Abbreviations in Physiotherapy

Abbreviations assist healthcare professionals to make effective use of their time. These abbreviations should be recognised and agreed upon in order to ensure best practice.

For the detailed list of abbreviations used in Physiotherapy field, visit-
http://www.physio-pedia.com/Abbreviations_in_physiotherapy 

Physiotherapists: helping reduce sickness absence rates

Physiotherapists are established as one of the key types of professionals working alongside occupational health (OH) doctors and nurses to cut down on sickness absence rates. The collaboration between the two professional groups has led to discussions on how physiotherapists could be assessed under the Safe Effective Quality Occupational Health Service (SEQOHS) accreditation scheme.

Employers that contract physiotherapists to provide OH services are seeing good returns because people are able to stay in work through a combination of preventive measures and fast, effective treatment.

These physiotherapists work with employers to provide safe, effective work environments and offer advice and treatment to employees who begin to develop a problem that could result in sick leave. In many cases, this early intervention prevents any absence from being necessary.

If someone does go on sick leave, they are seen as soon as possible before their condition worsens, to ensure that symptoms are treated and any underlying behavioural or environmental factors, such as poor posture or a poorly designed work station, are dealt with to facilitate a swift return to work.

 

Physiotherapy and the Health and Work Service

This is good for the individual, saves money for the employer and boosts the economy overall by keeping a taxpayer in work.

This “triple win” was cited in early February 2014, when the Government made the latest announcement on its new Health and Work Service (HWS). The service will offer an assessment to anyone who has been off sick for more than four weeks to help identify ways to get them back to work.

Clearly, physiotherapists will play a big part in this service, fulfilling two roles. First, they will use their expertise in movement and function to assess a person’s condition, identify the causes of the problem and then suggest the steps that could help them return to work. These steps might include changes to working practices and patterns, alterations to the work environment or seeing a health professional for treatment.
This is where the second role comes in: providing treatment at the earliest opportunity to prevent problems from becoming long-term, chronic conditions.

Physiotherapists use body posture as a tool that can be adapted to meet job demands with minimum stress on the musculoskeletal system. They give expert advice to maintain fitness and flexibility, and to develop a reserve of strength to meet demands of an individual’s job. They also identify how habitual patterns of movement and working predispose musculoskeletal problems, and work with individuals and groups to improve musculoskeletal health, prevent injuries and improve efficiency.

Up to 30% of sickness absence is because of a musculoskeletal condition and, in many cases, early access to a physiotherapist could have dealt with the immediate problem and corrected any other factors to avoid a recurrence.

 

Evidence of improvement

Pilot schemes of the HWS have already shown promising results; for some people, physiotherapists have been able to support an earlier return to work than might otherwise have been possible.

In April 2013, the BBC reported on a scheme running in Leicestershire that helped a warehouse worker who had developed a shoulder injury. His GP referred him to the scheme, which in turn arranged for him to receive physiotherapy immediately, rather than wait on an NHS list for several weeks.

By providing this fast access to physiotherapy and then arranging a phased return to work, the employee was able to get back to his job much quicker than his GP had initially anticipated. As noted at the time by Dame Carol Black, whose report on sickness absence led to the creation of the pilot schemes, too many people fall out of work when their condition could have been managed: “It wastes human life. It ruins people’s sense of self-worth, dignity. It’s bad for families, bad for the economy, and bad for the community.”

 

Benefitting both the public and private sectors

Much of the coverage around that service has focused on help for the private sector, but OH physiotherapy is also helping public bodies make critical savings during this time of austerity.

In 2012, Staffordshire County Council contracted a private OH physiotherapy company to reduce its sickness absences. The rapid-access physiotherapy service begins with a telephone triage to allow contact with the employee within 24 hours of first being off work. During the call the nature of the problem is established, with self-management advice and exercises discussed. If necessary, a face-to-face physiotherapy appointment can be arranged at a convenient time and location for the employee.

Since the start of this rapid-access physiotherapy programme, the council has reported an 8% drop in staff absence, amounting to 9,000 fewer sick days per year, a 12% reduction in musculoskeletal absences and a 300% return on investment.

A dedicated physiotherapy service is now in place for staff with conditions such as pain and stiffness in joints, muscles, nerves and soft tissues. It offers rapid treatment to help staff to return to work quickly.

 

Rolling out good practice

In the NHS, although more work still needs to be done, there are signs that it is getting a grip on high levels of sickness absence. Perhaps ironically, the health service historically has not done a great job of looking after the wellbeing of its own employees. The Boorman Review, published in 2009, said that the NHS could save £555 million per year by providing fast access to services such as physiotherapy to help keep staff fit for work. The review also highlighted that improved staff health ensured better treatment for patients, because sickness absences had led to cancelled appointments and longer waiting times. Yet even last year, an audit conducted by the Chartered Society of Physiotherapy found that about 40% of health trusts in England still did not have a health and wellbeing strategy in place for its staff – despite this being a key recommendation from Boorman.

At a time when the NHS is tasked with saving £20 billion by 2015, it is remarkable that this simple way to reduce costs is being overlooked.

 

Services that work

There are, of course, pockets of excellence. Fast Physio is a dedicated, inhouse service that provides rapid access for employees at East Lancashire Hospitals NHS Trust. Urgent referrals are seen for an assessment, management and advice within three working days, and routine assessments within 10 days. Employees also get telephone and email advice to enable them to self-manage their injury more effectively, and there are recommendations for workplace adjustments where appropriate. Advice and support is provided for both managers and employees during an individual’s return to work. After the service had been running for 18 months, there had been a 32% reduction in days lost to musculoskeletal-related sickness.

 

Proven investment

Physiotherapists have been demonstrating their effectiveness and return on investment across all sectors for a number of years in OH.

When PricewaterhouseCoopers analysed the impact of health and wellbeing initiatives at 55 organisations, ranging in size from 70 to 100,000-plus employees, it found consistent evidence of reduced absence and increased productivity.

In one case, an employer experienced a return of £34 for every £1 spent on providing in-house and discounted physiotherapy for staff.

Now the effectiveness of those services looks set to get official recognition. SEQOHS is the system for accrediting an OH service that complies with a rigorous set of standards. The professional network, the Association of Chartered Physiotherapists in Occupational Health and Ergonomics (ACPOHE), is working with SEQOHS to introduce a quality assurance system for OH physiotherapy. ACPOHE has recruited six organisations that represent the breadth of OH physiotherapy services, and a one-year pilot project began in November 2013. During the pilot period the sites will provide documentary evidence to demonstrate how their organisation meets the SEQOHS standards. The feedback from the pilot will feed into the Faculty of Occupational Medicine’s review of the SEQOHS standards. At the end of the pilot, all participating organisations will receive a written report with regards to their level of achievement against the standards and an action plan identifying where further evidence improvement is required.

Organisations that can successfully demonstrate compliance will also receive a letter from SEQOHS stating that the organisation meets the standards. These organisations will then be ready to apply for full accreditation in 2015 when the updated standards are issued.

This would make the UK the first place in the world where OH physiotherapists can receive a quality assurance standard for their practice.

OH physiotherapists now work in a diverse range of settings across all sectors. Whatever type of workplace they are in, however, the evidence shows the employer will see an average return of £3 for every £1 invested in the service. As the economy continues to struggle back to life, the importance of that statistic speaks for itself.



via-http://www.personneltoday.com/hr/physiotherapists-helping-reduce-sickness-absence-rates/

Proud to be a Physiotherapist

Role of Physiotherapy in Diabetes

Physiotherapy is an ancient science, which involves physical treatment techniques, such as massage, and the use of electrotherapeutic and mechanical agents – rather than drug therapy – for the management of a condition.

Physiotherapists play an important role in helping people to overcome disability and pain related to orthopedic, musculoskeletal, neurological and rheumatologic illnesses.

Any person with diabetes whose aching legs have experienced relief after a massage, or whose painful feet have been relaxed after a soak in cool water will testify to the importance of physiotherapy in relieving their symptoms.

Preventing diabetes-

The Diabetes Prevention Project demonstrated that lifestyle modification, including intensive exercise, is more effective in preventing diabetes than pharmacological therapy, and highlighted the role of trained professionals in motivating people to follow lifestyle interventions. Similar results have been reported by the Malmö Study, the Da Qing Study, the Finnish Diabetes Prevention Study and the Wenying Study. Physiotherapists are able to help people, to plan an individualized exercise programme in order to maintain good blood glucose control and achieve optimal weight. Furthermore, physiotherapy leads to metabolic improvements even in the absence of weight loss, reducing the frequency of cardiovascular events and improving life expectancy. Effective exercise counseling ensures both cardio respiratory and musculoskeletal fitness. This helps people with diabetes improve their quality of life, and contributes to overall control of blood glucose. The use of alternative therapies, such as yoga, can contribute to the achievement of optimal cardio-respiratory health.

Physiotherapists can help people to maintain good blood glucose control and achieve optimal weight. Physiotherapists, with their knowledge of physiology and anatomy, can suggest specific exercises for people with coexisting complications, cautioning against certain movements that might be detrimental to their health. For example, an isotonic exercise like jogging will benefit a person with high blood pressure and diabetes, but the repeated foot trauma associated with jogging may harm someone with peripheral sensory neuropathy or Charcot foot.

Beyond exercise counseling-

Most people with diabetes suffer from musculoskeletal complications, which might include frozen shoulder, back pain or osteoarthritis. Many people with poorly managed type 1 diabetes develop a syndrome of limited joint mobility. Diabetic amyotrophy is a type of neuropathy that involves muscle wasting and weakening, especially in the thighs. Carpal tunnel syndrome and sciatica are other neurological conditions that are commonly suffered by people with diabetes. In all these conditions, physiotherapy plays a pivotal role in returning people to normal levels of health and wellbeing. The physiotherapist uses a combination of active and passive exercises, and mechanical and electrical aids to

improve musculoskeletal and neurological functions.

Pain relief-

Physiotherapy offers various effective non-pharmacological approaches for pain relief. Transcutaneous electrical nerve stimulation (TENS) involves electrical nerve stimulation through the skin, sending a painless current to specific nerves. The mild electrical current generates heat that serves to relieve stiffness, improve mobility, and relieve pain.

Interferential therapy (IFT) uses the strong physiological effects of low frequency electrical stimulation of nerves.

TENS and IFT are considered gold-standard therapies for the relief of neuropathic pain, and have proven benefits in the management of painful diabetic neuropathy, edema (build-up of fluid in tissue) and resistant foot ulcers. TENS has been shown to be most effective against burning and stabbing pain, but comparatively less efficient for the relief of painfully sensitive skin and restless legs syndrome. Other modalities, such as ultrasonic therapy and hot wax, are useful for specific conditions in both people with diabetes and people without the condition. In spite of the benefits – safety, lack of drug interactions, efficacy, cost – associated with these methods, few centers’ have adopted TENS/IFT as primary treatments for painful neuropathy. Perhaps this underscores the need to create specialized diabetes physiotherapy units, staffed by qualified physiotherapists specializing in the care of

people with diabetes.

Physiotherapy can play an important role in preventing and managing foot problems.

Improving feet-

Physiotherapy centers’ can play an important role in preventing and managing foot problems. Teaching the importance of correct gait and posture, along with the basic principles of off-loading when required, can prevent or stabilize a number of foot complications. In people with tropic ulcers, for example, which are typical in people with diabetes-related foot problems, the effective use of crutches or foot splints can ensure off-loading and early healing. In people who are unfortunate enough to undergo an amputation, the physiotherapist helps with post-operative pain relief, rehabilitation, limitation of disability, and the optimum use of prostheses. Similar rehabilitative measures, exercises and therapeutic aids are available for people who are recovering from heart attack, stroke, peripheral

vascular surgery, or other traumas or surgical interventions.

Wider benefits-

Physiotherapeutic interventions, usually delivered on a one-to-one basis are patient-centered, in line with the contemporary approach that all providers of chronic medical care, including endocrinologists, try to provide to people in their care. The time spent with the physiotherapist during the course of treatment can strengthen patient provider bonding and enhance communication.

As the number of people with diabetes continues to rise, and as the existing diabetes population ages, the need for efficient physiotherapy services will continue to grow. Including specialized physiotherapists as equal members of the diabetes care team will help us to utilize their services effectively in order to improve the health and well-being of all people with diabetes.

Treatment of Osteitis Pubis

Osteitis Pubis is a condition that many consider rare, however, it is probably more common than you may think. The incidence of groin pain, in some sports, is as high as 13% (Ekstrand and Ringbord, 2001). Thus, it is highly likely that as a sports physiotherapist you will encounter may athletes with a diagnosis of osteitis pubis. Therefore, as is frequently stated on this site, you need to be aware of the current research and evidence based practice, even in a world with limited research

OVERVIEW
Osteitis pubis is defined as a painful inflammatory process involving the pubic symphysis and surrounding structures including the pubic rami, cartilage, musculotendinous and ligamentous pelvic structures (Batt et al, 1995). It is suggested that this is caused by repetitive stresses of the pubic symphysis during strenuous physical activity, most commonly secondary to reduced hip range of motion (LeBlanc and LeBlanc, 2003).

TREATMENT
The following discussion regarding treatment decisions is guided by the systematic review by Choi et al (2011). Whilst they searched for the best available evidence, they were unable to identify any RCTs regarding treatment decisions for osteitis pubis. Therefore, the following recommendations are based on clinical experience and case studies/series. Hint, hint… not a lot of rock solid evidence going around.

CONSERVATIVE MANAGEMENT
This generally involves the three mainstays of an inflammatory musculoskeletal condition: relative rest, NSAIDs, and physiotherapy!
Physiotherapy treatment, as always, should be based on the individual athlete and their assessment findings. Thus, as stated above, you should assess for biomechanical and functional impairments and treat accordingly. The components of a successful conservative rehabilitation program included (Wollin and Lovell, 2006):

*.Manual techniques to restore full range of motion in the lumbar, sacral and hip joints. This included soft tissue, MET, mobilisation and manipulative techniques
.*.Core Control Exercises (TrA and Pelvic Floor Training)
*.Adductor Strengthening (Progression of gentle isometric through to loaded isotonic strengthening)
*.Gluteal Strengthening
*.PNF patterns
*.Stationary Bike
*.Return to running program
*.Graduated and progressive return to play

Whilst this is by no means a recipe for your patients, it should serve as an indicator of the components of a successful rehabilitation program. In this small case series (n=4) all players returned to play at a mean timeof 13 weeks.The results of this study mirrored the overall findings of Choi et al (2011) who found that the mean return toplay for all patients undergoing conservative management was 9.55 weeks.

INJECTIONAL THERAPY
The studies examined two types of injectional therapy corticosteroid or prolotherapy.

*.Corticosteroid Injections: Overall 58.6% of patients RTP in 8 weeks, whilst there was no response in approximately 20% of patients.
*.Prolotherapy Injections: Topol et al (2005) examined prolotherapy injections in patients with chronic groin pain and found much more promising than the corticosteroid injections! 91.7% of the athletes RTP in 9 weeks, and there was a 8.3% no response rate.

SURGICAL MANAGEMENT
As you may expect surgical management should only be considered as a last resort. Dependant on the choice of surgery, which is widely variable in clinical practice, it can be a season ending operation. Therefore, it is not a decision to make lightly. The case series literature describes three surgical techniques (Choi et al, 2011).

These are discussed below:
1.Curettage of Pubic Symphysis: 72% RTP at an average of 5.6 months
2.Arthrodesis of the Pubic Symphysis: 87% RTP at an average of 6.6 months, with a 25% complication rate.
3.Polypropylene Mesh Placement into the Preperitoneal Retropubic Space: 92.3% RTP at an average of7.2 weeks.

HOME MESSAGES
*.There is a dearth of quality research to guide treatment decisions for osteitis pubis.
*.Conservative management should always be the first line of treatment for osteitis pubis.
*.Optimal management is individualised and always looks “beyond the groin”!
*.Prolotherapy could be used if physiotherapy fails (but it hurts!).
*.Surgery is a last resort only

Source-
http://www.thesportsphysiotherapist.com/osteitis-pubis-treatment-decisions-in-a-world-with-limited-research/

Lumbar Canal Stenosis and Associated Deformities

Degenerative lumbar spinal stenosis results from pathological degeneration of the facet joints, disc herniation, hypertrophy and buckling of the ligamentum flavum, and spondylolisthesis. Degenerative changes in the three-joint complex (the intervertebral disc and two facet joints) explain the fluctuation in symptoms with alterations in posture, load, and duration of load. Lumbar intervertebral disc degeneration represents a cascade of events involving disc herniation, bulging of the disc and ligamentum flavum into the canal, and resulting chronic facet arthrosis, sclerosis, and osteophytic growth. Hypertrophy of the ligamentum flavum is also an important element in the development of spinal stenosis. Lumbar spinal encroachment induces ligamentum flavum hypertrophy, which further aggravates stenosis. Disease of the nerve roots and cord, however, does not typically result directly from compression of the nerves. Rather, the resulting stenosis causes decreased flow of cerebrospinal fluid, which represents approximately 60% of the nutritional supply to the cauda equina, and increased venous pressure. In such a scenario, any concurrent spinal deformities may critically compromise the nerve roots and cord, as well as exacerbate neurological symptoms of lumbar stenosis.

Spondylolisthesis can be caused by congenital, developmental, traumatic, neoplastic, or degenerative conditions. In degenerative spondylolisthesis, the most common type observed with lumbar stenosis, anterior/posterior displacement of a VB results from facet joint erosion and attenuation of the muscular, capsular, and ligamentous structures. Fourfold more common in females than in males, degenerative spondylolisthesis occurs most frequently at the L4-5 and L5-S1 levels.Disc degeneration causes spondylolisthesis with resulting segmental hypermobility, compounded by arthritis in sagittal facet joints.

There are many other spinal deformities associated with the LCS. For the detailed article visit-

http://www.medscape.com/viewarticle/448310_2

Athletic performance improved even after deception revealed

Indiana University researchers say a little deception caused cyclists in their 4-kilometer time trial to up their performance even after they realized they had been tricked.

The findings support the idea that the brain plays a powerful role in how hard athletes push their bodies.

"The idea is that there's some sort of governor in your brain that regulates exercise intensity so you don't overheat, or run out of gas, so to speak," said Ren-Jay Shei, a doctoral student in the IU School of Public Health-Bloomington. "In this case, the governor was reset to a higher upper limit, allowing for improved performance."

For the study, 14 trained, competitive male cyclists participated in four time trials. For each session, they rode cycle ergometers, which are stationary bikes that measure such variables as speed and power output and display the readings on computer monitors on the handlebars.

For the full research, visit-

http://www.medicalnewstoday.com/releases/277537.php

Vibration Exercise- A Relief for Fibromyalgia

Whole-body vibration exercise may reduce pain symptoms and improve aspects of quality of life in individuals diagnosed with fibromyalgia, research shows. Whole-body vibration exercise involves standing, sitting or lying on a machine with a vibrating platform that causes muscles to contract and relax as the machine vibrates. The machines primarily are used by researchers but have begun appearing in fitness centers and are sold commercially.

A pilot study by Indiana University researchers found that whole-body vibration exercise may reduce pain symptoms and improve aspects of quality of life in individuals diagnosed with fibromyalgia.

For the whole study, visit-

http://www.sciencedaily.com/releases/2014/05/140529154009.htm

Structured physical activity program can help maintain mobility in vulnerable older people

A carefully structured, moderate physical activity program can reduce risk of losing the ability to walk without assistance, perhaps the single most important factor in whether vulnerable older people can maintain their independence, a study has found.

Older people who lose their mobility have higher rates of disease, disability, and death. A substantial body of researchhas shown the benefits of regular physical activity for a variety of populations and health conditions. But none has identified a specific intervention to prevent mobility disability.

In this large clinical study, researchers found that a regular, balanced, and moderate physical activity program followed for an average of 2.6 years reduced the risk of major mobility disability by 18 percent in an elderly, vulnerable population. Participants receiving the intervention were better able to maintain their ability to walk without assistance for 400 meters, or about a quarter of a mile, the primary measure of the study. Results of the large clinical trial, conducted by researchers at the University of Florida, Gainesville and Jacksonville, and colleagues at seven other clinics across the country, were published online on May 27, 2014, in the Journal of the American Medical Association. The researchers were supported by the National Institute on Aging (NIA) and the National Heart, Lung, and Blood Institute (NHLBI) of the National Institutes of Health.

For the whole study, visit-

http://www.nih.gov/news/health/may2014/nia-27.htm

The Effects of Virtual Reality-based Yoga on Physical Function in Middle-aged Female LBP Patients

The objective of this research was to determine the effects of a virtual reality-based yoga program on middle-aged female low back pain patients. Thirty middle-aged female patients who suffered from low back pain were assigned to either a physical therapy program or a virtual reality-based yoga program for a period of four weeks. Participants could check their posture and weight bearing on a monitor as they shifted their weight or changed their postures on a Wii balance board. There were a total of seven exercise programs. A 30-minute, three times per week, virtual reality-based Wii Fit yoga program or trunk stabilizing exercise was performed, respectively. Repeated-measures analysis of covariance revealed significant differences in between before and after VAS, algometer, Oswestry low-back pain disability index (ODI), Roland Morris disability questionnaire (RMDQ), and fear avoidance beliefs questionnaire (FBQ) scores. The VAS, algometer, ODI, RMDQ, and FBQ scores exhibited significant differences in groups. Regarding the effect of time-by-group interaction, there were significant differences in VAS, ODI, ODI, and FBQ scores.

The study concluded that for middle-aged female patients who have low back pain, a virtual reality-based yoga program was shown to have positive effects on physical improvements, and the program can be employed as a therapeutic medium for prevention and cure of low back pain.

For the full study, visit-

http://www.physiospot.com/research/the-effects-of-vr-based-wii-fit-yoga-on-physical-function-in-middle-aged-female-lbp-patients/

Physiotherapy Definitions- At Indian level & International level

1. World Health Organization (WHO): "Physiotherapists assess, plan and implement rehabilitative programs that improve or restore human motor functions, maximize movement ability, relieve pain syndromes, and treat or prevent physical challenges associated with injuries, diseases and other impairments. They apply a broad range of physical therapies and techniques such as movement, ultrasound, heating, laser and other techniques. They may develop and implement programmes for screening and prevention of common physical ailments and disorders" (Reference: http://www.who.int/hrh/statistics/Health_workers_classification.pdf )

2. The International Labour Organization (ILO ): Physiotherapists and related associate professionals treat disorders of bones, muscles and parts of the circulatory or the nervous system by manipulative methods, and ultrasound, heating, laser or similar techniques, or apply physiotherapy and related therapies as part of the treatment for the physically disabled, mentally ill or unbalanced. The International Labour Organization (ILO) is the international organization responsible for drawing up and overseeing international labour standards. It is the only 'tripartite' United Nations agency that brings together representatives of governments, employers and workers to jointly shape policies and programmes promoting Decent Work for all. (Reference: http://www.ilo.org/public/english/bureau/stat/isco/isco88/3226.htm )

3. International Standard Classification of Occupations (ISCO) is a tool for organizing jobs into a clearly defined set of groups according to the tasks and duties undertaken in the job. The World Health Organization (WHO) has classified physiotherapists in professional group (ISCO Code 2264) and paramedical professionals have been classified in a separate entity (ISCO code 2240). (Reference: http://www.who.int/hrh/statistics/Health_ workers_classification.pdf)

4. World Confederation of Physical Therapy (WCPT) : Physical therapists are qualified and professionally required to: -undertake a comprehensive examination/assessment of the patient/client or needs of a client group -evaluate the findings from the examination/assessment to make clinical judgments regarding patients/clients -formulate a diagnosis, prognosis and plan -provide consultation within their expertise and determine when patients/clients need to be referred to another healthcare professional -implement a physical therapist intervention/treatment programme -determine the outcomes of any interventions/treatments -make recommendations for self-management. (Reference: http://www.wcpt.org/what-is-physical-therapy)

5. Delhi Council for Physiotherapy & Occupational Therapy Bill 1997 : “Physiotherapy” means physiotherapeutic system of medicine which includes examination, treatment, advice and instructions to any persons preparatory to or for the purpose of or in connection with movement dysfunction, bodily malfunction, physical disorder, disability, healing and pain from trauma and disease, physical and mental conditions using physical agents including exercise, mobilization, manipulation, mechanical and electrotherapy, activity and devices or diagnosis, treatment and prevention. (Reference: http://delhiassembly.nic.in/aspfile/billspassed/141997.htm)

6. Maharashtra State OTPT Council: "Physiotherapy" means a branch of modern medical science which includes examination, assessment, interpretation, physical diagnosis, planning and execution of treatment and advice to any person for the purpose of preventing, correcting, alleviating and limiting dysfunction, acute and chronic bodily malfunction including life saving measures via chest physiotherapy in the intensive care units, curing physical disorders or disability, promoting physical fitness, facilitating healing and pain relief and treatment of physical and psychosomatic disorders through modulating physiological and physical response using physical agents, activities and devices including exercise, mobilization, manipulations, therapeutic ultrasound, electrical and thermal agents and electrotherapy for diagnosis , treatment and prevention. (Reference: http://www.msotptcouncil.com/OTPTActs.aspx )

Seronegative Spondyloarthropathies

Visit-

http://www.ncbi.nlm.nih.gov/books/NBK27224/

For the full information about seronegative spondyloarthropathies

Predictors of Clinical Outcome After Acute Achilles Tendon Ruptures

Abstract

Background: In patients with an acute Achilles tendon rupture, it has not been possible to determine the superiority of a single specific treatment modality over other treatments with respect to symptoms and function. When several pertinent treatment protocols are available for an injury, it is of interest to understand how other variables, such as age, sex, or physical activity level, affect outcome to better individualize the treatment.

Purpose: To investigate predictors of both symptomatic and functional outcomes after an acute Achilles tendon rupture.

Study Design: Cohort study (Prognosis); Level of evidence, 2.

Methods: Ninety-three patients (79 men and 14 women; mean age, 40 years) were evaluated prospectively at 3, 6, and 12 months. The main outcome measures in this study were the Achilles tendon Total Rupture Score (ATRS) for symptoms and maximum heel-rise height for function. The independent variables evaluated as possible predictors of outcome included treatment, sex, age, body mass index (BMI), physical activity level, symptoms, and quality of life.

Results: Treatment, age, BMI, physical activity level, heel-rise height at 6 months, and the ATRS at 3 months were eligible for further analysis. Only male sex was included for the prediction models. The 4 different multiple linear regression models (predicting the ATRS at 6 and 12 months and heel-rise height at 6 and 12 months) were significant (P < .001-.002), and the R 2 values for the models were 0.222 to 0.409. Surgical or nonsurgical treatment is a moderate predictor of symptoms and a weak predictor of heel-rise height after an acute Achilles tendon rupture. At the 6-month follow-up, surgical treatment was associated with a larger heel-rise height, but the opposite was seen at 12 months. Surgical treatment resulted in a lower degree of symptoms. Increasing age was a strong predictor of reduced heel-rise height, and an increase in age of 10 years reduced the expected heel-rise height by approximately 8%. A higher BMI was also a strong predictor of a greater degree of symptoms, and a 5-unit higher BMI predicted a reduction of approximately 10 points in the ATRS.

Conclusion: The present study identified important possible predictors of outcome. Despite having a wide range of clinically relevant variables, the models had a limited ability to predict the final individual outcome. In general, the models appear to be better at predicting function than symptoms.

For the full text, kindly visit-

http://m.ajs.sagepub.com/content/42/6/1448?etoc

Effectiveness of powered hospital bed movers for reducing physiological strain and back muscle activation

Battery powered bed movers are becoming increasingly common within the hospital setting. The use of powered bed movers is believed to result in reduced physical efforts required by health care workers, which may be associated with a decreased risk of occupation related injuries. However, little work has been conducted assessing how powered bed movers impact on levels of physiological strain and muscle activation for the user.  The muscular efforts associated with moving hospital beds using three different methods; powered Stamina Lift Bed Mover (PBM1), powered Gzunda Bed Mover (PBM2) and manual pushing were measured on six male subjects by the authors. Fourteen muscles were assessed moving a weighted hospital bed along a standardized route in an Australian hospital environment. Trunk inclination and upper spine acceleration were also quantified.  The authors concluded that powered bed movers exhibited significantly lower muscle activation levels than manual pushing for the majority of muscles.

When using the PBM1, users adopted a more upright posture which was maintained while performing different tasks (e.g. turning a corner, entering a lift), while trunk inclination varied considerably for manual pushing and the PBM2. The reduction in lower back muscular activation levels may result in lower incidence of lower back injury.

For the whole study visit-

http://www.physiospot.com/research/effectiveness-of-powered-hospital-bed-movers-for-reducing-physiological-strain-and-back-muscle-activation/

Physiotherapist Job in Govt. of Delhi

Physiotherapist job in Delhi State Health Mission (Govt. of Delhi)

Name of post- Physiotherapist

Qualification-
1. Graduate in Physiotherapy with 03 years experience.
2. Working knowledge of computers.

Salary- Rs. 25000 per month

Last Date :09 Jun 2014

Walk-in –Interview will be held on 09th June 2014.

Place-
Conference Room, 2nd Floor, F-17, Karkardooma, Delhi-110032.

Disclaimer-
This post is purely for helping other Physiotherapists. This site doesn't take any responsibility about the jobs. One should do proper inquiry before joining.

Physiotherapist Vacancy in London, UK

Position:Physiotherapist

Employer:Lewisham and Greenwich NHS Trust

Department:Medicine

Location:Physiotherapy QEH, London.

Salary:£24,836 to £32,086 PA Inclusive of HCA

For further details contact:

Victoria Hampshire MSK Out-patient Physiotherapy team lead QEH – 020 8836 6060
or
Email- victoria.hampshire@nhs.net

Primary Patellar Dislocation: Management

Patellar dislocation accounts for 2 – 3% of all knee injuries, however, is the second most common cause of knee haemarthrosis (Aglietti et al., 2001). Patellar dislocation is most commonly associated with sports injuries, and therefore, is encountered commonly by the sports physiotherapist. In recent times there has been controversy on the most appropriate forms of management following primary (or first time) patellar dislocation.

Management-

A CASE FOR PRIMARY SURGERY:-

Stefancin and Parker (2007), suggest that surgery is indicated in the following cases:
*.Significant chondral injury
*.Osteochondral fractures
*.Large medial patellar stabilizer defects (i.e. MPFL, medial retinaculum, VMO)
*.Subsequent dislocation
*.Failure to improve with conservative management

CONSERVATIVE MANAGEMENT:-

The physiotherapy management of patellar dislocation should include the following:

A period immobilisation/bracing in extension (at least 3 weeks). This follows the results of Maenpaa and Lehto (1997) who found a 3-fold higher risk of redislocation in those treated with immediate mobilization, rather than a period of immobilisation.This should be followed by functional rehabilitation, with the aims of:
*.Quadriceps strengthening
*.VMO Biofeedback – aimed at reducing inhibition*.Restoration of ROM
*.Stretching of lateral structure tightness
*.Mobilisation for cartilage nutrition

The outcomes of conservative management are quite favourable. The systematic review (Stefancin and Parker, 2007) showed an excellent to good results in 76% of patients, with an average re-dislocation rate of about 48%.

ASPIRATION:-

In patients who present with significant effusion, aspiration may aid both therapy and diagnosis (Stefancin and Parker, 2007). This is because:
*.It can decrease pain and local anaesthetic injection can improve both clinical and radiographic assessment
*.It will achieve joint depression
*.Larger haemarthrosis volume will be related to a larger injury to the medial patellar stabilizers and/oran osteochondral injury
*.Analysis of the aspirate may identify the presence of fatty globules, which is indicative of an osteochondral fracture.

SURGICAL MANAGEMENT:-

As stated above, there are a number of cases in which surgical management is indicated. If the osteochondral fracture is greater than 10% of the patella articular surface, or if it is a part of the weight-bearing portion of the lateral femoral condyle, open repair is indicated (given that the fragment is amendable to fixation). Any large defects in the medial patellar stabilisers should under repair/reconstruction. A lateral release can also be performed to release tight lateral structures.The results of surgical management are positive. Subjectively there has been excellent to good results in 69% of patients, with a lower re-dislocation rate of 12%.

Effectiveness of Stretch for the Treatment and Prevention of Contractures in People With Neurological Conditions: A Systematic Review

In this study effectiveness of strech is measured to prevent the contractures in the neurological conditions.

Here is the full access to the study-

http://ptjournal.apta.org/content/91/1/11.full?sid=35251569-7056-4816-8f7a-88a4525f5112

Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee

Here is a Randomized Controlled Trial to Study the Effectiveness of Manual Physical Therapy and Exercise in Osteoarthritis of the Knee.

You can check the full research here-

http://annals.org/article.aspx?articleid=713255

The 10 Tips for Success with Physiotherapy

Questions are often asked to Physiotherapists by patients how can they recover speedily? Here are few tips for getting the most out of Physiotherapy-

1.Approaching physiotherapy with an open mind.

2.Improve your understanding on how and why we feel pain.

3.Use resources given to you and read up around the area. We retain very little information that is given to us in our first assessment.

4.Complete exercises as prescribed. Not just when you remember/feel like it. Set an alarm/diary. If you wanted to run a marathon you couldn’t get ‘fit’ to do it by sitting at home on the couch.

5.Progress as your body allows and spend time with your physio understanding when you can push through pain and when you should take things more gently.

6.Taking note of what aggravates/ eases pain.  Movement, stress, time of day?

7.FITT principle :frequency, intensity, time or type. Change ONE variable at a time to allow optimal progression without irritation.

8.Allow time. Bodies are incredible. If you find this hard to believe watch the video below. The body can withstand incredible forces and repair structures that you would thing are irreparable. Give it time let it do its job.

9.Hollistic. Take an objective view on your life and consider all factors ie stress, job, other illnesses, dependents, sleep.  These can cause hormonal/chemical changes in the body ,which can affect pain/healing so consider CBT, counselling or mindfulness to achieve long term goals.

10.As a general rule you should see improvement in symptoms  within 3-4 sessions(if completed the exercises as prescribed).

Ref.- PhysioWizz