Physiotherapy theory and practice
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Physiother Theory Pract · Jun 2020
Consideration of prevention and management of long-term consequences of post-acute respiratory distress syndrome in patients with COVID-19.
This manuscript provides support for physical therapists to focus on the long-term, as well as the short-term, consequences of acute respiratory distress syndrome (ARDS) associated with COVID-19. Since late November 2019, COVID-19 has become a global health pandemic and threat. ⋯ However, in recent years, research has focused on poor long-term functional outcomes in patients with ARDS, often associated with ICU-acquired weakness, deconditioning, and myopathies and neuropathies. In addition to physical therapists providing respiratory support in the ICU, the literature unequivocally supports the view that early intervention for ICU management of patients with ARDS secondary to COVID-19 needs to focus on reducing contributors to impaired long-term function, with direct attention paid to preventing or managing ICU-acquired weakness, deconditioning, and myopathies and neuropathies, in conjunction with respiratory care.
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Physiother Theory Pract · Apr 2020
Inter-observer reliability of trained physiotherapists on the Functional Status Score for the Intensive Care Unit Chilean-Spanish version.
Purpose: Evaluate inter-observer reliability of trained physiotherapists administering the Chilean-Spanish version of the Functional Status Score for the Intensive Care Unit (FSS-ICU). Methods: Six adult patients in a medical-surgical ICU were assessed and video-recorded by 1 of 2 expert physiotherapists. Twelve physiotherapists were then trained using recommended Spanish-language FSS-ICU materials. ⋯ The modified Bland-Altman plot revealed a mean difference of 0.6 (95% limits of agreement: -3.3 to 4.5). Conclusions: Twelve trained physiotherapists had excellent inter-observer reliability when administering the Chilean-Spanish FSS-ICU using videos of six critically ill patients, and had excellent agreement with an expert, revealing differences within the established minimal important difference. These findings provide new data supporting clinimetric properties of the Chilean-Spanish FSS-ICU.
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Physiother Theory Pract · Apr 2020
Dynamics of cardiorespiratory response during and after the six-minute walk test in patients with heart failure.
Purpose: The six-minute walk test (6MWT) is a useful measure to evaluate exercise capacity with a simple method. The kinetics of oxygen uptake ([Formula: see text]O2) throughout constant-load exercise on cardiopulmonary exercise testing (CPX) are composed of three phases and the [Formula: see text]O2 kinetics are delayed in patients with heart failure (HF). This study aimed to investigate the kinetics of the cardiorespiratory response during and after the 6MWT according to exercise capacity. ⋯ In the HF-L group, [Formula: see text]O2 and VE stabilized from 4 min, respectively, during the 6MWT and did not recover within 3 min after the 6MWT ended. On CPX in the HF-M group, [Formula: see text]O2 peak, and anaerobic threshold were significantly higher, while the relationship between minute ventilation and carbon dioxide production was lower compared with the HF-L group. Conclusion: In lower exercise capacity patients with HF had slower [Formula: see text]O2 and [Formula: see text]E kinetics during and after the 6MWT.
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Physiother Theory Pract · Jan 2020
Comparison of reliability and efficiency of two modified two-point discrimination tests and two-point estimation tactile acuity test.
Objectives: Determine reliability and minimal detectible difference of two modified two-point discrimination (TPD) testing methods and explore reliability of newer tactile acuity test, two-point estimation (TPE) method. Design: Non-experimental observational reliability study. Setting: Community. ⋯ Time to perform the TPD test were between 54 and 108 seconds, while TPE was 12 seconds. Conclusion: The modified TPD testing methods demonstrated similar reliability to previous research, even with reduced runs allowing for increased efficiency in performing the test. The TPE method showed poor reliability, so caution should be applied when using this method.
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Physiother Theory Pract · Jan 2020
Randomized Controlled TrialPain management using a multimodal physiotherapy program including a biobehavioral approach for chronic nonspecific neck pain: a randomized controlled trial.
Objective: To determine the effectiveness of a therapeutic patient education (TPE) intervention based on a biobehavioral approach combined with manual therapy (MT) to reduce pain in patients with chronic nonspecific neck pain (CNSNP). In addition, this study intended to assess the effectiveness of a multimodal physiotherapy program including TPE to reduce pain in patients with CNSNP. Design: Single-blind randomized controlled trial. ⋯ Results: Statistically significant differences in pain intensity were found when Exp2 was compared with Exp1 and the control group at 4 months (p = 0.015 and p = 0.001, respectively), but no difference was found between Exp1 and the control group at the same follow-up period (p = 0.86). Exp2 showed statistically significant differences in all of the secondary outcomes except for pain catastrophizing when compared with the control group at 4 months. Conclusions: The Exp2 group was more effective than Exp1 and the control group in terms of reducing pain intensity at 4 months; at post-treatment, only Exp2 was more effective than the control group.