paper regarding implementation of shakers exercise for impaired swallowing patients and compare pre , immediate and post implementation of the exercises
Efficacy of patient education and supervised exercise in Elderly patients wit...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Long-Term Effect of Exercise Therapyand Patient Education on.docxwkyra78
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T.
Long-Term Effect of Exercise Therapyand Patient Education on.docxcroysierkathey
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T ...
Sub153105.pdf my article Outcome Measurement of Electrical Stimulation on Qua...jayanta Jayanta0074U
Outcome Measurement of Electrical Stimulation on
Quadriceps Muscles for Knee Osteoarthritis
Jayanta Nath
Abstract: Introduction: Outcome measurement is very essential part to assess efficacy of treatment intervention. The first objective
was to perform a review of all outcome measurement used in manangement of knee OA. Secondly to know if there was any difference
of outcome measurement of electrical stimulation on quadriceps muscle based on collected review article. Question: What were the
various outcome measurement used for assessment of knee osteoarthritis specially when used electrical stimulation? Design: Review of
literature. Participant: reviewer. Adults with osteoarthritis of the knee. Intervention: Electrical stimulation for quadriceps. Outcome
measure : VAS, WOMAC, dynamometer,MMT,EMG etc Development: Literature searches were made in these databases: Medline
(Ovid), Pedro, SCOPUS, PsycINFO, Web of knowledge, CINAHL (EBSCOHost), SportDicus (EBSCOHost), DOAJ, Cochrane,
EMBASE, Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), and MedicLatina (EBSCOHost). A
retrospective search of 13 years was used until February 2015. 33 records were selected based on the affinity with the subject of the
review and their internal validity according to the PEDro scale. Conclusions: WOMAC, VAS, were most commonly used outcome
measurement for OA knee. recommend further research on ES and outcome measurement.There were many outcome measure for knee
OA based on literature search .The review evidence suggest that VAS,WOMAC,were useful for assessing quality of management.Out of
all outcome measurement tool the WOMAC,PPT, EMG were most valid and reliable tool.
Efficacy of patient education and supervised exercise in Elderly patients wit...iosrjce
IOSR Journal of Nursing and health Science is ambitious to disseminate information and experience in education, practice and investigation between medicine, nursing and all the sciences involved in health care. Nursing & Health Sciences focuses on the international exchange of knowledge in nursing and health sciences. The journal publishes peer-reviewed papers on original research, education and clinical practice.
By encouraging scholars from around the world to share their knowledge and expertise, the journal aims to provide the reader with a deeper understanding of the lived experience of nursing and health sciences and the opportunity to enrich their own area of practice. The journal publishes original papers, reviews, special and general articles, case management etc.
Long-Term Effect of Exercise Therapyand Patient Education on.docxwkyra78
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T.
Long-Term Effect of Exercise Therapyand Patient Education on.docxcroysierkathey
Long-Term Effect of Exercise Therapy
and Patient Education on Impairments
and Activity Limitations in People
With Hip Osteoarthritis: Secondary
Outcome Analysis of a Randomized
Clinical Trial
Ida Svege, Linda Fernandes, Lars Nordsletten, Inger Holm, May Arna Risberg
Background. The effect of exercise on specific impairments and activity limitations in
people with hip osteoarthritis (OA) is limited.
Objective. The study objective was to evaluate the long-term effect of exercise therapy and
patient education on range of motion (ROM), muscle strength, physical fitness, walking
capacity, and pain during walking in people with hip OA.
Design. This was a secondary outcome analysis of a randomized clinical trial.
Setting. The setting was a university hospital.
Participants. One hundred nine people with clinically and radiographically evident hip
OA were randomly allocated to receive both exercise therapy and patient education (exercise
group) or patient education only (control group).
Intervention. All participants attended a patient education program consisting of 3 group
meetings led by 2 physical therapists. Two other physical therapists were responsible for
providing the exercise therapy program, consisting of 2 or 3 weekly sessions of strengthening,
functional, and stretching exercises over 12 weeks. Both interventions were conducted at a
sports medicine clinic.
Measurements. Outcome measures included ROM, isokinetic muscle strength, predicted
maximal oxygen consumption determined with the Astrand bicycle ergometer test, and
distance and pain during the Six-Minute Walk Test (6MWT). Follow-up assessments were
conducted 4, 10, and 29 months after enrollment by 5 physical therapists who were unaware
of group allocations.
Results. No significant group differences were found for ROM, muscle strength, predicted
maximal oxygen consumption, or distance during the 6MWT over the follow-up period, but
the exercise group had less pain during the 6MWT than the control group at 10 months (mean
difference��8.5 mm; 95% confidence interval��16.1, �0.9) and 29 months (mean differ-
ence��9.3 mm; 95% confidence interval��18.1, �0.6).
Limitations. Limitations of the study were reduced statistical power and 53% rate of
adherence to the exercise therapy program.
Conclusions. The previously described effect of exercise on self-reported function was
not reflected by beneficial results for ROM, muscle strength, physical fitness, and walking
capacity, but exercise in addition to patient education resulted in less pain during walking in
the long term.
I. Svege, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
Kirkeveien 166, 0450 Oslo, Nor-
way. Address all correspondence
to Dr Svege at: [email protected]
ous-hf.no.
L. Fernandes, PT, PhD, Norwegian
Research Center for Active Reha-
bilitation, Department of Ortho-
paedics, Oslo University Hospital,
and Department of Orthopaedic
Surgery and T ...
Sub153105.pdf my article Outcome Measurement of Electrical Stimulation on Qua...jayanta Jayanta0074U
Outcome Measurement of Electrical Stimulation on
Quadriceps Muscles for Knee Osteoarthritis
Jayanta Nath
Abstract: Introduction: Outcome measurement is very essential part to assess efficacy of treatment intervention. The first objective
was to perform a review of all outcome measurement used in manangement of knee OA. Secondly to know if there was any difference
of outcome measurement of electrical stimulation on quadriceps muscle based on collected review article. Question: What were the
various outcome measurement used for assessment of knee osteoarthritis specially when used electrical stimulation? Design: Review of
literature. Participant: reviewer. Adults with osteoarthritis of the knee. Intervention: Electrical stimulation for quadriceps. Outcome
measure : VAS, WOMAC, dynamometer,MMT,EMG etc Development: Literature searches were made in these databases: Medline
(Ovid), Pedro, SCOPUS, PsycINFO, Web of knowledge, CINAHL (EBSCOHost), SportDicus (EBSCOHost), DOAJ, Cochrane,
EMBASE, Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), and MedicLatina (EBSCOHost). A
retrospective search of 13 years was used until February 2015. 33 records were selected based on the affinity with the subject of the
review and their internal validity according to the PEDro scale. Conclusions: WOMAC, VAS, were most commonly used outcome
measurement for OA knee. recommend further research on ES and outcome measurement.There were many outcome measure for knee
OA based on literature search .The review evidence suggest that VAS,WOMAC,were useful for assessing quality of management.Out of
all outcome measurement tool the WOMAC,PPT, EMG were most valid and reliable tool.
Outcome Measurement of Electrical Stimulation on
Quadriceps Muscles for Knee Osteoarthritis.Abstract: Introduction: Outcome measurement is very essential part to assess efficacy of treatment intervention. The first objective
was to perform a review of all outcome measurement used in manangement of knee OA. Secondly to know if there was any difference
of outcome measurement of electrical stimulation on quadriceps muscle based on collected review article. Question: What were the
various outcome measurement used for assessment of knee osteoarthritis specially when used electrical stimulation? Design: Review of
literature. Participant: reviewer. Adults with osteoarthritis of the knee. Intervention: Electrical stimulation for quadriceps. Outcome
measure : VAS, WOMAC, dynamometer,MMT,EMG etc Development: Literature searches were made in these databases: Medline
(Ovid), Pedro, SCOPUS, PsycINFO, Web of knowledge, CINAHL (EBSCOHost), SportDicus (EBSCOHost), DOAJ, Cochrane,
EMBASE, Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), and MedicLatina (EBSCOHost). A
retrospective search of 13 years was used until February 2015. 33 records were selected based on the affinity with the subject of the
review and their internal validity according to the PEDro scale. Conclusions: WOMAC, VAS, were most commonly used outcome
measurement for OA knee. recommend further research on ES and outcome measurement.There were many outcome measure for knee
OA based on literature search .The review evidence suggest that VAS,WOMAC,were useful for assessing quality of management.Out of
all outcome measurement tool the WOMAC,PPT, EMG were most valid and reliable tool.
The effect of hot intermittent cupping on pain, stiffness and disability of p...LucyPi1
Abstract Objective: The aim of this study was to investigate the effect of hot intermittent cupping on pain, stiffness and inability of patients with knee osteoarthritis (KO). Methods: The present study was a clinical trial, which was performed on 38 patients with KO referring to Gonabad Rheumatology Specialty Clinic. Based on permutation block method, the research units were divided into cupping therapy and control groups. For the cupping therapy group, four sessions of cupping therapy were performed every four days. To collect data, the form of demographic information, Visual Analogue Scale (VAS) and the Western Ontario and McMaster (WOMAC) osteoarthritis scale were used, and the data were analyzed by SPSS software v. 16 using descriptive statistics and independent t-test, paired t-test, Chi-square test and Fishers exact test with a significance level of P < 0.05. Results: Findings showed that there was no significant difference between the cupping therapy and control groups in terms of demographic characteristics and they were homogeneous. Findings indicated that, based on VAS, the mean pain intensity in the left (P < 0.001) and the right knees (P < 0.001), as well as based on WOMAC, stiffness (P = 0.006), pain intensity (P < 0.001) and disability (P < 0.001) in the cupping therapy group significantly decreased compared to the control group. Conclusion: Findings showed that hot intermittent cupping therapy reduced the pain intensity, stiffness and disability in patients with KO.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Abstract
Background: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder etc. Apart from culture competency and core medical knowledge a physiotherapist must be competent enough in all physiotherapist medical conditions where physical therapy plays a vital role. This study aims to identify the frequency of common clinical conditions among client presented at Habib Physiotherapy Complex (HPC), Hayatabad during 2010.
Methodology: This was a descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complaints and known diagnoses. Data was collected on a structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages.
Result: The majority of clients (1280 (29%)) were suffering from low back pain. The second common condition 891(20%) was osteoarthritis of the knee joint and cerebrovascular accidents 824(18.4%), while cervical pain accounted for 734(16.4%). The rest of clinical conditions included; frozen shoulder, pelvic inflammation, cerebral palsy, polio effected and paraplegia.
Conclusion: The Study reveals the occurrence of Osteoarthritis (Low Back, Cervical Pain, and Knee Joints Pain) were the most common condition which deteriorated the performance of common individuals in our society.
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
To Determine Preference of Shoulder Pain Management by General Physicians in ...suppubs1pubs1
Rotator cuff muscles are functionally active and provide stability to the shoulder joint and also thereby allow the full Range of Motion (ROM) by moving the head of humerus in the glenoid cavity. Any tear or fragility of the rotator cuff muscles can cause the dislocation or instability and hence damaging other muscles specially the long head of biceps muscle. The diseases related to the supraspinatus tendon are frequently linked with the long head of the biceps tendon. Other cause of chronic shoulder pain is the adhesive capsulitis with large prevalence rates of more than 5.3% in the general target population [3].
EVALUATION OF THE EFFICIENCY OF BISPHOSPHONATES IN THE TREATMENT OF OSTEOPORO...indexPub
Osteoporosis (OP) is a widespread metabolic disease of the skeleton, leading to decreased bone strength and increased risk of fractures. OP is a disease of varying nature that affects all age groups, but is most common in older people. For a long time, doctors did not have serious tools to treat this insidious disease and mainly dealt with its consequences - fractures.
Outcome Measurement of Electrical Stimulation on
Quadriceps Muscles for Knee Osteoarthritis.Abstract: Introduction: Outcome measurement is very essential part to assess efficacy of treatment intervention. The first objective
was to perform a review of all outcome measurement used in manangement of knee OA. Secondly to know if there was any difference
of outcome measurement of electrical stimulation on quadriceps muscle based on collected review article. Question: What were the
various outcome measurement used for assessment of knee osteoarthritis specially when used electrical stimulation? Design: Review of
literature. Participant: reviewer. Adults with osteoarthritis of the knee. Intervention: Electrical stimulation for quadriceps. Outcome
measure : VAS, WOMAC, dynamometer,MMT,EMG etc Development: Literature searches were made in these databases: Medline
(Ovid), Pedro, SCOPUS, PsycINFO, Web of knowledge, CINAHL (EBSCOHost), SportDicus (EBSCOHost), DOAJ, Cochrane,
EMBASE, Academic Search Complete (EBSCOHost), Fuente Académica (EBSCOHost), and MedicLatina (EBSCOHost). A
retrospective search of 13 years was used until February 2015. 33 records were selected based on the affinity with the subject of the
review and their internal validity according to the PEDro scale. Conclusions: WOMAC, VAS, were most commonly used outcome
measurement for OA knee. recommend further research on ES and outcome measurement.There were many outcome measure for knee
OA based on literature search .The review evidence suggest that VAS,WOMAC,were useful for assessing quality of management.Out of
all outcome measurement tool the WOMAC,PPT, EMG were most valid and reliable tool.
The effect of hot intermittent cupping on pain, stiffness and disability of p...LucyPi1
Abstract Objective: The aim of this study was to investigate the effect of hot intermittent cupping on pain, stiffness and inability of patients with knee osteoarthritis (KO). Methods: The present study was a clinical trial, which was performed on 38 patients with KO referring to Gonabad Rheumatology Specialty Clinic. Based on permutation block method, the research units were divided into cupping therapy and control groups. For the cupping therapy group, four sessions of cupping therapy were performed every four days. To collect data, the form of demographic information, Visual Analogue Scale (VAS) and the Western Ontario and McMaster (WOMAC) osteoarthritis scale were used, and the data were analyzed by SPSS software v. 16 using descriptive statistics and independent t-test, paired t-test, Chi-square test and Fishers exact test with a significance level of P < 0.05. Results: Findings showed that there was no significant difference between the cupping therapy and control groups in terms of demographic characteristics and they were homogeneous. Findings indicated that, based on VAS, the mean pain intensity in the left (P < 0.001) and the right knees (P < 0.001), as well as based on WOMAC, stiffness (P = 0.006), pain intensity (P < 0.001) and disability (P < 0.001) in the cupping therapy group significantly decreased compared to the control group. Conclusion: Findings showed that hot intermittent cupping therapy reduced the pain intensity, stiffness and disability in patients with KO.
To Compare The Effect Of Core Stability Exercises And Muscle Energy Technique...IOSR Journals
Abstract: Low back pain is considered one of the commonest condition in the western and industrialized
countries. It is estimated that up to 50% of adults experience low back pain during their life span. People of all
age group can be effected by this menace irrespective to their gender and quality of life. It has become one of
the leading causes for the visit to physician thus also puts a heavy burden on the currency of the country.
Physiotherapy is the most widely used form of treatment adopted for gaining relief from low back pain. The
exercises include stretching, strengthening, range of motion exercises, McKenzie therapy and core stability
exercises other techniques like muscle energy technique etc. It has been concluded in various studies core
stability exercises and muscle energy technique are beneficial in low back pain patients but comparison of their
effect needs to be established to provide early and better relief from the disability. Therefore objective of the
study was to compare the effect of core stability exercises and muscle energy techniques on low back pain
patients. 60 subjects aged 18 – 45 years with low back pain were made part of the study based on inclusion and
exclusion criteria and were then divided into three groups named A, B and C. Group A received core stability
exercise and conventional physiotheraphy and group B received muscle energy techniques and conventional
physiotherapy. The exercise program was given on alternate days with a total of 24 sessions and progression of
the activity was made within the tolerance of the patient. Pre and post treatment readings were taken of pain,
ROM and quality of life scale. Results were analyzed using paired, unpaired t- test and ANOVA. Results showed
that there is significant effect on pain, ROM and quality of life scale in the three groups but group A was
clinically more significant than the other groups. The study concluded that patients with low back pain are
benefitted more by core stability exercises. So, core stability exercises should be practiced more.
Keywords: Low Back Pain, Core Stabilization Exercises, Muscle Energy Technique.
Abstract
Background: Physiotherapy is multi-dimensional and can treat a vast variety of conditions, ranging from musculoskeletal aches, arthritis, joints problems, paraplegia, hemiplegic, sports injuries and frozen shoulder etc. Apart from culture competency and core medical knowledge a physiotherapist must be competent enough in all physiotherapist medical conditions where physical therapy plays a vital role. This study aims to identify the frequency of common clinical conditions among client presented at Habib Physiotherapy Complex (HPC), Hayatabad during 2010.
Methodology: This was a descriptive study; the data were retrieved from record register of HPC (Indoor and Outdoor patients) recording their presenting complaints and known diagnoses. Data was collected on a structure grid. Data was analyzed using SPSS version 15 and presented in term of frequency and percentages.
Result: The majority of clients (1280 (29%)) were suffering from low back pain. The second common condition 891(20%) was osteoarthritis of the knee joint and cerebrovascular accidents 824(18.4%), while cervical pain accounted for 734(16.4%). The rest of clinical conditions included; frozen shoulder, pelvic inflammation, cerebral palsy, polio effected and paraplegia.
Conclusion: The Study reveals the occurrence of Osteoarthritis (Low Back, Cervical Pain, and Knee Joints Pain) were the most common condition which deteriorated the performance of common individuals in our society.
Objective: To assess the effect of a kinesitherapeutic
program of special exercises for treatment of pain intensity and
endurance of the extensor trunk muscles in patients with
chronic lumbalgy.
Methods: The study included 110 patients with chronic
lumbalgy, equally distributed in two treatment groups.
Participants in the experimental group performed the
recommended special exercises 3 times a week at home, while
those in the control group only followed the guidelines of a
physician. At the beginning of the study and 12 months later,
the pain intensity of all the participants was assessed by means
of Visual Analog Scale.
Results: In contrast to the participants in the control
group, those in the experimental group at the end of observation
were reported to experience a significant reduction in pain
intensity.
Conclusions: Treatment with specific exercises proved
more effective in terms of pain complaints in patients with
chronic lumbalgy.
To Determine Preference of Shoulder Pain Management by General Physicians in ...suppubs1pubs1
Rotator cuff muscles are functionally active and provide stability to the shoulder joint and also thereby allow the full Range of Motion (ROM) by moving the head of humerus in the glenoid cavity. Any tear or fragility of the rotator cuff muscles can cause the dislocation or instability and hence damaging other muscles specially the long head of biceps muscle. The diseases related to the supraspinatus tendon are frequently linked with the long head of the biceps tendon. Other cause of chronic shoulder pain is the adhesive capsulitis with large prevalence rates of more than 5.3% in the general target population [3].
EVALUATION OF THE EFFICIENCY OF BISPHOSPHONATES IN THE TREATMENT OF OSTEOPORO...indexPub
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ACCORDING TO pewtrusts.org,
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VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
1. 1
Effect of Heat Application and Physical Exercise on Pain and Morning Stiffness
for Knee Osteoarthritis Patients: A comparative Study
على البدنية والتمارين الحرارة استخدام تأثير
دراسة :الركبة مفاصل التهاب لمرضى الصباحي والتصلب األلم
مقارنة
Protocol
Submitted for Publication of A scientific Paper
By
معانا اللي الدكاترة اسماء تضيفي يادكتور حضرتك استاذن
Zeinab Gamal Mohamed Ellatif Abouelezz,
Fellow Medical Surgical Nursing, Student Hospital, Mansoura University
2. 2
Effect of Heat Application and Physical Exercise on Pain and Morning Stiffness
for Knee Osteoarthritis Patients: A comparative Study
Musculoskeletal diseases are major public health problems in most countries; they cause
more functional disabilities in the adult and geriatric population than any other category
of disorders. Osteoarthritis (OA) is considered the most common musculoskeletal
disease all over the world, it is a painful and disabling inflammatory disease of the joints.
It is caused by multiple factors as joint injury or overuse, obesity, heredity and dramatical
increases in prevalence with age (Wagner and Luna, 2018).
Knee osteoarthritis (OA) is a common degenerative disease that causes the bones
and cartilage to break down in a joint characterized by the loss of articular cartilage
tissue. The most evident symptoms of knee OA are localized pain in a joint at rest; is
well-recognized as typically transitioning from intermittent weight-bearing pain to
chronic pain, morning stiffness usually lasting fewer than 30 minutes, bony tenderness
and bony enlargement in the joint line, deformities, physical function limitation, and
incapacity (Springer, 2019 & CDC, 2018), therefore cause several negative effects on
the quality of life in individuals with knee OA (Elsiwy, et al., 2019).
Since knee OA is not cured, its care typically focuses on preserving the patient's
functional ability by managing pain, other symptoms, and improving joint movement
and function; treatment involves both pharmacological and non-pharmacological
modalities (Lundgren-Nilsson et al., 2018). Although the role of pharmacological
management is well recognized in reducing swelling and pain, also the costs of treatment
and the prolonged-term side effects of medication should not be underestimated
(Salmon, et al., 2018).
3. 3
Different non‐pharmacological methods like patient education, protection of the
joint, losing weight, exercise, heat and cold application, joint protection techniques,
exercises, use of ancillary devices, thermal methods, Tai chi, acupuncture, and
transcutaneous electrical nerve stimulation (TENS) can be applied for the treatment of
knee OA (Uludağ and Kaşikçi, 2019 & Hochberg, et al., 2012). Previous studies
demonstrated that nonpharmacological methods, used independently or in combination
with pharmacological methods, are effective in pain management (Özveren, 2011&
Zhang et al., 2008).
Hot compresses are safe and low-cost option that can be used on its own or in
conjunction with other therapies, for long-term control of pain, stiffness, and
inflammation (Shafii, et al., 2018). In general, the physiological effects of heat therapy
can encourage the healing of damaged tissues and causes the blood vessels of the
muscles to dilate, which increases the flow of oxygen and nutrients to the muscles. In
addition to, warmth with gentle bending and flexing, can spur joint fluid production,
which can relax muscles and help lubricate joints, relieve muscle and joint stiffness, help
warm up joints before activity, or ease a muscle spasm. Warmth also, can stimulate
sensory receptors in the skin and decrease the transmissions of pain signals to the brain
(Zamri, et al., 2019).
Another nonpharmacological method used to eliminate pain and ensure
symptomatic relieve in knee OA is physical exercise. Exercise is crucial for knee OA
patients, as it can recover tendons, strengthen leg muscles, reduce the burden on joints,
and stimulate beneficial biochemical changes in synovial fluid by increasing blood
circulation in knee joints. Exercise can help controlling symptoms of osteoarthritis such
as pain, lack of flexibility, decreased strength, and morning stiffness. Controlling each
4. 4
of these can improve function which will result in improvement of quality of life (Bieler
et al., 2018).
The combination of heat application and exercises for knee OA patients has been
stated to reduce pain, ensure comfort, and enhance stiffness and physical function
(Shereif & Hassanin, 2011). In brief, heat application and exercises are reported to
reduce pain and enhance function levels among patients with knee OA. Randomized
controlled studies are further needed for nonpharmacological treatment methods
including thermal therapies in knee OA (Çalışkan, 2013). Nevertheless, the number of
studies using these two methods simultaneously is limited (Kim et al., 2013; Shereif &
Hassanin, 2011). Hence, the current study aimed to assess the effect of physical
exercise, heat application, and combination of physical exercise and heat application on
relieving pain and morning stiffness for knee OA patients.
Aim of the study:
The current study aimed to assess effect of physical exercises, heat application,
and exercises after heat application on relieving pain and morning stiffness for knee OA
patients.
Through the following objectives:
1. Assess effect of heat application on relieving pain and morning stiffness for
patients with knee OA.
2. Assess effect of physical exercises on relieving pain and morning stiffness for
patients with knee OA.
3. Assess effect of combination of heat application and physical exercises on
relieving pain and morning stiffness for patients with knee OA.
4. Compare between physical exercises, heat application, and combination of heat
5. 5
application and physical exercises on relieving pain and morning stiffness for
patients with knee OA.
Research hypothesis:
Post application of heat application, physical exercises, or combination of both treatment
regimens, patients will exhibit improved relieving pain and morning stiffness for patients
with knee OA than pre application of the intervention.
Materials and method:
Design:
A quasi-experimental design was used in the present study.
Setting:
This study will be conducted at the orthopedic outpatient clinics in Suez Canal
University Hospital which serving the Suez Canal region including Ismailia, Port Said,
Suez, and Sinai with free services.
Subjects:
A purposive sample of 120 patients with osteoarthritis was enrolled in this study using
pre and posttest based on the following criteria:
Inclusion criteria:
1- Patient aged above 21 years.
2- Have no comorbid diseases (cardiac patients).
3- Have no joint surgeries.
Exclusion criteria:
1- Have communication disability.
2- Body mass index of patients above 35.
6. 6
Tools for Data Collection:
Two tools were used for collection of data and achieve the aim of the study as the
following:
Tool 1: Structured Interview Questionnaire:
This tool was developed by the researcher and reviewed by a panel of five experts
in medical surgical nursing aimed to identify patient demographic data, health relevant
data, and assess patient's knowledge about the disease and its management, it takes about
(10) minuets to be completed: it is divided into three parts as follow:
Part I: Demographic data:
It included (6) multiple choice closed ended questions ask about patients' gender,
age, and educational level, occupation, marital status and life environment(rural/urban).
Part II: Health relevant data: It included (5) questions to assess past history and
present health status for patients.
Part III: Knowledge regarding knee osteoarthritis and its management:
It included (8) questions ask about duration, symptoms, and management methods of
osteoarthritis.
Tool 2: The Knee Injury and Osteoarthritis Outcome Score (KOOS):
The Knee Injury and Osteoarthritis Outcome Score (KOOS) is a questionnaire
adapted from Roos, et al (1998), designed to assess short and long-term patient-relevant
outcomes following knee injury. The KOOS is self-administered and assesses five
outcomes: pain, symptoms, activities of daily living, sport and recreation function, and
knee-related quality of life. The researcher excluded the part of quality of life because it
is not suitable for the study aim.
Scoring System:
The KOOS's tool contains (38) questions, and takes about 10 minutes to fill
out the total questions and includes four patient-relevant dimensions which scored
separately: Pain (nine items); Symptoms (seven items); ADL Function (17 items); Sport
and Recreation Function (five items). A Likert scale is used and all items have five
possible answer options scored from 0 (No problems) to 4 (Extreme problems) and each
of the four scores is calculated as the sum of the items included. Scores are transformed
to a 0–100 scale, with zero representing extreme knee problems and 100 representing no
7. 7
knee problems as common in orthopedic scales and generic measures. Scores between 0
and 100 represent the percentage of total possible score achieved.
Total score for each subscale will categorized into
< 100 – 66 Mild
< 66- 33 Moderate
< 33- 0 Extreme
Phases of the Study
1. An official letter from the Faculty of Nursing will be submitted to the appropriate
authorities in the selected setting for obtaining the permission.
2. Ethical considerations:
Approval will be obtained from the research ethics committee, Faculty of Nursing,
Mansoura University. Informed consent will be obtained from study participants, who
will be informed of the purpose of the study and will be assured that their identities and
responses to the questionnaire would be confidential; answering was voluntary, and
participation (or not) would have no effect on their current or future condition.
The validity of the study will be tested by:
- A jury that involves five experts of medical surgical nursing and neurologist will
test validity of the developed tools, and the required modification will be carried
out.
- A Pilot study on 10 % persons who are not included in the study to test the validity
and reliability of the questionnaire. Accordingly, any required modifications will be
done.
- Accordingly, any required modifications will be done.
8. 8
Results
Data collection will be coded, tabulated and presented in tables, figures and proper
statistical analysis will be used.
Discussion
Discussion of the obtained data will be done based on the findings, other related
studies and literature review.
10. 10
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