Hong Kong Physiotherapy Journal

A Healthy Trend

Priscillia Lam Lam

Isometric Grip Strength and Endurance of Patients With Cervical Spondylosis and Healthy Controls: A Comparative Study

Michael O. Egwu, Benjamin A. Ajao, Chidozie E. Mbada, Isaac O. Adeoshun

Abstract: This study compared the grip strength (GS) and grip endurance (GE) of patients with cervical spondylosis (CS) with those of healthy controls and determined the effect of hand dominance on these variables. Forty subjects (20 with CS and 20 controls; age range, 27–70 years; mean age, 47.5 ± 13.9 years) participated in this study. Sitting on an armless chair of standard height, the subject's test arm was held at 90° elbow flexed with the forearm in neutral position; subjects squeezed a dynamometer maximally (GS) and held it until the contact force output could not be maintained (GE) while being timed with a stop watch. Patients with CS had significantly lower GS (p < 0.05) and GE (p < 0.001) than the controls in both dominant and non-dominant hands. There was no significant difference (p > 0.05) between the GS and GE of the dominant and non-dominant hands in patients with CS and controls. GS and GE are lower in CS patients than in controls but are similar in the dominant and non-dominant hands in both groups, suggesting that limb dominance does not affect GS and GE.

A New Stroke Unit: Implementation Issues

Lorraine Sheppard, Kwai Fu Ko

Abstract: Stroke units are geographically distinct units providing dedicated care for people who have suffered a stroke. This study aimed to understand the financial benefits of stroke unit care. The cost of acute beds and the average length of hospital stays were compared between the stroke unit group and the general ward group. The mean length of inpatient stay in the stroke unit group was 43.7 days; in the general medical wards, it was 69.3 days with a significant 95% confidence interval of 36.96–14.19. The reduced length of stay reduced the cost of care provided by the stroke unit. Stroke units provide more cost-effective care.

Transcutaneous Electrical Nerve Stimulation for the Treatment of Pain in Physiotherapy Practices in Hong Kong and the United Kingdom—A Survey of Usage and Perceived Effectiveness Compared With Other Pain Relieving Modalities

Abstract: This study compared the use and perceived effectiveness of transcutaneous electrical nerve stimulation (TENS) with other electrophysical modalities for pain management by physiotherapists (PTs) in Hong Kong (HK) and the United Kingdom (UK). Two random samples (n = 600 each) of HK and UK PTs were mailed questionnaires. Four hundred and sixteen out of 1,200 respondents (34.7%) returned fully completed questionnaires (HK,34.2%; UK, 35.2%). A significant difference was found in the type of electrodes used (p < 0.001); self-adhesive electrodes were used more commonly in the UK (UK, 73.0%; HK, 18.4%), compared with carbon rubber electrodes and gel in HK (HK, 75.6%; UK, 15.7%). A significantly higher percentage of HK PTs reported receiving an undergraduate education in TENS (84.4% vs. 43.1%; p < 0.001). Acupuncture was used more in the UK (67.7%) than in HK (48.8%; p < 0.001), but it was rated equally effective, especially for chronic pain. There were significant differences in perceived effectiveness of TENS for chronic pain (p < 0.001); TENS was rated second most effective for the management of chronic pain by UK PTs and fourth by HK PTs. This survey has highlighted differences in the patterns of use and perceived effectiveness of TENS and other modalities in the UK and HK.

Reference Values for Handgrip Strength Among Healthy Adults in Nigeria

Abstract: Handgrip strength (HGS) measurements provide an objective index of the functional integrity of the upper extremity. Motivated by the paucity of reference values for HGS for an African population, this study sought to establish reference values for HGS in healthy Nigerian adults. The HGS of 745 (409 male and 336 female) healthy volunteers from the ages of 20–70 years was measured using a Takei Kiki Kogyo handgrip dynamometer in accordance with the American Society of Hand Therapists protocol. Men exhibited higher HGS than that in women in both dominant (35.2 kilogram force [kgf] vs. 24.9 kgf) and non-dominant (31.6 kgf vs.22.8 kgf) hands. Using percentile values cut points, less than 25th (poor grip strength), 25th–75th (moderate grip strength), and > 75th (good grip strength) percentile were < 29.0 kgf, 29.0–34.0 kgf, and > 34.0 kgf, respectively, for the dominant hand and < 24.0 kgf, 24–36.0 kgf, and > 36.0 kgf, respectively, for the non-dominant hand. These findings suggest that males have a significantly higher HGS than females. HGS decreases with increasing age for both dominant and non-dominant hands. The reference values derived in this study would be useful in assessing impairment in functional ability of the upper extremities in both healthy and patients' populations.

Participation in and Adherence to Physical Activity in People With Physical Disability

Ka Chuen Lui, Stanley S.C. Hui

Abstract: It is a challenge for physiotherapists and fitness instructors to promote adherence to regular physical activity/exercise in people with physical disabilities. Although there has been emerging awareness of this in recent years, this topic remains relatively underexplored. The literature has shown that multiple factors affect the initiation and maintenance of participation in regular physical activity in this population, and relevant behavioural strategies are useful in this regard. The main theme of the present review is to provide frontline exercise professionals a wide picture for understanding participation in and adherence to physical activity for people with physical disabilities. The objectives are as follows: (1) to explore the need for regular physical activity/exercise for people with physical disability; (2) to sum up the correlates between people with disabilities and physical activity participation, as well as physical activity adherence; (3) to review strategies for increasing physical activity participation and adherence in people with disabilities; and (4) to point out the practical difficulties and implications from the reviewed papers concerning the improvement of physical activity/exercise participation and adherence.

The Effects of a Community-based Water Exercise Programme on Health Outcomes for Chinese People With Rheumatic Disease

Lavinia K.Y. Wong, Rhonda J. Scudds

Abstract: The purpose of this study was to investigate the effects of a community-based water exercise programme (CBWEP) on physical disability, quality of life, and confidence in performing exercise for people with rheumatic disease. A multiple pretest, within-subject design was used. All subjects participated in a 4-week CBWEP followed by an 8-week maintenance period. Physical disability, pain intensity, quality of life, and level of confidence in performing the exercises were evaluated using a self-administered questionnaire at baseline, pre-class, post-class, and at follow-up. Thirty-one subjects (30 female, 1 male) participated in the study. Repeated measures analysis of variance showed a statistically significant difference in pain intensity (p < 0.001) as well as in six domains of the SF-36 questionnaire: general health (p < 0.001), physical function (p = 0.001), role-physical (p = 0.001), role-emotional (p = 0.001), vitality (p < 0.001), and bodily pain (p = 0.006). There was also an improvement in confidence in performing the exercises (p < 0.001) and exercise participation at the end of the study. A CBWEP and continued maintenance classes may be beneficial for pain reduction and improvement in quality of life. These findings provided evidence for the value of this type of community exercise programme for people with rheumatic disease in Hong Kong.

Target-flow Inspiratory Muscle Training Improves Running Performance in Recreational Runners: A Randomized Controlled Trial

Thomas M.K. Kwok, Alice Y.M. Jones

Abstract: Inspiratory muscle training (IMT) has been shown to possibly improve exercise performance, but reports on IMT and running performance are rare. The objective of the present study was to examine the effect of target-flow IMT on running performance in recreational runners. Sixteen healthy recreational runners (five females) were recruited for the present study. They were randomly allocated into either an experimental or control group. Participants in the experimental group underwent a 6-week target-flow IMT programme, while those in the control group underwent a 6-week shoulder circumduction exercise programme. Running performance during a 1,500-m time trial run was assessed before and after the intervention period. After the intervention period, only the experimental group demonstrated an increase in inspiratory muscle strength (by 16.15 ± 7.44 cmH2O; p < 0.05) and reduced completion time in the 1,500-m time trial (by 9.63 ± 5.42 seconds; p < 0.05). Exertion sensation was reduced by 1.63 ± 0.74 points (p < 0.05). No changes were observed in maximal aerobic capacity and pulmonary function in either group after the intervention period. A 6-week target-flow IMT programme enhanced running performance in recreational runners.

Trunk Position Sense in Older Tai Chi Sword Practitioners

William W.N. Tsang, Siu N. Fu, Frederick Lui, Christina W.Y. Hui-Chan

Abstract: To examine whether older Tai Chi sword practitioners had developed better trunk position sense than healthy control subjects, 16 female Tai Chi sword practitioners from a local community Tai Chi Club in Hong Kong were compared with 11 female healthy control subjects. Active trunk repositioning was used to test trunk proprioceptive acuity. Tai Chi sword practitioners made significantly smaller absolute angle errors than control subjects in trunk rotation to the left (2.2° ± 0.9° vs. 4.4° ± 2.7°; p = 0.006) and to the right (2.1° ± 0.9° vs. 4.2° ± 2.9° of control; p = 0.01), but there were negligible improvements in trunk forward flexion (3.9° ± 3.0° and 4.8° ± 3.0°, respectively; p = 0.46). These results demonstrate that Tai Chi sword practitioners had developed better position sense in trunk rotation but not in trunk flexion than healthy older subjects.