{"title":"Tackling multimorbidity: patient characteristics and outcomes from a generic rehabilitation programme","authors":"Aynsley Cowie, Janet Mckay, J. Holt, Moray Baylis","doi":"10.12968/ijtr.2021.0036","DOIUrl":"https://doi.org/10.12968/ijtr.2021.0036","url":null,"abstract":"This service evaluation analyses the first 3 years of a novel 10-week generic rehabilitation programme, describing the cohort population assessed at baseline, and examining outcomes generated by programme completion. The programme is part of a wider specialist-generalist health and social care model, based within Ayrshire, Scotland, which has been designed to be a sustainable approach to tackling multimorbidity. Sociodemographic and diagnostic data were obtained for all service users who attended for baseline assessment. Two groups were compared: those who completed the 10-week programme (completers group) and those who did not (assessment+ group). Quality of life data were obtained from the completers group at the start and end of the 10-week programme, while emergency bed days accrued in the 12 months pre- and post-referral were recorded from both groups. Over 3 years, n=978 service users attended for assessment (mean age 66.3 years; male:female ratio 441:537 [45%:55%]; average of four co-existing conditions). Deprivation was significantly higher for the assessment+ group (P=0.003). The completers group demonstrated significant improvements across various quality of life outcomes (P<0.001), and significantly reduced emergency bed days (P=0.005; P=0.001) following the programme. In this generic multimorbidity rehabilitation programme, the baseline population was older adults, comprised slightly more women than men, and who had presented with complex multimorbidity. Deprivation was significantly higher in those who did not complete the programme, and further qualitative and quantitative exploration of this group is required. Completing the programme appeared to significantly improve quality of life and unscheduled care use.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42315913","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Does patient mobilisation culture really begin in intensive care settings?","authors":"M. Polastri, Claire Black, Allaina Eden","doi":"10.12968/ijtr.2022.0041","DOIUrl":"https://doi.org/10.12968/ijtr.2022.0041","url":null,"abstract":"","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44082032","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Punia, Varun Singh, Shabnam Joshi, M. Malik, M. Saini
{"title":"Effects of walking in individuals with prehypertension and stage 1 hypertension in India: a randomised controlled trial","authors":"S. Punia, Varun Singh, Shabnam Joshi, M. Malik, M. Saini","doi":"10.12968/ijtr.2020.0163","DOIUrl":"https://doi.org/10.12968/ijtr.2020.0163","url":null,"abstract":"Physical activity, such as walking, is a cheap approach with a low risk of injury that can be used in daily life. The aim of this study was to determine the effects of low impact aerobic exercise training on resting blood pressure in patients with prehypertension and stage 1 hypertension specifically for people in India. A total of 63 sedentary adults with prehypertension and stage 1 hypertension participated in the study. All sedentary adults were randomly allocated to either the study group (aerobic training) (n=30) or the control group (n=33). Those in the study group walked for 30 minutes, three times a week for 8 weeks at an intensity of 60–75% of their target heart rate. The control group received no training but followed their usual prescribed medication and diet. The primary outcomes of systolic blood pressure and diastolic blood pressure were measured at the end of every 2 weeks for 8 weeks. Secondary outcomes of pulse pressure, mean arterial pressure and pulse rate were calculated. Significant changes in various outcome measures in the study group were noted (systolic blood pressure=7.30 mmHg (95% confidence interval [CI] 2.14 to 3.00; P=0.001); diastolic blood pressure=6.50 mmHg (95% CI 1.23 to 4.04; pulse pressure=0.000; mean arterial pressure=6.77 mmHg (95% CI 1.46 to 3.84; P=0.000) and pulse rate=6.90 bpm (95% CI 1.73 to 3.43; P=0.000) when compared with those in the control group, who had non-significant changes. The findings of the present study concluded that aerobic exercise training improves blood pressure.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-04-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41748767","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Acute effects of varying densities of foam roller on hamstring flexibility and eccentric strength","authors":"D. Rhodes, Sean Crowie, J. Alexander","doi":"10.12968/ijtr.2020.0130","DOIUrl":"https://doi.org/10.12968/ijtr.2020.0130","url":null,"abstract":"Foam rolling is a popular form of self-administered soft tissue therapy, commonly used in sporting environments. There are several variations in foam roller types including differences in density. No studies have examined the effects of different density type rollers on performance. This study compares the effects of varying foam roller density on hamstring flexibility and eccentric hamstring strength in active men. A total of 28 healthy male participants (height 176.7 ± 5.9 cm; body mass 75.8 ± 9.6 kg; age 21.6 ± 4.0 years) were randomly allocated to receive a low density, medium density or high density foam roller or allocated to a control group. Outcome measures included hamstring flexibility through active knee extension (°) and eccentric hamstring strength pre and immediately-post foam roller application. Significant foam roller x time interactions were found for hamstring flexibility (P<0.05). Significant increases in active knee extension were reported post-foam roller application for all foam roller densities (P<0.05). No significant changes in strength parameters (break angle, peak and average force and torque) were found (P>0.05). No significant interactions between strength parameters, limb, type of roller or time were found (P>0.05). Foam roller use elicits immediate positive increases in hamstring flexibility through active knee extension assessment, with the lower density foam roller displaying the largest increases in hamstring flexibility. No change in strength parameters were noted with the increases in flexibility; however, this does not denote that injury risk is reduced because of this. Findings provide practitioners with insight to inform decision making for the use of different densities of foam roller in practical settings.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44872386","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RM Akhila, S. Karthikbabu, Divya Mohan, prem venkatesan, A. K. Roy
{"title":"Task-related trunk training on balance, trunk control, pulmonary function and quality of life in patients with Parkinson's disease. A randomised controlled trial","authors":"RM Akhila, S. Karthikbabu, Divya Mohan, prem venkatesan, A. K. Roy","doi":"10.12968/ijtr.2020.0146","DOIUrl":"https://doi.org/10.12968/ijtr.2020.0146","url":null,"abstract":"Stooped posture and ‘en-bloc’ movement of the trunk in people with Parkinson's disease are related to balance issues, pulmonary dysfunction and difficulty in daily tasks. The primary objective of this study was to examine the effects of task-related trunk training on balance in people with Parkinson's disease. The secondary objective was to observe whether trunk control, thoracic rotation range, pulmonary function and quality of life would change for patients with Parkinson's disease after trunk training. A total of 32 individuals participated in this randomised controlled trial. They had a mean age of 70.8 years, with a modified Hoehn and Yahr Scale grade of 1.5–3, could take more than six steps in the 360° turn test, were scored as grade I or II on the retropulsion test and had an absence of severe cognitive deficits. Task-related trunk training emphasised the thoracic spine's extension and rotation in prone position on elbows, hands and knees and in kneeling, sitting and standing positions. Standard physiotherapy included breathing exercises, stretching of shoulder and neck muscles, balance and walking training. Both groups practised for 1 hour a day, 3 days a week over 6 weeks. The primary outcome measure was the Mini-Balance Evaluation Systems Test. The secondary outcome measures were the Trunk Control Test, thoracic rotation range of movement, Pulmonary Function Test and Parkinson's Disease Questionnaire-39. Repeated measure analysis of variance revealed significant group by time interaction for the Mini-Balance Evaluation Systems Test and thoracic rotation range (P<0.05), but not for the pulmonary function test and quality of life measures. Task-related trunk training appears to be more beneficial in the balance capacity of individuals with Parkinson's disease than standard physiotherapy, but does not have any significant effects for pulmonary function and health-related quality of life.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49167425","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Quality of life impacts and wider benefits following upper limb surgery for spasticity management","authors":"L. Duke, Sohail Salam, S. Stevenson","doi":"10.12968/ijtr.2020.0158","DOIUrl":"https://doi.org/10.12968/ijtr.2020.0158","url":null,"abstract":"A new, collaborative, multidisciplinary clinic for the management of people with upper limb spasticity and contracture was established between two healthcare trusts. The aim of this study was to determine the perceived benefits to patients of this new clinic and of upper limb surgery, where performed. A service evaluation of a collaborative upper limb surgical assessment clinic for patients with complex problems of their upper limbs as a result of spasticity was undertaken. Questionnaires were distributed to 21 patients who attended the clinic in its first year (December 2017–2018), with follow-up focus groups. A rough cost–benefit review was undertaken. Patients highlighted benefits in both passive and active care tasks. They chose outcome measures that they felt were most useful to measure these benefits and coproduced multimedia information resources. The cost–benefit review indicated that a break-even point could be reached in as little as 1 year. The team has gained a broad perspective of potential impacts on the patient and their carers, as well as future service development and research options.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49229877","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shelley Fulton, Tyson Baird, Siang Naik, K. Stiller
{"title":"Prehabilitation-plus for patients undergoing major lower limb amputation may reduce acute hospital and total hospital length of stay: a retrospective, matched, case-controlled pilot service evaluation","authors":"Shelley Fulton, Tyson Baird, Siang Naik, K. Stiller","doi":"10.12968/ijtr.2020.0156","DOIUrl":"https://doi.org/10.12968/ijtr.2020.0156","url":null,"abstract":"‘Prehabilitation’ refers to interventions that seek to enhance a person's functional capacity to help withstand a forthcoming stressor, such as major surgery. There is little research evaluating prehabilitation before major lower limb amputation. This study evaluated if a comprehensive multidisciplinary pre-admission programme, which included prehabilitation plus other interventions (eg education, home assessment and modifications), hereinafter called ‘prehabilitation-plus’, might shorten hospital length of stay by allowing earlier discharge home from hospital after major lower limb amputation. The aim of this study was to investigate the effect of prehabilitation-plus on hospital length of stay and discharge destination for patients undergoing major lower limb amputation. Seven patients receiving prehabilitation-plus were retrospectively matched with seven control patients in this case-controlled pilot service evaluation. Prehabilitation-plus was provided by a multidisciplinary team. Hospital length of stay was compared using Mann–Whitney U tests and discharge destination using Fisher's exact test. Acute hospital and total hospital length of stay were significantly lower in the prehabilitation-plus group than the control group (P=0.038 and 0.011 respectively). No significant difference was seen for rehabilitation hospital length of stay (P=0.400). More prehabilitation-plus patients were discharged directly home after their acute hospital stay, but this was not significant (P=0.286). Patients who received prehabilitation-plus had reduced acute hospital and total hospital length of stay compared to matched control patients. While these preliminary results are promising for the ability of programmes such as prehabilitation-plus to reduce hospital length of stay, further studies with more robust designs are required to confirm and extend this finding.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45400887","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
P. Ahadi, Mandana Rezaei, Z. Salahzadeh, M. Talebi, P. Sarbakhsh, M. Azghani
{"title":"Assessment of the head, cervical spine, thoracic spine and shoulder girdle postures in people with and without chronic headache","authors":"P. Ahadi, Mandana Rezaei, Z. Salahzadeh, M. Talebi, P. Sarbakhsh, M. Azghani","doi":"10.12968/ijtr.2019.0140","DOIUrl":"https://doi.org/10.12968/ijtr.2019.0140","url":null,"abstract":"Cervical dysfunction is one of the common symptoms of chronic headaches. This study was conducted to assess the posture of the head, cervical and thoracic spine and the shoulder girdle in people with and without cervicogenic and migraine headaches. The postural angles of the head, cervical and thoracic spine and the shoulder girdle in frontal and sagittal planes, as well as thoracic spine curvature, were measured on 90 people who were split into three groups: 20 people with cervicogenic headache, 20 people with migraine and 50 people as the control group. There were significant differences among the three groups in the craniovertebral angle, coronal head tilt angle and scapular upward rotation angle (P<0.05). There was no relationship between postural angles. The results of this study revealed that forward head posture was evident in people with cervicogenic and migraine headache. Decreased scapular upward rotation seen in the migraine headache group highlights the importance of shoulder girdle-related dysfunctions in people with chronic headaches.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48677548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Gemma M. Clunie, L. Bolton, L. Lovell, Elizabeth Bradley, Cara Bond, Sarah Bennington, J. Roe
{"title":"Considerations for speech and language therapy management of dysphagia in patients who are critically ill with COVID-19: a single centre case series","authors":"Gemma M. Clunie, L. Bolton, L. Lovell, Elizabeth Bradley, Cara Bond, Sarah Bennington, J. Roe","doi":"10.12968/ijtr.2021.0078","DOIUrl":"https://doi.org/10.12968/ijtr.2021.0078","url":null,"abstract":"Patients treated with intubation and tracheostomy for COVID-19 infection are at risk of increased incidence of laryngeal injury, dysphagia and dysphonia. Because of the novelty of the SARS-CoV-2 virus, little is known about the type of dysphagia patients experience as a result of infection and critical illness. The aim of this case series report was to progress understanding of COVID-19 and dysphagia following admission to an intensive care unit and to guide speech and language therapy clinical practice in the ongoing pandemic. A retrospective case review was conducted of all patients at Imperial College Healthcare NHS Trust, London who underwent a tracheostomy because of COVID-19 and received an instrumental assessment of swallowing in the early stages of the pandemic. A total of 11 patients were identified, and descriptive statistics were used to present demographic data, with a narrative account of their dysphagia profile used to describe presentation. Causes and presentation of dysphagia were heterogenous, with each patient requiring individualised clinical management to maximise outcome. A positive trend was seen in terms of recovery trajectory and progressing to oral intake. This study reports on early experience of the presentation of dysphagia in patients with COVID-19 and demonstrates the value of instrumental assessment. It indicates the need for further research to consolidate knowledge and guide clinical practice.","PeriodicalId":46562,"journal":{"name":"International Journal of Therapy and Rehabilitation","volume":" ","pages":""},"PeriodicalIF":0.5,"publicationDate":"2022-02-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43203120","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}