Adult patient perceptions on the effectiveness of scoliosis specific exercises

Author(s):  
A Sbihli ◽  
F Tudini ◽  
K Chui

There is a paucity of research focusing on adults with scoliosis, yet many of these individuals suffer from pain and disability. Recent literature has demonstrated that for this patient population general physical therapy is no better than other non-operative treatment options.[1-3] This study assessed the perceptions of the effectiveness of Physiotherapeutic Scoliosis Specific Exercises (PSSE) on adult scoliosis. The purpose of this study is to present the results of a retrospective analysis of how adults with scoliosis perceive that physical therapy utilizing PSSE has impacted their quality of life (QoL), function, and pain. A 10 question survey was sent via a secure server (Qualtrics) to all PSSE participating patients ≥ 18 years old from one PSSE specialty clinic from the beginning of the PSSE program, 7 years. Survey responses were anonymous, collected by someone other than the primary investigator, and statistics were calculated with SPSS 24 (IBM Corp., Armonk, NY). Results: Fifty-seven adults (88.9% female) responded to the survey (55% response rate) with 67.2% being over the age of 55 years. The majority (61.9%) felt that PT had moderately or significantly positively impacted their QoL. The most common number of PT visits ranged from 5–10, after which 71.9% of participants were either somewhat or very confident in their ability to perform their PSSE program unsupervised at home. The most common frequency of home exercise program (HEP) performance was 1-2 times per week (46.0%) for a duration of 5–40 minutes. Quantitative analysis of exercise adherence using a Spearman’s rho (rs) revealed positive associations between confidence in correctly performing the HEP with the perceived positive impact of the exercises (rs = .45, p < .001), the greater frequency of performing the HEP (rs = .30, p = .024) and greater time performing the HEP (rs = .33, p = .004). This retrospective analysis showed that 61.9% of adults with scoliosis felt that PT utilizing PSSE had moderately or significantly positively impacted their QoL. Adherence to a HEP is critical to the success of the program. Greater confidence in correctly performing the HEP was positively correlated with perceived impact, frequency and time spent exercising. The sample was limited to adults from one clinic that specializes in scoliosis and may not be generalizable to other clinics.

Healthcare ◽  
2021 ◽  
Vol 9 (2) ◽  
pp. 109
Author(s):  
Isabel Reed ◽  
Stacy Menz ◽  
Beth A. Smith

The objective of this case series was to examine the potential of the Otteroo as a tool to support physical therapy intervention in infants with or at risk for developmental disability. The Otteroo is a float with potential for use in aquatic therapy sessions or as part of a home exercise program. By tracking the amount of use and caregiver perception of the child’s response, we aimed to generate an understanding of the Otteroo’s potential as a family-based adjunct to physical therapy. Four children at risk of developmental delay participated in this study. The Otteroo was provided for four weeks, with recommendations for use. We used an activity log to track usage and collected survey data of caregiver perception of the child’s response. Activity logs showed that use ranged from 3–7 interactions and a total of 40–99.5 min (x¯ = 54.88, SD = 29.75). The survey responses varied as to whether caregivers perceived their children enjoyed the experience. Future research should focus on finding effective methods of encouraging Otteroo use if efficacy of an intervention is to be tested. This initial work provides a foundation for future efficacy research with the Otteroo in children with or at risk for developmental delay.


2006 ◽  
Vol 86 (3) ◽  
pp. 401-410 ◽  
Author(s):  
Rebecca Forkan ◽  
Breeanna Pumper ◽  
Nicole Smyth ◽  
Hilary Wirkkala ◽  
Marcia A Ciol ◽  
...  

Abstract Background and Purpose. This study looked at adherence, and factors affecting adherence, to a prescribed home exercise program (HEP) in older adults with impaired balance following discharge from physical therapy. Subjects. The subjects were 556 older adults (≥65 years of age) who were discharged from physical therapy during the period 2000 to 2003. Methods. A survey was developed to determine participation in a HEP. Univariate logistic regressions identified specific barriers and motivators that were associated with exercise participation following discharge from physical therapy. Results. Ninety percent of respondents reported receiving a HEP; 37% no longer performed it. Change in health status was the primary reason for poor adherence to a HEP. Eight barriers (no interest, poor health, weather, depression, weakness, fear of falling, shortness of breath, and low outcomes expectation) were associated with a lack of postdischarge participation in exercise. Discussion and Conclusions. Exercise adherence following discharge from a physical therapy program is poor among older adults. Barriers, not motivators, appear to predict adherence. [Forkan R, Pumper B, Smyth N, et al. Exercise adherence following physical therapy intervention in older adults with impaired balance.


2018 ◽  
Vol 3 (3) ◽  
pp. 2473011418S0028
Author(s):  
Meghan Kelly ◽  
Ashlee MacDonald ◽  
Rachel Olson ◽  
Grace Weyand ◽  
Ruth Chimenti ◽  
...  

Category: Sports Introduction/Purpose: Insertional Achilles Tendinopathy (IAT) affects 5% of the general population and up to 20% of the athletic population. Despite trials of non-surgical management such as physical therapy and heels lifts, more than 50% of patients ultimately pursue surgery. One hypothesis regarding the development of IAT pain and stiffness is that ankle dorsiflexion and associated calcaneal impingement causes transverse compression of the tendon insertion, inducing metaplastic changes within the Achilles tendon, and bursa, contributing to inflammation. Thus the aim of the current study is to examine the effect of a home exercise program designed to minimize compression of insertional tissues for patients with IAT on patient reported outcomes (PRO) measures at 3 months and one year. Methods: Thirty-five patients with IAT were enrolled in the study from May 2014 until June 2015 as two separate cohorts (21 and 14 patients, respectively) of whom 26 completed the study (mean age: 56.7 + 10.1 years, BMI: 29.5 + 6.0 kg/m2, 58% women). One patient elected for surgery prior to completing the physical therapy protocol. Physical therapy exercises were progressive eccentric loading of the Achilles tendon and seated isometric plantar flexion that were performed 4 times a week for 3 months. The Victorian Institute of Sport Assessment – Achilles (VISA-A), the Foot and Ankle Ability Measure (FAAM) and the SF-36 questionnaires were completed at baseline and at the completion of the 3-month physical therapy protocol. Six of the 14 patients in the second cohort returned for a 1 year follow up visit; four patients were lost to follow up and 4 had undergone surgical intervention prior to 1-year follow up. Results: Completion of the 3 month protocol resulted in statistically significant improvements in VISA-A, FAAM ADL and sports scores as well as multiple subcategories of the SF-36 (physical function, role limiting physical function, energy/vitality, social functioning and general pain). Twenty-two of the 26 patients (~85%) that completed the study had clinically significant, greater than MCID, improvements in their VISA-A and/or FAAM scores. In the second cohort, all six patients that returned for a one year follow up assessment maintained their improved VISA-A and FAAM scores observed at the end of the initial physical therapy protocol. Of the four patients that underwent surgical intervention prior to follow up, two did not demonstrate improvement in any of their outcomes following the initial study period. Conclusion: The results of the present study suggest that a physical therapy home exercise program utilizing eccentric and isometric Achilles exercises may result in a greater improvement in functional outcomes compared to other exercise programs that do not progressively increase both ankle dorsiflexion and Achilles tendon loading. Furthermore, improvements in pain and function result in increased energy and social wellbeing. Finally, symptomatic improvement that occurs after 3 months is likely to persist for at least one year following initial treatment.


2020 ◽  
Author(s):  
Limin Wang ◽  
Hongbo Chen ◽  
Han Lu ◽  
Yunlin Wang ◽  
Congying Liu ◽  
...  

Abstract Background: Knee osteoarthritis (KOA) is a common joint disease in people over 60 years old. Exercise therapy is one of the most effective non-pharmacological treatments for KOA, but low exercise adherence needs to be improved. The present study aimed to evaluate the effect of the Transtheoretical Model-lead home exercise intervention (TTM-HEI) program on exercise adherence, KOA symptoms, and knee function in older adults with KOA. Methods: A two-arm, superiority, assessor-blinded, cluster randomized trial was conducted. Community-dwelling older adults with KOA were recruited from 14 community centers in Beijing, China, via print and social media advertisements from April to October 2018. The present study lasted 48 weeks, with an intervention duration of 0–24 weeks and follow-up time of 24–48 weeks. The intervention was a two-stage and 24-week TTM-based exercise program, and the control group underwent a same-length exercise program guidance without any exercise-adherence interventions. The primary outcome was exercise adherence to the prescribed home exercise program and was measured using an 11-point numerical (0=not at all through and 10=completely as instructed) self-rating scale at week 4, 12, 24, 36, and 48 after the program started. KOA symptoms (pain intensity and joint stiffness) were measured using the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and knee function (lower limb muscle strength and balance) was measured using the Five-Times-Sit-to-Stand Test (FTSST) and the Timed Up and Go Test (TUG) at baseline, week 24 and week 48. Latent growth model (GLM), repeated measures ANOVA, and independent t-test were the main statistical tests used.Results: A total of 189 older adults (intervention group: n = 103, control group: n = 86) were enrolled. Differences of any outcome measures at baseline were not significant between groups. The growth rate of exercise adherence in the intervention group increased 2.175 units compared with the control group (unstandardized coefficient of slope on group B2 = 2.175, p < 0.001), and the intervention program maintained participants’ exercise adherence with 5.56 (SD = 1.00) compared with 3.16 (SD = 1.31) in the control group at week 48. In addition, TTM-HEI program showed significant effects on relieving KOA symptoms and improving knee function.Conclusion: Over time, TTM-HEI could improve participants’ exercise adherence, KOA symptoms, and knee function.Trial registration: This study was approved by the ethics committee (IRB00001052-17066) in July 2017 and was registered at Chinese Clinical Trails Registry (website: www.chictr.org.cn, registry number: ChiCTR1800015458).


2017 ◽  
Vol 30 (3) ◽  
pp. 242-252 ◽  
Author(s):  
Héctor Gutiérrez-Espinoza ◽  
David Rubio-Oyarzún ◽  
Cristian Olguín-Huerta ◽  
Rodrigo Gutiérrez-Monclus ◽  
Sebastian Pinto-Concha ◽  
...  

2018 ◽  
Vol 31 (1) ◽  
pp. 20-28 ◽  
Author(s):  
Joachim Gülke ◽  
Barbara Leopold ◽  
Daniel Grözinger ◽  
Björn Drews ◽  
Stephan Paschke ◽  
...  

2020 ◽  
Author(s):  
Daniel H. Major ◽  
Margreth Grotle ◽  
Chris Littlewood ◽  
Jens Ivar Brox ◽  
Dagfinn Matre ◽  
...  

Abstract Background: Exercise is recommended for patients with subacromial pain. It has been suggested that good exercise adherence improves clinical outcomes. Despite this, little attention has been paid to the need for behavioural frameworks to enhance adherence to home exercise programs for patients with subacromial pain.Methods: A feasibility study with pre-post design was used. Participants aged > 18 years, with subacromial pain, who had received conservative treatment during the past six months, were recruited. The Ad-Shoulder intervention consisted of 1-5 individual sessions provided over 3 months and was based on 5 self-management skills, which aimed to enhance the patients’ self-efficacy and adherence to self-managed exercises. The primary objectives were assessed according to predefined progression criteria: 1) The recruitment rate (10 patients enrolled within 12 weeks); 2) Follow-up rate (≥80% on all self-reported measures); 3) Objective physical activity measures (≥80% of participants would contribute valid data at each time point), 4) Adherence with the self-managed exercises (≥80% of the participants would adhere to ≥80% of the assigned home exercise program); 5) Fidelity of the delivery of the intervention (The therapists delivered the intervention according to the protocol); 6) Adverse events (<30% would report adverse events (including mild)). The results were reported using descriptive statistics.Results: Eleven patients were recruited during 16 weeks. Ten patients completed the self-reported measures at baseline and Week 12. Objective physical activity measures were successfully obtained for 100% at baseline, 64% at week six and 82% at week 12. 55% of the participants satisfactorily completed at least 80% of their home exercise program. All sessions were delivered according to the protocol. None of the patients reported any adverse events. Conclusions: Objective physical activity data measures at baseline and week 12, follow-up, the physiotherapists’ fidelity to the intervention and adverse events met our pre-specified progression criteria. Recruitment and adherence to the self-managed exercise program were both below the anticipated level. Further intervention development is necessary to understand whether adherence to the self-managed exercises could be enhanced and additional methods of recruitment would need to be considered, including additional recruitment sites, in any planning for a future main trial.Trial registration: ClinicalTrials.gov NCT04190836, Registered December 9, 2019 – Retrospectively registered, https://clinicaltrials.gov/ct2/show/NCT04190836


2019 ◽  
Vol 20 (1) ◽  
Author(s):  
Clare E. Safran-Norton ◽  
James K. Sullivan ◽  
James J. Irrgang ◽  
Hannah M. Kerman ◽  
Kim L. Bennell ◽  
...  

Abstract Background Knee osteoarthritis (OA) is prevalent and often associated with meniscal tear. Physical therapy (PT) and exercise regimens are often used to treat OA or meniscal tear, but, to date, few programs have been designed specifically for conservative treatment of meniscal tear with concomitant knee OA. Clinical care and research would be enhanced by a standardized, evidence–based, conservative treatment program and the ability to study the effects of the contextual factors associated with interventions for patients with painful, degenerative meniscal tears in the setting of OA. This paper describes the process of developing both a PT intervention and a home exercise program for a randomized controlled clinical trial that will compare the effectiveness of these interventions for patients with knee pain, meniscal tear and concomitant OA. Methods This paper describes the process utilized by an interdisciplinary team of physical therapists, physicians, and researchers to develop and refine a standardized in-clinic PT intervention, and a standardized home exercise program to be carried out without PT supervision. The process was guided in part by Medical Research Council guidance on intervention development. Results The investigators achieved agreement on an in-clinic PT intervention that included manual therapy, stretching, strengthening, and neuromuscular functional training addressing major impairments in range of motion, musculotendinous length, muscle strength and neuromotor control in the major muscle groups associated with improving knee function. The investigators additionally achieved agreement on a progressive, protocol-based home exercise program (HEP) that addressed the same major muscle groups. The HEP was designed to allow patients to perform and progress the exercises without PT supervision, utilizing minimal equipment and a variety of methods for instruction. Discussion This multi-faceted in-clinic PT program and standardized HEP provide templates for in-clinic and home-based care for patients with symptomatic degenerative meniscal tear and concomitant OA. These interventions will be tested as part of the Treatment of Meniscal Tear in Osteoarthritis (TeMPO) Trial. Trial registration The TeMPO Trial was first registered at clinicaltrials.gov with registration No. NCT03059004 on February 14, 2017. TeMPO was also approved by the Institutional Review Board at Partners HealthCare/Brigham and Women’s Hospital.


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