS: Five cohorts of three participants were included (n = 15). Mean (SD) age and time after stroke were 61 (9) years and 35 (42) months respectively. Set daily doses for the five cohorts were: 15, 30, 50, 40 then 35 minutes. The set dose for a subsequent cohort (six) would have been 38 minutes thus the difference from cohort five would have been three minutes i.e., 9% different. Therefore, the study stopped CONCLUSION: The identified MTD of lower limb mirror therapy was 35 minutes daily when frequency was set at seven days a week and duration as two weeks. CLINICAL TRIAL REGISTRATION NUMBER: NCT04339803 (ClinicalTrials.gov) CONTRIBUTION OF THE PAPER: This early phase study found that the maximum tolerable dose per day (MTD) of mirror movement therapy ankle exercises was 35 minutes when frequency was set at seven days a week and duration as two weeks. The optimal therapeutic dose will therefore be somewhere in the range of 15 (starting dose) to 35 minutes per day. Further dose articulation studies are required to identify the optimal therapeutic dose before use of findings in clinical practice. This study is the first step in that research process.

Exercise and physical activity promotion for people newly diagnosed with Parkinson's disease: a UK survey exploring current practice and the views of healthcare professionals.

Agley L, Hartley P, Lafortune L

Physiotherapy · 2024 Mar · PMID 38237262 · Publisher ↗

OBJECTIVES: Exercise and physical activity (PA) are increasingly recognized as important components in the management of Parkinson's disease (PD). Their promotion at diagnosis is essential for better management of sympto... OBJECTIVES: Exercise and physical activity (PA) are increasingly recognized as important components in the management of Parkinson's disease (PD). Their promotion at diagnosis is essential for better management of symptoms and overall well-being. Healthcare professionals (HCPs) are pivotal to the promotion of exercise and PA, but there is limited guidance on the content of such interventions. This study describes current practice, and explores views of HCPs around PA and exercise promotion at diagnosis for people with PD (PwP) DESIGN: A cross-sectional study using an anonymous online survey. PARTICIPANTS: HCPs working with PwP in the UK. RESULTS: Twenty-nine doctors, 17 nurses and 106 physiotherapists completed the survey. All nurses, 99% of physiotherapists and 72% of doctors reported that they always promote exercise and PA during clinic appointments. HCPs identified how PA impacts PD symptoms, evidence on the role of exercise, and signposting to support groups as core topics in PA promotion for PwP. However, these topics are mainly addressed during physiotherapy appointments. Referrals to physiotherapy occur most frequently when PwP experience falls or mobility issues, rather than at diagnosis. HCPs (52% doctors and 41% of nurses) identified lack of confidence as a barrier to prescribing exercise to PwP. CONCLUSION: The importance of promoting PA at diagnosis is widely acknowledged by HCPs. There are variations between disciplines in terms of the tools used, and the timing and duration of interventions. Previously identified barriers to exercise promotion were also found in this study, and should be explored further in order to aid the implementation of effective interventions.

Developing an international competency and capability framework for advanced practice physiotherapy: a scoping review with narrative synthesis.

Tawiah AK, Stokes E, Wieler M … +8 more , Desmeules F, Finucane L, Lewis J, Warren J, Lundon K, Noblet T, Cunningham C, Woodhouse LJ

Physiotherapy · 2024 Mar · PMID 38029504 · Publisher ↗

INTRODUCTION: The need to address increasing numbers of people seeking care, insufficient numbers of physicians, and providing high-value and sustainable care has contributed to changing physiotherapy practice across the... INTRODUCTION: The need to address increasing numbers of people seeking care, insufficient numbers of physicians, and providing high-value and sustainable care has contributed to changing physiotherapy practice across the world, often referred to as advanced practice physiotherapy. Currently, there is no internationally standardized competency and capability framework to support advanced practice physiotherapy. OBJECTIVES: This scoping review has two aims; 1) To identify and map out the competencies of advanced practice physiotherapy available in the literature. 2) To develop a competency and capability framework by mapping the competencies identified from the review. DESIGN: The Arksey and O'Malley framework and the PRISMA Scoping review methodology were used. Databases searched included CINAHL Plus, MEDLINE Ovid, PubMed, and Scopus. The competency and capability framework was developed through a narrative synthesis approach. RESULTS: Nineteen documents were included in the final review, with 13 grey literature (government reports, policy documents, thesis) and six research papers. Included publications came from the United Kingdom, Ireland, Australia, New Zealand, and Canada. The included documents covered predominantly musculoskeletal practice (n = 17). The others focused on cardiorespiratory care, incontinence and pelvic health. Through narrative synthesis, 27 competencies and capabilities were identified and grouped under seven domains. CONCLUSION: The synthesis of this scoping review provides the first competency and capability framework for advanced practice physiotherapy that integrates competencies and capabilities from five different countries. With the expansion of advanced practice physiotherapy, the framework developed from this review is the first step towards international recognition, standardization and consistency of education and training of practitioners. CONTRIBUTION OF THE PAPER.

Consensus on occupational health competencies for UK first contact physiotherapists.

Black C, Shanmugam S, Gray H

Physiotherapy · 2023 Dec · PMID 37852150 · Publisher ↗

BACKGROUND: Patients at risk of preventable sickness absence frequently attend at primary care. First contact physiotherapists (FCP) may provide an optimal way of reducing this risk; however, there is significant variabi... BACKGROUND: Patients at risk of preventable sickness absence frequently attend at primary care. First contact physiotherapists (FCP) may provide an optimal way of reducing this risk; however, there is significant variability in clinical practice, limited research directing best practice and this work and health role is traditionally seen as outside of the 'therapeutic relationship'. If FCP's training and development in this area is considered, FCP's will be able to effectively conduct fitness for work and sickness absence certification within UK primary care settings. AIMS: This study aimed to reach expert consensus for work-related competencies for FCP practice for patients at risk of preventable sickness absence. METHODS: A modified Delphi technique involved a UK-wide FCP expert panel completing three rounds of an online questionnaire. The initial 30-competency questionnaire, based on two separate Nominal Group Techniques in a FCP and Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE) physiotherapist cohort and Health Education England's published Roadmap to Practice, covered occupational health specific items (knowledge and skills) related to the topic. Consensus threshold was set a priori at 70% level of group agreement. Items not reaching consensus were modified and new items added based on themes from qualitative data from the open-ended free text questions present in each section. Items that reached values greater than or equal to 70% of agreement among experts were considered definitive for the competency items. Items between 51% and 69% of agreement were included for the next round and those items with less than or equal to 50% of agreement were considered unnecessary and were excluded. In the third round, the occupational health (OH) specific contents for primary care were classified according to the degree of consensus as follows: strong (≥70% of agreement), moderate (51-69% of agreement) and weak (50% of agreement) based on the maximum consensus reached. RESULTS: Of the 30 initial competencies, 20 (67%) reached a strong degree of consensus and 2 (7%) reached a moderate degree of consensus and 8 (27%) competencies were not recommended (≤50% of agreement). 20 OH specific competencies reached a priori consensus level of agreement to provide the final group list. CONCLUSIONS: This paper provides an empirically derived list of OH competencies for FCP education in primary care 'first point of care' physiotherapy with a high level of expert agreement and high retention rate between rounds. CONTRIBUTION OF THE PAPER.

Insufficient research on interventional pain therapies for managing low back pain during pregnancy.

Gargya A, Haider N

Physiotherapy · 2024 Mar · PMID 37852040 · Publisher ↗

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The effects of physiotherapeutic scoliosis-specific exercise on idiopathic scoliosis in children and adolescents: a systematic review and meta-analysis.

Ma K, Wang C, Huang Y … +3 more , Wang Y, Li D, He G

Physiotherapy · 2023 Dec · PMID 37820462 · Publisher ↗

BACKGROUND: Physiotherapeutic scoliosis-specific exercise (PSSE) is recommended by SOSORT as the first step in the treatment of adolescent idiopathic scoliosis (AIS). However, a thorough summary and meta-analysis of the... BACKGROUND: Physiotherapeutic scoliosis-specific exercise (PSSE) is recommended by SOSORT as the first step in the treatment of adolescent idiopathic scoliosis (AIS). However, a thorough summary and meta-analysis of the evidence for the effectiveness of PSSE is lacking. OBJECTIVE: To summarise the up-to-date evidence on the efficacy of PSSE in AIS compared with the other non-surgical therapies. DATA SOURCES: The PubMed, Web of Science, Cochrane, Scopus, Embase and CNKI databases were systematically searched from 1 January 2012 to 1 November 2022. STUDY SELECTION: Controlled trials comparing the effects of PSSE and other non-surgical therapies on improving Cobb angle and quality of life in young people aged 6-18 years were included. DATA SYNTHESIS: Three researchers independently extracted data and evaluated methodological quality. Meta-analysis was performed where possible; otherwise, descriptive syntheses were reported. RESULTS: Seventeen studies with a total of 930 participants (76% female) were included. Among them, ten studies were RCTs. Six studies were of excellent quality. Thirteen studies were included in the meta-analysis. PSSE corrected the Cobb angle in patients better than other non-surgical therapies (I = 82%, MD = -2.82, 95%CI = -4.17 to -1.48, P < 0.01). PSSE was more effective than brace in improving patients' pain, self-image and mental health. Patients with a Risser grade of 0-3 or who had never received brace therapy had better outcomes. CONCLUSION: Evidence from higher quality studies suggests that PSSE was superior to general exercise and conventional therapy for correcting the Cobb angle in AIS. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO ID CRD42022345157 CONTRIBUTION OF THE PAPER.

Outcomes of physiotherapy for people living with bronchiectasis: qualitative study to inform development of a core outcome set.

Hamzeh H, Kelly C, Spencer S

Physiotherapy · 2023 Dec · PMID 37812851 · Publisher ↗

INTRODUCTION: Evidence of the effectiveness of physiotherapy for bronchiectasis is inconsistent, partly due to variation in the selection and reporting of outcomes in clinical trials. This qualitative study is a componen... INTRODUCTION: Evidence of the effectiveness of physiotherapy for bronchiectasis is inconsistent, partly due to variation in the selection and reporting of outcomes in clinical trials. This qualitative study is a component of the development of a core outcome set (COS). The COS will identify a minimum group of outcomes for use in clinical trials of physiotherapy considering the views of researchers, patients, and clinicians. OBJECTIVES: To identify outcomes for use in physiotherapy research that are important to patients and physiotherapists and to explain their significance. METHODS: Semi-structured interviews were conducted with adult patients with bronchiectasis who received physiotherapy, in addition to physiotherapists clinically involved in bronchiectasis care. Interviews were audio recorded and transcribed verbatim. Thematic analysis was used to identify, classify, and explain the significance of outcomes. Outcomes were mapped into the list created from literature review and classified into domains. RESULTS: We interviewed 18 participants from four countries covering a range of experiences in different settings. Seventy outcomes were identified and grouped into 15 domains. Thirty-three outcomes were not previously reported in the literature. Thematic analysis revealed exacerbations, quality of life, use of healthcare resources, patient-reported symptoms, physical functioning, and sputum as the prominent themes reported by both patients and physiotherapists. CONCLUSIONS: This qualitative study highlighted the importance of considering stakeholder perspectives when planning research trials. Outcomes identified will be used to inform the next phase of COS development. REGISTRATION: This study is part of the COS development project registered with the Core Outcome Measures in Effectiveness Trials initiative (COMET) https://www.comet-initiative.org/Studies/Details/1931 CONTRIBUTION OF THE PAPER.

The effectiveness of high-intensity laser therapy in individuals with neck pain: a systematic review and meta-analysis.

Xie YH, Liao MX, Lam FMH … +4 more , Gu YM, Hewith A Fernando WC, Liao LR, Pang MYC

Physiotherapy · 2023 Dec · PMID 37812850 · Publisher ↗

OBJECTIVES: The primary objective of this meta-analysis was to determine whether high-intensity laser therapy (HILT) was effective in improving pain intensity, cervical range of motion (ROM), functional activity, and qua... OBJECTIVES: The primary objective of this meta-analysis was to determine whether high-intensity laser therapy (HILT) was effective in improving pain intensity, cervical range of motion (ROM), functional activity, and quality of life (QOL) in individuals with neck pain. DATA SOURCES: PubMed, PEDro, Embase, Cochrane Library, Web of Science, and ClinicalTrials.gov were searched from inception to March 26, 2022. STUDY SELECTION: Randomized controlled trials (RCTs) involving HILT for neck pain were selected. DATA EXTRACTION AND DATA SYNTHESIS: Two raters were independent in data extraction. The methodological quality was evaluated using the PEDro scale, and the level of evidence was assessed using the GRADE system. RevMan5.4 was used for meta-analysis. RESULTS: Eight RCTs were included and their PEDro scores were moderate to high. Compared with placebo, HILT was effective in improving pain intensity (SMD 2.12, 95%CI 1.24 to 3.00; moderate quality evidence), cervical flexion (SMD 1.31, 95%CI 0.27 to 2.35; moderate quality evidence), extension (SMD 1.43, 95%CI 0.24 to 2.63; moderate quality evidence), right lateral flexion (SMD 1.36, 95%CI 0.15 to 2.56; low-quality evidence). There was a trend of better outcome in functional activity after HILT (SMD 1.73, 95%CI -0.05 to 3.54; low quality evidence). LIMITATIONS: There was limited information available on QOL. CONCLUSION: HILT may be considered as an adjunctive treatment modality for neck pain. There was moderate quality evidence that HILT may improve pain intensity and cervical ROM in individuals with neck pain, but there was low quality evidence that HILT was not effective in improving functional activity. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42021254078 CONTRIBUTION OF THE PAPER.

Turkey and Syria earthquakes: frontline insights of primary care physiotherapy.

Armitage RC, Dexter C

Physiotherapy · 2023 Dec · PMID 37812849 · Publisher ↗

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Effect of exercise on the inter-rectus distance in pregnant women with diastasis recti abdominis: an experimental longitudinal study.

Theodorsen NM, Moe-Nilssen R, Bø K … +1 more , Haukenes I

Physiotherapy · 2023 Dec · PMID 37812848 · Publisher ↗

OBJECTIVE: To investigate the effect of acute contraction of the pelvic floor muscles (PFM) and abdominal exercises on the inter-rectus distance (IRD) compared to resting values, and differences between gestation weeks 2... OBJECTIVE: To investigate the effect of acute contraction of the pelvic floor muscles (PFM) and abdominal exercises on the inter-rectus distance (IRD) compared to resting values, and differences between gestation weeks 27 and 37, in pregnant women with diastasis recti abdominis (DRA). DESIGN: Experimental longitudinal design. SETTING: Physiotherapy clinic, primary health care. PARTICIPANTS: Thirty-eight pregnant women with DRA ≥ 2.8 cm. INTERVENTIONS: Two-dimensional ultrasound images of IRD 2 cm above and below the umbilicus were taken at rest and during PFM and abdominal exercises at gestation week 27 and 37. Repeated measures analyses of variance (ANOVAs) with post hoc tests was performed for each exercise for both locations and timepoints. MAIN OUTCOME MEASURES: Change in IRD. RESULTS: There was a mean increase of the IRD from rest during a PFM contraction (2 mm, 95% CI: 2, 3), drawing-in (4 mm, 95% CI: 3, 5) and a combination of these (5 mm, 95% CI: 4, 6) There was a mean decrease of the IRD from rest during the headlift (-3 mm, 95% CI: -4, -2), the curl-up (-3 mm, 95% CI: -4, -2) and the diagonal curl up (-4 mm, 95% CI: -5, -3). Effect of time from gestation week 27-37 was a mean increase of 8 mm (95% CI: 6, 9). CONCLUSION: Pelvic floor and drawing-in exercise increased the IRD, whilst headlift, curl up and diagonal curl up decreased the IRD in pregnant women with DRA at gestation week 27 and 37. CONTRIBUTION OF THE PAPER.

Research from low-income and middle-income countries will benefit global health and the physiotherapy profession, but it requires support.

Sharma S, Verhagen A, Elkins M … +11 more , Brismée JM, Fulk GD, Taradaj J, Steen L, Jette A, Moore A, Stewart A, Hoogenboom BJ, Söderlund A, Harms M, Pinto RZ

Physiotherapy · 2023 Dec · PMID 37768008 · Publisher ↗

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Does pain duration and other variables measured at baseline predict re-referral of low back pain patients managed on an evidence-based pathway? A cohort study.

Jess MA, Ryan C, Wellburn S … +10 more , Atkinson G, Greenough C, Peat G, Coxon A, Roper H, Fatoye F, Ferguson D, Dickson A, Ridley H, Martin D

Physiotherapy · 2023 Dec · PMID 37591028 · Publisher ↗

OBJECTIVE: To explore the association between baseline pain duration and the likelihood of re-referral of patients with low back pain (LBP) managed on the evidence-based North East of England Regional Back Pain and Radic... OBJECTIVE: To explore the association between baseline pain duration and the likelihood of re-referral of patients with low back pain (LBP) managed on the evidence-based North East of England Regional Back Pain and Radicular Pain Pathway (NERBPP). STUDY DESIGN: Longitudinal, observational cohort study. METHODS: In all, 12,509 adults with LBP were identified as having been discharged from the pathway, between May 2015 and December 2019. To quantify any association between baseline pain duration and the likelihood of re-referral, two statistical modelling approaches, were used: logistic regression models for odds ratios and generalised linear models with a binomial link function in order to quantify risk differences. RESULTS: Twenty-five percent of patients with LBP, who were discharged, re-referred for management over a 4.5-year period. A large difference in pain duration of 2 SD days was statistically associated with re-referral, with an odds ratio of 1.22 (95% CI: 1.03, 1.44) and a risk difference of 3.6% (95% CI: 0.6, 6.6). Nevertheless, the predictive value of an individual's pain duration was found to be weak for re-referral. Higher baseline disability [odds ratio of 1.40 (95% CI: 1.07, 1.83)] and a younger age at baseline [odds ratio of 0.73 (95% CI 0.61, 0.86)] were also associated with an increased risk of re-referral. CONCLUSIONS: Baseline pain duration, disability and younger age are statistically associated with re-referral onto the NERBPP. However, the value of these variables for predicting an individual's risk of re-referral is weak. CONTRIBUTION OF PAPER.

Developing an application for the UK Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF): the collective experience of a community of physiotherapists.

May P, Mitham K, Maher N … +7 more , Pitt L, Whelan G, Mazuquin B, Moffatt M, Selfe J, Yeowell G, Littlewood C

Physiotherapy · 2023 Dec · PMID 37536077 · Publisher ↗

For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both fo... For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both for clinicians and patients. One way to embark on research is to apply for a personal fellowship such as the National Institute for Health and Care Research (NIHR) Pre-Doctoral Clinical Academic Fellowship (PCAF). While the NIHR has guidance on how to complete the application form, it can be difficult to implement this guidance and understand what a competitive application looks like. As a group of physiotherapists and academic supervisors, who have applied for NIHR PCAFs, what follows is a supportive resource, to inform others who might be thinking of applying. CONTRIBUTION OF PAPER.
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