Hong Kong Physiotherapy Journal

Physiotherapy clinical education: Pros and cons and the way forward

Marco Y.C. Pang — 2011-10-05

Clinical placement is an integral component of physiotherapy education. Clinical learning experiences, if appropriately constructed, are critical in transforming an individual from being a student therapist to an entry-level practitioner. In their article entitled “The slave of duty: Why clinical educators across the continuum of care provide clinical education in physiotherapy” published in this issue of the Journal, Sevenhuysen and Haines used a qualitative research design to explore clinical educator’s perceptions of the clinical education experience and barriers to delivering more clinical education. Their study has shed some light into the motivators for delivering clinical education and the perceived advantages and disadvantages of offering clinical education placements. Comparisons between clinical educators in hospital-based settings and those in community-based settings are made, and some interesting differences are found. The results presented in their articles are indeed very useful to those who are involved in planning and delivering physiotherapy clinical education and aspire to increase both the capacity for and quality of student placements.

A review on the effects of glucosamine for knee osteoarthritis based on human and animal studies

Karly Oi Wan Chan, Gabriel Yin Fat Ng — 2011-08-24

Abstract: Glucosamine (GlcN) is a popular nutritional supplement/prescription for relieving symptoms of osteoarthritis (OA), particularly for the knee joint. Although there are certain studies reporting the positive effects of GlcN for OA, its use remains controversial and the mechanism behind is unclear. This article critically reviewed published papers on the effects of GlcN in human clinical trials and animal studies. Twelve human clinical studies were reviewed and half of the studies reported positive effects of GlcN for OA or regular knee pain. Eight animal studies were reviewed and most of them had involved histological examination of cartilage, glycosaminoglycan content, subchondral bone, and synovium. Besides, nociceptive behaviour, biochemical markers, and immunohistochemistry of the joints were also examined. There is some evidence showing the beneficial effects of GlcN on joint structural repair in animals, but further research is needed to confirm the applicability of these models in human.

Systematic review: The effectiveness of physical treatments on thoracic outlet syndrome in reducing clinical symptoms

Chi-ngai Christopher Lo, Saiful Adli Bukry, Saad Alsuleman, Joel Varghese Simon — 2011-09-19

Abstract: Thoracic outlet syndrome (TOS) is a well-discussed neurovascular condition in upper limbs that prompted the scientists to conduct several reviews and to write articles on the topic during the last three decades. Most of the treatments are surgery and a series of conservative treatments. However, the variation of conservative treatments is wide and not defined. The aim of this systematic review was to define the effectiveness of physical treatments, as one of the conservative managements, for patients with TOS, in terms of pain relief. Eleven articles published during the period 1990–2009 were selected for this review. Results show that physical treatments can reduce the pain of patients with TOS, which is the primary outcome. However, there is no firm evidence to support their effectiveness.

The slave of duty: Why clinical educators across the continuum of care provide clinical education in physiotherapy

Samantha Lee Sevenhuysen, Terry Haines — 2011-08-25

Abstract: This study was a qualitative investigation aimed at exploring clinical educator’s perceptions of the clinical education experience and barriers to providing more clinical education. An online questionnaire was sent to physiotherapy clinical educators at hospital and community sites operated by Southern Health in Victoria, Australia. Using the responses, a framework involving key themes “motivators for delivering clinical education,” “consequences of delivering clinical education,” and “beneficiaries of clinical education” was constructed. Motivation for delivering clinical education was consistently reported as duty or responsibility. Consequences of delivering clinical education were comprised of positive effects on department profile, educator professional development, student professional development, and development of the physiotherapy profession, and negative effects on non-clinical tasks. The effect of clinical education on workload was seen as both positive and negative, depending on student ability, attitude, and quantity, as well as on staffing levels. These consequences were distributed across a range of beneficiaries of clinical education, inclusive of students, educators, patients, the department, and the profession. Strategies aimed at enhancing the positive aspects and managing the negative aspects for the clinical educator may be more successful in increasing capacity for student placements.

Nigerian physiotherapists’ perceptions of their profession’s prestige and implications

2011-08-25

Abstract: This study investigated Nigerian physiotherapists’ perceived prestige of their profession relative to 11 selected occupations and how their perception was influenced by selected sociodemographics. A total of 368 copies of a questionnaire adapted from a previous study were sent to registered physiotherapists working in Nigeria as of May 2007. Data were analysed using Chi-square, Kendall’s W, and multidimensional scaling analysis. Two hundred sixty copies of the questionnaire were completed and returned (70.7% response rate). Respondents included 161 men (62%) and 99 women (38%). Most of them (78.5%) were aged between 20 years and 39 years and were bachelor degree holders (67.2%). Physiotherapy was ranked second on level of education, third on usefulness to the society, fifth on level of responsibility, sixth on social standing, and seventh on income. Physiotherapy was rated fifth overall. The only sociodemographic variable that significantly influenced overall perceived occupational prestige of physiotherapy was type of workplace. Physiotherapists in Nigeria perceived their profession as having moderate occupational prestige, placing it in the fifth position below accountant, lawyer, doctor, and engineer. Physiotherapists in Nigeria need to work hard on improving the prestige standing of their profession.

Acute effects of combination of glucosamine sulphate lontophoresis with exercise on fasting plasma glucose of participants with knee osteoarthritis

Ayodele Teslim Onigbinde, Adetayo Ebun Talabi, Raheem Adaramaja Shehu — 2011-08-25

Abstract: Glucosamine administration is being speculated to alter glucose metabolism and few studies had investigated the effects to confirm this speculation. It is not known if glucosamine sulphate administration through the process of iontophoresis will contradictorily raise the plasma glucose being a sugar. Fifty-two participants with Knee osteoarthritis were randomly assigned to 3 groups: Group 1 participants received exercise therapy followed by administration of 300 mg (an equivalent of 3 mL) of glucosamine sulphate through iontophoresis. Group 2 also received an equivalent of 3 mL glucosamine sulphate iontophoresis without exercise whereas Group 3 received exercise therapy only. Glucometer (One Touch-Ultra easy model) was used to monitor the pre and post fasting plasma glucose. Descriptive and inferential statistics (analysis of variance) were used. The result of analysis of variance showed that there was no significant difference in the final fasting blood sugar (FBS) of the 3 groups. Within session assessment for Group 1 showed that there was also no significant difference in the FBS at different phases of interventions. However, for Group 2, there was significant reduction in FBS immediately after iontophoresis (p < 0.05). Similarly, for Group 3, the FBS was significantly lowered immediately after exercise (p < 0.03). This study concluded that Glucosamine sulphate iontophoresis did not raise plasma concentration of glucose.

Effectiveness of electromyographic biofeedback training on quadriceps muscle strength in osteoarthritis of knee

Shahnawaz Anwer, Nishat Quddus, Mohammad Miraj, Ameed Equebal — 2011-09-28

Abstract: The objective of this randomised controlled trial was to evaluate the effectiveness of electromyographic biofeedback as an add-on therapy with isometric exercise on quadriceps strengthening in patients with osteoarthritis of knee. Thirty three, 10 men and 23 women, patients with osteoarthritis of knee participated in the study. Patients were randomly placed into two groups: a biofeedback group (n = 17) and a control group (n = 16). The biofeedback group received electromyographic biofeedback-guided isometric exercise programme for 5 days a week for 5 weeks, whereas the control group received an exercise programme only. On between-group comparisons, the maximum isometric quadriceps strength in biofeedback group, at the end of 5th week was significantly greater than that of the control group (p < 0.004). The addition of electromyographic biofeedback to a 5-week isometric exercise program appeared to increase quadriceps muscle strength, compared to the exercise program alone for people with knee osteoarthritis. The finding, however, should be interpreted with caution due to limitations of the study design.

Motor Ability and Weight Status are Determinants of Extra-Curricular Activity Participation in Children with Developmental Coordination Disorder

2011-12-01

Background and Purpose: According to the ICF model, participation in everyday activities is integral to child development. This study aimed to: (1) compare the motor performance and pattern of extra-curricular activity participation between children with and without Developmental Coordination Disorder (DCD), and (2) identify the role of motor ability and weight status in activity participation diversity amongst children with DCD.

Validation and Reliability of the Kujala Scale for Chinese Population with Patellofemoral Disorders

R.T.H. Cheung, S.P.C. Ngai, P.L. Lam, J.K.W. Chiu, E.Y.H. Fung — 2011-12-01

Background and Purpose: Patellofemoral disorders are common orthopaedic conditions in active adults. However, a validated instrument for outcome measurement in Chinese population was lacking. This study translated and validated the Kujala scale, a well documented questionnaire for this patient group, into Chinese version.

The Effects of Scapular Postural Control on Neck and Upper Limb Muscular Activities During Static and Dynamic Functional Tasks

K.M.L. Kwok, G.P.Y. Szeto — 2011-12-01

Background and Purpose: The concept of shoulder postural control or “scapular stabilization” has been commonly adopted as a therapeutic exercise in physiotherapy for the management of work-related neck and upper limb disorders (WRNULD). The objective of the present study is to investigate the muscle activities of the neck and upper limb muscles, while individuals perform functional tasks with and without scapular stabilization.

Sedentary Lifestyle and Electronic Game Use Contributes to Musculoskeletal Discomfort in Hong Kong Primary and Secondary School Students

D.P.Y. Lui, G.P.Y. Szeto, A.Y.M. Jones — 2011-12-01

Background and Purpose: Previous studies have reported that young persons in different countries adopt inactive lifestyle from prolonged electronic game (EG) use, computer use and television viewing. Participation in such sedentary activities has been associated with adverse health effects, but research on the effect of EG use in relation to musculoskeletal discomfort are sparse. The objectives of this study were (1) to examine the pattern of different types of EG use and (2) to explore the pattern of EG use with musculoskeletal discomforts in different body regions.

Reliability of Transcranial Magnetic Stimulation Induced Corticomotor Excitability for a Hand Muscle

H. Liu, S.S.Y. Au-Yeung — 2011-12-01

Background and Purpose: Transcranial magnetic stimulation (TMS) has been a neurophysiological measurement of corticomotor synaptic activities in human. This study aimed to determine the reliability of TMS-induced corticomotor excitability measurements for the first dorsal interroseus hand muscle.

Effectiveness of Physiotherapy Management After Bariatric Operation

C.H.E. Wong, C.N. Auw Yang, Y.H.P. Poon — 2011-12-01

Background and Purpose: Literature showed bariatric operation was effective for treating obesity. In this study, the effectiveness of physiotherapy management after bariatric operation in terms of physical performance and quality of life was evaluated.

A Prospective Cohort Study to Predict Fall Risk in Patients with Recent Hip Fracture

D.T.Y. Yau, M.Y.C. Pang — 2011-12-01

Background and Purpose: Little is known about the prevalence of falls and the related risk factors in patients who have undergone surgery following a hip fracture. This prospective cohort study aims to assess the relationship between potential risk factors and fall incidence in this patient population. There is an increased risk of recurrent falls and hip fractures in elderly who has suffered the first hip fracture. Identification on potential recurrent fallers at early stage is thus important for improving health outcomes in these individuals as well as reducing the economic burden on the public health care system.

Associated Reactions at Different Levels of Force in People with Cerebral Palsy

H.C. Chiu, N. O'Dwyer, M. Halaki — 2011-12-01

Background and Purpose: Associated reactions (ARs) may be a significant clinical problem if increased levels of muscle contraction in cerebral palsy are found to be triggers of ARs. The purpose here was to provide measures of ARs at varying force levels in people with hemiplegic and quadriplegic cerebral palsy compared with people with normal development.

Repeatability of Vicon Motion Analysis System for Upper Limb Kinematic Measurement During Fencing Lunge Action

W.M. Chung, S. Yeung, C.H. Pak, R. Lee — 2011-12-01

Background and Purpose: Three-dimensional (3D) kinematic motion analysis systems are widely used for clinical decision-making and evaluation of the therapeutic outcome. The objectives of this study were: (1) to assess the 3D upper limb kinematics during the fencing lunge in the able-bodied foil fencers and (2) to evaluate the within- and between-session repeatability of the VICON system.

Effect of Exercise Intervention on Balance and Fear of Falling in Elderly Subjects

S.L. Kuo, J.C. Nitz — 2011-12-01

Background and Purpose: Previous studies have shown improvement of balance after exercise intervention in elderly subjects. The objectives of this study were to examine the effect of exercise intervention on (1) balance tests (Functional Reach, Timed Up and Go and Step Test) and (2) fear of falling in elderly subjects.

Effect of Transcranial Direct Current Stimulation (tDCS) on Gait Performance Under Concurrent Cognitive Task Condition in Patients with Parkinson's Disease

L.L. Yu, M.Y. Chan, M.K.Y. Mak — 2011-12-01

Background and Purpose: Transcranial direct current stimulation (tDCS) to primary motor cortex was found to improve motor performance in stroke patients. Two previous studies showed a single session of tDCS enhanced upper limb motor function and gait performance in PD patients. This study aimed to determine whether tDCS could improve gait performance during dual cognitive-walking task in PD patients.

Development and Validation of the Physical Activity Scale for the Elderly in Chinese Population (PASE-C)

S.P.C. Ngai, R.T.H. Cheung, P.L. Lam, J.K.W. Chiu, E.Y.H. Fung — 2011-12-01

Background and Purpose: Physical Activity Scale for the Elderly (PASE) is a widely used questionnaire to assess the physical activity level for elderly. This study aims to translate and validate PASE in the Chinese population.

Validity of VICON Motion Analysis System for Upper Limb Kinematic MeasuremeNT – A Comparison Study with Inertial Tracking Xsens System

W.M. Chung, S. Yeung, W.W. Chan, R. Lee — 2011-12-01

Background and Purpose: The aim of this study was to establish the validity of the VICON motion analysis system (VICON, Oxford Metrics Group; Oxford, United Kingdom) for three-dimensional upper limb (UL) kinematic measurement. The VICON was compared against inertial tracking sensors (XSENS, Xsens Technologies 2007) for measuring fast-speed shoulder, elbow and wrist joint motions.

A Preliminary Evaluation of the Clinical Outcomes of Biofeedback Training for Patients with Functional Constipation

M.Y.A.B. Suen, Y.H.P. Poon, H.Y.S. Chau, S.C. Lee — 2011-12-01

Background and Purpose: Constipation affects up to 30% of our populations. It is a subjective symptom of various pathology conditions. Targeted treatment is important for achieving successful outcome. The objective of this study was to evaluate the clinical outcomes of biofeedback training for patients with functional constipation.

A Modified Physiotherapy Risk Assessment Model for Patients Undergoing Abdominal Surgery

2011-12-01

Background and Purpose: It has been reported that 9%-40% of patients who underwent abdominal surgeries suffered from postoperative pulmonary complications (PPCs) which contributed to morbidity and additional health care costs. Chest physiotherapy is one of the strategies to reduce PPCs. A modified risk assessment model was used to triage high risk patients for appropriate interventions.

Efficacy of Modified 3 Phases Exercise Program for Patient Following Breast Cancer Surgery at Tseung Kwan O Hospital

Y.K. Fung, W.W. Choi, T.C. Lo, T.K. Au, W.M. Choi, C.C. Tam — 2011-12-01

Background and Purpose: Traditionally patients would start immediate shoulder mobilization after breast cancer surgeries. However, premature shoulder elevation increases the risk of seroma formation while delayed and inadequate physiotherapy might lead to shoulder stiffness. Physiotherapy program was modified in 2009 for prevention of these known complications.

Impact of the Active Lifestyle Therapeutic Exercise Program on Vascular Risk Factors Control in Secondary Stroke Prevention

T.C.M. Kwok, H.T. Lui, C.C. Lo, T.K. Au, C.Y. Yick, K.Y. Wong, Y.M. Chu — 2011-12-01

Background and Purpose: Stroke survivors have higher risk for recurrent. It was greatest in the first year from 4 to 14%. Promoting an active lifestyle will be important in secondary stroke prevention. This study aimed to examine the effect of an active lifestyle with therapeutic exercise program (ALTEP) on physical functioning and vascular risk factors control in acute ischemic stroke patients.

A Randomized Controlled Trial to Investigate the Feasibility and Clinical Efficacy of Whole Body Vibration Therapy in Modifying Bone Metabolism and Neuromotor Performance in Individuals with Chronic Stroke

R.W.K. Lau, S.P. Yip, M.Y.C. Pang — 2011-12-01

Background and Purpose: Whole body vibration (WBV) has gained increasing popularity in rehabilitation of various patient populations. The aim of this study was to examine the feasibility and clinical efficacy of whole body vibration therapy in enhancing bone health and neuromotor performance in individuals with chronic stroke.

To Study the Efficacy of Acupuncture in Improving Functional Mobility in Acute Stroke – A Randomized, Controlled and Single Blinded Study

H.S.F. Yip — 2011-12-01

Background and Purpose: The global burden caused by stroke is coming more and more severe. Good and early recovery can minimize post-stroke disability and dependency. This study was designed to investigate the efficacy of acupuncture in improving functional mobility in acute stroke.

Spinal Movement Coordination and Muscular Activity in Adults with Chronic Mechanical Neck Pain

S.M.H. Tsang, G.P.Y. Szeto, R.Y.W. Lee — 2011-12-01

Background and Purpose: Comprehensive analysis of movement coordination of the cervico-thoracic spine in people with neck pain was limited in previous studies. The purposes of this study were: (1) to examine the spinal kinematics of the cervical and upper thoracic regions and the associated electromyographic activities (EMG) in people with chronic mechanical neck pain (CMNP) during active neck movements and (2) to compare the movement coordination and EMG patterns with the healthy adults.

Neck and Upper Limb Muscle Activity During Electronic Game Playing in School Children

D.P.Y. Lui, G.P.Y. Szeto, A.Y.M. Jones — 2011-12-01

Background and Purpose: Electronic game (EG) playing has become very popular among youngsters, and nowadays, many different game devices are played by school children. Use of these game devices (such as small-screen handheld and active) may affect the postures and muscular loading, and prolonged exposure can lead to musculoskeletal symptoms. The present study aimed: (1) to examine the muscle activity in the neck and upper limb during EG playing and (2) to compare with handheld game device and active game device.

Effects of 12-Week Strategy-Focused Balance Training on Balance Performance and Balance Confidence in Patients with Parkinson's Disease

X. Shen, M.K.Y. Mak — 2011-12-01

Background and Purpose: Fear of falling has been found to be an important and independent fall predictor in patients with Parkinson's disease (PD). There are inconsistent findings on whether balance training could improve balance confidence. The present study aimed to explore the effects of a 12-week strategy-focused balance training on balance performance and balance confidence in PD patients.

A Double-Blinded and Randomized Controlled Trial for the Effectiveness of Electro-Acupuncture for the Management of Signs and Symptoms Associated with Collapse of Spine

R.K.W. Lau, T.F.O. Lau, C.P.Y. Cheng, S.W. Law, K.Y. Fung — 2011-12-01

Background and Purpose: Collapsed spine is a common complication of osteoporosis among geriatric patients in HK. Electro-acupuncture has demonstrated its effect on different LBP conditions. However, the efficacy of electro-acupuncture on collapsed spine has not been well established.

Ankle Muscle Weakness in Individuals with Parkinson's Disease: The Influence of Contraction Type, Speed, and Joint Angle

M.Y.C. Pang, M.K.Y. Mak — 2011-12-01

Background and Purpose: While it is known that force production in muscle of healthy subjects is influenced by muscle length, no study has examined the effect of neurological pathology, such as Parkinson disease (PD), on force production across different joint angles. In this study, we aimed to compare the isokinetic ankle muscle strength and torque-angle relationship between patients with PD and healthy controls.

Immediate Effect of Functional Electrical Stimulation to Activity in Children and Adolescents with Cerebral Palsy: A Systematic Review

H.C. Chiu, L. Ada — 2011-12-01

Background and Purpose: Functional electrical stimulation training is defined as a task-specific manner, in which a muscle is stimulated when it should be contracting during a practicing an activity, such as sitting, sit to stand, walking or reaching and manipulation. The purpose of this systematic review is to determine the effect of functional electrical stimulation as an intervention to improve activities in children and adolescents with cerebral palsy, activities during functional electrical stimulation are thoroughly assessed with the use of congruent outcome measures in this review.