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A Comparative Study to Evaluate Efficacy of Curcumin and Aloe Vera Gel along with Oral Physiotherapy in the Management of Oral Submucous Fibrosis: A Randomized Clinical Trial.
Nerkar Rajbhoj, A, Kulkarni, TM, Shete, A, Shete, M, Gore, R, Sapkal, R
Asian Pacific journal of cancer prevention : APJCP. 2021;(S1):107-112
Abstract
UNLABELLED Rationale (Hypothesis): The antioxidant,anti-inflammatory,immunomodulatory and anti-tumorigenic properties of natural plant's extracts like aloe Vera and curcumin may produce beneficial therapeutic effects on OSMF patients and may lead to their symptomatic relief. Also, increase in the tissue elasticity with the help of oral physiotherapy excercises , would help in reinforcing increment in mouth opening. AIM: The aim of the study is to compare the efficacy of Curcumin gel with Aloe Vera gel when both the gel are supplemented along with oral physiotherapy in the management of OSMF. MATERIALS AND METHODS A study of parallel group trial design, using simple randomization technique, was conducted on confirmed cases of OSMF. Patients were divided into two groups, one group(30 patients) was given curcumin gel(Curenext) and other group (30 patients) aloe Vera gel (Aloe Vera 100% relief) and each group was asked to do same oral physiotherapy excercises supplementally. Follow-up was done for 6 weeks and patients were assessed on the basis of improvement in mouth opening and burning sensation at 2, 4, and 6 weeks. RESULTS There was an improvement in both the parameters at subsequent visits, but the Aloe Vera gel showed better improvement than curcumin gel in burning sensation after 6 weeks of treatment which was highly statistically significant p < 0.01. CONCLUSION Curcumin gel and Aloe Vera gel are effective in improving OSMF symptoms, but aloe Vera gel is more efficacious in burning sensation improvement without any side effects. Hence, we can advocate these drugs as adjuvant treatment in addition to the recommended treatment.
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The history of light therapy in hospital physiotherapy and medicine with emphasis on Australia: Evolution into novel areas of practice.
Liebert, A, Kiat, H
Physiotherapy theory and practice. 2021;(3):389-400
Abstract
Objective: The objective of this narrative review was to investigate the history of light therapy in hospital settings, with reference to physiotherapy and particularly in an Australian context.Types of articles and search method:a review of available literature was conducted on PubMed, Medline and Google Scholar using keywords light therapy, photobiomodulation, physiotherapy, low-level laser, heliotherapy. Physiotherapy textbooks from Sydney University Library were searched. Historical records were accessed from the San Hospital library. Interviews were conducted with the San Hospital Chief Librarian and a retired former Head Physiotherapist from Royal Prince Alfred Hospital.Summary: Historically, light treatment has been used in both medical and physiotherapy practice. From its roots in ancient Egypt, India, and Greece, through to medieval times, the modern renaissance in 'light as therapy ' was begun by Florence Nightingale who, in the 1850s, advocated the use of clean air and an abundance of sunlight to restore health. Modern light therapy (phototherapy) had a marked uptake in use in medicine in Scandinavia, America, and Australia from 1903, following the pioneering work of Niels Finsen in the late 19th century, which culminated in Dr Finsen receiving the Nobel Prize for Medicine for the treatment of tuberculosis scarring with ultraviolet (UV) light, and treatment of smallpox scarring with red light. Treatment with light, especially UVB light, has been widely applied by physiotherapists in hospitals for dermatological conditions since the 1950s, particularly in Australia, Scandinavia, USA, England and Canada. In parallel, light treatment in hospitals for hyperbilirubinemia was used for neonatal jaundice. Since the 1980s light was also used in the medical specialties of ophthalmology, dermatology, and cardiology. In more recent years in physiotherapy, light was mostly used as an adjunct to the management of orthopedic/rheumatological conditions. Since the 1990s, there has been global use of light, in the form of photobiomodulation for the management of lymphedema, including in supportive cancer care. Photobiomodulation in the form of low-level laser has been used by physiotherapists and pain doctors since the 1990s in the management of chronic pain. The use of light as therapy is exemplified by its use in the San Hospital in Sydney, where light therapy was introduced in 1903 (after Dr. John Harvey Kellogg visited Niels Finsen in Denmark) and is practiced by nurses, physiotherapists and doctors until the present day. The use of light has expanded into new and exciting practices including supportive cancer care, and treatment of depression, oral mucositis, retinopathy of prematurity, and cardiac surgery complications. Light is also being used in the treatment of neurological diseases, such as Parkinson's disease, traumatic brain injury, and multiple sclerosis. The innovative uses of light in physiotherapy treatment would not be possible without the previous experience of successful application of light treatment.Conclusion: Light therapy has had a long tradition in medicine and physiotherapy. Although it has fallen somewhat out of favour over the past decades, there has been a renewed interest using modern techniques in recent times. There has been continuous use of light as a therapy in hospitals in Australia, most particularly the San Hospital in Sydney where it has been in use for almost 120 years.
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A Consensus Statement for the Management and Rehabilitation of Communication and Swallowing Function in the ICU: A Global Response to COVID-19.
Freeman-Sanderson, A, Ward, EC, Miles, A, de Pedro Netto, I, Duncan, S, Inamoto, Y, McRae, J, Pillay, N, Skoretz, SA, Walshe, M, et al
Archives of physical medicine and rehabilitation. 2021;(5):835-842
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Abstract
OBJECTIVE To identify core practices for workforce management of communication and swallowing functions in coronavirus disease 2019 (COVID-19) positive patients within the intensive care unit (ICU). DESIGN A modified Delphi methodology was used, with 3 electronic voting rounds. AGREE II and an adapted COVID-19 survey framework from physiotherapy were used to develop survey statements. Sixty-six statements pertaining to workforce planning and management of communication and swallowing function in the ICU were included. SETTING Electronic modified Delphi process. PARTICIPANTS Speech-language pathologists (SLPs) (N=35) from 6 continents representing 12 countries. INTERVENTIONS Not applicable. MAIN OUTCOME MEASURES The main outcome was consensus agreement, defined a priori as ≥70% of participants with a mean Likert score ≥7.0 (11-point scale: 0=strongly disagree, 10=strongly agree). Prioritization rank order of statements in a fourth round was also conducted. RESULTS SLPs with a median of 15 years of ICU experience, working primarily in clinical (54%), academic (29%), or managerial positions (17%), completed all voting rounds. After the third round, 64 statements (97%) met criteria. Rank ordering identified issues of high importance. CONCLUSIONS A set of global consensus statements to facilitate planning and delivery of rehabilitative care for patients admitted to the ICU during the COVID-19 pandemic were agreed by an international expert SLP group. Statements focused on considerations for workforce preparation, resourcing and training, and the management of communication and swallowing functions. These statements support and provide direction for all members of the rehabilitation team to use for patients admitted to the ICU during a global pandemic.
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Does vibration benefit delayed-onset muscle soreness?: a meta-analysis and systematic review.
Lu, X, Wang, Y, Lu, J, You, Y, Zhang, L, Zhu, D, Yao, F
The Journal of international medical research. 2019;(1):3-18
Abstract
OBJECTIVE Delayed-onset muscle soreness (DOMS) is a symptom of exercise-induced muscle injury that is commonly encountered in athletes and fitness enthusiasts. Vibration is being increasingly used to prevent or treat DOMS. We therefore carried out a meta-analysis to evaluate the effectiveness of vibration in patients with DOMS. METHOD We searched nine databases for randomized controlled trials of vibration in DOMS, from the earliest date available to 30 May 2018. Visual analogue scale (VAS) and creatine kinase (CK) levels were set as outcome measures. RESULTS The review included 10 identified studies with 258 participants. The meta-analysis indicated that vibration significantly improved the VAS at 24, 48, and 72 hours after exercise, and significantly improved CK levels at 24 and 48 hours, but not at 72 hours. CONCLUSION Vibration is a beneficial and useful form of physiotherapy for alleviating DOMS. However, further studies are needed to clarify the role and mechanism of vibration in DOMS.
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Primary care implications of the British Thoracic Society Guidelines for bronchiectasis in adults 2019.
Gruffydd-Jones, K, Keeley, D, Knowles, V, Recabarren, X, Woodward, A, Sullivan, AL, Loebinger, MR, Payne, K, Harvey, A, Grillo, L, et al
NPJ primary care respiratory medicine. 2019;(1):24
Abstract
The British Thoracic Society (BTS) Guidelines for Bronchiectasis in adults were published in January 2019, and comprise recommendations for treatment from primary to tertiary care. Here, we outline the practical implications of these guidelines for primary care practitioners. A diagnosis of bronchiectasis should be considered when a patient presents with a recurrent or persistent (>8 weeks) productive cough. A definitive diagnosis is made by using thin-section chest computed tomography (CT). Once diagnosed, patients should be initially assessed by a specialist respiratory team and a shared management plan formulated with the patient, the specialist and primary care teams. The cornerstone of primary care management is physiotherapy to improve airway sputum clearance and maximise exercise capacity, with prompt treatment of acute exacerbations with antibiotics.
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Exploring variation in patient access of post-discharge physiotherapy following total hip and knee arthroplasty under a choice based system in the UK: an observational cohort study.
Hamilton, DF, Loth, FC, MacDonald, DJ, MacFarlane, GJ, Beard, DJ, Simpson, AHR, Patton, JT, Howie, CR
BMJ open. 2019;(2):e021614
Abstract
OBJECTIVES To assess a targeted 'therapy as required' model of post-discharge outpatient physiotherapy provision. Specifically, we investigated what proportion of patients accessed post-discharge physiotherapy following total hip arthroplasty (THA) and total knee arthroplasty (TKA), whether accessing therapy was associated with post-arthroplasty patient reported outcomes and whether it was possible to predict which patients would access post-discharge physiotherapy from pre-operative data. DESIGN Prospective, observational, longitudinal cohort study. SETTING Single National Health Service orthopaedic teaching hospital in the UK. PARTICIPANTS 1395 patients undergoing total hip arthroplasty and 1374 patients undergoing total knee arthroplasty. PRIMARY AND SECONDARY OUTCOME MEASURES Self-reported access of post-discharge physiotherapy, the Oxford Hip or Knee Score, EuroQol 5-dimension questionnaire and post-operative surgical episode satisfaction metric. RESULTS 662 (48.2%) patients with TKA and 493 (35.3%) patients with THA accessed additional post-discharge physiotherapy. Patient-reported outcomes (p<0.001) and surgical episode satisfaction (p=0.001) in both THA and TKA were higher in patients that did not participate in post-discharge physiotherapy. Regression models using pre-operative symptom burden and demographic data predicted post-discharge therapy access with an accuracy of only 17% greater than chance in patients with THA and 7% greater than chance in patients with TKA. CONCLUSIONS In a choice-based service model of 'therapy as required' following hip and knee arthroplasty only a third of THA and half of TKA patients accessed post-discharge therapy. Patients who did not access physiotherapy reported greater post-operative outcomes. This variation in the need for post-discharge physiotherapy suggests that targeting of rehabilitation may be a cost-effective model, however it was not possible to reliably predict which patients would access post-discharge physiotherapy from pre-operative data.
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The effects of the Bowen technique on hamstring flexibility over time: a randomised controlled trial.
Marr, M, Baker, J, Lambon, N, Perry, J
Journal of bodywork and movement therapies. 2011;(3):281-90
Abstract
The hamstring muscles are regularly implicated in recurrent injuries, movement dysfunction and low back pain. Links between limited flexibility and development of neuromusculoskeletal symptoms are frequently reported. The Bowen Technique is used to treat many conditions including lack of flexibility. The study set out to investigate the effect of the Bowen Technique on hamstring flexibility over time. An assessor-blind, prospective, randomised controlled trial was performed on 120 asymptomatic volunteers. Participants were randomly allocated into a control group or Bowen group. Three flexibility measurements occurred over one week, using an active knee extension test. The intervention group received a single Bowen treatment. A repeated measures univariate analysis of variance, across both groups for the three time periods, revealed significant within-subject and between-subject differences for the Bowen group. Continuing increases in flexibility levels were observed over one week. No significant change over time was noted for the control group.
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Implementing one standardized rehabilitation protocol following autologous chondrocyte implantation or microfracture in the knee results in comparable physical therapy management.
Assche, DV, Caspel, DV, Staes, F, Saris, DB, Bellemans, J, Vanlauwe, J, Luyten, FP
Physiotherapy theory and practice. 2011;(2):125-36
Abstract
OBJECTIVE The major aim of the study was (1) to compare the physiotherapy management in patients treated with autologous chondrocyte implantation (ACI) versus microfracture (MF) at the knee using a standardized rehabilitation protocol; and (2) to investigate the effect of activities in low-load conditions after surgery on the functional recovery was explored. DESIGN 95 physiotherapists received a standardized rehabilitation protocol that was used in a randomized controlled trial. A secondary analysis on patients' outcome was studied in a cohort design. OUTCOME MEASURES An electronic report form including 18 physiotherapy variables was used to compare physiotherapy management. Patients' functional outcome was assessed using the KOOS (Knee Injury Osteoarthritis Outcome Score) and the pooled symmetry index (SI) based on one strength and three hop tests. Both subjective and objective outcomes were evaluated pre-surgery, and at 1 and 2 years post-surgery. RESULTS 65 physiotherapists adhered very consistently to the protocol during the first 3 months and showed a similar preference and timing for the physiotherapy modalities in both treatment groups. Patients with high amount of low-load activities (LLA+, n=21) post-surgery performed significantly better compared to patients with low amount of LLA (LLA-, n=17). At 24 months the mean pooled SI of LLA+ cohort was 92.4 compared to 78.2 for LLA- cohort (95% confidence interval [CI] 1.8 to 26.2). CONCLUSION Overall, the compliance post-surgery with the rehabilitation protocol was excellent and the applied rehabilitation was comparable in both treatment groups. A high amount of low-load activities post-surgery appears beneficial for the objective functional outcome.
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Device use: walking AIDS, braces, and orthoses for symptomatic knee osteoarthritis.
Gross, KD
Clinics in geriatric medicine. 2010;(3):479-502
Abstract
With too few conservative options in the current medical system, increasing numbers of osteoarthritis (OA) sufferers are using untested folk remedies and self-prescribed dietary supplements. There is enormous popular demand for noninvasive and nonpharmacologic therapies for OA, and there is a pressing need for clinicians to respond to this demand by updating their practice. This review introduces clinicians to the most important noninvasive devices used in the conservative management of knee OA. Because the shared goal of these devices is to favorably alter lower limb biomechanics, each section of the review considers evidence of biomechanical and clinical efficacy.
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Rehabilitation after critical illness: could a ward-based generic rehabilitation assistant promote recovery?
Salisbury, LG, Merriweather, JL, Walsh, TS
Nursing in critical care. 2010;(2):57-65
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Abstract
AIM: The aim of this paper is to explore issues surrounding the implementation of a generic rehabilitation assistant (GRA) to provide ward-based rehabilitation after critical illness. BACKGROUND Following critical illness a range of both physical and psychological problems can occur that include muscle wasting and weakness, fatigue, reduced appetite, post-traumatic stress, anxiety and depression. Limited research exists evaluating the provision of rehabilitation to this patient group. This paper explores one possible service delivery model providing ward-based rehabilitation after critical illness. The model explored is a GRA working in conjunction with ward-based staff. RESULTS We describe how a GRA worked effectively with ward-based teams to provide additional rehabilitation in the period after discharge from intensive care. Benefits included greater continuity of care that was flexible to the individual needs of patients. Some aspects of the role were challenging for the GRA and highlighted the need for good communication skills. A need for comprehensive training of the GRA was demonstrated. CONCLUSIONS Our experience demonstrates that it is feasible to deliver ward-based rehabilitation after critical illness using the GRA service delivery model. RELEVANCE TO CLINICAL PRACTICE This model of service delivery offers the potential to improve outcomes for patients after a critical illness. Further research evaluating this model of care is required before implementation into clinical practice.