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Physical Therapy Effectiveness

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Nguyễn Gia Hào

Academic year: 2023

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The effectiveness of physical therapy, edited by Mario Bernardo-Filho, Danúbia da Cunha de Sá-Caputo and Redha Taiar p. Vincent Grote, Alexandra Unger, Henry Puff and Elke Böttcher Section 3 Neurophysiological aspects and physical therapy.

Pelvic Floor Physical Therapy and Women’s Health

Provisional chapterDOI: 10.5772/intechopen.88740

  • Introduction
  • Management of types of sexual dysfunction through pelvic floor physical therapy
  • The role of physical therapy in treatment of urinary incontinence
  • The role of physical therapy in treatment of pelvic organ prolapse
  • The role of physical therapy in treatment of constipation
  • Conclusion

Pelvic floor physical therapy is an important tool in the conservative management of sexual dysfunction, urinary incontinence, pelvic organ prolapse, and constipation [2]. Prolonged over-activity of the pelvic floor muscles (PFM) can lead to hypertonicity and functional tissue shortening [6].

Author details

Pelvic floor muscle exercise versus no treatment, or inactive control treatments, for urinary incontinence in women. Individualized pelvic floor muscle training in women with pelvic organ prolapse (POPPY): A multicentre randomized controlled trial.

Efficacy of Physical Therapy in the Management of Reproductive Disorders

Provisional chapter

Review methodology

In this review, the external validity of the findings from case reports/series is considered. The credibility of the findings of true experimental designs (also known as randomized controlled trials-RCT) is.

Figure 1 illustrates the credibility rating criteria used to evaluate the 47 articles reviewed
Figure 1 illustrates the credibility rating criteria used to evaluate the 47 articles reviewed

Results

  • Chronic pelvic inflammatory disease/salpingo-oophoritis
  • Urinary and fecal (anal) incontinence
  • Sexual dysfunction
  • Vestibulodynia and dyspareunia
  • Post-partum depression and obesity prevention
  • Survivors of breast cancer in cancer rehabilitation
  • Infertility due to adhesive disease
  • Gestational diabetes mellitus prevention

Forty women with vestibulodynia were randomly divided into two groups - an active TENS group and a sham (placebo) group and each group was treated twice a week for a total of 20 treatment sessions - either TENS or sham treatment was administered via vaginal probe. Compared with baseline measurements, symptoms of vulvovaginal atrophy (vaginal dryness, vaginal burning, vaginal itching, dyspareunia, dysuria), vaginal health index score (mean = 13.1; SD = 2.5 at baseline vs. mean = 23.1; SD = 1.9), physical and mental outcomes, and quality of life of women improved after laser treatment. d significant (p < 0.001) at the end of 12 weeks.

Table 1. The relevant information on the efficacy of physical therapy in the management of reproductive disorders.
Table 1. The relevant information on the efficacy of physical therapy in the management of reproductive disorders.

Discussion

The women in the control group (n = 33) received best supportive care, while the women in the treatment group (n = 35) received three weeks of hydrotherapy. Xerosis (88% of women at baseline) healed completely in all women in the hydrotherapy treatment group.

Conclusion

At least three systematic reviews and one meta-analysis found PCET to be safe and effective in the treatment of urinary and faecal incontinence. The evidence for the use of PHT in the treatment of mental health, sexual dysfunction, lymphedema, pain and dermatological side effects in women with breast cancer warrants additional systematic reviews and meta-analysis studies.

Conflict of interest

Effectiveness of physical therapy in the management of reproductive disorders http://dx.doi.org/10.5772/intechopen.89808 37. Effectiveness of physical therapy in the management of reproductive disorders http://dx.doi.org/10.5772/intechopen.89808 39.

Musculoskeletal Rehabilitation with Physical Therapy Approaches

Whole-Body Vibration Exercise as an Intervention to Improve Musculoskeletal Performance

Provisional chapterDOI: 10.5772/intechopen.89372

Whole-Body Vibration Exercise as an Intervention to Improve Musculoskeletal Performance

  • Vibrating platform
  • Biomechanical parameters of mechanical vibrations
  • Biological responses and tools used to evaluate musculoskeletal responses to the WBV
    • Approaches of the whole-body vibration in rehabilitation
    • Approaches of the whole-body vibration in fitness of trained and untrained individuals
  • Undesirable and unpleasant effects of the whole-body vibration

Comparison between the CG and WBV exercise group revealed that the BMD of the WBV exercise group increased significantly. The importance of WBV exercise as a physical therapy intervention for better human optimization was emphasized.

Figure 2 illustrates the displacement of a sinusoidal mechanical vibration and some biome- biome-chanical parameters are indicated
Figure 2 illustrates the displacement of a sinusoidal mechanical vibration and some biome- biome-chanical parameters are indicated

Acknowledgements

A comparison of whole-body vibration and total work resistance training in the rotator cuff. Effects of whole-body vibration on lumbar abdominal muscle activation in healthy young adults: a pilot study.

What to Expect: Medical Quality Outcomes and Achievements of a Multidisciplinary Inpatient

Orthopedic rehabilitation

Due to the high incidence of degenerative diseases in the musculoskeletal system, there is also a need for surgical treatment with endoprosthetic material. The severity of the underlying condition and the expectation of recovery of physical function are requirements to obtain inpatient orthopedic rehabilitation.

Efficacy and sustainability of orthopedic rehabilitation

Each patient is offered a program of at least 1800 therapy minutes during 3 weeks, divided into approximately 50% active and 50% passive treatments that highly exceed the physical activity guidelines of the WHO (150 minutes of moderate intensity exercise and strengthening exercise twice a week). Medical rehabilitation is structured in different ways around the world, although a tendency towards a standardization of the social and health system can be observed.

Methods

  • Orthopedic reference sample at the clinical trial center
  • Ethical aspects
  • Medical outcome quality
  • Output values and descriptive data for individual measurements
  • Comparison of outcomes based on ICD-classification
  • Influencing factors of age, gender and initial values
  • Nonspecific quality of outcomes
  • Specific quality of outcomes
  • The applicability of our results in rehabilitative clinical practice
  • Limitation

The results become visible by "the difference between the initial state and the state at the end of the treatment" (cf. [46]). The non-specific overall score - "Health Index (UHIndex)" - shows that 72.5% of patients directly benefit from the rehabilitation stay.

Table 4. Overview of medical quality outcomes.
Table 4. Overview of medical quality outcomes.

Conclusions

Comparison of the effects of two types of massage and usual care on chronic low back pain: a randomized controlled trial. Exercise for the prevention of low back pain: a systematic review and meta-analysis of controlled trials.

Neurophysiological Aspects and Physical Therapy Interventions

Effectiveness of Motor Imagery on Physical Therapy

Neurophysiological Aspects of Motor Imagery

Provisional chapterDOI: 10.5772/intechopen.90277

The spinal motor neuron excitability during MI under different imagined muscle contraction strengths

  • Purpose
  • Materials
  • Methods
  • F-wave data analysis
  • Statistical analysis
  • Results
  • Discussion
  • Conclusion

We performed two experiments to determine the spinal motor neuron excitation during MI under different imagined muscle contraction strengths. The spinal motor neuron excitation during MI under different imagined muscle contraction strengths imagined muscle contraction strengths.

Table 1. The F-wave under 10% MI condition.
Table 1. The F-wave under 10% MI condition.

Does the duration of motor imagery affect the spinal motor neuron excitability?

  • Purpose
  • Materials
  • Methods
  • Statistical analysis
  • Results
  • Discussion
  • Conclusion

Our previous research has shown significant facilitation of spinal motor neuron excitability during MI of isometric thenar muscle activity. The imagined force of muscle contraction may not be affected by spinal motor neuron excitability.

Figure 1. Changes in persistence and F/M amplitude ratio during MI for 5 min (*p < 0.05, **p < 0.01)
Figure 1. Changes in persistence and F/M amplitude ratio during MI for 5 min (*p < 0.05, **p < 0.01)

Imagery strategy affects the spinal motor neuron excitability

Finally, practice time and MI skill were considered as potential factors affecting spinal motor neuron excitability. However, in this study, we did not investigate time-dependent changes in spinal motor neuron excitability after 5 min of motor learning.

  • Purpose
  • Materials
  • Methods
  • Statistical analysis
  • Results
  • Discussion
  • Conclusion
  • How to use MI in physical therapy?

The effect of motor imagery on spinal motor neuron excitability and its clinical application in physiotherapy. The effectiveness of motor imagery on physical therapy: neurophysiological aspects of motor imagery http://dx.doi.org/10.5772/intechopen.90277 113.

The rating score of SKI vividness was significantly lower than that at rest (*p < 0.05; Table 10).
The rating score of SKI vividness was significantly lower than that at rest (*p < 0.05; Table 10).

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

Provisional chapterDOI: 10.5772/intechopen.89360

Parkinson’s Disease Rehabilitation: Effectiveness Approaches and New Perspectives

Pathophysiology of PD

All of these changes alter the function of the basal ganglia system, leading to Parkinson's major movement disorders. Lewy bodies can be found in many regions of the brain and some reports have suggested that the substantia nigra is not the first site where they form in Parkinson's disease [14].

Figure 1. A schematic view of the functional anatomy of the basal ganglia. There are the normal direct and indirect  pathways (panel a) and the alteration of direct and indirect pathways in Parkinson’s disease (panel b)
Figure 1. A schematic view of the functional anatomy of the basal ganglia. There are the normal direct and indirect pathways (panel a) and the alteration of direct and indirect pathways in Parkinson’s disease (panel b)

Parkinson’s clinical signs, diagnosis, and rating scales

  • Clinical motor cardinal signs
  • Additional motor signs
  • Nonmotor signs and symptoms
  • Diagnosis of Parkinson’s disease
  • Rating scales for Parkinson’s disease

Thus, the presence of non-motor features has contributed during the process of diagnosing Parkinson's disease. Note: Based on the websites of the European Parkinson's Disease Association [29] and the International Parkinson and Movement Disorders Association [30].

Table 1. Nonmotor signs and symptoms of Parkinson’s disease [23–25].
Table 1. Nonmotor signs and symptoms of Parkinson’s disease [23–25].

Parkinson’s disease treatment

  • Physical therapy in Parkinson’s disease treatment

Other forms of aerobic exercise have been stimulated in the rehabilitation process in Parkinson's disease. Effectiveness of exercise interventions for people with Parkinson's disease: a systematic review and meta-analysis.

Table 4. Main target areas for deep brain stimulation (DBS) in Parkinson’s disease.
Table 4. Main target areas for deep brain stimulation (DBS) in Parkinson’s disease.

Physical Therapy Interventions Related to Pulmonary Conditions

Application of a Single-Case Research Design to

Present the Effectiveness of Rehabilitation in the Clinic

Application of a Single-Case Research Design to Present the Effectiveness of Rehabilitation in the Clinic

Research design

There have been a variety of single-case research designs such as (1) AB, (2) reversal, (3) multiple baseline, and (4) alternating treatment [11]. For example, the effectiveness of a 7-day chest wall stretching exercise in patients with chronic obstructive pulmonary disease (COPD) compared with 7 days at baseline [12].

Data collection and presentation

Line graph representation of chest wall excursion (cm) in two cases showing baseline and intervention phases with different baseline phase scores. Therefore, the effectiveness of rehabilitation in the intervention phase can be compared with the extended line from the baseline phase, which is called the acceleration line as in Figure 6.

Figure 1. Flowchart of procedure on a single-case research design.
Figure 1. Flowchart of procedure on a single-case research design.

Plot the data (Figure 7(1))

The celeration line can be found by the freehand method [19], several semi-averages [18] and the least squares method, including calculation in a specific program such as SPSS or SigmaPlot. The simple method of drawing the celeration line can be performed by therapists using the semi-average [18] or "split-middle" method.

Divide the data in half by drawing a solid vertical line and dividing each of the halves in half by drawing dashed vertical lines before plotting the median level of each half phase, so

The trend line in each phase, especially between the baseline and the intervention phase, can show the effectiveness of rehabilitation using some techniques, for example, the dyspnea deceleration trend line (Figure 5(2)) and the chest wall displacement acceleration trend line (Figure 5(1)).

Finally, extend the celeration line from baseline to the intervention phase (Figure 7(3))

  • Statistical analysis
    • Serial dependency analysis

Calculate the mean of the scores in each phase with the sum of all data divided by total numbers

Find the difference values by minutes in each score (Table 1) with its mean

In addition, the effectiveness of rehabilitation can be represented from the difference between the mean level and the trend line compared to the celeration line in the baseline phase. However, the effectiveness of rehabilitation in the intervention phase can also be compared statistically.

Figure 6. Line graphs showing the celeration line from the baseline phase of chest wall excursion (1) and vital capacity (2).
Figure 6. Line graphs showing the celeration line from the baseline phase of chest wall excursion (1) and vital capacity (2).

Calculate the sum of multiple first and second difference values from Step 2

Calculate the sum of the square of difference values from Step 2

Calculate the autocorrelation coefficient (r) in each phase by dividing the sum value in Step 3 by the square sum of difference values in Step 4

Analyze the autocorrelation coefficient as statistically significant or not; a simple procedure called Bartlett test can be used. If the autocorrelation value (r) in Step 5 is less than

  • Transformation data

Difference values

Calculate the sum of multiple first and second difference values

Calculate the autocorrelation coefficient (r) in each phase by dividing the sum value in Step 3 by the square sum of difference values ​​in Step 4. If the autocorrelation value (r) in Step 5 is less than 2/√n (n = number of data), the non-significant autocorrelation within or in the phase is confirmed.

Calculate the squared sum of difference values

The following moving average method reduces the serial dependency that consists of simply plotting the mean values between two adjacent data points over the entire series data

  • Statistical evaluation

Application of a single case research design to present the effectiveness of rehabilitation in the clinic http://dx.doi.org/10.5772/intechopen.90665 161. Different results of training occurred in the two subjects, with the first subject showing the most points (8 out of 10 points) below the 2-SD band; thus, it can be concluded that exercise significantly reduces systolic blood pressure (1), whereas 10 points are located within the 2-SD band in the other subject, implying non-significant change when exercise is implicated (2).

Figure 8. Line graphs of expiratory tidal volume (mL) at baseline and intervention by chest physical therapy phase (1) and t-test analysis from the Wilcoxon signed-rank test in the SPSS program (2).
Figure 8. Line graphs of expiratory tidal volume (mL) at baseline and intervention by chest physical therapy phase (1) and t-test analysis from the Wilcoxon signed-rank test in the SPSS program (2).

Each value from Step 1 is squared and the sum repeated

The calculation formula was based on the binomial test xn pn, where is the number of data points in the intervention phase, x is the number of data points above (or below) the acceleration lines and p is the probability of obtaining data points above or below the predicted acceleration line [27]. The result of the binomial test in Table 3 shows an asymmetrically significant value (0.375) greater than 0.05, which means the acceptance of the null hypothesis.

The mean value of the baseline points is calculated

The formula for calculation is based on the binomial test nx pn, where is the number of data points in the intervention phase, x is the number of data points above (or below) the celeration lines, and p is the probability of obtaining data points above or below the projected celeration line [27]. Note: Group 1 is the number of data points above the acceleration line, while Group 2 is the number of data points below the acceleration line from the baseline phase.

Figure 10. Line graph depicting the 2-SD band method for identifying the statistical significance between two subjects.
Figure 10. Line graph depicting the 2-SD band method for identifying the statistical significance between two subjects.

The value of mean-difference for each set of data is calculated by subtracting each raw score from the mean value of squared results before summing up the squared mean difference

The C score is computed using the formula

The standard error for the C statistic is computed using the formula

In determining whether the C statistic is significant, a Z score is computed by dividing the C statistic value from Step 6 by the standard error from Step 7

Data in the intervention phase are included with the baseline phase and completed as in Step 2

The value of the mean-difference for each set of data is calculated by subtracting each raw score from the mean value of squared results before summing up the squared mean

Standard error =√ðn�2Þ=ðn�1Þðnþ1Þ, in which n = number of data points in the data series from which the C-statistic is calculated. Application of a single-case research design to present the effectiveness of rehabilitation in the clinic http://dx.doi.org/10.5772/intechopen.90665 167.

The C score is computed using the formula

The standard error for the C statistic is computed using the formula

In determining whether the C statistic is significant, a Z score is computed by dividing the C statistic value from Step 14 by the standard error from Step 15

  • Discussion and critical point for a single-case research study

The effectiveness of rehabilitation can be seen both in a single case study design and in the practice of psychological research [33]. Application of a single case study design to present the effectiveness of rehabilitation in the clinic http://dx.doi.org/10.5772/intechopen.90665 169.

Targeting Limb Muscle Dysfunction in COPD

Development and applications of the single-case design risk tool for evaluating single-case design research study reports.

Provisional chapterDOI: 10.5772/intechopen.90815

Features and importance of limb muscle dysfunction in COPD

  • Etiology and pathophysiology of limb muscle dysfunction
  • Muscle mass
  • Muscle strength
  • Muscle endurance
  • In summary

People with COPD are inactive [28], and deconditioning due to disuse appears to play an important role in limb muscle dysfunction. Dysfunction of limb muscles is evident in up to a third of all people with COPD and is closely linked to the prognosis of the disease.

Figure 1. Illustration of the complex interplay of factors and outcomes were limb muscle dysfunction playing a role for  people with COPD, some have been thoroughly studied whereas others have not.
Figure 1. Illustration of the complex interplay of factors and outcomes were limb muscle dysfunction playing a role for people with COPD, some have been thoroughly studied whereas others have not.

How to assess limb muscles in clinical practice

  • Muscle mass
  • Muscle strength
  • Muscle endurance and fatigue
  • Functional testing
  • In summary

For example, among people with COPD, assessment of limb muscle mass and function should always include the quadriceps muscle because of its clinical and prognostic value [ 4 , 7 ]; However, as all assessments are muscle group specific, other limb muscles can also be assessed to provide valuable information [4]. Assessment of limb muscle mass and function should be part of the routine care of people with COPD.

Table 2. Commonly used procedures for assessment of quadriceps muscle strength and endurance among people with  COPD [19, 55, 58, 61, 79, 82].
Table 2. Commonly used procedures for assessment of quadriceps muscle strength and endurance among people with COPD [19, 55, 58, 61, 79, 82].

How to improve limb muscles among people with COPD?

  • Exercise training
  • In summary

Guidelines for the evaluation and treatment of muscle dysfunction in patients with chronic obstructive pulmonary disease. Comparison of effects of strength and endurance training in patients with chronic obstructive pulmonary disease.

Early Mobilization on Patients with Mechanical Ventilation in the ICU

Resistance training with low load/high repetition elastic bands in patients with COPD: a randomized, controlled, multicenter study.

Provisional chapterDOI: 10.5772/intechopen.89984

Early Mobilization on Patients with Mechanical Ventilation in the ICU

Critical care in ICU

Recent data indicate that the mortality rate in patients with acute respiratory failure is 25–30% [2]; it must now focus on the aftermath of critical illness survivors. Recent data for those who survive indicate that 50–70% of ICU survivors will suffer cognitive impairment and 60–80% of survivors will have functional impairment or ICU-acquired weakness (ICU-AW) [ 7 ].

Muscle injury during mechanical ventilation

  • Intensive care unit-acquired weakness
  • Definition
  • Epidemiology of ICU-acquired weakness
  • Mechanisms
  • Critical illness polyneuropathy
  • Critical illness myopathy
  • Risk factors
  • Bed rest
  • Sedation
  • Sepsis
  • Delirium and ICU-AW
  • Muscle weakness, nutrition, metabolism in ICU patients

Early mobilization in mechanically ventilated patients in the ICU http://dx.doi.org/10.5772/intechopen.89984 199. Early mobilization in mechanically ventilated patients in the intensive care unit http://dx.doi.org/10.5772/intechopen.89984.

Figure  1. Time  course  of  limb  and  respiratory  muscle  weakness  during  mechanical  ventilation
Figure 1. Time course of limb and respiratory muscle weakness during mechanical ventilation

Hình ảnh

Figure 1 illustrates the credibility rating criteria used to evaluate the 47 articles reviewed
Table 1. The relevant information on the efficacy of physical therapy in the management of reproductive disorders.
Table 1. The relevant information on the efficacy of physical therapy in the management of reproductive disorders.
Figure 1. Research credibility pyramid.
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