Hand dexterity rehabilitation using selective functional electrical stimulation in a person with stroke

We report a 69 year old who suffered a cardioembolic ischaemic stroke on 23 September 2019, which resulted in a left hemiplegia with motor impairment in upper and lower extremities that made impossible for her to use the affected arm in daily living activities. The person commenced her comprehensive physiotherapy programme based on functional electrical stimulation (FES) in Fesia Clinic rehabilitation centre in October 2020. A multifield technology-based FES device was used, which allowed to train different selective movements in isolation and combined with mirror therapy, achieving excellent functional outcomes.

Physiotherapy in palliative medicine: patient and caregiver wellness

ObjectivesDespite the demonstrated efficacy of physiotherapy in palliative care programmes, there are scarce data of its real-life impact on patients’ and caregivers’ wellness and stress. Our aim was to assess effectiveness of a 30-day physiotherapy programme in psychological wellness and health-related quality of life (HRQoL) of patients with advanced chronic diseases or cancer and in their caregivers’ stress.MethodsQuasiexperimental before–after study applying personalised kinesitherapy, exercise with curative effects, respiratory physiotherapy, therapeutic massages and ergotherapy. Psychological wellness, HRQoL and caregiver’s strain outcomes were measured.Results207 patients (60% men, with a mean age of 73.6±12 years) were included; 129 (62.3%) with advanced cancer, and the remaining 78 with advanced chronic diseases. Psychological wellness (Emotional Stress Detection Tool decreased from 12.4±3 to 11±3; p<0.0001), caregiver’s strain (Caregiver Strain Index decreased from 8.5±3.2 to 7.9±3.5; p<0.0001) and HRQoL (WHO-BREF physical health domain increased from 8.3±2.6 to 9.4±2.9; p<0.0001) showed a significant improvement after the physiotherapy programme. Global satisfaction with the physiotherapy intervention was also high (Client Satisfaction Questionnaire-8 of 28.3±3.3 points).ConclusionsA personalised physiotherapy programme incorporated to integral palliative care improved psychological wellness, HRQoL and caregivers’ strain of patients with advanced chronic diseases and cancer.

A Rare Etiology of Bilateral Foot Drop: Weight Loss

Excessive weight loss especially when it occurs in a short period of time can lead to some neurological problems including peroneal nerve palsy. Foot drop is the most common presentation of peroneal neuropathies and they rarely occur bilaterally at the same time. Herein, we presented a 46-year-old male patient who developed bilateral foot drop after losing 25 kgs. in two months with an intensive weight reduction diet which was advised by a doctor as a therapeutic regimen. The electromyographic study confirmed the bilateral entrapment neuropathy of the peroneal nerves at the fibular necks and these findings could not be attributed to any other factor except the weight loss. After a balanced diet and a physiotherapy programme, he recovered completely. This case highlights an uncommon but a well documented etiology of peroneal neuropathies. Being aware of this complication and close follow-up are important for the prognosis of these patients. Keywords: foot deformities, peroneal neuropathies, weight loss

School physiotherapy programme: Improving literacy regarding postures adopted at home and in school in adolescents living in the south of Portugal

BACKGROUND: Health literacy consists of an individual’s ability to make informed decisions in various sectors, including school. Most of the health problems and risky behaviours associated with the environment and lifestyle can be minimised or even prevented by increasing health literacy. OBJECTIVES: This study aimed to evaluate the effectiveness of a school physiotherapy programme in improving literacy regarding postures adopted at home and in school in adolescents living in the south of Portugal. METHODS: The sample was comprised of 84 students in the 5th grade, 42 (50%) were boys, aged to 10 and 13 years old (10.35±0.61). The measurement instruments included a theoretical and practical test applied one week before and one week after the school physiotherapy programme. RESULTS: The values obtained on the theoretical test before and after the intervention ranged from 1–13 (7.70±2.47) and 5–13 (10.83±2.27), respectively (p≤0.001) and, on the practical test, before and after ranged from 0–10 (4.14±2.21) and 6–15 (11.8±2.28), respectively (p≤0.001). CONCLUSION: This study found significant improvements in both theoretical and practical knowledge acquisition after participants attended a school physiotherapy programme. Thus, a school physiotherapy programme could be a useful tool to prevent and/or minimise musculoskeletal disorders in adolescents.

Physiotherapy in addition to vacuum bell therapy in patients with pectus excavatum

OBJECTIVES Vacuum bell and exercise therapy are non-invasive treatments for pectus excavatum (PE). The purpose of this study was to determine the effects of the physiotherapy programme applied in addition to vacuum bell treatment in patients with PE. METHODS The study included 26 male patients with PE aged 11–18 years. Patients were randomly divided into 2 groups: group 1 received only vacuum bell treatment; group 2 had vacuum bell therapy and physiotherapy. Patient demographic and disease-related characteristics, type of sternal depression, perception of their deformity, postural evaluations, treatment satisfaction and quality of life were evaluated before and 12 weeks after treatment. RESULTS From external chest circumference measurements related to PE, sternal depression and anthropometric index values showed improvement in both groups (P &lt; 0.05), but better results were observed in group 2 than in group 1 (P &lt; 0.05). Modified percent depth and scores from the T3 region (distance between the most prominent point of the sternum and the spinous process of the vertebra at the same level) showed improvement only in group 2 (P &lt; 0.01), whereas severity of PE, the patient’s perception of his deformity and parental physiological quality-of-life scores improved in both groups (P &lt; 0.05). Posture, satisfaction with treatment and the patients’ physiological quality-of-life scores were significantly better in group 2 (P &lt; 0.05). CONCLUSIONS Due to the additional improvements and greater satisfaction in the group receiving physiotherapy, we think that a proper rehabilitation programme should be applied simultaneously with the vacuum bell treatment in patients with PE. Clinical trial registration: clinicaltrials.gov NCT04167865.

Effect of Dual Task Training on Balance and Functional Mobility in Children with Cerebral Palsy

Research background. It was found that dual task training improves functional abilities in subjects with neurological disorders, however it is not known how dual task training affects balance and functional mobility in children with cerebral palsy (CP).The aim. To determine the effectiveness of dual motor tasks training and basic physiotherapy programme on balance and functional mobility in children with spastic diplegic CP.Methods. The study included 20 children with spastic diplegic CP. Subjects were randomly assigned into two groups: control group (40 min basic physiotherapy programme) and experimental group (20 min basic physiotherapy programme and 20 min dual motor task training). Physiotherapy was applied for 3 weeks (5 times a week). Balance and functional mobility were assessed at baseline and at the end.Results. There was a statistically significant improvement in balance and functional mobility in both the control and experimental groups after three weeks of physiotherapy (p < 0.05). Comparing two groups with each other, there was a statistically significant improvement in the experimental group on balance and walking (p < 0.05).Conclusion. Dual task training can be used as an effective intervention to improve balance and walking in children with spastic diplegic CP.Keywords: motor tasks, cerebral palsy, balance, functional mobility.

Degenerative rotator cuff tear, repair or not repair? A review of current evidence

Introduction We review the literature and highlight the important factors to consider when counselling patients with non-traumatic rotator cuff tears on which route to take. Factors include the clinical outcomes of surgical and non-surgical routes, tendon healing rates with surgery (radiological outcome) and natural history of the tears if treated non-operatively. Methods A PRISMA-compliant search was carried out, including the online databases PubMed and Embase™ from 1960 to the end of June 2018. Findings A total of 49 of the 743 (579 PubMed and 164 Embase™) results yielded by the preliminary search were included in the review. There is no doubt that the non-surgical route with an appropriate physiotherapy programme has a role in the management of degenerative rotator cuff tears. This is especially the case in patients with significant risk factors for surgery, those who do not wish to go through a surgical treatment and those with small, partial and irreparable tears. However, rotator cuff repair has a good clinical outcome with significant improvements in pain, range of motion, strength, quality of life and sleep patterns.