1. |
- Alfredson, Håkan
(author)
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Clinical commentary of the evolution of the treatment for chronic painful mid-portion Achilles tendinopathy
- 2015
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In: Revista Brasileira de Fisioterapia. - : FapUNIFESP (SciELO). - 1413-3555 .- 1809-9246. ; 19:5, s. 429-432
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Journal article (other academic/artistic)abstract
- The chronic painful Achilles tendon mid-portion was for many years, and still is in many countries, treated with intratendinous revision surgery. However, by coincidence, painful eccentric calf muscle training was tried, and it showed very good clinical results. This finding was unexpected and led to research into the pain mechanisms involved in this condition. Today we know that there are very few nerves inside, but multiple nerves outside, the ventral side of the chronic painful Achilles tendon mid-portion. These research findings have resulted in new treatment methods targeting the regions with nerves outside the tendon, methods that allow for a rapid rehabilitation and fast return to sports.
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2. |
- Carnaz, L., et al.
(author)
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Effects of sensor, trials and knee joint variables on electrogoniometric gait recordings
- 2008
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In: Revista Brasileira de Fisioterapia. - 1809-9246. ; 12:6, s. 460-467
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Journal article (peer-reviewed)abstract
- Introduction: Different sources of variations, such as electrogoniometer characteristics and procedures, may affect the accuracy and precision of movement measurements during gait. Objective: To quantify the variations and compare the effects produced by different sources of variation in electrogoniometric gait recordings: the sensors, procedures (trials) and the knee joint. Methods: Knee flexion/extension and valgus/varus movements were recorded during gait on the treadmill. The recordings were partitioned into strides and normalized in time using a routine developed in MatLab. Mean curves for the knee during gait were derived from 50 strides, and seven conditions were evaluated: one comparing pairs of sensors; two comparing pairs of different trials (including variations due to sensors); and four comparing the right and left knees (including variations due to sensors and trials). Mean standard deviations of the differences were calculated. To estimate the variations relating to the trial and the knee joint, the compound standard deviations were transformed into variances and split into their components. Results: The variation introduced by pairs of sensors in the same model applied in one trial was smaller than the variation introduced by the same sensor used in two consecutive trials. Furthermore, the variation introduced by the difference between the right and left knees was greater than the variation introduced by the difference between sensors (A and B) and trials (1 and 2). Conclusions: It is, therefore, preferable to use different sensors in the same data recording (simultaneous) than use the same sensor in two different recordings (consecutive).
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3. |
- Fältström, Anne, et al.
(author)
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Self-reported knee function and activity level are reduced after primary or additional anterior cruciate ligament injury in female football players: a five-year follow-up study
- 2023
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In: Revista Brasileira de Fisioterapia. - : ASSOCIACAO BRASILEIRA PESQUISA POS-GRADUACAO FISIOTERAPIA-ABRAPG-FT. - 1413-3555 .- 1809-9246. ; 27:6
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Journal article (peer-reviewed)abstract
- Background: Playing football involves a high risk of anterior cruciate ligament (ACL) injuries and these may affect knee function and activity level. Objectives: To measure changes in self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players with or without an ACL-recon-structed knee. Methods: Female football players, age 19.9 (SD 2.6) years, with either a primary ACL-recon-struction 1.6 (SD 0.7) years after ACL-reconstruction (n = 186) or no ACL injury (n = 113) were fol-lowed prospectively for five years. Self-reported data collected at baseline and follow-up included knee function (International Knee Documentation Committee Subjective Knee Form [IKDC-SKF]), activity level (Tegner Activity Scale), and satisfaction with knee function (Likert scale 1=happy; 7=unhappy) and activity level (1-10 scale). Information on any new ACL injury during the follow-up period was collected. Results: Players with ACL-reconstruction at baseline who either did (n = 56) or did not (n = 130) sustain an additional ACL injury, and players with no injury at baseline who remained injury free (n = 101) had a lower Tegner score at follow-up. Players with additional ACL injury had lower IKDC-SKF score (mean difference:-11.4, 95% CI:-16.0,-6.7), and satisfaction with activity level (mean difference:-1.5, 95% CI:-2.3,-0.7) at follow-up. Players with no additional ACL injury had higher satisfaction with knee function (mean difference: 0.6, 95% CI: 0.3, 0.9) at fol-low-up. Players with no ACL injury had lower satisfaction with activity level (mean difference:-0.7, 95% CI:-1.1,-0.3) at follow-up. Players with additional ACL injury had larger decreases in all variables measured compared to the two other groups. Conclusion: Primary, and even more so additional, ACL injuries decreased self-reported knee function, activity level, and satisfaction with knee function and activity level in female football players. (c) 2023 The Author(s). Published by Elsevier Espana, S.L.U. on behalf of Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. This is an open access article under the CC BY license (http://creativecommons.org/licenses/by/4.0/).
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4. |
- Hernández, Edgar D, et al.
(author)
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Intra- and interrater reliability of Fugl-Meyer Assessment of Lower Extremity early after stroke.
- 2021
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In: Brazilian journal of physical therapy. - : Elsevier BV. - 1809-9246 .- 1413-3555. ; 25:6, s. 709-718
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Journal article (peer-reviewed)abstract
- The Fugl-Meyer Assessment of Lower Extremity (FMA-LE) is a widely used and recommended scale for evaluation of post-stroke motor impairment. However, the reliability of the scale has only been established by using parametric statistical methods, which ignores the ordinal properties of the scale.To determined intra- and inter-rater reliability of the FMA-LE at item and summed score level early after stroke.Sixty patients (mean age 65.9 years, median FMA-LE 29 points) admitted to the hospital due to stroke were included. The FMA-LE was simultaneously, but independently, scored by three experienced and trained physical therapists randomly assigned into pairs, on two consecutive days, between 4 to 9 days post stroke. A rank-based statistical method for paired ordinal data was used to assess the level of agreement and systematic and random disagreements.The item-level reliability was high (percentage of agreement [PA] ≥75%). Two items (ankle dorsiflexion during flexor synergy and normal reflex activity) showed some systematic disagreement in intrarater analysis. A satisfactory intrarater reliability (PA ≥70%) was reached for all summed scores when a 1- or 2-point difference was accepted between ratings.The FMA-LE is a reliable tool for assessment of motor impairment both within and between raters early after stroke. The scale can be recommended not only for use in Spanish speaking countries, but also internationally. A unified international use of FMA-LE would allow comparison of stroke recovery outcomes worldwide and thereby potentially improve the quality of stroke rehabilitation.
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5. |
- Munneke, Wouter, et al.
(author)
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Comparing physical therapy students' attitudes and beliefs regarding chronic low back pain and knee osteoarthritis: an international multi-institutional comparison between 2013 and 2020 academic years
- 2024
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In: BRAZILIAN JOURNAL OF PHYSICAL THERAPY. - 1413-3555 .- 1809-9246. ; 28:1
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Journal article (peer-reviewed)abstract
- Background: In 2013, physical therapy students demonstrated low guideline -adherent recommendations regarding chronic low back pain (CLBP) for spinal pathology, activity, and work. Objectives: To assess the differences in physical therapy students' attitudes, beliefs, and adherence to guideline recommendations regarding CLBP and knee osteoarthritis between 2013 and 2020. Methods: In 2013 and 2020, second and fourth -year physical therapy students were recruited from 6 Belgian and 2 Dutch institutions. Attitudes and beliefs regarding CLBP and knee OA were evaluated using the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT), the Health Care Providers' Pain and Impairment Relationship Scale (HC -PAIRS), and a questionnaire regarding therapeutic exercise and knee osteoarthritis. A clinical vignette was used to measure guideline -adherent recommendations regarding spinal pathology, activity, and work. Results: In 2013, 927 second -year and 695 fourth -year students; in 2020, 695 second -year and 489 fourth -year students; were recruited to participate in the study. Compared to 2013, students had less biomedical and stronger biopsychosocial attitudes and beliefs regarding CLBP, more guideline -adherent recommendations for activity, and more biopsychosocial beliefs regarding the benefits of exercise for patients with knee osteoarthritis in both the second and fourth year. Only fourth -year students in 2020 scored significantly better on HC -PAIRS and guideline -adherent recommendation relating to spinal pathology. No differences were found regarding work recommendations. Conclusions: Between 2013 and 2020, physical therapy students made a positive shift towards a more biopsychosocial approach to CLBP and knee osteoarthritis management. Guideline -adherent recommendations for CLBP concerning activity improved, however, concerning work and spinal pathology, it remained low.
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7. |
- Poletto, P. R., et al.
(author)
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Peak torque and knee kinematics during gait after eccentric isokinetic training of quadriceps in healthy subjects
- 2008
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In: Revista Brasileira de Fisioterapia. - 1809-9246. ; 12:4, s. 331-337
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Journal article (peer-reviewed)abstract
- Objective: To evaluate the effects of eccentric isokinetic training on knee range of motion (ROM) of healthy subjects. Methods: The knee extensor and flexor isokinetic peak torques and ROM of flexion/extension and varus/valgus knee movements during gait of 18 healthy men (21.7 +/- 2.2 years; 1.73 +/- 0.10m; 68.7 +/- 9.4kg; body mass index: 22.6 +/- 2 kg/m(2)) were analyzed, before and after six weeks of bilateral eccentric isokinetic training of the knee extensors at 30 degrees/s. Results: The knee extensor torque increased in both limbs (right, from 229 +/- 54 to 304 +/- 53Nm; p<0.01; and left, from 228 +/- 59 to 311 +/- 63Nm; p<0.01), without any difference in torque gain between them. The knee flexor peak torque increased (from 114 +/- 30 to 123 +/- 22Nm; p<0.05), but the hamstrings/quadriceps (H/Q) ratio decreased (from 0.5 +/- 0.08 to 0.39 +/- 0.07; p<0.01) after the training. There were no differences in the flexion/extension and varus/valgus movements after the training, except for a small change (4 degrees) in valgus for the left knee, Conclusions: The eccentric isokinetic training of the knee extensors increased the extensor torque and decreased the H/Q ratio, although the effect on the gait pattern seemed negligible in healthy subjects. Associated training for flexors, complementary to the extensor training, seems to be necessary for balance between knee agonists and antagonists.
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8. |
- Smitheman, H. P., et al.
(author)
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Putting the fear-avoidance model into practice - what can patients with chronic low back pain learn from patients with Achilles tendinopathy and vice versa?
- 2023
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In: Brazilian Journal of Physical Therapy. - 1413-3555 .- 1809-9246. ; 27:5
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Journal article (peer-reviewed)abstract
- Background: Fear-avoidance variables are present in patients with musculoskeletal pain conditions, such as chronic low back pain (CLBP) and Achilles tendinopathy (AT) and can lead to reduced function and recovery. It is unknown how these variables relate in populations with different etiologies but similar pain provocation mechanisms. Objective: To compare kinesiophobia, pain catastrophizing, and disability between these two groups. Methods: Patients with CLBP and those with AT were included. Tampa Scale of Kinesiophobia (TSK-17) and Pain Catastrophizing Scale (PCS-13) were evaluated in both groups. The CLBP group completed the Oswestry Disability Index (ODI) and the AT group completed the PROMIS-29 questionnaire. Gait speed was calculated for each group. Disability outcomes were normalized between groups. Results: 119 patients in the CLBP group (64 female, 46 +/- 8 years) and 83 patients in the AT group (42 female, 48 +/- 12 years) were included. Both groups (CLBP, AT) presented with high prevalence of kinesiophobia (67%, 55%) but the CLBP group presented with higher prevalence of pain cata-strophizing (22%, 2%). The CLBP group demonstrated higher levels of disability via normalized ODI (MD= 12.4, 95% CI: 9.2, 15.5) but the AT group demonstrated slower gait speed (MD= 0.1 m/ s, 95% CI: 0.0, 0.2). Conclusion: Similarly high prevalence of kinesiophobia was found in patients with CLBP and patients with AT. While the CLBP group reported greater prevalence of catastrophizing thoughts and greater disability, the AT group had slower gait speed. Overall, these findings demonstrate that CLBP and AT have similarities that may allow clinicians to learn from one to inform treatment of the other. Clinical Trial Registration Numbers: NCT03523325, ISRCTN17115599. (c) 2023 Associacao Brasileira de Pesquisa e Pos-Graduacao em Fisioterapia. Published by Elsevier Espana, S.L.U. All rights reserved.
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9. |
- Svahn Ekdahl, Annika, 1969, et al.
(author)
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Expertise and individually tailored interventions are expected by pregnant women with pelvic girdle pain who seek physical therapy: a qualitative study.
- 2023
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In: Brazilian journal of physical therapy. - : Elsevier BV. - 1413-3555 .- 1809-9246. ; 27:2
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Journal article (peer-reviewed)abstract
- Pelvic girdle pain (PGP) in pregnancy may result in activity limitations and thus a negative impact on the individual woman's everyday life. Women's expectations when they seek physical therapy because of PGP are not yet known.To explore pregnant women's lived experience of PGP and what needs and expectations they express prior to a physical therapy consultation.A qualitative study using a descriptive phenomenological method. Interviews conducted with 15 pregnant women seeking physical therapy because of PGP, recruited through purposive sampling at one primary care rehabilitation clinic.PGP was described by four themes; An experience with larger impact on life than expected, A time for adjustments and acceptance, A feeling of insecurity and concern, A desire to move forward. PGP had a large impact on the pregnant women´s life. Thoughts of PGP as something to be endured was expressed, the women therefore accepted the situation. Finding strategies to manage everyday life was hard and when it failed, the women described despair and a need for help. They expected the physical therapist to be an expert who would see them as individuals and provide advice that could make their everyday life easier.Our results reveal that pregnant women with PGP delay seeking physical therapy until their situation becomes unmanageable and they run out of strategies for self-care. The women express, in light of their individual experiences, needs and expectations for professional management and advice tailored to their individually unique situation.
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