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Dissertations / Theses on the topic 'Musculoskeletal Physiotherapy'
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Cruz, Eduardo José Brazete Carvalho. "Clinical reasoning in musculoskeletal physiotherapy in Portugal." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/5d5210fe-b5d1-4bc6-be38-aa29f91a1178.
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Clinical reasoning refers to the process in which practitioners, interacting with their patients, structure meaning, goals, and health management strategies based on clinical data, patient/client choices, and professional judgment and knowledge (Higgs & Jones, 2000, p. 11). Recent literature in physiotherapy and other allied health professions describes clinical reasoning as moving between cognitive and decision-making processes required to optimally diagnose and manage impairment and physical disabilities (hypothetic-deductive), and those required to understand and engage with patients' experience of disabilities and impairments (narrative reasoning). Clinical reasoning has been described as a universal process, common to all clinicians, in particular in the musculoskeletal area. However, clinical reasoning models emerged from research developed in specific and well-developed health care and professional cultures, such as Australia and United States, but there has been little discussion of their relevance and applicability to other cultural groups. Since research literature concerning physiotherapy in Portugal is almost non-existent, the aims of this study were twofold. The first aim was to explore clinical reasoning processes in a sample of Portuguese expert physiotherapists and secondly, to identify the current perspective of clinical reasoning held by educators and students, and how it is promoted in the undergraduate curriculum. The focus of the study was musculoskeletal physiotherapy. The research was influenced by the interpretative/constructivist paradigm of inquiry. The study consisted of three parts. In part one, the clinical reasoning approach of a sample of Portuguese expert therapists in musculoskeletal physiotherapy was investigated. The study focused on Portuguese clinicians' interaction with their patients in order to define and manage clinical problems. Data was collected through non-participant observation, semi-structured interviews, memos and field notes, and analysed thematically to identify and compare the practice and reasoning approach used. In part two, the generic aspects of undergraduate physiotherapy curricula in Portugal were analysed to provide a first insight of how educational programmes are organized and delivered in Portugal. Then, current musculoskeletal physiotherapy curricula in Portuguese entry-level physiotherapy programs were analysed by a questionnaire survey and documentary analysis. The specific aim was to capture the educational process and actions underlying current educational practice across undergraduate courses. In part three (Study 3 and 4), a sample of musculoskeletal lecturers and a sample of near graduate students were selected against criteria relating to the diversity of institutions that offer undergraduate physiotherapy courses (private versus public institutions) and length of time as a Physiotherapy education provider. Each course was examined from lecturer and student perspectives (through individual interviews and focus groups) to see what kind of clinical reasoning approach were most emphasised in relation to physiotherapy intervention in musculoskeletal conditions. Data were transcribed and subjected to thematic analysis. Findings showed some similar characteristics in the reasoning process of this group of Portuguese expert physiotherapists in the study when compared with other studies in the musculoskeletal physiotherapy field. However, findings also highlighted that Portuguese physiotherapists were more likely to use and value an instrumental approach to clinical practice. There was little evidence of patients sharing their perspectives about their problems or participating in clinical decisions made. An instrumental approach to reasoning and practice was also dominant in current Portuguese musculoskeletal programs as well in educators' and students' perspectives. The focus was on diagnostic and procedural strategies of reasoning with little emphasis on promoting student competences to involve patients in the decision making process. In this sense, the practice and reasoning of this sample could be seen as more instrumental than communicative. Perspectives on clinical reasoning differ between cultures and contexts of practice and this has implications for the quality of health care education and service delivery. This research has identified the current model of clinical reasoning in Portuguese Physiotherapy practice. The findings have significant implications for clinical practice in musculoskeletal physiotherapy, curriculum development, and wider education and health service policy.
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
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Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
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Brooker, Heather. "Incidence of musculoskeletal injuries in professional dancers." Master's thesis, University of Cape Town, 2020. http://hdl.handle.net/11427/32453.
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Background: Professional ballet dancers focus on the high levels of discipline, perfection and mobility to achieve the fluid, controlled lines of movement presented on the stage. Dancers undergo long hours of strenuous, repetitive training which increases the risk of developing overuse or traumatic injuries and may compromise the longevity of dancers' careers. Relevant research, particularly in the South African context, is needed to provide recommendations on the intrinsic and extrinsic factors contributing to musculoskeletal injuries in professional ballet dancers. Aim: The aim of this study was to determine the incidence of musculoskeletal injuries and their associated risk factors over a three-month period in adult female professional ballet dancers in South Africa. Specific Objectives: The specific objectives of this study were: • To determine the incidence of traumatic and overuse injuries per 1000 dance hours over a three-month training and performance period in South African female professional ballet dancers; • To determine the relationships between a) Functional Lower Extremity Evaluation (FLEE) scores and injury incidence; b) intrinsic factors (amenorrhoea; body mass index; skinfold measurements; caloric intake) and injury incidence; and c) extrinsic factors (training hours; performance hours) and injury incidence respectively, in South African female professional ballet dancers. Methods: This study had a prospective, descriptive design. Eighteen female dancers were recruited from professional dance companies in the Gauteng, Western Cape and North West provinces of South Africa. Data were collected over a three-month period and included a subjective questionnaire, three-day food diary, skinfold measurements and the Functional Lower Extremity Evaluation (FLEE). Injuries were reported using an injury reporting form over the three-month period. Results: Participants had an average age of 22.1 ± 3.0 years. The dancers had an average BMI of 21.4 ± 2.1 kg.m⁻²; LBM of 41.7 ± 4.9 kg and body fat percentage of 24.7% ± 2.9%. Injury incidence was 3.3 injuries per 1000 dance hours with a total of 4605.58 hours reported overall. Of the 15 injuries reported, 13 occurred in the lower limb, with eight in the ankle and foot. Overuse injuries accounted for 93.3% of the total injuries, with only one traumatic injury reported. None of the descriptive characteristics was associated with increased injury risk. The average caloric intake of 1810.0 ± 503.7 calories, while lower than what is recommended for female athletes, also showed no significant relationship to injury. There were also no significant associations between pre-injury FLEE measurements and training loads; and injury incidence over the course of the study. Conclusion: An overall injury incidence of 3.3 injuries per 1000 dance hours was found in professional female ballet dancers in South Africa, which is higher than the injury incidences identified in previous studies in high-income countries. With regards to injury profile, overuse injuries are 86% more prevalent than traumatic injuries among this population type. We were unable to identify any intrinsic or extrinsic risk factors associated with injury incidence; however, we recognise the limitations of the small sample size in this study. With a high level of injury incidence and inconclusive results on injury risk factors, there is a clear need for significant further research in the field of injury prevention in professional ballet dancing. Further, this study identified a strong need for further research in South African dance companies to facilitate injury prevention and management in South Africa.
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Greybe, Rykie. "Risk factors for lower limb musculoskeletal injuries in novice runners: a prospective study." Master's thesis, University of Cape Town, 2015. http://hdl.handle.net/11427/15523.
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The aim of this study was to identify the possible risk factors for the development of lower limb musculoskeletal injuries in novice runners. The specific objectives of this study were: (a) to describe the demographic and training characteristics of novice runners; (b) to establish the incidence of self-reported running-related injuries in novice runners; (c) to determine if specific intrinsic factors, namely age, gender, body mass index, quadriceps angle, foot alignment, hamstring flexibility, balance, muscle power and a history of previous injury were risk factors for lower limb musculoskeletal injuries in novice runners; and (d) to determine if specific extrinsic factors, namely training frequency, session duration, and intensity were risk factors for developing lower limb musculoskeletal injuries in novice runners.
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Madi, Mohammad Abdelfattah Atallah. "Investigating the impact of postgraduate musculoskeletal physiotherapy education on practitioners' clinical reasoning skills." Thesis, University of Birmingham, 2018. http://etheses.bham.ac.uk//id/eprint/8702/.
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Advancing clinical reasoning skills is one of the main outcomes of postgraduate master's level (M-level) programmes approved by the Musculoskeletal Association of Chartered Physiotherapists (MACP). While, the outcomes of these programmes were investigated in multiple retrospective studies, there is a limited understanding of the learning culture that drives change. Thus, the aim was to examine the learning culture of an MACP approved programme to capture the sociocultural mediators that advanced clinical reasoning skills. An empirical longitudinal mixed-methods theory-seeking case study was conducted over a period of 18 months. Participants included seven educators and six students. Data analysis was premised on the methods of a Constructivist Grounded Theory. Gradual and progressive advancement of clinical reasoning skills was identified. A model of a culture of convergence and synergy was constructed to conceptualise the relationship between students, the programme and the wider context. It demonstrates the value of convergence and synergy in supporting professional learning. This novel conceptual understanding of advancing clinical reasoning through M-level education suggest that pedagogues need to actively seek to create a culture convergence and synergy to achieving successful learning outcomes. The context-bounded knowledge provided in the thesis aid pedagogues to better design M-level curriculums.
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King, Valerie. "Irritable bowel syndrome : a case for musculoskeletal assessment." Thesis, Loughborough University, 1998. https://dspace.lboro.ac.uk/2134/10611.
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Abdominal pain of non-visceral origin has been recognised as a clinical entity for many years. In many gastroenterology clinics up to 50 per cent of patients attending have no pathological cause to their symptoms and such patients often become chronic attenders and suffer repeated investigation without resolution of their problem. They are often left with a label' of Irritable Bowel Syndrome (lBS) without a precise diagnosis being made. This is both unsatisfactory for the patient and physician. This study set out to determine the incidence of musculoskeletal causes of abdominal pain and to determine what diagnostic tools will help identify this group of patients and thus allow the physicians to refer the appropriate patients at an early stage. The aims were to identify questions that act as predictors of the presence of abdominal pain of musculoskeletal origin, patterns of pain presented in this group of patients and the ability of physiotherapists to detect cases of abdominal pain of musculoskeletal origin. The incidence of abdominal pain of musculoskeletal origin in this study was 14 per cent. Questions that act as predictors include an affirmative response to pain being aggravated by movements such as bending, twisting and turning, and coughing and sneezing, and a negative response to change in bowel habit, symptoms being aggravated by food and no weight change. The ability of the physiotherapist to detect cases was 88.3 per cent. No particular pattern of pain areas emerged to differentiate patients with abdominal pain of visceral and musculoskeletal causes. Early assessment of the musculoskeletal system by a trained physiotherapist is recommended. An early referral will lead to prompt and appropriate treatment and, consequently, to a reduction in costs for the NHS. For patients where the cause of their abdominal pain is not obvious it is unacceptable that they are left with the diagnosis of IBS without the musculoskeletal system being assessed. This study shows that such an assessment is vital to detect cases where the pain has a musculoskeletal origin.
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Alenezi, Majid. "Motor imagery as a potential tool for improvement of musculoskeletal function in physiotherapy practice." Thesis, Bangor University, 2018. https://research.bangor.ac.uk/portal/en/theses/motor-imagery-as-a-potential-tool-for-improvement-of-musculoskeletal-function-in-physiotherapy-practice(2daf1dd3-2404-45aa-9626-cb05013a012a).html.
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Motor imagery (MI) is a cognitive simulation technique with increasing importance in psychology, sport psychology and applied therapeutic domains (Dickstein & Deutsch, 2007; Guillot & Collet, 2008; Moran, Guillot, MacIntyre, & Collet, 2012). MI can be described as executing specific actions/tasks mentally, without any bodily movement, by adopting different sensory modalities (e.g. Collet & Guillot, 2010; Cumming & Ramsey, 2008; Jackson, Lafleur, Malouin, Richards, & Doyon, 2001). In the last two decades, a considerable amount of work has been performed to introduce MI as an effective rehabilitation tool for motor function, especially in the neurorehabilitation setting (Braun et al., 2006; Dickstein & Deutsch, 2007; Malouin & Richards, 2013; Mulder, 2007; Schuster, Butler, Andrews, Kischka, & Ettlin, 2012; Zimmermann-Schlatter et al., 2008). Despite the accumulating evidence supporting the benefits of cognitive techniques (e.g. MI) for patients with various neurological conditions, relatively little attention has been paid to the effects of imagery applications on the musculoskeletal system (Pelletier, Higgins, & Bourbonnais, 2015a, 2015b; Snodgrass et al., 2014). Consequently, the general objective of this thesis is to explore the potential role of MI as a therapeutic tool to be used as an alternative or adjunct to the traditional physiotherapeutic exercise for musculoskeletal parameters. The thesis is written as a collection of research studies committed to the objective described above. Chapter 1 represents a review of the literature exploring the potential role of imagery in musculoskeletal rehabilitation. Although the review chapter shows encouraging findings from the recent literature, it reveals the need to improve and develop the existing imagery intervention protocols for muscle strength outcomes to be used as a physiotherapeutic tool. Based on this need, our thesis comprises two experimental studies examining imagery’s efficacy on maximal force production in larger muscle groups, which is relevant in physiotherapy practice. In addition, this thesis builds on the potential expansion of research activities using imagery in Arabic countries by translating the vividness movement imagery questionnaire (VMIQ-2) to the Arabic language. Chapter 2 describes outcomes of a randomised control study examining the efficacy of cognitive imagery training on hip abductor strength in healthy individuals. In the study, two newly developed imagery protocols with specific imagery modalities, namely kinaesthetic with visual (KIN+VI) and kinesthetic only (KIN), were used and compared with a control group (no practice). The results demonstrated the efficacy of the imagery intervention for increasing strength in the hip abductor muscles and emphasised superior outcomes for the combined protocol (KIN+VI) for strength gains. In addition, the study revealed the efficacy of the KIN+VI imagery intervention for improving imagery ability (vividness). Chapter 3 reports the results of the second experimental study, which examines the efficacy of imagery practice (using the KIN+VI protocol from study 1) on the maximal isometric strength and electrical activity (EMG) of hip abductors (i.e. the efficacy of the ipsilateral training effect and bilateral transfer effects) compared with exercise in healthy individuals. In this study, the results showed a significant ipsilateral increase in strength and EMG amplitude in the trained hip abductor muscles of the imagery group (KIN+VI), while the exercise group did not show considerable gains. In addition, this chapter reports a novel finding concerning a bilateral transfer effect occurring after unilateral imagery training of the tested muscle group, with no strength gains occurring following exercise training. Finally, this study shows a clear indication that the home-imagery intervention protocol should be favoured over the home-exercise training due to the higher level of commitment in the imagery group; this illustrates the possibility of using imagery practice as a self-management intervention. Chapter 4 reports on the translation and validation of the VMIQ-2 to Arabic among Arabic native speakers living in the United Kingdom and Saudi Arabia. The chapter provides information about the translation process, cognitive debriefing test and initial reliability of the VMIQ-2 Arabic version. The study used an advanced analytical procedure to evaluate factorial validity by employing Bayesian structural equation modelling (BSEM) for each country’s dataset. The findings of this study provide initial support for the newly translated VMIQ-2-A with adequate psychometric properties; hence, it represents the first imagery ability questionnaire that has been translated into Arabic. Chapter 5 provides a summary of the thesis findings and clarifies the novelty of the current thesis. In addition, it outlines the future implications of the findings from the application and research perspectives. Furthermore, this chapter addresses the strengths and limitations of the thesis. Finally, it presents the conclusion of the current work.
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Theis, Nicola. "An examination of muscle and tendon properties in children with spastic cerebral palsy and their response to stretch : a theoretical basis for evidence-based clinical practice." Thesis, Brunel University, 2013. http://bura.brunel.ac.uk/handle/2438/8728.
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Cerebral palsy (CP) is a heterogeneous disorder in which movement and posture are affected. Increased excitation of the central nervous system leads to neural symptoms, which can cause spasticity and muscle weakness. These neural abnormalities result in secondary CP-related mechanical adaptations of muscles and tendons, which can lead to muscle contracture, joint deformities and pain. Therapeutic interventions are therefore essential to treat CP-induced abnormalities. Passive stretching in particular is a popular treatment method in clinical practice. However, due to a lack of scientific evidence, clinicians often have to make assumptions about the mechanical adaptability of muscles and tendons. Currently, the mechanical properties of muscles and tendons in children with CP and their adaptability are not well understood, which makes it difficult to implement evidence-based practice in clinical settings. Therefore, the overall purpose of this research was to examine the mechanical properties of the medial gastrocnemius muscle and Achilles tendon in children with spastic CP, and the adaptations of the muscle and tendon to acute and long-term passive stretching. The first experimental Chapter (3) was carried out in healthy adults, to assess the agreement between two methods of deriving Achilles tendon stiffness (i) active contraction of the triceps surae muscles to elongate the Achilles tendon, or (ii) passive rotation of the ankle joint. Taking into consideration the tendon’s viscoelastic response, the effects of strain-rate on Achilles tendon stiffness were also described. Results revealed that tendon stiffness measured using the “active method” was 6% greater than the “passive method”. There was also a significant increase in Achilles tendon stiffness in response to increased strain-rate. As the more commonly used active method is problematic to be used in children with CP, due to muscle weakness and excessive co-contraction, the passive method of deriving tendon stiffness was used in subsequent experimental studies. In experimental Chapter 4, differences in the mechanical properties of the Achilles tendon and triceps surae muscles between children with CP and their typically developing (TD) peers, were investigated. The results revealed that estimates of triceps surae muscle stiffness were significantly greater in children with CP compared to TD children. The results also showed that despite a smaller tendon cross-sectional area in children with CP, Achilles tendon stiffness was not different between groups. In addition, children with CP had a steeper tendon stiffness-strain-rate relationship compared to TD children. These results have significant clinical implications regarding the diagnosis of spasticity using the current clinical methods. Experimental Chapters 5 and 6 examined the muscle’s and tendon’s response to stretch. Passive stretching, implemented by a clinician or by the children themselves, is a commonly used intervention for children with CP with the aim of inducing structural alterations in muscles and tendons to improve function. In order for these alterations to take place, elongation of the muscle and fascicles would presumably need to occur with acute stretching. To date, this assumption has not been tested. Thus, the purpose of Chapter 5 was to investigate the medial gastrocnemius and muscle fascicle response to acute stretching, using two commonly used stretch techniques. Results of this study revealed that 100 s of stretching caused a transient increase in tendon (1.0 cm), muscle (0.8 cm) and fascicle lengths (0.6 cm). This effect was independent of stretch technique. These results provide evidence that the muscle and fascicles are capable of elongating in response to stretch in children with spastic CP. They provide a basis for the hypothesis that the spastic muscle may be able to adapt in response to long-term stretching. Thus, the purpose of the final experimental Chapter (6) was to assess the effects of a six week passive stretching intervention (four days per week, 15 minutes per day) on muscle and tendon properties, and gait parameters in children with CP. Results revealed there was a significant reduction in joint stiffness in the experimental group following six weeks of stretching. This was accompanied by a reduction in muscle stiffness, but with no alterations in Achilles tendon stiffness. Additionally, there were no positive effects of passive stretching on gait parameters. Together, the results of the present series of investigations demonstrates how fundamental knowledge of muscle and tendon mechanics in children with spastic CP, can be implemented to support evidence-based clinical practice.
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Yates, Christopher. "Effects of reconstruction surgery and individualised rehabilitation on neuromuscular, sensorimotor and musculoskeletal performance in patients with anterior cruciate ligament deficiency." Thesis, Queen Margaret University, 2016. https://eresearch.qmu.ac.uk/handle/20.500.12289/7421.
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Rehabilitation following Anterior Cruciate Ligament (ACL) Reconstruction (ACLR) benefits most patients electing ACLR surgery. Contemporary practice offers limited adaptation of the service to the needs of individual patients. This thesis focuses on a Randomised Control Trial (RCT) that evaluated the effects of a novel formulation of patient-centred musculoskeletal rehabilitation involving the Performance Profiling Technique (Butler and Hardy, 1992). Performance Profile Management (PPM), a programme of rehabilitation, was adapted to incorporate patient-physiotherapist negotiation and agreement on decisions for subsequent rehabilitation and treatment strategies. Therefore, the primary aim of the research was primarily to assess the efficacy of individually-tailored, self-managed rehabilitative care (PPM) in comparison to contemporary (CON) clinical practice. The latter would facilitate an understanding of patient needs and verify the circumstances in which rehabilitation might be enhanced by allowing individuals to play a key role in designing their treatment and recovery. A secondary clinical aim was to evaluate the strength of relationships amongst Patient-Based Outcome Measures (P-BOMs) and Clinician-Based Outcome Measures (C-BOMs). Currently, it is unknown which combination of outcome measures (P-BOMs or C-BOMs) delivers an optimum global assessment of functional and physical performance capabilities during patients’ post-surgical rehabilitation. A clinically-relevant and significant association amongst P-BOMs and C-BOMs might indicate correct scaling of patients’ own capability perceptions with those measured using objective assessment methods (C-BOMs) and endorse the utility for the clinical use of P-BOMs.
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Mudawarima, Tapfuma. "Burn injuries in Zimbabwe: development of guidelines for physiotherapy rehabilitation of musculoskeletal impairments and functional limitations." Doctoral thesis, Faculty of Health Sciences, 2021. http://hdl.handle.net/11427/33837.
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Background and need: Burn injuries are a major cause of hospital admission in low-income countries such as Zimbabwe and often lead to secondary complications such as disfigurements, contractures, and scar formations. The study aimed to establish “Guidelines for Rehabilitation of Musculoskeletal Impairments and Functional Limitations for Zimbabwe for Patients with Burns” based on the best evidence available. There were three good candidates for use as the source guideline, but ultimately, the Agency for Clinical Innovation (ACI) of New South Wales in Australia guidelines1 was chosen. The contextualisation of these guidelines for the Zimbabwean situation was informed by the outcomes of five sub-studies. A summary of the methodologies applied and the key results follow. Methods and Results: The Epidemiology of Burns in Zimbabwe: The characteristics of patients with burns in Zimbabwe was established through a retrospective record review (descriptive review) to characterise patients admitted with burns to the two central hospitals in Harare over fifteen months. The sample consisted of 926 admission records and 435 full patient folders were retrieved and analysed. Unfortunately, 425 full folders of children were missing and 85 folders of adults. There was a clear difference in presentation between children and adults, with children constituting over threequarters of all admissions, but with less severe injuries. Post-discharge follow-up: Access to rehabilitation and impact on Health-Related Quality of Life (HRQoL): The second study investigated the utilisation of post-discharge care, regarding referral after discharge and home programme. This was a study with a small sample, 14 adult and 23 child respondents. Despite referrals having been made to local rehabilitation departments, there was practically no further post-discharge contact with rehabilitation and only a single person received post-discharge rehabilitation. Both Health-Related Quality of Life (HRQoL) instruments used by the adult respondents indicated less impact on physical domains of functioning with the greatest impact in pain and emotional well-being. In the absence of trained counsellors, rehabilitation therapists might need to step into this role. Systematic review: The broad objective of this review was to systematically evaluate the effectiveness, safety and applicability to low-income countries of therapeutic exercises utilised by physiotherapists to improve function in patients with burns. The review, which included 19 papers, established that exercises (either resistance or aerobic), are effective and generally have a positive effect on muscle strength and aerobic capacity. However, there was a risk of bias in many of the papers and the evidence is not of high quality. As most of the research enrolled paediatric patients older than seven years and no adverse effects were reported, it can be concluded that resistance exercise is safe for this group of patients. However, as most children admitted with burns are younger than seven years, exercise needs to be carefully monitored in this group as safety and efficacy have not been proven for younger children. iii The results from this support the use of aerobic and resistance as an important component of a burn rehabilitation program as they have shown to improve muscle strength aerobic capacity and functional status even after hospital discharge, especially in patients with severe burns. Documentation of the current rehabilitation practice: This phase documented clinical interventions used to treat musculoskeletal problems by observation of seven rehabilitation workers (not only physiotherapists), based in the five central hospitals, one provincial and one district hospital. The treatments of five adults and five paediatric patients were observed at each hospital, a total of 70 treatments in all. The most significant finding was that the management of patients with burns was offered by a single rehabilitation worker a Physiotherapists (PT), Occupational Therapists (OT) or Rehabilitation Technician (RT), working in Burns' Units without any specialised training or additional courses. The management of burns across all hospitals was similar, and information saturation was reached with the planned number of observations. Passive and active movements were used almost universally, and the patients received a ward programme, which included positioning. Sitting and standing were included in some patients and patients were monitored for any adverse effects. A major weakness observed was the lack of baseline assessment or treatment progress during treatment. No compression bandages were applied and no scar tissue massage was done. Identification and adaptation of the suitable guidelines: Following a literature search and examination of different guidelines by two independent reviewers, the Agency for Clinical Innovation of New South Wales, Australia1 was chosen as a candidate for amendment. The guidelines were amended based on the results of the previous studies and subjected to a Delphi process with four to six Zimbabwean rehabilitation therapists who were experienced in the field of burn management. A credible set of guidelines for Zimbabwe for the rehabilitation of musculoskeletal impairments and functional limitations was thus produced. Conclusion: The current study adds to the body of knowledge through the development of guidelines for the physiotherapy rehabilitation of musculoskeletal impairments and functional limitations for patients with burns in low- and middle-income countries. The thesis has provided an evidence-based framework for patients, rehabilitation workers and policymakers to inform the provision of effective management of patients with burns. The Zimbabwe Guidelines should be regarded as a first attempt rather than the final version and hopefully will be subjected to further review as they are tried out in practice.
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Klaber, Moffett Jennifer. "The role of psychological variables in the assessment and physiotherapeutic management of musculoskeletal disorders." Thesis, King's College London (University of London), 1994. https://kclpure.kcl.ac.uk/portal/en/theses/the-role-of-psychological-variables-in-the-assessment-and-physiotherapeutic-management-of-musculoskeletal-disorders(5c0b24da-d6e4-40db-97c2-4b802a515d40).html.
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Prins, Yolandi. "The aetiology of upper quadrant musculoskeletal pain in high school learners using desktop computers : a prospective study." Thesis, Stellenbosch : Stellenbosch University, 2008. http://hdl.handle.net/10019.1/1996.
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Thesis (MScPhysio (Physiotherapy))--Stellenbosch University, 2008.The Western Cape Education Department initiated a project that aims to provide all the learners from the province with computer access and to promote computer use in schools. Prolonged sitting in front of computers and psychosocial factors have been associated with musculoskeletal symptoms internationally. However, the impact of computer use on musculoskeletal pain among South African high school learners is yet to be determined. Objective The objective of the study was to determine whether sitting postural alignment and psychosocial factors contribute to the development of upper quadrant musculoskeletal pain in grade ten high school learners working on desktop computers. Study design An observational analytical study was performed on a sample of 104 asymptomatic high school learners. Methodology Six high schools in the Western Cape metropole were randomly selected 322 grade ten learners who are using desktop computers, were screened for upper quadrant musculoskeletal pain. Measurements at baseline were taken of the 104 asymptomatic learners, 49 girls and 55 boys. The sitting postural alignment was measured by using the Portable Posture Analysis Method (PPAM), which measured head tilt; cervical angle; shoulder pro- and retraction angle and thoracic angle in the sagittal plane. Depression and anxiety were described by using the Beck Depression Inventory (BDI) and the Multidimensional Anxiety Scale for Children (MASC) respectively. The exposure to computer use was described in terms of duration and frequency of daily and weekly computer use. At three and six months post baseline, the onset and area of upper quadrant musculoskeletal pain was determined by using the Computer Usage Questionnaire. Results After six months, 27 of the 104 learners developed upper quadrant musculoskeletal pain due to seated or computer-related activities. There was no difference in computer exposure between the learners who developed upper quadrant musculoskeletal pain symptoms and the learners who remained asymptomatic. An extreme cervical angle (<34.75° or >43.95°; OR 2.6; 95% CI: 1.0-6.7) and a combination of extreme cervical and thoracic angle (<63.1° or >71.1°; OR 2.19; 95% CI: 1.0-5.6) were significant postural risk factors for the development of upper quadrant musculoskeletal pain. There was a tendency for boys to be at a greater risk for upper quadrant musculoskeletal pain than the girls (OR 1.94; 95% CI: 0.9-4.9). Weight greater than 54.15kg and a depression score greater than 11 was found to be significantly associated with a poor posture (OR 3.1; 95% CI: 1.0-9.7; OR 1.02; 95% CI: 1.0-1.1). Discussion and conclusion The study concluded that poor posture, relating to extreme cervical and thoracic angles, is a risk factor for the development of upper quadrant musculoskeletal pain in high school learners working on desktop computers. South African boys were at a greater risk of developing upper quadrant musculoskeletal pain than the girls. However the study found no causal relationship between depression, anxiety and upper quadrant musculoskeletal pain among South African high school learners and computer usage.
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Barnes, Roline Yvette. "An investigation into the nature and prevalence of musculoskeletal conditions among women attending a community clinic, and the effectiveness of an intervention programme for these patients." Doctoral thesis, University of Cape Town, 2016. http://hdl.handle.net/11427/23424.
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The thesis set out to document the process of developing and testing a non-pharmacological biopsychosocial intervention programme which included exercise and health education for women with musculoskeletal conditions attending a clinic in a poorly resourced area of the Free State Province in South Africa. To inform the development of an appropriate intervention, several sub-studies were undertaken. Systematic reviews on the use of exercise and health education in adults were undertaken, one on the impact of these interventions on adults with chronic diseases of lifestyle (diabetes mellitus type II, hypertension) and the risk factor obesity, and the other on the impact on adults with musculoskeletal conditions. The selected research tools, which were chosen based on the framework of the International Classification of Functioning, Disability and Health (ICF) were subjected to a rigorous translation process. A facility-based descriptive observational cross-sectional study was undertaken to determine the prevalence and nature of musculoskeletal conditions amongst women between the ages of 40 and 64 years attending a community clinic. The gathered information was then used to modify and adapt existing non-pharmacological programmes and develop an intervention programme tailor made for these patients. Finally, an experimental randomised controlled trial was undertaken to determine the effectiveness of usual care against a non-pharmacological intervention utilising a workbook for the women identified in the survey.
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Wanyonyi, Nancy Eileen Nekoye. "Development of standards for undergraduate occupational health in a physiotherapy curriculum: A case in Kenya." University of Western Cape, 2020. http://hdl.handle.net/11394/7680.
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Philosophiae Doctor - PhDOccupational health (OH) in physiotherapy is well known for addressing workrelated musculoskeletal disorders (WRMDs), which are high in number according to the available statistics (Fingerhut, Concha, Punnet, Steenland, & Driscoll, 2014). The introduction of the Bachelor of Science in Physiotherapy degree in Kenya in 2010 created a good platform for the development and review of occupational health content in the curriculum
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Metcalfe, Caroline Jane. "An investigation of patients' expectations of outpatient physiotherapy for peripheral musculoskeletal conditions and their effect on treatment outcome." Thesis, University of Hull, 2003. http://hydra.hull.ac.uk/resources/hull:8473.
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Little or no research has been conducted to explore patients' expectations of physiotherapy, or the effect that pre-conceived expectations might have on the outcome of treatment. This thesis aimed to fill that void. Stage one involved a review of the literature to develop a conceptual framework and understanding of expectations and how they may affect outcome. Stage two explored the evidence regarding the role of patients' expectations of physiotherapy and the impact that such expectations may have on the outcome of treatment. Three studies were carried out (1) a Delphi study with physiotherapists; (2) exploratory interviews with patients; and (3) the development and testing of a questionnaire. Stage three examined the relationship between patients' expectations of benefit and the outcome of physiotherapy using a postal survey of patients, with upper or lower limb musculoskeletal problems. Stage four consisted of a randomised-controlled trial aimed at determining whether manipulation of patients' expectations of benefit could influence treatment outcome in patients with non-traumatic knee problems. The results from stage one suggested that patient expectations were likely to be associated with patients' previous experiences of physiotherapy, anecdotal knowledge, preferences, expectation of benefit, time related issues, such as duration of condition (chronicity), educational level and work status. In stage two, the Delphi study with thirteen physiotherapists, resulted in a list of factors, ranked in order of importance, that they believed may influence the outcome of physiotherapy. The list concurred with the literature. Twelve patients were then interviewed. They generally had a positive view of physiotherapy, understood why they needed to have physiotherapy, but had limited knowledge of what physiotherapy is, what physiotherapists do or what level of involvement that they would have in their treatment. Their knowledge came mainly from first-hand or anecdotal experience of physiotherapy. Finally, a questionnaire was developed to gather information on patients' expectations and tested on 18 patients. The survey in stage three (n=289) found statistically significant positive relationships (p<0.002) between expectations of benefit before treatment and trauma, upper limb problems, locus of control and satisfaction with the health care received so far. Furthermore, negative relationships were found between the expectations variable and duration of condition and previous experience of physiotherapy. A statistically significant positive relationship (p<0.004) was also found between expectations of benefit and treatment outcome in terms of change in functional disability, perceived improvement, change in health status and satisfaction. Finally, 95 patients with nontraumatic knee problems participated in the randomised controlled trial in stage four. However, the results found no evidence that the intervention, through changes In expectations or locus of control, improved the outcome of physiotherapy. The research carried out in this thesis appears to support the notion that the characteristics that patients demonstrate in terms of their beliefs, perceptions and cognitions appear to have some influence on the course of their physiotherapy. The findings suggest that physiotherapists need to be more aware of the psychological attributes of their patients as well as the effect that their intervention (communication, handling and therapeutic) has on their patients' beliefs, perceptions and cognitions. However, further research is needed to determine whether, and by what means, patients' expectations can be influenced to improve the outcome of physiotherapy.
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Smith, Leone. "Computer-related musculoskeletal dysfunction among adolescent school learners in the Cape Metropolitan region." Thesis, Stellenbosch : University of Stellenbosch, 2007. http://hdl.handle.net/10019.1/1545.
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Thesis (MScPhysio (Physiotherapy))--University of Stellenbosch, 2007.INTRODUCTION Computer use has been identified as a risk factor for the development of musculoskeletal dysfunction among children and adolescents internationally. Computer exposure has increased in the Western Cape since 2002, with the inception of a project to install computer laboratories in all schools in the province. As musculoskeletal dysfunction experienced during adolescence is predictive of musculoskeletal disorders in adulthood, it is essential to identify all risk and/or associative factors. METHODOLOGY A descriptive study was conducted with the aim to investigate whether the musculoskeletal dysfunction of high school learners in the Cape Metropolitan region was related to their computer use. This study was conducted in two phases. Phase 1 of the study entailed the completion of a new questionnaire, the Computer Usage Questionnaire, by grade 10-12 learners. The learner sample was divided in a computer and a non-computer group depending on their exposure to the school computer. Phase 2 of the study involved the assessment of the ergonomic design of the computer laboratories at randomly selected high schools within the Cape Metropolitan region. RESULTS A total of 1073 learners (65% girls & 35% boys), aged 14-18 years, completed the CUQ in phase 1 of the study. The results indicated that learners in the computer group had greater weekly exposure to computers than the non-computer group. The prevalence of musculoskeletal dysfunction among this learner sample was 74%. The most common body areas of dysfunction were the head, low back and neck. The female gender, playing sport and using the school computer for more than three years were associated with musculoskeletal dysfunction. Weekly computer use of more than seven hours was predictive of general musculoskeletal dysfunction, low back pain and neck pain. Twenty nine computer laboratories within 16 selected high schools were assessed by means of the Computer Workstation Design Assessment (CWDA). Out of a total score of 40, the computer laboratories obtained average scores of less than 45%, indicating compliance with less than half of the standard ergonomic requirements. The average scores for the workspace environment was less than 40%. The design of the desk, chair and computer screen had the poorest compliance to ergonomic guidelines. DISCUSSION AND CONCLUSION The prevalence of musculoskeletal dysfunction among this sample was higher than among other similar samples on the same study topic. The higher prevalence may be attributed to the poor ergonomic design of the computer laboratories in the Cape Metropolitan region. Learners’ reduced participation in activities such as sport and working on a computer due to their musculoskeletal dysfunction, may impact on their choice of a future career. The tendency of learners not to seek medical advice for their musculoskeletal dysfunction may predispose the development of chronic musculoskeletal disorders. Education of related parties on safe computing habits as well as advice on the ergonomic design of computer laboratories is recommended to prevent the progression of adolescent musculoskeletal dysfunction into chronic disorders in adulthood.
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Brink, Yolandi. "Sitting posture : a predictive factor for upper quadrant musculoskeletal pain in computing high school students." Thesis, Stellenbosch : Stellenbosch University, 2012. http://hdl.handle.net/10019.1/71876.
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Thesis (PhD)--Stellenbosch University, 2012.Includes bibliography
ENGLISH ABSTRACT: Introduction: The increased prevalence of adolescent upper quadrant musculoskeletal pain (UQMP) is becoming a great concern to health professionals. The risk factors associated with adolescent UQMP are complex and multifactorial, including, among others sitting as a physical risk factor. However, no evidence exists to support sitting postural angles as a potential predictive factor for adolescent UQMP in computing high school students. Thus, the current project aimed to describe the three-dimensional (3D) sitting postural angles of computing South African high school students in a real-life setting, using a well-tested and documented posture measurement instrument. Methodology: This research project is comprised of seven related studies. Part I of the dissertation presents a systematic review describing the reliability and validity testing of posture measurement instruments. This is followed by three primary correlation and repeated measures observational studies aimed at ascertaining the reliability and validity of a newly developed 3D Posture Analysis Tool (3D-PAT) in the measurement of nine sitting postural angles of computing high school students. Part II of the dissertation presents a systematic review, that evaluates the latest published research evidence of whether sitting is related to UQMP, and, if so, to identify the elements of sitting that significantly contribute to UQMP. This review is followed by a description of a cohort study, with a prospective period of one year. The 3D-PAT was implemented in a clinical research setting in order to measure the 3D sitting posture of a cohort of asymptomatic computing high school students and in order to assess the outcome, seated-related UQMP, prospectively. The prospective study design enabled the research project to contribute to an understanding of any causative relationship between the exposure (sitting postural angles) and the outcome (seated-related UQMP) in a subgroup of adolescents (computer users). Results: After the first phase of psychometric testing of the 3D-PAT using high school students, the findings indicated that the instrument required modifications prior to further psychometric testing. The second phase of testing revealed that the 3D-PAT compared very well with the reference standard for measurement of the X-, Y- and Z-coordinates of the reflective markers on a mannequin. The findings from the phase three study, again using high school students, indicated that the 3D-PAT compared very well with the reference standard and justified its use for the measurement of six sitting postural angles of the upper quadrant in computing high school students. For the cohort study, a 60% response rate for participation was achieved at baseline, with 98% of the students participating at six-month and 80% at one-year follow up. Of the students, 33.5% complained of seated-related UQMP during the follow-up period. Exposure to increased head flexion (>80°) (ρ=0.0001) and the combination of increased head flexion and decreased cranio-cervical angles (ρ=0.007) were significant predictors of seated-related UQMP for those computing high school students complaining of pain greater than the 90th percentile for such. Conclusion: The project described in the current dissertation is the first research project to assess sitting postural angles in asymptomatic high school students, while they worked on desktop computers in a school computer classroom and to assess UQMP prospectively. The research project reports a causal relationship between increased head flexion and seated-related UQMP as increased head flexion was found to be a predictor of seated-related UQMP developing within six to 12 months for computing high school students with a pain score equal or greater than the 90th percentile for pain. The research project emphasises that further research is warranted to investigate the causal pathway between sitting posture and adolescents’ UQMP.
AFRIKAANSE OPSOMMING: Inleiding: Die stygende voorkoms van boonste-kwadrant muskuloskeletale-pyn (BKMP) onder adolessente is besig om ’n groot bron van kommer vir professionele gesondheidswerkers te word. Die risiko-faktore waarmee adolessente BKMP gepaard gaan, is kompleks en multifaktories. Dit sluit onder andere sit as ’n fisiese risiko-faktor in. Daar is egter nog geen bewyse om sittende posturale hoeke as potensiële voorspeller van adolessente BKMP te ondersteun nie. Dus beoog hierdie projek om die drie-dimensionele (3D) sittende posturale hoeke van Suid-Afrikaanse hoërskoolleerders wat ook rekenaargebruikers is, in ’n werklike omgewing te beskryf, deur gebruik te maak van ’n instrument wat postuur meet en wat goed getoets en gedokumenteerd is. Metodiek: Hierdie navorsingsprojek is saamgestel uit sewe studies. Gedeelte I van die proefskrif bied ’n sistematiese oorsig van betroubaarheids- en geldigheidstoetsing van instrumente wat postuur meet. Dit word gevolg deur drie primêre korrelasie studies en studies vir die waarneming van herhaalde meting wat die betroubaarheid en geldigheid van n nuut-ontwikkelde 3D instrument vir posturale analise (3D-PAT) bepaal, wanneer nege sittende posturale hoeke van hoërskoolleerders wat rekenaars gebruik, gemeet word. Gedeelte II van die proefskrif bied ’n sistematiese oorsig van die jongste gepubliseerde navorsing om te evalueer of daar bewyse is dat sit verband hou met BKMP, en, indien wel, om die elemente van sit wat betekenisvol bydra tot BKMP, te identifiseer. Die sistematiese oorsig word deur ’n beskrywing van ‘n jaarlange kohortstudie gevolg. Die 3D-PAT is gebruik in ’n kliniese-navorsingsraamwerk om die 3D-sitpostuur van ’n kohort simptoomvrye hoërskoolleerders wat rekenaargebruikers is, te meet en sitverwante BKMP as uitkoms in die vooruitsig te stel. Die studie ontwerp het dit vir die navorsingsprojek moontlik gemaak om ’n insiggewende bydrae te lewer tot begrip vir enige oorsaaklikheidsverwantskap tussen die blootstelling (sittende posturale hoeke) en die uitkoms (sitverwante BKMP) in ’n subgroup van adolessente (rekenaargebruikers). Resultate: Na afloop van die eerste psigometriese toesting van die 3D-PAT, waarin hoërskoolleerders gebruik is, het bevindings daarop gedui dat die instrument verander moet word voordat toetsing kan voortgaan. Die tweede fase van toetsing het getoon dat die 3D-PAT baie goed vergelyk met die verwysingstandaard vir die meet van die X-, Y- en Z-koördinate van die reflektiewe merkers op ’n mannekyn. Die bevindings van die derde fase van die studie, waartydens hoërskoolleerders weer gebruik is, het aangedui dat die 3D-PAT baie goed vergelyk met die verwysingstandaard. Dit het die gebruik van die instrument om ses sittende posturale hoeke van die boonste kwadrant van hoërskoolleerders wat rekenaars gebruik te meet, bevestig. Die kohortstudie het ’n 60%-reaksiesyfer vir deelname behaal tydens die basislynmetings, waarvan 98% leerders deelgeneem het aan die sesmaande-opvolgmetings en 80% aan die eenjaaropvolgmetings. ’n Totaal van 33.5% van die leerders het gekla van sitverwante BKMP gedurende die eenjaar opvolgperiode. Blootstelling aan ’n vergrootte kopfleksie-hoek (>80°) (ρ = 0.0001) en die kombinasie van ’n vergrootte kopfleksie- en verminderde kranio-servikale hoek (ρ = 0.007) was betekenisvolle voorspellers van sitverwante BKMP vir die hoërskoolleerders wat rekenaars gebruik en kla van groter pyn as die 90ste persentiel daarvan. Gevolgtrekking: Hierdie projek is die eerste navorsing wat sittende posturale hoeke van simptoomvrye hoërskoolleerders wat op tafelrekenaars in die skool se rekenaarklaskamer werk, meet en BKMP voorspel. Die navorsingsprojek rapporteer ‘n oorsaaklikheidsverwantskap tussen ‘n vergrootte kopfleksie-hoek en sitverwante BKMP omdat vergrootte kopfleksie ‘n voorspeller is van sitverwante BKMP wat binne ses tot 12 maande by hoërskoolleerders wat rekenaars gebruik, met ‘n pyntelling gelyk of groter as die 90ste persentiel van pyn, ontwikkel. Die navorsingsprojek beklemtoon dat verdere navorsing om die oorsaaklikheidsroete tussen sitpostuur en adolessente BKMP te ondersoek, geregverdig is.
Medical Research Council of South Africa
National Research Fund
Division of Research Development and Support of Stellenbosch University
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Hills, Rosemary Eleanor. "Patient satisfaction with outpatient physiotherapy : an examination of needs and expectations of patients with acute and chronic musculoskeletal conditions." Thesis, King's College London (University of London), 2003. https://kclpure.kcl.ac.uk/portal/en/theses/patient-satisfaction-with-outpatient-physiotherapy--an-examination-of-needs-and-expectations-of-patients-with-acute-and-chronic-musculoskeletal-conditions(c9f0dd3b-12a0-4947-834b-4a3ad235b675).html.
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Costa, Catarina. "Efetividade da fisioterapia no tratamento dos sintomas associados ao uso de smartphones: uma revisão bibliográfica." Bachelor's thesis, [s.n.], 2020. http://hdl.handle.net/10284/9117.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Compreender a efetividade da fisioterapia no tratamento dos sintomas associados ao uso de smartphones. Metodologia: Pesquisa computadorizada nas bases de dados Pubmed/Medline, Web of Science, PEDro e Cochrane de modo a selecionar estudos experimentais que avaliassem o efeito da fisioterapia no tratamento dos sintomas associados ao uso de smartphones. Resultados: Esta revisão incluiu quatro estudos experimentais que cumpriram os critérios de elegibilidade definidos. Conclusão: A fisioterapia desempenha um papel fundamental no tratamento dos sintomas associados ao uso de smartphones, nomeadamente através da utilização de exercícios respiratórios, de fortalecimento, de alongamento, correção postural e terapia manual.
Aim: Understanding the effectiveness of physiotherapy on the treatment of the symptoms associated with the use of smartphones. Methodology: Computerized research was executed in the PubMed/Medline, Web of Science, PEDro e Cochrane databases in order to select experimental studies about the effect of physiotherapy on the treatment of the symptoms associated with the use of smartphones. Results: This review included four experimental studies that fulfilled the eligibility criteria. Conclusion: Physiotherapy plays a fundamental role in the treatment of the symptoms associated with the use of smartphones, namely through the use of respiratory exercise, strengthening, stretching, postural correction and manual therapy.
N/A
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Marques, Teresa Cristina Marta dos Anjos Andrês. "Prevalência de sintomatologia músculo-esquelética e Burnout em Fisioterapeutas." Bachelor's thesis, [s.n.], 2016. http://hdl.handle.net/10284/5667.
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Projeto de Graduação apresentado à Universidade Fernando Pessoa como parte dos requisitos para obtenção do grau de Licenciada em FisioterapiaObjetivo: Avaliar a prevalência de sintomatologia músculo-esquelética e de Burnout em fisioterapeutas portugueses. Metodologia: A amostra foi constituída por 71 fisioterapeutas a desempenhar funções há mais de um ano em clínicas privadas da região Norte. Para a recolha de dados utilizou-se o Questionário Nórdico Musculo Esquelético (QNM) e a Medida de Burnout de Shirom-Melamed (MBSM). Resultados: 94,40% dos fisioterapeutas afirmaram ter LMERT, sendo que as áreas mais afetadas foram a coluna cervical (83,10%), a coluna lombar (77,50%) e os ombros (55,00%). Em relação ao Burnout e no que concerne ao Score Total encontramos uma prevalência de 15,50%. Conclusão: Os resultados sugerem uma grande prevalência de sintomas músculo-esqueléticos em fisioterapeutas. A prevalência de Burnout, apesar de não ser tão elevada, alerta para a necessidade de vigilância neste domínio.
Objective: To evaluate the prevalence of musculoskeletal symptoms and Burnout in Portuguese physiotherapists. Methodology: The sample consisted of 71 physiotherapists working for more than a year in private practice, in the Northern Region of Portugal. The instruments used were the Nordic Musculoskeletal Questionnaire (QNM) and the Measure of Burnout of Shirom-Melamed (MBSM) Results: 94,40% of physiotherapists reported musculoskeletal symptoms and the most affected areas were the cervical spine (83,10%), the lumbar spine (77,50%) and the shoulders (55,00%). Regarding the total score of Burnout it was found a prevalence of 15,50%. Conclusion: The results suggest a high prevalence of musculoskeletal symptoms in physiotherapists. The prevalence of Burnout, although not so relevant, signals for attention in this domain.
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Ryall, Alison Claire. "The natural history of and risk factors for musculoskeletal disorders of the upper limb presenting to primary care and physiotherapy services." Thesis, University of Southampton, 2005. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436927.
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Mercado, Dapne. "Assessment of the Effects of Global Postural Re-Education on Musicians with Nonspecific Musculoskeletal Pain as Assessed by Questionnaires and Infrared Thermography." Thesis, Université d'Ottawa / University of Ottawa, 2018. http://hdl.handle.net/10393/38422.
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Background: The Global Postural Re-education (GPR) method seems to be an effective method for the treatment of musculoskeletal disorders. However, no study has examined its effects on a group of musicians with musculoskeletal pain. Additionally, infrared thermography (IRT) has been widely used in the field of medicine as a monitoring a diagnostic tool, which can provide empirical data about the effectiveness of the GPR method. Objective: To examine the effects of GPR using scales and questionnaires and IRT. Methods: This thesis enclosed two articles. In the first, musicians with (N=6) and without (N=6) musculoskeletal pain underwent a thermographic evaluation to examine the skin temperature asymmetry (STA) between both groups as a representation of musculoskeletal pain. The second article was a randomized control trial and examined the effects of the GPR on a group of 13 participants with musculoskeletal pain (7 experimental, 6 controls) after receiving 8 sessions of GPR. Pain, disability and quality of life data was collected using the
VAS, MPIIQM, SF-36. A thermographic assessment was also conducted to examine the correlation between pain severity and degree of STA, and changes in contralateral skin asymmetries before and after the intervention. Results: The first article revealed no significant differences in STA between groups. Results from the second article showed statistical significant improvements in pain, disability and quality of life on the group who received the GPR intervention. Results from the IRT analysis were not significant. Conclusion: Results from the self-report questionnaires suggest that GPR is effective in treating musculoskeletal pain in the targeted group of musicians. Pain changes did not correlate with thermal outcomes. Further studies are needed to confirm the results obtained with IRT.
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Malmgren-Olsson, Eva-Britt. "Health problems and treatment effects in patients with non-specific musculoskeletal disorders : a comparison between Body awareness therapy, Feldenkrais and individual physiotherapy." Doctoral thesis, Umeå universitet, Fysioterapi, 2002. http://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-100580.
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Grobler, S. H. (Susanna Helena). "The impact of a change in work posture on work-related musculoskeletal disorders among sewing-machine operators, managed within a physiotherapy and ergonomics programme." Diss., University of Pretoria, 2013. http://hdl.handle.net/2263/28796.
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When implementing a managed healthcare intervention among a working population, evidence-based healthcare is critical. In the current study, the change of work posture of sewing-machine operators from seated to stand-up (the intervention) was managed within a physiotherapy and ergonomics programme (programme) in Johnson Controls Automotive S.A. (Pty) Ltd (company) without local evidence to guide the postural transition. The management of the intervention, implemented over a period of 4.5 years, presented the opportunity for a retrospective longitudinal study. The study determined the impact of the change in work posture on the incidence of work-related musculoskeletal disorders (WRMSDs) from June 2004 to January 2009 (period). The role of the physiotherapist in the programme was to deliver manual therapy to all sewing-machine operators with WRMSDs, and to provide a clinical - ergonomics service, as a member of a multidisciplinary team, to the company. The population of sewing-machine operators (n=123) was described in terms of personal factors (e.g. age, medical history, musculoskeletal history, and body mass index (BMI)), ergonomic risk factors (e.g. work posture, force and duration) and overall incidence of WRMSDs. The associations of risk factors (personal and ergonomic) with WRMSDs, and work posture with WRMSDs among sewing-machine operators were statistically determined. The majority of the population (97.6%) was female, with mean age 42.3± 8 years. At baseline, 17.9% were hypertensive, 3.3% had arthritis, 6.5% were diabetic, and the mean BMI was 29.7 kg/m² (22% of BMIs was normal). The largest proportion of the sewing-machine operators were sewing cloth and leather (79.7%) (compared to sewing cloth and vinyl), and the remainder performed forceful precision stitching (20.3%), including headrest covers, airbags and top stitching on the final product. Job rotation took place between forceful precision stitching and straight stitching (for 36.6% of the sewing-machine operators).p> The intervention was implemented within the study period. At baseline 100% of sewing machine operators were sewing in the seated work posture. Early in the study, 17.9% of them changed their work posture from seated to stand-up, 30.1% changed to the stand-up work posture in January 2007, and 34.9% a year later. The last 17.1% remained seated till the last year of the study period. From July 2008, 100% of the sewing-machine operators were sewing in the stand-up work posture. The results indicated two strong associations of risk factors and a change in work posture with WRMSDs. Obesity (specifically morbid obesity) was a personal risk factor for upper limb disorders and working in the stand-up work posture was protective for spinal disorders, compared to working in the seated work posture. Furthermore, the results indicated a high incidence of disorders (specifically of the spinal area and upper limb) during the first three months of the programme, as well as an increased incidence of lower leg disorders for the first and consecutive month of the change in work posture from seated to standing up. Lower limb disorders were specifically associated with obesity. The increase of lower limb disorders during the postural adaptation phase was temporary, and was addressed within the programme with proper shoe wear, silicone innersoles, supportive stockings and exercises. The combination proved to be effective in preventing and/or managing lower limb disorders. The outcome of the current study provided evidence on the incidence of WRMSDs, and associations between risk factors and work posture, and WRMSDs among sewing machine operators managed within the programme.Dissertation (MPhysT)--University of Pretoria, 2013.
Physiotherapy
unrestricted
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Olsson, Ebba, and Bergvall Frida Lundqvist. "UPPLEVELSER OCH ERFARENHETER AV GRUPPTRÄNING I TEAMREHABILITERING FÖR PERSONER MED REUMATISK SJUKDOM : En kvalitativ intervjustudie ur ett socialkognitivt perspektiv." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-27865.
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Bakgrund: Evidens styrker att teamrehabilitering är en lämplig rehabiliteringsform för patienter med reumatiska sjukdomar. Gruppträning har i tidigare studier visat goda resultat för personer med reumatisk sjukdom. Dock är forskning om den subjektiva upplevelsen av gruppträningen bristfällig. Syfte: Syftet med studien är att ur ett socialkognitivt perspektiv undersöka vilka upplevelser och erfarenheter deltagare med reumatisk sjukdom fått av den gruppträning som ingår i teamrehabiliteringen. Metod: Studien har en kvalitativ design med induktiv ansats. Semistrukturerade intervjuer utfördes. Fem deltagare inkluderades och det insamlade materialet analyserades genom en kvalitativ innehållsanalys. Resultat: Det framkom att deltagarna hade en positiv uppfattning om teamrehabiliteringen och att de tog med sig många erfarenheter därifrån. Samhörigheten i gruppen framhölls särskilt av deltagarna. Resultatet visar också att deltagarna fick ökad förståelse om träningens effekt i relation till välmående och smärthantering. Slutsats: Gruppträning skapar en samhörighet som skapar förutsättningar för en ökad förståelse för sin situation. Erfarenheten att leva med en reumatisk sjukdom kan sammanföra personer och bidrar till att ett erfarenhets- och kunskapsutbyte sker. Många av upplevelserna och erfarenheterna som framkom kunde kopplas till begrepp inom den socialkognitiva teorin. Större och kvantitativa studier inom ämnet gör det möjligt överföra studiens resultat till en större population.Background: Evidence proving the team rehabilitation is an appropriate rehabilitation for patients with rheumatic diseases. Group training has previously shown good result for people with rheumatic disease. Research on the subjective experience of group training is deficient. Objective: The purpose of this study is that from a social cognitive perspective investigate the perceptions and experiences of participants with rheumatic disease received by the group exercise as part of the rehabilitation. Method: The study has a qualitative design with inductive approach. Semi-structured interviews were conducted. Five participants were included and the collected material was analyzed by qualitative content analysis. Result: It was revealed that the participants had a positive perception of the team rehabilitation and they brought with them many experiences from there. The connection within the group was particularly emphasized by the participants. The result also shows that the participants had increased understanding of the benefits of exercise in relation to well-being and pain management. Conclusion: The experience of living with a rheumatic disease can bring together people and contributes to the experience and knowledge exchange takes place. Many of the experiences and the experiences that emerged could be linked to concepts in the social cognitive theory.
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Meyer-Lie, Tove. "Violiniststudenters upplevelser och erfarenheter av att spela med smärta eller skada : En kvalitativ studie." Thesis, Uppsala universitet, Åsenlöf: Fysioterapi, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-395207.
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Bakgrund Det är välkänt att musiker, studerande såväl som praktiserande, ofta drabbas av smärtproblematik och det finns en hög prevalens för smärta i nacke, skuldra, arm och handområden hos violinister. Syfte Syftet var att belysa och beskriva violiniststudenters upplevelser av att spela med smärtor/skador och upplevelser om underlättande och försvårande faktorer för spel samt deras upplevelser om behandlingar/möjlighet till behandlingar. Design och metod Studien har en kvalitativ ansats med en explorativ design med semistrukturerade intervjuer som datainsamlingsmetod. Resultat Ur analysen identifierades fem kategorier: ”Konsekvenser av smärta och skada vid spel”, ”smärtans påverkan i vardagen”, ”underlättande faktorer för spel”, ”försvårande faktorer för spel”, och ”upplevelser av behandling”. God kunskap hos musikläraren, ergonomi och fysisk träning upplevdes som underlättande faktorer och minskade smärtan. Instrumentets utformning och höga krav upplevdes som försvårande faktorer för spel och påverkade smärtproblematiken negativt. Deras upplevelser av behandling var att vården var oförstående för deras problematik och att mer kunskap om hur de kan få hjälp behövs. Konklusion Fysisk träning, ergonomi och coping är exempel på faktorer som underlättat för spel och minskat smärtproblematiken hos studenterna. Detta kan vården och specifikt fysioterapeuter hjälpta till med men det behöver utforskas ytterligare för att kunna utveckla anpassade behandlingar för att minska smärtproblematik hos violiniststudenter.Background It is well known that musicians, both students and working professionals, often are affected by pain related problems and there is a high prevalence for violinists to get pain in the neck, shoulders, arms and hands. Purpose The purpose of the study was to describe the violin student experiences of pain and/or injuries whilst playing, experiences of aggravating and mitigating factors for playing music and their experiences with therapy/possibilities for therapy. Design and method The design used was a qualitative and explorative design with semi-structured interviews as the method to collect the data. Result From the analysis five categories were identified: “Consequences of pain and injurie when playing”, “the pains effect in day to day life”, “aggravating factors for playing”, “mitigating factors for playing” and “experiences with treatments”. The music teacher’s knowledge, ergonomics and physical training was perceived as aggravating factors. The instruments form and high demands was described by the students as mitigating factors for playing music and that it had a negative impact on their pain. Their experiences with therapy/possibilities for therapy was of the sort that the healthcare professionals were uncomprehending about their complex of problems and that more knowledge about how to sufficiently help the students is needed. Conclusion Physical training, ergonomics and coping are examples of factors that is aggravating for playing and that it has decreased the pain for the students. Healthcare and especially physical therapy can help with this but further research is needed to develop proper treatments to minimize pain for violinist students.
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Carrasco, Gamboa Pamela. "The Lives of the People from Banken 1. : A study based on muscular development and other activity markers." Thesis, Uppsala universitet, Institutionen för arkeologi och antik historia, 2019. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-392563.
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Tre skelett från en kyrkogård daterad till Gotlands sen-vikingatid till tidig medeltid har analyserats avseende aktivitetsspår. Metoden som användes innebar observation av muskelutvecklingen tillsammans med förändringar i entesiterna som är fästen för muskler och ligament. Hittills har forskningen ägnat sig åt att studera dessa förändringar på ett kvantitativt sätt, genom att tilldela poäng till de olika förändringarna enligt hur utvecklade de är och sedan skapa en statistik. Men dessa metoder har fortfarande många begränsningar, eftersom det är väldigt få av dessa entesiter som har studerats. Syftet med studien har varit att undersöka vilka muskler var utvecklade och utröna hur dessa rörde sig tillsammans för att återskapa ett rörelsemönster som kan hjälpa att skapa en teori om vilka aktiviteter individerna sysslade med (arbetsuppgifter, fritidssysslor, m.m.). Analysen har gjorts med hjälp av litteratur om aktivitetsspår, paleopatologi, fysioterapi och med referensmaterialet från Osteologilaboratoriet vid Uppsala Universitet, Campus Gotland.
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Paskell, Rachel Grace. "Military culture and psychosocial factors associated with motivation for, and engagement in, rehabilitation after musculoskeletal injury : a feasibility study with male British military and civilian physiotherapy patients." Thesis, University of Bath, 2016. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.698972.
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Engagement in rehabilitation, such as physiotherapy, is critical to enhanced outcomes from musculoskeletal injuries (MIs) and has been found to be related to psychosocial factors, including increased personal control, higher levels of autonomous-motivation and more problem-focused type coping strategies in sports populations. However, this has not been empirically studied in British military groups, despite MIs being the most common reason for medical discharge from the British armed forces. Military personnel are thought to cope with injury within the context of a 'military culture' that is not found in civilians. This study tested a concept of military culture being related to greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation; lower levels of emotion-focused coping strategies; a greater use of problem-focused coping strategies and better engagement in rehabilitation. Data from self-report questionnaires and physiotherapist ratings of engagement in rehabilitation, provided by two groups, was compared. Group one consisted of 16 serving male military personnel and group two of 22 committed sports men; all had MIs sustained within the past 6 months, for which they were having physiotherapy. The sports group were found to show statistically significant greater adherence to masculine norms, and use of problem-focused and emotion-focused coping strategies. No significant differences were found between the groups on perceived personal control, autonomous motivation nor engagement in rehabilitation. A military culture defined by greater adherence to masculine norms; higher levels of perceived personal control and autonomous motivation and a greater use of problem-focused coping strategies has therefore not been supported by this study. However, only sufficient power was achieved for the analysis of emotional-focused coping strategies so caution must be taken when interpreting these results. Clinical and research implications are discussed with recommendations for further work with methodological lessons learnt.
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Puppo, Eugenio Francesco. "Effetti Placebo, Nocebo e Fattori di Contesto: meccanismi che influenzano l’outcome fisioterapico e la risoluzione del dolore muscoloscheletrico. Una revisione narrativa della letteratura." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2019. http://amslaurea.unibo.it/19322/.
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Negli ultimi anni la ricerca sugli effetti placebo, nocebo e sui fattori di contesto si è molto sviluppata, rivelando considerazioni importanti sul contesto psicosociale e sul peso che questo ha nell’influenzare gli outcome di trattamento. L’obiettivo di questa revisione narrativa è quello di ricercare uno schema generale dei fattori contestuali che possono influenzare gli esiti del trattamento fisioterapico per la risoluzione del dolore muscoloscheletrico.
Si è condotta una ricerca sulle banche dati PubMed, CINAHL, PEDro e MEDLINE includendo tutti gli articoli che trattassero degli effetti placebo, nocebo e dei fattori di contesto in ambito fisioterapico e del loro utilizzo per la riduzione del dolore muscoloscheletrico. Sono stati esclusi studi che prendevano in esame persone con dolore non di origine muscoloscheletrica, con patologie reumatiche o oncologiche, con gravi disturbi d’ansia, depressione o patologie psichiche.
Alla fine della ricerca sono stati inclusi 7 articoli. L’analisi di tali studi ha confermato la conoscenza superficiale dell’argomento sia da parte dei fisioterapisti specializzati in terapia manuale, che delle persone assistite.
I risultati suggeriscono che un utilizzo etico ed appropriato dei fattori contestuali in clinica può innescare degli effetti placebo, migliorando così il dolore; mentre un utilizzo sbagliato o addirittura una negligenza nei confronti del contesto può sfociare nell’effetto nocebo, il quale incide negativamente sull’outcome, ottenendo risultati meno rilevanti, neutri o addirittura peggiorando le condizioni della persona. In conclusione, ritengo che l’obiettivo della mia ricerca abbia posto in evidenza un contesto molto rilevante nella pratica clinica, pur non avendo potuto trarre delle conclusioni sufficientemente supportate dalla letteratura, che spero si potrà dedicare con maggior attenzione a questo argomento.
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Lumpkins, Logan, and Craig Wassinger. "Effects of Lower Extremity Aerobic Exercise and Conditioned Pain Modulation on Evoked Shoulder Pain." Digital Commons @ East Tennessee State University, 2017. https://dc.etsu.edu/honors/434.
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Background: Emerging evidence suggests that aerobic exercise and conditioned pain modulation may be advocated in treating patients with musculoskeletal pain. The effects of lower extremity aerobic exercise and conditioned pain modulation on evoked shoulder pain are not known.
Purpose: To determine the acute effects of lower extremity aerobic exercise and conditioned pain modulation on outcomes of evoked shoulder pain from pain pressure threshold measurements.
Study Design: Repeated measures.
Methods: Thirty (30) healthy volunteers were tested over the course of two sessions. Session 1 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a conditioned pain modulation with cool water. Session 2 consisted of collecting pain pressure threshold measurements over the infraspinatus before and immediately following a bout of lower extremity aerobic exercise on a recumbent stepper apparatus.
Results: Pain pressure threshold was not significantly influenced by the conditioned pain modulation using cool water (p=0.725). Pain pressure threshold was significantly increased immediately following the lower extremity exercise session (P<0.001).
Conclusion: Conditioned pain modulation with cool water did not produce any significant changes in pain pressure threshold. Lower extremity aerobic exercise acutely increased pain pressure threshold in participants with experimentally induced shoulder pain. Physical therapists may consider lower extremity aerobic exercise to produce short-term hypoalgesic effects and facilitate the application of more active interventions.
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Gomes, Lúcia Catarina Soares. "Prioridades de Investigação em Fisioterapia músculo-esquelética em Portugal utilizando o método modificado de Delphi." Master's thesis, Instituto Politécnico de Setúbal. Escola Superior de Saúde, 2018. http://hdl.handle.net/10400.26/25577.
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Relatório do Projeto de Investigação apresentado para cumprimento dos requisitos necessários à obtenção do grau de Mestre em Fisioterapia. Área de especialização em Fisioterapia em Condições Músculo-EsqueléticasIntrodução e Objetivos: Nos últimos anos tem existido uma crescente ênfase na necessidade dos profissionais realizarem a sua prática informada pela evidência (PIE) científica. De forma a promover a PIE, a integração das questões e necessidades da prática clínica nas prioridades da investigação científica têm sido recomendadas. O objetivo principal deste estudo foi identificar as prioridades de investigação em fisioterapia na área da músculo-esquelética em Portugal. Metodologia: Foi utilizado o método modificado de Delphi para a identificação das prioridades de investigação através do consenso nacional. Foram convidados 360 potenciais participantes, divididos por cinco painéis: experts, docentes, educadores clínicos e mestres em fisioterapia músculo-esquelética, e indivíduos com uma condição clínica na mesma área Na ronda 1 foi pedido que fossem identificadas entre 3-5 prioridades de investigação, e após análise de conteúdo foram identificados os temas. Na ronda 2 e 3 foi pedido aos participantes que graduassem a importância dos temas numa escala de Likert de 1-5. O grau de consenso foi obtido com a média≥ 4, mediana≥ 4, coeficiente de variação≤ 30%, e ≥ 80% de consenso. Foi utilizado o coeficiente de concordância de Kendall para avaliar o consenso. Resultados: A percentagem de resposta nas três rondas variou entre 28,8- 32,7%. Na ronda 1 (n=116) foram identificados os tópicos de investigação, que após a análise de conteúdo foram categorizados em 21 temas. Na ronda 2 identificaram-se 18 temas como sendo os mais importantes, tendo reduzido para 10 a ronda 3. O coeficiente de concordância de Kendall foi de 0,100 e 0,112 na ronda 2 e 3, respetivamente. Conclusões: A partir de um processo de consenso nacional envolvendo fisioterapeutas de condições músculo-esqueléticas e utentes com estas condições foram identificados e graduados temas de investigação em fisioterapia. Os temas de investigação identificados representam áreas em evolução de importância para a fisioterapia músculo-esquelética maximizando o foco no desenvolvimento da base de evidências.
Introduction and Objectives: Over the past years, there has been an increasing emphasis on the need for physiotherapist to take an evidence-based practice (EPB). In order to promote EBP the integration of clinical practice issues and needs into the priorities of scientific research have been recommended. The study’s main objective is to identify musculoskeletal physiotherapy research priorities in Portugal. Methodology: The modified Delphi method was used to identify research priorities through the national consensus. 360 participants were invited, divide into five panels: experts, teachers, clinical educators and masters in musculoskeletal physiotherapy, and individuals with a clinical condition in the same area. In round 1 request to identify 3-5 research priorities, and after content analysis the themes were identified. In round 2 and 3 the participants were asked to grade the themes importance on a 1-5 Likert scale. Level of consensus was established with a mean rating≥4, median≥4, coefficient of variation ≤30%, e ≥80% agreement. Consensus across participants was evaluated using Kendall’s coefficient of concordance (W). Results: The response rate in the three rounds ranged from 28,8-32,7%. In round 1 (n=116), research topics were identified, which after the content analysis categorized into 21 themes. In round 2, 18 themes were identified as being the most important, having reduced to 10 in round 3. The Kendall’s coefficient of concordance was 0.100 and 0.112 in round 2 and 3, respectively. Conclusions: From a national consensus process involving stakeholders – musculoskeletal physiotherapist and users, research topics in physiotherapy were identified and graded. The identified research topics represent important areas for musculoskeletal physiotherapy, maximizing the focus on the development of evidence base.
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Bolzan, Valeria. "Indagine sull'impatto della teleriabilitazione su vari outcome psicologici in persone con patologie muscoloscheletriche in trattamento durante la pandemia da COVID-19. Uno studio osservazionale prospettico." Bachelor's thesis, Alma Mater Studiorum - Università di Bologna, 2020. http://amslaurea.unibo.it/21988/.
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BACKGROUND: le misure di lockdown imposte dal Governo a causa della pandemia di COVID-19 hanno impedito alle persone di accedere alle strutture per effettuare riabilitazione convenzionale. Ciò, insieme a incertezze create dalla pandemia, può aver condizionato il benessere psicologico, andando a influire sul recupero fisico.
OBIETTIVO: valutare come un servizio di teleriabilitazione influisce sulle componenti psicologiche in soggetti con lesioni all’apparato muscoloscheletrico durante la quarantena conseguente al COVID-19.
MATERIALI E METODI: durante il lockdown è stato inviato un questionario per analizzare le componenti psicologiche. Ognuno dei partecipanti ha seguito un programma di teleriabilitazione. Dopo un mese, è stato compilato nuovamente il medesimo questionario. I dati sono stati studiati tramite analisi sulle medie dei valori tramite ANOVA e analisi di regressione, di correlazione bivariata lineare e non parametriche.
RISULTATI: solo autoefficacia ha mostrato un cambiamento significativo nel tempo. Si sono mantenuti alti i livelli di resilienza e di percezione di supporto dei fisioterapisti, che ha relazioni con autoefficacia, ottimismo e aderenza. Non ci sono differenze significative legate ad età e attività sportiva. Le donne a T1 presentano maggiore depressione e sintomi di disturbo post-traumatico da stress e a T2 maggiore tensione
CONCLUSIONI: la teleriabilitazione può essere utile a limitare ricadute psicologiche e di mantenere alti i livelli di aderenza al trattamento e di ottimismo. Ciò può essere dovuto ad elevati livelli di supporto da parte dei rieducatori e all’elevata resilienza riscontrata nel campione. Inoltre, l’intervento può aver contribuito a mantenere stabili i livelli di depressione, di sintomi da PTSD e di stati negativi dell’umore, soprattutto nelle donne e nelle persone più giovani. Vi sono dei limiti metodologici, per cui ulteriori studi sono necessari per aumentare la forza delle conclusioni e fornire spiegazioni aggiuntive.
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Hidman, Karin, and Catarina Jahr. "Copingstrategier hos personer som varit sjukskrivna mellan 3 och 6 månader." Thesis, Mälardalens högskola, Akademin för hälsa, vård och välfärd, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:mdh:diva-12027.
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Bakgrund: Personer med muskuloskeletala och psykiska diagnoser står för 57 % av sjukskrivningarna i Västerås. Majoriteten av dessa är kvinnor. Det har blivit vanligare att man, vid rehabilitering, förutom personens fysiska funktion även beaktar psykiska aspekter, så som copingstrategier. Syfte: Att kartlägga de mest förekommande copingstrategierna hos personer som varit sjukskrivna mellan 3 och 6 månader och att undersöka eventuella skillnader i copingstrategier mellan män och kvinnor samt mellan personer med psykiska och muskuloskeletala besvär. Metod: En enkätbaserad deskriptiv tvärsnittsstudie genomfördes. Urvalet var ett bekvämlighetsurval som rekryterades i samarbete med Sjukskrivningskommittén och Försäkringskassan i Västerås. Åttio personer tillfrågades om deltagande varav 40 personer var sjukskrivna på grund av psykiska besvär och fyrtio på grund av en muskuloskeletala besvär. Resultat/Slutsats: Tjugo personer deltog i studien. Av dessa var 17 kvinnor och 3 män, 16 personer hade muskuloskeletala besvär och 4 psykiska besvär. De mest förekommande copingstrategierna inom gruppen långtidssjukskrivna var att öka aktivitet, smärtbeteende och självstärkande. Det är vanligare med katastroftankar hos personer med muskuloskeletala besvär än hos personer med psykiska besvär. Ingen skillnad mellan män och kvinnor kunde analyseras eftersom könsfördelningen bland deltagarna var ojämnt fördelad. Det går ej att dra några absoluta slutsatser utifrån resultatet på grund av det stora bortfallet och det låga deltagarantalet.Background: People with musculoskeletal and mental disorders account for 57% of sick leave in Västerås. The majority of these are women. It has become more common in rehabilitation that also to take into account psychological aspects, such as coping strategies. Objective: To identify the most prevalent coping strategies in persons on sick leave between 3 and 6 months and to analyze possible differences in coping strategies between men and women as well as between people with mental and musculoskeletal disorders. Method: A questionnaire-based descriptive cross-sectional study. A convenience sample was invited to participate the sample was recruited in cooperation with Sjukskrivningskommittén and Försäkringskassan in Västerås. Eighty persons were asked for participation of which 40 were on sick leave due to mental disorders and 40 due to musculoskeletal disorders. Results/Conclusion: Twenty people participated in the study. Of these were 17 women and three were men. Of those, 16 people had a musculoskeletal disorder and four had a mental disorder. The most prevalent coping strategies within the group long-term sickness was increasing activity, pain anxiety and self-reinforcing. People with musculoskeletal disorders had more catastrophizing thoughts than people with mental disorders. No difference between men and women were possible to analyse because the gender distribution among the participants were uneven. The small sample size and high drop- out rate does not allow any absolute conclusions based on the study results.
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Smith, Brennan L. "MUSCLE SYNERGY DURING A SINGLE LEG STANDING TEST IN AMBULATORY CHILDREN WITH CEREBRAL PALSY." UKnowledge, 2018. https://uknowledge.uky.edu/khp_etds/51.
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INTRODUCTION: Cerebral Palsy (CP) is a sensorimotor disorder characterized by dysfunctional motor coordination, balance problems, and loss of selective motor control. Motor coordination exhibited as co-contraction, has been subjectively quantified using gait analysis, but recent studies have begun to objectively analyze the amount of co-contraction by collecting electromyography (EMG) data. Center of pressure excursion (COPE) measurements collected during a single leg standing test (SLST) have shown to be more valid measurements of balance in populations with motor disabilities than a SLST alone. A recent study has correlated increased COPE velocity with a lower fall risk as determined by reported fall frequency, suggesting a more objective measure of fall risk. The current study aimed to determine if the fall risk calculated by COPE velocity in children with CP is correlated with co-contraction index value in various muscle synergy groups. It was hypothesized that i) co-contraction index values will differ between high and low fall risk groups, ii) there will be preferential activation of different synergy groups within the high and low fall risk groups, and iii) there will be a negative and direct correlation between COPE velocity and co-contraction index values for all synergy groups. METHODS: Fall risk grouping was determined by average COPE velocity values calculated from previously reported fall frequency groups. Balance ability was determined by COPE measurements during a SLST on a force plate. Muscle synergy groups were determined by common muscle pairings at the hip, knee and ankle. Co-contraction indices were determined from linear envelopes plotted from muscle group EMG data. An independent t-test was run on muscle synergy groups between high and low fall risk groups. Nonparametric Analysis of Variance (ANOVA) and Tukey post-hoc tests were run on the high and low fall risk groups separately to determine differences in co-contraction index value within high and low fall risk groups. A Pearson correlation analyzed COPE velocity and co-contraction index value. RESULTS: No significant differences in muscle synergy between the high and low fall risk groups were found (p = 0.476, 0.076, 0.064, 0.364). The ANOVA and Tukey post-hoc tests for high fall risk group found significant differences in co-activation index value between the sagittal hip and frontal hip groups (p = 0.022) and sagittal hip and ankle groups (p = 0.016). Low fall risk group was found to have significant differences between the sagittal hip and frontal hip groups (p = 0.038) and frontal hip and knee groups (p = 0.012). Weak and negative correlations were found between COPE velocity and both knee and ankle groups (r = -0.309, -0.323, p = 0.059, 0.050). Negligible and insignificant correlations were found between frontal hip and sagittal hip synergies and COPE velocity ((r = 0.013, -0.068, p = 0.475, 0.367). CONCLUSION: There is insufficient evidence to claim that muscle group activations are different depending on fall risk grouped by COPE velocity. It is not currently possible to correlate COPE velocity to a specific synergy group recruitment. However, data do suggest that sagittal hip and knee strategies are recruited more than ankle and frontal hip strategies during SLST.
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Amaral, Ana Paula. "Influência da mobilização mandibular inespecífica sobre o movimento mandibular de indivíduos com disfunção temporomandibular: ensaio clínico, aleatorizado, placebo-controlado e cego." Universidade Nove de Julho, 2016. http://bibliotecatede.uninove.br/handle/tede/1834.
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Temporomandibular dysfunction is defined as a group of heterogeneous alterations that affect the temporomandibular joint, affecting important functional and anatomical elements, characterizing itself as a complex and multifactorial disease. His doctoral thesis was divided into four studies with the following objectives: Article 1 (protocol) and Article 4: to evaluate the influence of non-specific mandibular mobilization on mandibular opening movements and lateral excursions in women with TMD by means of pachymetry and the three-dimensional kinematic analysis of movement, as well as assessing pain intensity, functionality and quality of life; Article 2: identify if manual therapy is effective in treating TMD, as well as assess the accuracy of tools that are used to evaluate the rehabilitation of patients with TMD; Article 3: investigate the immediate effect of nonspecific mandibular mobilization on the range of motion in individuals with temporomandibular dysfunction. Thus we obtained as a result and conclusion: Article 2: manual therapy is effective in the treatment of TMD mainly in the reduction of muscular pain and to improve the ROM. The visual analogue scale (VAS) and clinical evaluation using RDC / TMD are the most used tools to evaluate the effects of Manual Therapy; Article 3: Nonspecific mandibular mobilization led to an immediate increase in maximal vertical mandibular movement, as well as increases in right and left lateral excursion in individuals with and without TMD; Article 4: Non-specific mandibular mobilization decreases pain intensity and influences the clinical improvement of the mandibular opening amplitude measured by pachymetry, but does not influence the functionality, quality of life and trajectory of the mandibular movements of patients with temporomandibular dysfunction.
A disfunção temporomandibular é definida como um grupo de alterações heterogêneas que afetam a articulação temporomandibular, acometendo importantes elementos funcionais e anatômicos, caracterizando-se assim como uma doença complexa e multifatorial. Essa tese de doutorado foi dividida em quatro estudos com os seguintes objetivos: Artigo 1 (protocolo) e Artigo 4 : avaliar a influência da mobilização mandibular inespecífica, sobre os movimentos mandibulares de abertura e excursões laterais, em mulheres com DTM, por meio da paquimetria e da análise cinemática tridimensional do movimento, bem como avaliar a intensidade da dor, a funcionalidade e a qualidade de vida; Artigo 2: identificar se a terapia manual é eficaz no tratamento para DTM, bem como avaliar a acurácia das ferramentas que são utilizadas para avaliar a reabilitação dos pacientes com DTM; Artigo 3: investigar o efeito imediato da mobilização mandibular inespecífica, na amplitude de movimento em indivíduos com disfunção temporomandibular. Assim obtivemos como resultado e conclusão: Artigo 2: a terapia manual é eficaz no tratamento da DTM principalmente na diminuição da dor muscular e para melhorar a ADM. A escala visual analógica (EVA) e avaliação clínica com o uso do RDC/TMD são as ferramentas mais utilizadas para avaliar os efeitos da Terapia Manual; Artigo 3: A mobilização mandibular inespecífica levou a um aumento imediato do movimento mandibular vertical máximo, bem como aumentos na excursão lateral direita e esquerda em indivíduos com e sem DTM; Artigo 4: A mobilização mandibular inespecífica diminui a intensidade de dor e influencia na melhora clínica da amplitude de abertura mandibular mensurada pela paquimetria, porém não influencia na funcionalidade, na qualidade de vida e na trajetória dos movimentos mandibulares de pacientes com disfunção temporomandibular.
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Arvidsson, Malin, and Lisa Skogs. "Muskuloskeletal skadeprevalens i nedre extremitet hos rekryter efter genomförd grundläggande militär utbildning." Thesis, Uppsala universitet, Fysioterapi, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-322533.
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BACKGROUND: Previous studies have shown a high injury rate in the lower extremities among military recruits. A correlation has been shown between female gender or a low level of physical activity prior to basic military training and a higher risk of injury. AIM: To investigate the self-reported injury rate in the lower extremities among Swedish recruits and the difference in injury rate between men and women. Another aim was to investigate correlation between self-reported injury rate in the lower extremities and self-reported physical activity, and to study this correlation for both men and women. METHOD: A quantitative study with a prospective, descriptive, comparative and correlative design. Data from two different questionnaires were answered by 177 recruits. RESULTS: 26% of the recruits reported injury in lower extremities after completing the basic training. There was a significant difference (p=0.006) in self-reported injury between female and male recruits. The level of prior physical activity and the injury rate amongst the recruits had a low correlation. CONCLUSION: The results indicate a high injury rate among Swedish recruits, especially among the female recruits. No correlation between self-reported physical activity and the injury rate in lower extremities was found.BAKGRUND: Tidigare studier visar på hög skadeprevalens i nedre extremiteter hos militära rekryter under grundläggande militär utbildning. Samband har setts mellan kvinnligt kön eller låg fysisk aktivitetsnivå före utbildningsstart och ökad skaderisk. SYFTE: Undersöka den självrapporterade skade-/besvärsprevalensen i nedre extremitet hos svenska rekryter efter avslutad grundläggande militär utbildning (GMU), samt studera skillnader mellan könen i detta avseende. Syftet var också att undersöka sambandet mellan självrapporterad fysisk aktivitetsnivå inför GMU och skade-/besvärsprevalensen i nedre extremiteter efter genomförd utbildning samt studera sambandet för män respektive kvinnor. METOD: En kvantitativ studie med prospektiv, deskriptiv, komparativ och korrelerande design. Data från två olika enkäter besvarades av 177 rekryter. RESULTAT: 26% av rekryterna rapporterade skada/besvär i nedre extremitet vid avslutad utbildning. Signifikant skillnad (p=0,006) kunde ses i självrapporterad skade-/besvärsprevalens mellan kvinnliga (42%) och manliga (21%) rekryter. Nivå av fysisk aktivitet och skade-/besvärsprevalensen hos rekryterna hade inget signifikant samband och låg korrelation. KONKLUSION: Resultaten tyder på hög skadeprevalens inom GMU, framförallt hos kvinnliga rekryter. Något samband mellan självskattad nivå av fysisk aktivitetsnivå och skade-/besvärsprevalens i nedre extremitet fanns inte hos rekryterna. Sambandet fanns varken för män eller kvinnor på gruppnivå.
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Mayer, Kirby. "CHANGES IN MUSCLE SIZE, QUALITY AND POWER ARE RELATED TO PHYSICAL FUNCTION IN PATIENTS WITH CRITICAL ILLNESS." UKnowledge, 2019. https://uknowledge.uky.edu/rehabsci_etds/56.
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Patients admitted to intensive care unit (ICU) are known to develop significant impairments in physical function. Patients with critical illness suffer up to 30% reductions in muscle size within the first ten days of admission to the ICU. Muscle strength testing, Medical Research Council-sum score, is current gold-standard to diagnosis ICU-acquired weakness and predicts risk of mortality and long-term physical function. Muscle power different from muscle strength in that it accounts for velocity of movement, is potentially a better independent predictor of function that has not been studied in this population. In addition, we hypothesize that muscle size and quality measured through ultrasound imaging has better applicability and prediction that strength testing. Therefore, we prospectively collected data surrounding these muscle parameters in patients admitted to the medicine ICU at University of Kentucky. Primary outcomes included physical function, muscle power with a novel assessment tool for the critically ill population, muscle strength, and muscle size and quality assess through ultrasound imaging. 36 patients admitted to ICU and 18 aged-matched controlled were enrolled. Patients had significantly lower scores on muscle power assessment at ICU discharge (33.6 ±19.0 W; t= 4.01, p < 0.001) and at hospital discharge (40.9 ±16.5 W; t= 4.81, p < 0.001) in comparison to controls (59.3± 14.7 W). Patients with better scores on muscle power assessment had significantly better scores on physical function measures (Six-minute walk test; rs = 0.548, p = 0.0001). Muscle size (cross-sectional area of rectus femoris muscle) and muscle power were strongly correlated (rs = 0.66, p < 0.0001). These data suggest that patients with critical illness have significantly reduced muscle power which directly related to deficits in physical function.
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Malca, Sandoval Sonia. "Trastornos musculoesqueléticos de origen laboral en el cuello y las extremidades superiores de los fisioterapeutas en Cataluña." Doctoral thesis, Universitat de Lleida, 2017. http://hdl.handle.net/10803/420862.
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Els fisioterapeutes (FTs) tenen el risc de patir trastorns musculoesquelètics d'origen laboral en coll i
extremitats superiors (TMOLCES). El propòsit d'aquest estudi transversal va ser determinar la
prevalença de TMOLCES en els FTs de Catalunya, investigar les associacions entre TMOLCES i
àrees anatòmiques, i aspectes demogràfics i laborals dels FTs, le seves respostes i els factor de risc
laboral percebuts com a causes de TMOLCES.
Es va trobar una prevalença de vida de TMOLCES de 87,3%; de 12 mesos, de 81,9%, i la puntual, de
65,94%. El 57,4% dels menors de 30 anys es van lesionar en els 3 primers anys d'exercici
professional. Els TMOLCES més freqüents van ser a l'espatlla, el canell i la mà.
La prevalença de TMOLCES esntre els FTs a Catalunya és més alta que la trobada en altres països.
El gènere, les àrees d'especialitat i les tècniques utilitzades estan correlacionats amb aquesta alta
prevalença.Los fisioterapeutas (FTs) están en riesgo de sufrir trastornos musculoesqueléticos de origen laboral en cuello y extremidades superiores (TMOLCES). El propósito de este estudio transversal fue determinar la prevalencia de TMOLCES en los FTs de Cataluña, investigar las asociaciones entre TMOLCES y áreas anatómicas, y aspectos demogràficos y laborales de los FTs, sus respuestas y los factores de riesgo que perciben como causas de TMOLCES. Se encontró una prevalencia de vida de TMOLCES de 87,3%; de 12 meses, de 81,9%, y la puntual, de 65,94%. El 57,4% de los menores de 30 años se lesionaron en los 3 primeros años de ejercicio profesional. Los TMOLCES más frecuentes fueron en el hombro, muñeca y mano. La prevalencia de TMOLCES entre los FTs de Cataluña fue más alta que la reportada en otros países. El género, las áreas de especialidad y las técnicas utilizadas están correlacionados con esta alta prevalencia.
Physiotherapists (PTs) are at risk for work-related neck and upper limb musculoskeletal disorders (WRULDS). The purpose of this cross-sectional study was to determine the prevalence of WRULDS in the PTs of Catalonia, to investigate the associations between WRULDS and the anatomic areas, and the demographic and labor aspects of the PTs, their responses and compensation strategies as well as the occupational risk factors perceived as causes of WRULDS. A life prevalence of WRULDS of 87,3% was found, the prevalence of 12 months was 81,9% and the point prevalence was 65,94%. 57,4% of PTs under 30 had been injured in the first 3 years of professional practice. The most frequent WRULDS were in the shoulder, wrist and hand. The prevalence of WRULDS among PTs in Catalonia is higher than the prevalence reported in other countries. Our data suggest that gender, areas of speciality and techniques used are correlated with this high prevalence.
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Miller, Peter. "Pattern recognition is a clinical reasoning process in musculoskeletal physiotherapy." 2009. http://hdl.handle.net/1959.13/44629.
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Masters Research - Master of Medical SciencePattern recognition is a non-analytical clinical reasoning process which has been reported in the medical and allied health literature for some time. At a time when clinical problem solving was largely considered to consist of the analytical process of hypothetico-deductive reasoning, pattern recognition was introduced in the literature with observations of greater efficiency and accuracy. The research that followed these apparent opposing models of clinical reasoning resulted in significant growth in the understanding of problem solving in healthcare. On commencing this thesis the knowledge surrounding pattern recognition in physiotherapy was insufficient for its inclusion in educational design. Consequently the aims of the study described in this thesis were to clearly identify pattern recognition using high fidelity case methods and observe its relationship with accuracy and efficiency. The study utilised a single case study with multiple participants. A real clinical case with a diagnosis of high grade lumbar spine spondylolisthesis was simulated using a trained actor. This provided a high fidelity case study method allowing the observation of more realistic problem solving practices as compared with the common low fidelity paper case approach. Two participant groups were included in the study to investigate the common belief that pattern recognition is an experience based reasoning process. The expert group comprised ten titled musculoskeletal physiotherapists with a minimum of ten years overall clinical experience and greater than two years experience following the completion of postgraduate study. The novice group included nine physiotherapists in their first year of clinical practice following completion of an undergraduate degree. Qualitative data collection methods included observation of the participant taking a patient history of the simulated client and a stimulated retrospective recall interview with the participant. The mixed method analysis used in the study provided methodological triangulation of the results and supported the presence of pattern recognition in musculoskeletal physiotherapy. The quantitative research findings indicated that pattern recognition was significantly more likely to produce an accurate diagnostic outcome than analytical reasoning strategies during a physiotherapy history. However its use was not a guarantee of success with only three of the four experts using pattern recognition identifying the correct diagnosis. Although four experts utilised pattern recognition as compared with only one novice, no significant overall differences were found in the use of pattern recognition between the expert and novice participant groups. The findings relating to time data found that expert participants took longer to conduct the client history than novices. Similarly those participants identified using pattern recognition also required more time which seemingly contradicts the view of pattern recognition being an efficient clinical reasoning process. This finding was limited by the incomplete nature of the study which did not include a physical examination or any client management.
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Hess, Danelle. "Do physiotherapy students employ evidence-based practice in the management of musculoskeletal disorders and sports injuries." 2013. http://hdl.handle.net/11394/3564.
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Magister Scientiae (Physiotherapy) - MSc(Physio)Background: Musculoskeletal disorders (MSD’s) and sports injuries are commonly sustained throughout the world daily. They are dominant in many countries, with considerable cost involvement and impact on quality of life. For this reason they need to be recognised as a necessary part of general practice. MSD’s refer to a wide variety of diseases and disorders of the musculoskeletal system, such as degenerative and inflammatory conditions (arthritis), spinal and soft tissue disorders, osteoporosis and musculoskeletal injury. Managing these musculoskeletal conditions are a challenge and using the best available evidence should be the first the choice. All health professionals should have the ability to determine the best available evidence and thus strive to give their patients the best health care known to them. Evidence-based practice (EBP) is an important key in making this happen as it uses the best current evidence in the decision-making process regarding the care of patients. Literature highlights that health care professionals are expected to implement evidence-based practice (EBP); this means that newly graduated students and health care professionals alike are required to be confident in exercising this skill of EBP. When expecting EBP from students, educators need to realize that students have limited clinical experience. Therefore, they need the skills to acquire the best research evidence when applying the best treatment for patients. In introducing evidence-based practice, various research is aimed at evaluating the health professional’s attitude and behaviour towards evidence-based practice (EBP). There is limited research regarding the actual implementation of EBP in everyday practice. Aim: Therefore, the aim of the study was to determine if undergraduate physiotherapy students implement evidence-based practice in the management of musculoskeletal disorders and sports injuries. Objectives: The study had four objectives: i) To determine the most common treatment techniques used by students in the management of the conditions treated at the UWC clinic through data extraction of patient records in the clinic using a self-designed data extraction sheet, ii) To determine the knowledge and beliefs about EBP among undergraduate physiotherapy students through a survey, iii) To determine an evidence-based intervention strategy of one of the most common conditions seen through a systematic review and iv) To map the links between current practice, student beliefs and evidence-based information. vii Methodology: The study used a predominantly quantitative approach with a few open ended questions and took place at a student training Physiotherapy clinic. The first phase was a retrospective document analysis study which consisted of data extraction of patient records for the period January 2009 to December 2011. The second phase used a mixed methods approached and consisted of a questionnaire with both closed and open-ended questions. It was completed by the 2012 registered fourth year students regarding attitudes and knowledge of EBP. The third phase consisted of a systematic review to identify the evidence for interventions used to manage one of the most common conditions identified. In the final phase and discussion of this thesis triangulation of the data was used by the researcher in order to formulate a picture of whether students apply evidence-based practice by using the data extracted from the patient folders in combination with the questionnaire survey of the participants and the systematic review. Data analysis for phases one and two was done using SPSS Statistical package software to determine frequencies and descriptive statistics. Phase two also had two open ended questions and this was analysed thematically and data was coded, themes allocated and responses counted. The systematic review focused on systematic reviews of treatments for low back pain and this was narratively described. The research project received ethical clearance from the University of the Western Cape Research Grants and Study Leave Committee (project registration number: 12/3/12), and permission to conduct the survey was obtained from the Head of Department. Informed consent was obtained from all participants, they were informed of the research process at the outset of the project, and kept up-to-date at every major stage. Questionnaires for surveys were accompanied by an information sheet explaining the background and reason for conducting the survey, and students gave written, informed consent following an opportunity to clarify the study details. Results: The results showed that males were predominantly seen at the physiotherapy clinic, and that the most common complaint was pain in the neck, shoulder and lower back area. The students most common treatment choice was soft tissue mobilisation and the use of heat for all three these areas of pain. The questionnaire responses were also captured using SPSS and frequencies and descriptive statistics employed. These results showed that although students knew what EBP was it was not clear that they knew how to implement it. The systematic review assessed and established the most common treatments used in literature for the treatment of lower back pain; and pain, function and disability were viii the only outcomes considered. The only intervention that had a positive effect on the included outcomes was the use of manual therapy (spinal manipulation and mobilisation). In triangulating the data, it was shown that the students do not seem to use the same treatment choices as the literature indicates. Conclusion: The results show that there is very little link between the students choices of treatment for one of the common conditions highlighted and the current literature. It is therefore possible that although students understand the term EBP they do not show that they know how to use or implement the concept. Implications for practice: Institutions may need to be more vigilant about making provision for EBP in the curriculum as well as how it is implemented so that students can be comfortable with this practice. More randomised controlled trials and systematic reviews are necessary on physiotherapy interventions so that practice can be better informed. Finally, EBP is perhaps one way to promote a culture of life-long learning within the physiotherapy profession.
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Cheng, Ching-Chou, and 鄭景州. "Healthcare-seeking Behavior, Perception and Attitudes toward Workplace Physiotherapy Consulting Service for Musculoskeletal Disorders in Taiwanese Workers." Thesis, 2011. http://ndltd.ncl.edu.tw/handle/02720484078061518774.
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碩士國立陽明大學
物理治療暨輔助科技學系
99
Background: Musculoskeletal disorders are the major health problems of Taiwanese workers. According to the survey of perceptions of safety and health in the work environment in 2007 at Taiwan, 37.9% of the employees reported body aches and pains in the past year. The prevalence for body aches and pains in the past year were 38.5% for shoulder, 31.9% for neck, and 26.0% for lower back and lumbar area. In the severer condition, body aches and pains influenced the performance of work and increased the days of sick leaves. Since the factors of the healthcare-seeking behavior for musculoskeletal disorders among Taiwanese workers have not been investigated, we conducted this survey study. Purposes: (1) To investigate the influencing factors of the healthcare-seeking behavior for musculoskeletal disorders in Taiwanese workers. (2) To investigate the perceptions and attitudes towards physiotherapy in Taiwanese workers. (3) To investigate the perceptions and attitudes towards workplace physiotherapy consulting service in Taiwanese workers. Study Design: An exploratory cross-sectional study. Materials and Methods: A structural questionnaire was designed for this study. Three experts were consulted for assessing the content validity of the questionnaire. A convenient sample of 332 Taiwanese workers was recruited to participate in this survey. Statistical analyses were conducted using the SPSS 15.0 software. Results: Almost 60% Taiwanese workers suffered body aches and pains over the shoulder, neck and lumbar area in the past year. Almost 30% Taiwanese workers looked for Chinese medicine treatment, and only 10% looked for physiotherapy treatment when they suffered musculoskeletal pain. The influencing factors of treatment choices for musculoskeletal disorders included professional skills of the physiotherapist, good service attitude, and correct evaluation and explanation of the disorders. Only 50-60% workers have correct perceptions and positive attitudes toward physiotherapy. The influencing factors of receiving physiotherapy consulting service included the professional ability of physical therapy, the effect of symptom reduction, and the cost saving (money and time). Discussions: Results of this study regarding the influencing factors of treatment choices for musculoskeletal disorders and receiving physiotherapy consulting service provide important information for better planning a workplace physiotherapy consulting service to fulfill the need of Taiwanese workers.
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Svobodová, Barbora. "Hodnocení muskuloskeletálních poruch u klavíristů." Master's thesis, 2017. http://www.nusl.cz/ntk/nusl-353301.
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Title: Evaluation of musculoskeletal disorders in pianists Background: Musculoskeletal (MS) disorders are common in pianists. Allsop and Ackland (2010) in their study describe that pianists suffer from MS disorders in 42 %. However, the prevalence of MS disorders differs depending on the region. There has not been done yet any evaluation of prevalence of MS disorders in pianists in Czech republic. This evaluation is crutial to make a comparison of our national results internationally. Furthermore, it is required to establish well-prepared preventional program for starting pianists. Aims: The purpose of this study is to evaluate prevalence of musculoskeletal disorders in pianists. Methods: Our data were collected using questionnaire survey. We distributed questionnaires among czech profesional pianists, piano teachers, and piano students by emails who were older than 18. Results: We sent 390 questionnaires by emails and received 78 of them completed. We revealed that the prevalence of musculoskeletal disorders of all respondents was 72 %. The prevalence was the highest in the group of the age from 18 to 60 reaching 90 %. The most common locality of musculoskeletal disorder was in the forearm. The group of pianists who started to play piano at the age from 3 to 4 were more prone to present with...
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Palacká, Klára. "Možnosti fyzioterapie v průběhu gravidity." Master's thesis, 2016. http://www.nusl.cz/ntk/nusl-342023.
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Title: Possibilities of physiotherapy in pregnancy Objectives: The aim of this study is to create a comprehensive overview of current knowledge concerning the issue of pregnancy from the point of view of a physiotherapist. Literature resources will be collected in order to provide information about the frequent difficulties of pregnant women in the context of the musculoskeletal system and their possible treatment by physiotherapy and also about physical activity during pregnancy. Methods: This study is a literature review. It is a theoretical study primarily based on foreign sources found in electronic databases such as Pubmed, EBSCO, OvidSP, Google Scholar and ProQuest. 139 foreign studies related to pregnancy were included, of which 133 were published between the years 2000 and 2015. Next 6 studies published from 1978 to 1999 were found in the primary sources. A combination of the following keywords was used to search the databases: pregnancy, physical therapy, physiotherapy, physiological changes, low back pain, pelvic girdle pain, pelvic floor muscles, musculoskeletal problems, foot arch, exercise, physical activity, gestational diabetes mellitus, preeclampsia. Results: There are a lot of studies concerning to this issue, but in many cases they are too heterogeneous to draw clear conclusions....
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Stibor, Eva. "Poruchy pohybového aparátu související s výkonem profese tanečnice - baletky." Master's thesis, 2021. http://www.nusl.cz/ntk/nusl-447039.
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Thesis title: Work related musculoskeletal disorders in professional ballet dancers Objective: The high demands of the ballet dancers' profession are reflected especially within the individual dancer's musculoskeletal body system which is repeatedly exposed to a physical load that is specific for classical dance. The objective of this thesis is to find out what are the work related musculoskeletal disorders ("WRMD") in dancers who work in the Czech Republic, what risk factors prevail and which preventive strategies are applied to avoid the occurrence of WRMD. Methods: The stated objective was achieved by means of a questionnaire survey, during which randomly selected women/young adults with vocational training in ballet who are/were professional ballet dancers voluntarily filled in a questionnaire. In total, 56 ballet dancers within the region of the Czech Republic took part in this survey. The questionnaire consisted of open and closed questions and its conception was based on the Nordic Musculoskeletal Questionnaire ("NMQ"), with selected questions adapted to the specifics of the ballet profession. The first part of the questionnaire consisted of questions related to sociodemographic data, the next part aimed to gather data on the musculoskeletal disorders suffered and preventive strategies...
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Laliberté, Maude. "Exploration et analyse éthique des facteurs influençant la priorisation des patients, ainsi que la fréquence et la durée des traitements en physiothérapie musculosquelettique." Thèse, 2017. http://hdl.handle.net/1866/20256.
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Nadeau, Marie-Josée. "Fiabilité et changement minimal détectable de mesures obtenues à partir d'images enregistrées par ultrasonographie afin de caractériser l'intégrité du tendon d'Achille." Thèse, 2013. http://hdl.handle.net/1866/11817.
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Problématique : La quantification de l’intégrité du tendon d’Achille (TA) représente un défi en réadaptation. L’adoption de mesures quantitatives du TA, extraites à partir d’une image ultrasonographique (QUS), pourrait remédier à cette lacune. Objectifs : 1) Évaluer la fiabilité test-retest et la précision de mesures QUS du TA; 2) Déterminer le meilleur protocole de collecte de mesures QUS à employer en pratique clinique. Méthodologie : Un total de 23 TAs présentant des symptômes d’une tendinopathie achilléenne et 63 TAs asymptomatiques ont été évalués. Pour chaque TA, 8 images ont été enregistrées (2 visites * 2 évaluatrices * 2 images). Différents types de mesures QUS ont été prises : géométriques (épaisseur, largeur, aire), dérivées d’un histogramme des niveaux de gris et dérivées d’une matrice de co-occurrence. Une étude de généralisabilité a quantifié la fiabilité et la précision de chaque mesure QUS et une étude de décision a fait ressortir les meilleurs protocoles de prise de mesures. Résultats : Les mesures géométriques ont démontré une excellente fiabilité et précision. Les mesures dérivées de l’histogramme des niveaux de gris ont démontré une fiabilité et précision médiocres. Les mesures dérivées d’une matrice de co-occurrence ont démontré une fiabilité modérée à excellente et une précision variable. En pratique clinique, il est recommandé de moyenner les résultats de trois images collectées par un évaluateur lors d’une visite. Conclusion : L’utilisation des mesures QUS géométriques permet de quantifier l’intégrité du TA (clinique et recherche). Davantage d’études sur les mesures QUS dérivées d’une matrice de co-occurrence s’avèrent nécessaires.Background: Quantifying the integrity of the Achilles tendon (AT) represents a challenge in rehabilitation. The adoption of quantitative measurements of the AT, extracted from an ultrasound image (QUS) could remedy this shortcoming. Objectives: 1) To assess the test-retest reliability and accuracy of QUS measurements of the AT; 2) To determine the best protocol of QUS measurements to use in clinical practice. Methods: A total of 23 ATs with symptoms of mid-portion Achilles tendinopathy and 63 asymptomatic ATs were evaluated. For each AT, 8 images were recorded (2visits* 2 evaluators* 2 images). Different types of QUS measurements were taken: geometric (thickness, width, area), derived from a gray-level histogram and derived from a co-occurrence marix. A generalizability study quantified the reliability and accuracy of each QUS measurement whereas a decision study highlighted the best protocols for measuring use. Results: The geometric measurements showed excellent reliability and accuracy. The measures derived from the gray-level histogram showed poor reliability and accuracy. The measurements derived from a co-occurrence matrix have shown moderate to excellent reliability and a variable precision. In clinical practice, it is recommended averaging the results of three images collected by an assessor during a single visit. Conclusions: The use of geometric QUS measures allows to quantify the integrity of the AT in clinical practice and in research. Further studies on QUS measurements derived from a matrix of co-occurrence are needed.
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Carvalho, Joana Brito de. "Avaliação da eficácia dos planos de proteção aplicados a operadores com lesões músculo-esqueléticas ao nível do membro superior." Master's thesis, 2016. http://hdl.handle.net/10400.5/11865.
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A presente dissertação apresenta a análise da eficácia de regimes de proteção, nomeadamente fisioterapia e alterações no posto de trabalho, aplicados a operadores que sofrem ou sofreram de lesões músculo-esqueléticas relacionadas com o trabalho, do membro superior, numa amostra de operadores de uma empresa da indústria, composta por 41 homens e 14 mulheres, com idades compreendidas entre os 28 e os 53 anos. Ao longo do estudo foi aplicada uma compilação de questionários que avaliavam a perceção dos operadores no que diz respeito à incapacidade do membro superior e à prática de atividade física. No final da análise verificou-se que houve uma melhoria na capacidade funcional dos operadores após terem sido sujeitos a regimes de proteção, no entanto não se verificaram diferenças estatisticamente significativas quando comparada com as variáveis sociodemográficas. Foi recolhido o score de risco dos postos avaliados e na sua maioria, o nível de risco identificado era baixo, com algumas exceções. Ao longo do estudo, a adesão dos operadores foi muito positiva, mas alguns mostraram desânimo pois sentiam que os seus problemas não estavam a ser tratados convenientemente, segundo os seus pontos de vista. No final da dissertação são apresentadas as limitações do estudo e algumas propostas futuras.The following dissertation presents the analysis of protection regimes efficiency, mainly physiotherapy and changes in the work environment, applied to operators that have suffered or currently suffer from work related upper limbs musculoskeletal disorders, in a sample of operators that work in an industrial company, composed by 41 men and 14 women, with a range of ages that varies from 28 to 54 years. During the study a compilation of inquiries was applied, that evaluated the perception of the operators, regarding their upper limbs incapability and physical activity. In the end of the analysis it was verified that there was an improvement in the functional capability of the operators after being subjected to protection regimes, although there weren’t verified significant statistical differences when compared to sociodemographic variables. A risk score of the evaluated workstations was collected, and in its majority the level of identified risk was low, with a few exceptions. Also during the study the adhesion of the operators was very positive, although some operators showed discouragement, because they felt that their problems weren’t being conveniently taken care of, according to their point of view. In the end of the dissertation the study limitations and some future proposals are presented.