This study describes the reliability of pragmatic combinations of acupuncture points for lateral epicondylalgia (LE) as prescribed by physiotherapists who were experts in acupuncture. Raters (n = 14; 33-59 years) independently prescribed acupuncture points for 30 simulated human patients with LE who were surveyed via a printed questionnaire. The frequency and cooccurrence of acupuncture points prescribed for patients with lateral epicondylitis were assessed. Absolute agreement and Light's kappa (${\kappa}_{Light}$) with 95% confidence interval (CI) were used to quantify the interrater agreement. Raters prescribed 103 unique acupuncture points in different combinations with a median (min-max) of 5 (0-11) acupuncture points. The most prescribed acupuncture point was LI-11 (297 of 420; 71%), and the most common cooccurring acupuncture points were LI-11 and LI-4 (160 of 420; 38%). The absolute agreement for prescribing the acupuncture points ranged from 70% (point GB-20) to 0% (points LI-10, SP-6, LI-11, GB-34, LI-12, and LI-4). Point LR-3 showed the highest interrater reliability for prescribing the acupuncture points [${\kappa}_{Light}=0.112$, 95% CI = (0.055-0.194)], whereas point LI-4 showed the lowest reliability [${\kappa}_{Light}=-0.003$, 95% CI = (-0.024 to 0.024)]. These findings suggest that pragmatic prescriptions of acupuncture points for LE are unreliable among physiotherapists who are experts in acupuncture. Explicit, high-level evidence-based rules for prescribing and teaching combinations of acupuncture points for LE are warranted.
Purpose: This study aimed to compare the effects of a four-week scapular stabilization exercise program using the PNF technique on scapular symmetry and range of flexion motion (ROM), pain, function, and quality of life (QOL) in post-mastectomy women with breast cancer. Methods: This study included 20 women divided into an experimental group (n = 10) and a control group (n = 10). All patients performed complex decongestive physiotherapy for 40 min daily, five times per week for four weeks. The experimental group performed the extra scapular stabilizing exercise program using the PNF technique for 50 min daily, five times per week for four weeks. Scapular symmetry, shoulder flexion ROM, pain and function, and QOL were subsequently assessed. For ROM measurement, the range of shoulder flexion was measured using a clinometer smart phone application; the pain of the shoulder was measured using the visual analogue scale (VAS); the scapular position was measured using a lateral scapular slide test (LSST); the level of pain and functional activity was measured using the Shoulder Pain and Disability Index (SPADI); and the QOL was measured using Functional Assessment of Cancer Therapy-Breast. Results: There were significant differences in shoulder flexion ROM, VAS, SPADI, and LSST 0˚ and 45˚ when the experimental group was compared with the control group (p < 0.05). After the intervention, there was an improved within-group change in the ROM, SPADI, LSST, and QOL in both the experimental and control groups. Conclusion: These findings suggest that a scapular stabilization exercise program using the PNF technique may be used as a possible treatment option for post-mastectomy women with breast cancer that aims to improve scapular position, shoulder ROM and function, and QOL.
Background: Children with cerebral palsy have difficulty acquiring motor skills through motor learning due to lack of motor planning of the central nervous system and musculoskeletal dysfunction. Motor learning is the acquisition or modification of movements with the aim of developing skilled movements and behaviors. Cerebral palsy improve motor function through motor learning, and effective motor learning mainly depends on practice parameters such as learning feedback. Therefore, we investigate the effect of motor learning in children with cerebral palsy and try to present the possibility of clinical application. Design: A systemic review. Methods: Research papers were published from Jan, 2010 to Dec, 2020 and were searched using PubMed and Medline. The search terms are 'task specific training' OR 'motor learning' OR 'feedback(Mesh term)' OR 'goal activity' AND 'cerebral palsy(Mesh term)'. A total of eight papers were analyzed in this study. The paper presented the quality level based on the research evidence, and also presented PEDro (Physiotherapy Evidence Database) scores to evaluate the quality of design studies in randomized clinical trials. Results: The results showed that motor learning coaching in children with cerebral palsy improved motor function in post and follow up tests. Also, self-control feedback of motor learning is more effective than external control feedback. 100% external control feedback of motor learning is effective in the acquisition phase and 50% external feedback of motor learning is effective in the retain phase. Conclusion: These results suggest that it will be an important data for establishing evidence on the effect of motor learning arbitration methods in children with cerebral palsy to develop clinical applicability and protocols.
Background: For generations, cigarette smoking has presented an important public health concern. This study aimed to compare the health-promoting behavior, exercise capacity, physical activity level, health literacy, and knowledge level of smoking-related diseases between smokers and non-smokers. Methods: The study included 71 smokers (mean age, 32.69±8.55 years) and 72 non-smokers (mean age, 31.88±9.94 years) between the ages of 20 and 60 years. Assessments included a 6-minute walking test (6MWT), Godin Leisure-Time Physical Activity Questionnaire, Health-Promoting Lifestyle Profile II (HPLP-II), Cardiovascular Risk Factors Knowledge Level Scale (CARRF-KL), Asthma/COPD Awareness Questionnaire, the World Health Organization Quality of Life-Bref questionnaire (WHOQoL-Bref [TR]), and Health Literacy Questionnaire (HLQ). Results: The results from the study show that the number of coronary artery disease risk factors measured significantly higher among the smoker group members when compared to that of the non-smoker group members (p=0.001). Smokers had significantly lower %6MWT distance than non-smokers (84.83±4.72 and 93.45±7.16, respectively; p<0.05). However, there were no significant differences between the smokers and non-smokers in terms of physical activity, CARRF-KL, HLQ, WHOQoL-Bref, and HPLP-II subscales or total scores (p>0.05). Additionally, while only forty-one smokers (57.7%) were active, 48 of the non-smoker group was active (66.7%). Conclusion: Smokers suffer greater negative effects to their exercise capacity in comparison to non-smokers. Although smokers and non-smokers have similar levels of health literacy and similar levels of knowledge about cardiovascular disease risk factors and obstructive lung diseases, health professionals could continue to further increase individuals' awareness of smoking-related risk factors and continue to emphasize the importance of physical activity and exercise for protecting cardiopulmonary health.
International Journal of Computer Science & Network Security
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v.22
no.2
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pp.91-100
/
2022
To support early intervention, it is necessary to develop programming system tools that enable accurate, valid, and reliable assessments and can help achieve reasonable, generalizable, and measurable goals. This study examined the Assessment, Evaluation, and Programming System (AEPS) used by associations of children with disabilities in Saudi Arabia to assess its suitability for children with intellectual disabilities. A group of 16 specialists with different professional backgrounds (including special education, physiotherapy, occupational therapy, speech therapy and psychology) from 11 associations of children with disabilities took part in semi-structured personal interviews. The study concluded that AEPS is generally suited for use with children with intellectual disabilities. However, its suitability depends on the type and severity of the child's disability. The more severe the disability, the less effective the AEPS is likely to be. On the basis of this finding the researchers formed interdisciplinary teams to organise and integrate the children's learning and assess the benefits of AEPS, including its accuracy and ability to achieve adaptive, cognitive, and social targets, enhance family engagement and learning and develop basic development skills. This study also identified obstacles associated with the use of AEPS. These include the lack of comprehensiveness and accuracy of the goal, lack of precision and non-applicability to large movements and the fact that it cannot be used with all children with intellectual disabilities. In addition, the research showed that non-cooperation within the family is a major obstacle to the implementation of the AEPS. The results of this study have several implications.
Schembri, Emanuel;Barrow, Michelle;McKenzie, Christopher;Dawson, Andrew
The Korean Journal of Pain
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v.35
no.1
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pp.4-13
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2022
Changes in diagnostic criteria, for example, the various International Classification of Headache Disorders criteria, would lead to changes in the outcomes of epidemiological studies. International Classification of Headache Disorders-1 was based mainly on expert opinion, yet most of the diagnostic criteria were reliable and valid, but it did not include chronic migraine. In its second version, the classification introduced chronic migraine, but this diagnosis resembled more a high-frequency migraine rather than the actual migraine transformation process. It also introduced medication overuse headache, but it necessitated analgesic withdrawal and subsequent headache improvement to be diagnosed as such. Hence patients having medication overuse headache could only be diagnosed in retrospect, which was an awkward situation. Such restrictive criteria for chronic migraine and medication overuse headache omitted a high proportion of patients. International Classification of Headache Disorders-3 allows a diagnosis of medication overuse headache due to combination analgesics if taken for at least 10 days per month for more than three months. Hence the prevalence rate of medication overuse headache and chronic migraine can increase compared to the previous version of the headache classification. Different criteria have been used across studies to identify chronic migraine and medication overuse headache, and therefore the information acquired from previous studies using earlier criteria becomes uncertain. Hence much epidemiological research would need to be interpreted cautiously or repeated with the most updated criteria, since the subjects in studies that apply the latest criteria may be phenotypically different from those in older studies.
Yoo, Yong Jun;Park, Hye Jin;Han, Myung Woul;Kim, Ji Won
Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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v.33
no.1
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pp.26-30
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2022
Background and Objectives Cough suppression therapy (CST) is a physiotherapy that can be used for patients with chronic refractory cough (CRC). We aimed to investigate the efficacy of CST for CRC. Materials and Method A prospective randomized controlled trial was conducted in 27 patients with CRC. Participants were randomized to receive either standard mucolytic medications for CRC combined with supplemental CST (CST group) or standard medications alone (control group). CST consists of laryngeal hygiene management, humidification, cough suppression technique, breathing method, and counseling. We assessed the symptoms change at baseline and week 4 with the Leicester Cough Questionnaire (LCQ). Secondary efficacy outcomes included the degree of cough Visual Analog Scale (VAS) score (0 to 100 scale). Results From 2019 to 2021, 14 CST group patients and 13 control group patients were included. The improvement was significantly greater in the CST group than in the control group for cough VAS score (36.67 to 13.33 vs. 74.29 to 16.43, p<0.001). Patients in the CST group had a significant improvement in total (70.14 to 107.71, p=0.005), physical (31.42 to 43.86, p=0.015), psychological (23.57 to 40.14, p=0.003), and social (15.14 to 23.71, p=0.005) LCQ scores. However, there was not a significant pre- to post-treatment LCQ score improvement in control group. Conclusion CST might be an effective supplemental intervention for CRC.
Background: The purpose of this study is to investigate the effect of muscle energy technique and stretching on pain and pressure pain fear-avoidance beliefs questionnaire in patients with chronic back pain aged 30~40 years. Design: Pretest-Posttest design: single blind. Methods: The subjects of this study were 30, 22 males and 8 females between the ages of 30 and 40 with chronic back pain. Each group consists of three groups of 10 people. Changes in back pain were observed using Korean version of Oswestry Disability Index (K-ODI), visual analogue scale (VAS), and fear-avoidance beliefs questionnaire (FABQ). And the change in tenderness was observed using digital pressure statistics. Changes between groups after 3 weeks were compared with those before the experiment using one way ANOVA to determine the changes after 3 weeks. And the change within the group was investigated using the paired t-test. Results: As a result of the experiment, there were significant differences in the group changes in K-ODI, VAS, FABQ, and pressure pain (p<0.05). And there was a significant difference in all items after 3 weeks compared to before the experiment (p<0.05). Conclusion: In patients with chronic back pain, the muscle energy technique and stretching gave a significant difference in pain and pressure pain, fear-avoidance beliefs questionnaire changes. And this result suggests the possibility of providing basic data for future research and clinical physiotherapy intervention.
Ciudad, Pedro;Escandon, Joseph M.;Manrique, Oscar J.;Bustos, Valeria P.
Archives of Plastic Surgery
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v.49
no.2
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pp.227-239
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2022
Complications experienced during lymphatic surgery have not been ubiquitously reported, and little has been described regarding how to prevent them. We present a review of complications reported during the surgical management of lymphedema and our experience with technical considerations to reduce morbidity from lymphatic surgery. A comprehensive search across different databases was conducted through November 2020. Based on the complications identified, we discussed the best approach for reducing the incidence of complications during lymphatic surgery based on our experience. The most common complications reported following lymphovenous anastomosis were re-exploration of the anastomosis, venous reflux, and surgical site infection. The most common complications using groin vascularized lymph node transfer (VLNT), submental VLNT, lateral thoracic VLNT, and supraclavicular VLNT included delayed wound healing, seroma and hematoma formation, lymphatic fluid leakage, iatrogenic lymphedema, soft-tissue infection, venous congestion, marginal nerve pseudoparalysis, and partial flap loss. Regarding intra-abdominal lymph node flaps, incisional hernia, hematoma, lymphatic fluid leakage, and postoperative ileus were commonly reported. Following suction-assisted lipectomy, significant blood loss and transient paresthesia were frequently reported. The reported complications of excisional procedures included soft-tissue infections, seroma and hematoma formation, skin-graft loss, significant blood loss, and minor skin flap necrosis. Evidently, lymphedema continues to represent a challenging condition; however, thorough patient selection, compliance with physiotherapy, and an experienced surgeon with adequate understanding of the lymphatic system can help maximize the safety of lymphatic surgery.
The purpose of this study was to systematic review about randomized controlled trials the characteristics and effect of non-pharmacological intervention on depressive symptom in elderly with mild cognitive impairment. We searched studies published from January 2011 to July 2021 in 3 databases. A total 1,455 studies were found and included 11 studies in final analysis. Methodological quality was assessment with the Cochrane's RoB(risk of bias) tool. Geriatric Depression Scale(GDS) was the most used as the assessment tool for identifying the depressive symptom. Intervention were yoga, psychosocial intervention, cognitive training, health education, multi-component intervention, game training, aerobic/pulmonary physiotherapy, art therapy, music reminiscence activity, memory specificity training, cognitive stimulation therapy and SWTW(sleep well, think well) program. Among the intervention programs, yoga, multi-component intervention and game training were effective in improving depressive symptom. This study provided a clinical evidence for planning and implementing intervention on depressive symptom in elderly with mild cognitive impairment.
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