Physiotherapy Techniques

物理治疗技术
  • 文章类型: English Abstract
    SARS-CoV-2感染可引起一系列呼吸道后遗症,特别是患有严重新冠肺炎的患者。鉴于在短时间内发生这种感染的患者人数众多,新冠肺炎后的后续访问正在进行中,但尚未建立临床随访方案来建议进行的补充试验和这些手术的频率.这份共识文件是由来自西班牙肺科和胸外科学会(SEPAR)不同领域的专业人士起草的,目的是帮助临床医生确定急性疾病后几个月可能发生的呼吸道并发症。并规范他们的后续行动和其他测试。它建议在新冠肺炎后的各个阶段进行检查和干预,并详细说明这些程序的具体目标。首先,我们的目标是确保患者得到及时的临床随访,遵循预先设定的时间表,该时间表考虑了疾病的严重程度和长期后遗症的可能性。另一个目标是通过避免检查和/或咨询来避免卫生系统过载,在许多情况下,不必要的。最后,我们定义了转诊有特定后遗症的患者的标准(间质性肺病,肺血管疾病,支气管扩张)到相应的专业单位。
    SARS-CoV-2 infection can cause a range of respiratory sequelae, especially in patients who have had severe Covid-19 pneumonia. Given the high number of patients who have developed this infection over a short period of time, numerous post-Covid-19 follow-up visits are being carried out, but no clinical follow-up protocol has been established to advise on the complementary tests to be performed and the frequency of these procedures. This consensus document was drawn up by professionals from different areas of the Spanish Society of Pulmonology and Thoracic Surgery (SEPAR) in order to assist the clinician in identifying possible respiratory complications that may occur during the months following the acute disease, and to protocolize their follow-up and additional tests to be performed. It recommends examinations and interventions to be carried out at various stages in the post-Covid-19 period, and details the specific objectives of these procedures. Primarily, we aim to ensure that patients receive timely clinical follow-up, following a pre-established schedule that takes into account the severity of the disease and the likelihood of long-term sequelae. Another objective is to avoid overloading the health system by eschewing examinations and/or consultations that are, in many cases, unnecessary. Finally, we define criteria for referring patients with specific established sequelae (interstitial lung disease, pulmonary vascular disease, bronchiectasis) to the corresponding specialized units.
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  • 文章类型: Journal Article
    背景:非特异性下腰痛(LBP)的治疗运动(TE)建议旨在支持患有这种疾病的人的治疗选择。这项研究的目的是就TE在LBP患者护理中的定义和使用达成协议。
    方法:采用正式的共识程序和充分的科学证据进行了Delphi研究,使用既定的方法。进行了四轮匿名问卷调查,以就LBP患者的治疗活动提出有用的建议和说明,和一个集体共识会议。
    结果:在35名物理治疗师完成问卷后,对大多数问题达成了共识。与会者一致认为,适当的TE需要正确的姿势,身体意识,呼吸,运动控制,和指令。建议患有LBP的患者每周两次参加监督会议,持续30至60分钟,为期3至6个月。参与者补充说,量身定制的评估和运动处方,监测,和锻炼的功能整合,以及使用特定设备,会使LBP患者受益。
    结论:针对LBP患者的TE建议应根据其个人心理需求进行剂量和定制。健身水平,和运动恐惧症。
    BACKGROUND: Therapeutic exercise (TE) recommendations for non-specific low back pain (LBP) are meant to support therapy choices for people who suffer from this condition. The aim of this study was to reach an agreement on the definition and use of TE in the care of people with LBP.
    METHODS: A Delphi study was carried out with a formal consensus procedure and sufficient scientific evidence, using an established methodology. Four rounds of anonymous questionnaires were administered to create useful suggestions and instructions in terms of the therapeutic activity for patients with LBP, and a group consensus conference.
    RESULTS: A consensus was reached on most of the questions after 35 physiotherapists completed the questionnaires. Participants agreed that proper TE requires correct posture, body awareness, breathing, movement control, and instruction. Patients with LBP were advised to participate in supervised sessions twice a week for 30 to 60 min for a period of 3 to 6 months. Participants added that tailored evaluation and exercise prescription, monitoring, and functional integration of exercise, as well as using specific equipment, would benefit patients with LBP.
    CONCLUSIONS: TE recommendations for patients with LBP should be dosed and customized based on their personal psychological needs, level of fitness, and kinesiophobia.
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  • 文章类型: Journal Article
    背景:慢性颈痛(CNP)可能与肩胛骨提肌(LS)中的潜在肌筋膜触发点(MTrPs)有关,可以用缺血性压迫(IC)和干针刺(DN)治疗。评估变量和弹性成像变化,以比较两种DN治疗方法的短期疗效。
    方法:对80名参与者进行随机临床试验,分为两组:DN组(n=40)和IC组(n=40)。持续时间为12周,和机械异质性指数,压力痛阈值(PPT),和疼痛强度在基线测量,紧接着,48小时后,治疗后一周。
    结果:两组之间立即观察到统计学上的显着变化:DN组PPT降低(p=0.05),而在IC组增加。在治疗后48小时和一周,这些值在DN组增加,并保持高于IC组.两组的异质性指数均有所改善,但DN组比IC组更为显着。
    结论:在LS肌肉中具有潜伏性痛觉过敏MTrP的CNP受试者中,DN在PPT中优于IC,疼痛强度,以及开始治疗后48小时和一周的机械异质性指数。
    BACKGROUND: Chronic neck pain (CNP) may be associated with latent myofascial trigger points (MTrPs) in the levator scapulae (LS), which can be treated with ischemic compression (IC) and dry needling (DN). Variables and elastography changes are evaluated to compare the short-term efficacy of two treatments with DN.
    METHODS: A randomized clinical trial is conducted with 80 participants in two groups: the DN group (n = 40) and IC group (n = 40). The duration is 12 weeks, and mechanical heterogeneity index, pressure pain threshold (PPT), and pain intensity are measured at baseline, immediately after, 48 h after, and one week after treatment.
    RESULTS: Statistically significant changes were immediately observed between the two groups: PPT decreased in the DN group (p = 0.05), while it increased in the IC group. At 48 h and one week after treatment, these values increased in the DN group and remained higher than in the IC group. The heterogeneity index improved in both groups but more significantly in the DN group than in the IC group.
    CONCLUSIONS: In subjects with CNP who had latent plus hyperalgesic MTrPs in the LS muscle, DN outperformed IC in PPT, pain intensity, and mechanical heterogeneity index at 48 h and one week after initiating therapy.
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  • 文章类型: Randomized Controlled Trial
    目的:作者研究了在接受体外循环心脏手术的患者中,除了胸部理疗(CP)外,积极工作的气道正压(PAP)对肺不张(PA)的影响。
    方法:随机对照研究。
    方法:在单中心三级医院。
    方法:80例接受心脏手术的成年患者(冠状动脉旁路移植术,瓣膜手术,或两者),并在术后第1天或第2天气管插管后出现PA,从2014年11月至2016年9月进行随机分组.
    方法:三天的CP,每天两次,与积极工作相关的PAP效应(干预组)与单纯CP(对照组)。肺不张是通过使用每日胸部X线测量的放射学肺不张评分(RAS)来评估的。所有X光片都是盲目检查的。
    结果:在纳入的患者中,79(99%)完成试验。主要结果是纳入后第2天的平均RAS。干预组明显较低(平均差异和95%CI:-1.1[-1.6至-0.6],p<0.001)。次要结果是在CP和临床变量之前和之后测量的鼻吸气压力。在第2天,干预组的Sniff鼻吸气压力显着升高(7.7[3.0-12.5]cmH2O,p=0.002)。干预组的呼吸频率较低(-3.2[95%CI-4.8至-1.6]呼吸/分钟,第2天p<0.001)。两组间的经皮氧饱和度/氧需求比没有发现差异,心率,疼痛,和呼吸困难评分。
    结论:积极致力于PAP效应,结合CP,CP后2天接受心脏手术的患者的RAS显着降低,在临床相关参数中没有观察到差异。
    The authors investigated the effect of active work with positive airway pressure (PAP) in addition to chest physiotherapy (CP) on pulmonary atelectasis (PA) in patients undergoing cardiac surgery with cardiopulmonary bypass.
    A randomized controlled study.
    At a single-center tertiary hospital.
    Eighty adult patients undergoing cardiac surgery (coronary artery bypass grafting, valve surgery, or both), and presenting with PA after tracheal extubation on postoperative days 1 or 2, were randomized from November 2014 to September 2016.
    Three days of CP, twice daily, associated with active work with PAP effect (intervention group) versus CP alone (control group). Pulmonary atelectasis was assessed by using the radiologic atelectasis score (RAS) measured from daily chest x-rays. All radiographs were reviewed blindly.
    Among included patients, 79 (99%) completed the trial. The primary outcome was mean RAS on day 2 after inclusion. It was significantly lower in the intervention group (mean difference and 95% CI: -1.1 [-1.6 to -0.6], p < 0.001). The secondary outcomes were the sniff nasal inspiratory pressure measured before and after CP and clinical variables. Sniff nasal inspiratory pressure was significantly higher in the intervention group on day 2 (7.7 [3.0-12.5] cmH2O, p = 0.002). The respiratory rate was lower in the intervention group (-3.2 [95% CI -4.8 to -1.6] breaths/min, p < 0.001) on day 2. No differences were found between the 2 groups for percutaneous oxygen saturation/oxygen requirement ratio, heart rate, pain, and dyspnea scores.
    Active work with the PAP effect, combined with CP, significantly decreased the RAS of patients undergoing cardiac surgery after 2 days of CP, with no differences observed in clinically relevant parameters.
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  • 文章类型: Randomized Controlled Trial
    中风是一种神经系统疾病,对成年人的身体残疾有很大影响,需要具体有效的康复方法。虚拟现实(VR)不断发展的技术方法,在许多康复领域都有很大的适用性,包括中风。这项研究的目的是分析传统的基于神经物理治疗的方法结合特定的基于VR的计划在中风后康复患者治疗中的效果。在过去六个月中被诊断为中风的参与者(n=24)被随机分为对照组(n=12)和实验组(n=12)。两组均接受一小时的神经理疗,为期6周,而实验组是,此外,补充VR。通过丹尼尔斯和沃辛汉量表对患者进行评估,改良Ashworth量表,运动指数,行李箱控制测试,Tinetti平衡量表,Berg平衡量表与Sagunto医院功能行走分类。与对照组相比,实验组在运动指数上获得了统计学上的显着改善(p=0.005),干线控制试验(p=0.008),Tinetti平衡量表(p=0.004),Berg平衡量表(p=0.007)和Sagunto医院功能行走分类(p=0.038)。除传统的物理医治办法外,运用VR是医治中风的有用战略。
    A stroke is a neurological condition with a high impact in terms of physical disability in the adult population, requiring specific and effective rehabilitative approaches. Virtual reality (VR), a technological approach in constant evolution, has great applicability in many fields of rehabilitation, including strokes. The aim of this study was to analyze the effects of a traditional neurological physiotherapy-based approach combined with the implementation of a specific VR-based program in the treatment of patients following rehabilitation after a stroke. Participants (n = 24) diagnosed with a stroke in the last six months were randomly allocated into a control group (n = 12) and an experimental group (n = 12). Both groups received one-hour sessions of neurological physiotherapy over 6 weeks, whilst the experimental group was, in addition, supplemented with VR. Patients were assessed through the Daniels and Worthingham Scale, Modified Ashworth Scale, Motor Index, Trunk Control Test, Tinetti Balance Scale, Berg Balance Scale and the Functional Ambulation Classification of the Hospital of Sagunto. Statistically significant improvements were obtained in the experimental group with respect to the control group on the Motricity Index (p = 0.005), Trunk Control Test (p = 0.008), Tinetti Balance Scale (p = 0.004), Berg Balance Scale (p = 0.007) and the Functional Ambulation Classification of the Hospital of Sagunto (p = 0.038). The use of VR in addition to the traditional physiotherapy approach is a useful strategy in the treatment of strokes.
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  • 文章类型: Journal Article
    本文提供的数据集用于一项先导随机对照试验,该试验评估了手动物理治疗(MPT)与常规药物治疗(CPT)治疗慢性小儿功能性便秘(CPC)的有效性。试点试验是在奥维耶多的阿斯图里亚斯中央大学医院进行的,西班牙,儿童胃肠病学家对47名2至12岁的儿童进行了评估。参与者接受了9次MPT,前两个月每周一次,第三个月每两周一次。在试验开始时(时间1)评估儿科生活质量问卷(PedsQLTM)评分,它的结束(时间2),5年后(时间3)。数据集包含收集的原始数据,包括按问题组分类的参与者人口统计数据和PedsQLTM分数,以及每个参与者在每个时间点的总分。该数据集可用于进一步分析结果,并且该研究可能会被复制。
    The dataset presented in this article was used in a pilot randomized and controlled trial that evaluated the effectiveness of manual physical therapy (MPT) compared to conventional pharmacologic treatment (CPT) for treating chronic pediatric functional constipation (CPC). The pilot trial was carried out at the Central University Hospital of Asturias in Oviedo, Spain, with 47 children between 2 and 12 years old being evaluated by a Pediatric Gastroenterologist. Participants received 9 sessions of MPT which were spaced out weekly for the first two months and bi-weekly for the third month. The Pediatric Quality of Life questionnaire (PedsQLTM) scores were assessed at the start of the trial (Time 1), its end (Time 2), and 5 years later (Time 3). The dataset contains the collected raw data, including participant demographics data and PedsQLTM scores categorized by question group, as well as total scores for each participant at each time point. This dataset can be used to further analyze the results and the study can be potentially replicated.
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  • 文章类型: Journal Article
    UNASSIGNED:Kinesio胶带已被提议用于改善肌肉的延展性。然而,文献中存在矛盾的结果。
    UNASSIGNED:研究Kinesio胶带对腿筋肌紧绷的大学生腿筋肌延长以及腿筋和股四头肌加强的影响。
    UNASSIGNED:在这个前后实验研究中,从伊玛目阿卜杜勒拉赫曼·本·费萨尔大学招募了96名腿筋肌肉紧绷的女学生,达曼,沙特阿拉伯,随机分配给Kinesio磁带,假磁带,或对照组(每组32个)。抑制技术用于Kinesio胶带应用,从肌肉插入到原点的胶带。在干预前和干预后15分钟进行测量。结果测量包括主动膝盖伸展测试,以测量腿筋肌肉长度,以及使用手持式测力计测量腿筋和股四头肌的等距力量。
    UNASSIGNED:在Kinesio(P=0.001)和假(P=0.004)胶带组中,腿筋肌的直接长度显着增加,而对照组无差异(P=0.066)。Kinesio胶带组的肌肉延长明显大于假胶带组(P=0.001)和对照组(P=0.001)。在所有三组中,股四头肌和腿筋肌肉强度的前后测量没有差异。
    UNASSIGNED:这些结果表明,应用Kinesio胶带对腿筋肌肉的延伸性有立竿见影的效果,但对股四头肌和腿筋肌肉强度没有影响。
    未经评估:NCT03076840。
    UNASSIGNED: Kinesio tape has been proposed to improve the muscle extensibility. However, there are contradictory results in the literature.
    UNASSIGNED: To investigate the effect of Kinesio tape on hamstring muscle lengthening and on hamstring and quadriceps muscle strengthening in university students with hamstring muscle tightness.
    UNASSIGNED: In this pre-post experimental study, 96 female students with hamstring muscle tightness were recruited from Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia, and randomly assigned to Kinesio tape, sham tape, or control groups (32 in each group). The inhibition technique was used for the Kinesio tape application, with the tape being applied from the muscle insertion to the origin. Measurements were taken before and 15 min after the intervention. Outcome measurements included active knee extension test to measure the hamstring muscle length, and isometric strength measurements of hamstring and quadriceps muscles using a handheld dynamometer.
    UNASSIGNED: A significant increase in the immediate hamstring muscle length was found in both the Kinesio (P = 0.001) and sham (P = 0.004) tape groups, while no difference was noted in the control group (P = 0.066). The muscle lengthening was significantly greater in the Kinesio tape group than the sham tape (P = 0.001) and control (P = 0.001) groups. There was no difference in the pre- and post-measurements in the quadriceps and hamstring muscle strengths in all three groups.
    UNASSIGNED: These results demonstrate that applying Kinesio tape has an immediate effect on hamstring muscle extensibility, but has no effect on the quadriceps and hamstring muscle strengths.
    UNASSIGNED: NCT03076840.
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  • 文章类型: Journal Article
    血流受限运动(BFRE)对康复的兴趣不断增加,但其对内皮功能的影响尚未得到很好的研究。我们的目的是研究低抗性BFRE对内皮功能和血管生成的影响。这项前瞻性交叉研究涉及35名年轻健康成年人。他们进行了21分钟的低抵抗力运动,血液流动受到手臂和紧身衣上的压力袖带的限制。他们也做了同样的训练,但没有血流限制。在运动前和运动后20分钟内评估内皮参数和血管生成生物标志物。两种类型的运动都会增加流量介导的扩张(FMD),但与对照组相比,BFRE后的升高更为显着。刚度指数仅在BFRE后下降,而反射指数在两种类型的运动后均显着下降,但在BFRE后较高。两种运动类型都增加了血小板内皮细胞粘附分子(PECAM-1)和血管内皮生长因子受体2(VEGFR-2)的浓度,但与对照组相比,BFRE后的升高更高。只有BFRE升高了平均血清CD34蛋白浓度。基于这些结果,我们可以假设,与没有血流限制的相同训练相比,低阻力BFR运动更显著地刺激血管生成和改善内皮功能.
    Blood-flow-restricted exercise (BFRE) has been gaining constantly increasing interest in rehabilitation, but its influence on endothelial functions has not been well studied yet. Our aim is to examine the influence of low-resistance BFRE on endothelial functions and angiogenesis. This prospective cross-over study involved 35 young healthy adults. They conducted a 21-min low-resistant exercise with blood flow restricted by pressure cuffs placed on arms and tights. They also did the same training but without blood flow restriction. Endothelial parameters and angiogenesis biomarkers were evaluated before and up to 20 min after exercise. Both types of exercise increased Flow-Mediated Dilatation (FMD) but elevation after BFRE was more significant compared to the controls. The stiffness index decreased only after BFRE, while the reflection index decreased significantly after both types of exercise but was higher after BFRE. Platelet endothelial cell adhesion molecule (PECAM-1) and vascular endothelial growth factor receptor 2 (VEGFR-2) concentrations were increased by both exercise types but elevations were higher after BFRE compared to the controls. Only BFRE elevated the mean serum CD34 protein concentration. Based on these results, we can assume that low-resistance BFR exercise stimulates angiogenesis and improves endothelial functions more significantly compared to the same training performed without blood flow restriction.
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  • 文章类型: Journal Article
    臀中肌潜伏性肌筋膜触发点(MTrP)的存在是非特异性下腰痛的可能原因之一。干针(DN)和缺血性压迫(IC)技术可用于治疗这些MTrP。
    对于这项研究,将80名参与者随机分为两组:干针组,谁接受了一次DN到臀中肌再加上痛觉过敏(n=40),和IC集团,他接受了一次对臀中肌肌加痛觉过敏的IC治疗(n=40)。疼痛强度,压力疼痛阈值(PPT),运动范围(ROM),在基线时评估生活质量,治疗后立即,48小时后,治疗后一周。
    在干预后立即显示两组之间的统计学差异。显示DN组PPT减少(p<0.05),IC组PPT增加。与IC组相比,DN组的这些值在治疗48h和一周后增加更多,并且保持得更好。两组的生活质量都得到了改善,DN组比IC组的改善更大。
    在非特异性下腰痛受试者中臀中肌痛觉过敏的潜在MTrP中,就UDP和疼痛强度而言,IC可能比DN更可取,治疗后立即。就PPT而言,DN可能比IC更有效,疼痛强度,在治疗48小时后和治疗一周后,非特异性下腰痛受试者的潜伏性加痛觉过敏臀中肌MTrP的生活质量。
    The presence of latent myofascial trigger points (MTrPs) in the gluteus medius is one of the possible causes of non-specific low back pain. Dry needling (DN) and ischemic compression (IC) techniques may be useful for the treatment of these MTrPs.
    For this study, 80 participants were randomly divided into two groups: the dry needling group, who received a single session of DN to the gluteus medius muscle plus hyperalgesia (n = 40), and the IC group, who received a single session of IC to the gluteus medius muscle plus hyperalgesia (n = 40). Pain intensity, the pressure pain threshold (PPT), range of motion (ROM), and quality of life were assessed at baseline, immediately after treatment, after 48 h, and one week after treatment.
    Statistically significant differences were shown between the two groups immediately after the intervention, showing a decrease in PPT (p < 0.05) in the DN group and an increase in PPT in the IC group. These values increased more and were better maintained at 48 h and after one week of treatment in the DN group than in the IC group. Quality of life improved in both groups, with greater improvement in the DN group than in the IC group.
    IC could be more advisable than DN with respect to UDP and pain intensity in the most hyperalgesic latent MTrPs of the gluteus medius muscle in subjects with non-specific low back pain, immediately after treatment. DN may be more effective than IC in terms of PPT, pain intensity, and quality of life in treating latent plus hyperalgesic gluteus medius muscle MTrPs in subjects with non-specific low back pain after 48 h and after one week of treatment.
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  • 文章类型: Journal Article
    评估筋膜治疗对感知生活质量的影响,疼痛强度,和血友病患者的关节健康。
    单盲随机对照试验.
    血友病患者协会。
    将血友病患者(N=69)随机分配到实验组(筋膜治疗方案)或对照组(无任何干预)。
    筋膜治疗干预持续3周,每周一次45分钟。
    评估的变量是感知的生活质量(简短形式健康调查-36),疼痛强度(视觉模拟量表)和关节健康(血友病关节健康评分)在基线和3和12周。
    实验组干预后,短期健康调查-36的身体成分(38.64±9.41和41.92±12.16)和精神成分(45.77±6.25和55.02±9.73)的平均值有所改善,以及疼痛强度和关节健康(P<.001)。身体角色变量的组间效应存在差异(P<.001)(F=49.22),情感角色(F=229.71),心理成分(F=9.86),疼痛强度(F=24.74),和关节健康(F=55.31)。
    血友病肘关节病患者的筋膜治疗方案可以改善其感知的生活质量。筋膜治疗患者肘部疼痛强度改善。这种技术可以改善肘关节健康。
    To evaluate the effect of fascial therapy on the perceived quality of life, pain intensity, and joint health in people with hemophilia.
    Single-blind randomized controlled trial.
    Hemophilia Patient Associations.
    Patients with hemophilia (N=69) were randomly allocated to an experimental group (fascial therapy protocol) or to a control group (no intervention whatsoever).
    The fascial therapy intervention lasted 3 consecutive weeks with one 45-minute weekly session.
    The variables evaluated were perceived quality of life (Short Form Health Survey-36), pain intensity (visual analog scale) and joint health (Hemophilia Joint Health Score) at baseline and at 3 and 12 weeks.
    The mean values of the physical (38.64±9.41 and 41.92±12.16) and mental (45.77±6.25 and 55.02±9.73) components of the Short Form Health Survey-36 improved after the intervention in the experimental group, as well as those for pain intensity and joint health (P<.001). There were differences (P<.001) in the intergroup effect in the physical role variables (F=49.22), emotional role (F=229.71), mental component (F=9.86), intensity of pain (F=24.74), and joint health (F=55.31).
    A fascial therapy protocol for patients with hemophilic elbow arthropathy can improve their perceived quality of life. Elbow pain intensity improved in patients treated with fascial therapy. This technique can improve elbow joint health.
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