Physiotherapist

Introduction: Scoliosis is a three-dimensional deformative abnormality of the spine, defined by the Cobb's angle of spine curvature in the coronal plane, and is often accompanied by vertebral rotation in the transverse plane and hypokyphosis in the sagittal plane. Based on the age of presentation, scoliosis is further categorized as infantile, juvenile or adolescent idiopathic. Adolescent idiopathic scoliosis (AIS) has the highest prevalence of the three categories. This type of scoliosis is present at age ten and lasts till the end of growth. Its prevalence is dependent on the curvature of the spine and gender of the patient. Objective: The purpose of this review is to evaluate the role of physiotherapy in reducing curve progression and pain, postponing or avoiding invasive treatment and improve the quality of life in adolescents with AIS. Methodology: The study is a Systematic Review, meta-analytic type, consisting of 5 studies (RCT) of the last ten years, which focus on the i...

Objectives: Musculoskeletal disorders (MSD) are the most prevalent occupational diseases
that are serious, fundamental and costly in nature.
Methods: This analytical descriptive study included 45 individuals of occupational and
physiotherapy community in Hamedan, Nahavand and Malayer cities of Iran.
The standardized Nordic questionnaire was used to collect data. Data analysis was done by
SPSS software, chi-square test, T-test and Kay Score tests.
Results: Study results revealed the prevalence of MSD accounting for 65.9% (n=27) of
the study population who at least had one part of their body infected. In a 12 months study
period, the disorder symptoms were seen in wrist (34.1%), lumbar (31.7%), knee (29.3%),
neck (26.8%), shoulder (19.5%), and back (17%). A significant relation was seen between
the symptoms of the wrist and hand. This was more common among occupational therapists.
The results also showed that the disorders in occupational therapists affected all the limbs,
except the neck. In addition, the females were more susceptible to the disorders compared to
the males.
Discussion: This study confirmed the rate of prevalence of work-related musculoskeletal
disorders and injuries in occupational and physical therapists, with wrist and lumbar being the
most affected. The promotion of therapist’s knowledge about MSD and following ergonomic
principles and new approaches in the treatment may lower or prevent MSD.

Aim: To compare the efficacy of Kaltenborn versus mulligan mobilisation in frozen shoulder. Objective: To assess and compare the efficacy of Kaltenborn versus mulligan mobilisation in frozen shoulder Methodology: A total of 40 subjects were recruited into this study. The subjects were divided randomly into two equal groups. Group A was given Kaltenborn mobilisation and Group B was given Mulligan mobilisation. The patients were informed about the procedure and a written informed consent was obtained from all the participants willing to be a part of this study. The baseline data of ROM of all movements of shoulder was obtained using universal goniometer, pain and disability data was obtained using SPADI. Statistics & Results: Data was collected on a data sheet & encoded for computerized analysis using SPSS version 22 for Windows. The statistical analysis of post values of Group A (Kaltenborn mobilization) when compared with the post values of Group B (Mulligan mobilization) VAS (p value <0.001), ROM with shoulder flexion (p value <0.0057), shoulder abduction (p value <0.0001), external rotation (p value <0.0065), internal rotation (p value <0.0075), SPADI (p value <0.0309) showed statistical significance. Thus Mulligan mobilization showed more improvement as compared to Kaltenborn mobilisation. Conclusions: Mulligan mobilization is more effective in improving VAS (Pain), ROM of shoulder and Shoulder pain and disability index (SPADI) than Kaltenborn mobilization.

Abstract
Despite the introduction of numerous additional tests, such as magnetic resonance or computed tomography, functional tests are a significant facilitation in the assessment of functional disorders. Their good knowledge along with the correct implementation is invaluable for making the right diagnosis. Clinical tests also play a huge role in the differentiation of root diseases, which increases the accuracy of the treatment.

Mimo wprowadzenia licznych badań dodatkowych, takich jak rezonans magnetyczny czy tomografia komputerowa, testy czynnościowe stanowią znaczne ułatwienie w procesie oceny zaburzeń funkcjonalnych. Ich dobra znajomość wraz z prawidłowym wykonaniem jest bezcenna dla postawienia odpowiedniej diagnozy. Testy kliniczne odgrywają także ogromną rolę w różnicowaniu dolegliwości korzeniowych, co zwiększa trafność stosowanego leczenia.

Background: Osteoarthritis (OA) is a degenerative joint disease and one of the major health problems that cause functional impairment and reduced quality of life. There is osteophyte formation remodeling of subarticular bone, ligamentous laxity, and syno­vial inflammation weakening of periarticular muscles. These changes may occur as a result of an imbalance in the equilibrium between the break down and repair of joint tissue. Hamstring tightness and quadriceps weakness are the major problems in osteoarthritis individuals. Tightness of hamstring muscle and quadriceps weakness can cause pain in patients with osteoarthritis. Stretching of hamstring and strengthening of quadriceps muscle can improve the pain and strength of the muscles around the knee joint. Retro walking can help in strengthening of the quadriceps muscles.
Methods: It was a Quasi experimental study with comparison between 2 groups consisting 30 participants (males and females) 15 in each group, with osteoarthritis. Group A received Hamstring stretch and quadriceps strengthening exercises and Group B received Retro walking, for 9 sessions, 3 days/week for a period of 3 weeks. Outcome measure was WOMAC and NRS measured before and after intervention.
Results: The results suggest that participants in Group B had significant improvement in NRS and WOMAC than Group A.
Conclusions: Both group A and group B showed significant results and displayed efficient improvement in decreasing pain and functional disability in patients with knee osteoarthritis.

Diagnostic tests help in a diversified way the different structures that build the knee, taking into account the area in which the patient complains of pain, and also take into account the functionality of these structures. They can be divided into three groups: patellar tests, meniscal tests and others, which aim to determine the type of instability and damage to a particular ligament. In addition to tests that refer to individual structures forming the knee (ligaments, muscles, bones), this article describes ways to assess exudate in the joint, which very often accompanies damage. The multitude of tests and their diversity give us the opportunity to accurately diagnose ailments, as well as to monitor the progress of the rehabilitation process.

Key words: clinical tests, knee brace, knee injuries

Testy diagnostyczne pomagają w pro-sty sposób zróżnicować poszczególne struktury budujące kolano, biorąc pod uwagę okolice, w której pacjent zgłasza dolegliwości bólowe, a także uwzględ-niają funkcjonalność tych struktur. Można je podzielić na trzy grupy: testy dotyczące rzepki, testy łąkotkowe oraz inne, których celem jest określenie rodzaju niestabilności oraz uszkodzenia konkretnego więzadła. Oprócz testów, które odnoszą się do poszczególnych struktur tworzących kolano (więzadła, mięśnie, kości), w niniejszym artykule zostały opisane sposoby oceny wysięku w stawie, który bardzo często towarzy-szy uszkodzeniu. Mnogość testów oraz ich różnorodność dają nam możliwość trafnego zdiagnozowania dolegliwości, a także monitorowania postępu procesu rehabilitacji.

Słowa kluczowe: testy kliniczne, więza-dło kolanowe, uszkodzenia kolana

Critical Physiotherapy strives to challenge and improve contemporary physiotherapy theory and practice through the exploration of views that deviate from conventional thought and practice (Gibson & Teachman 2012, Nicholls et al. 2016). It does so by examining its position on abnormality, deviance, and difference to recognize and address power asymmetries inherent in physiotherapy practice, particularly where they marginalize some groups at the expense of others (Pillay & Kathard 2015, Setchell et al. 2016). While there are variants of critical approaches, they share a common belief that medicine and physiotherapy are overly concerned with biological processes, leading to the exclusion of the moral, social, political, and cultural mediators of health and wellbeing (Nicholls & Gibson 2010, Setchell et al 2014). In this interactive symposium, we will begin with an introduction by David Nicholls to the basic tenets of critical approaches as a method of inquiry and how they can be used to interrogate any area of practice to inform and reimagine an “otherwise” physiotherapy. Each speaker will then explore an applied example of a critical approach and the implications for physiotherapy. Barbara Gibson will discuss research with parents and children that examined key ideas about disability and normality in children's physiotherapy and the consequences for young people labelled as disabled. Mershen Pillay will explore how teaching critical approaches can assist future and current rehabilitation professionals' to recognize how their practices reflect colonial origins; and how - globally - professional transformation must attend to decolonization. Jenny Setchell will draw on her research (Setchell et al. 2016) exploring (often unintentional and unrecognized) discrimination and stigma in physiotherapy. She will demonstrate how critical understandings help to highlight nuances of physiotherapy that make stigmatization and marginalisation possible in the profession. Viviana Silva Guerrero will focus on the growing influence of neoliberalism (Homedes & Ugalde 2005) on healthcare and physiotherapy. Drawing on her experience of recent changes in Colombia, she will explore how social and political forces affect professional practices and policy. An interactive session with the audience will follow. This will include facilitated opportunities for the audience members to discuss and reflect on their own experiences in physiotherapy from a critical perspective. There will also be opportunities to ask questions of the speakers. The session will conclude with summary remarks from the Chair.

Objective: To find the effect of physiotherapy in recurrent dislocation of patella-Wiberg Type II Design: A case report. Setting: Physiotherapy department at Almedica Clinic & Physiocare, Kolkata, India Subject: A young girl aged 10 years experienced patella dislocation causing severe pain during school sports with similar episodes experienced during the following weeks. The patella would move back into position with gentle pressure application. Intervention: A physiotherapy programme of 15 sessions of electrotherapy and exercises was planned which consisted of faradic stimulation of the quadriceps, followed by supervised exercises of the knee. Home exercises, which were similar to the supervised exercises, were advised to be done twice, daily. Outcome measures: Lysholm knee score, Norwich Patellar Instability (NPI) score, Knee extensor strength. Result: The apprehension in activity and frequency of dislocation of the patella had reduced by the 15th session of physiotherapy with significant improvement in strength of knee extensors. Home exercises were continued regularly and at six months of follow up the patient had reported no episodes of dislocation following the treatment sessions. Conclusion: Recurrent dislocation of patella-Wiberg Type II, can be controlled by physiotherapy which includes a course of faradic stimulation to quadriceps and regular strengthening exercises of the knee extensors.

ABSTRACT
Introduction: Respiratory physiotherapy includes rehabilitation techniques such as percussions, vibrations, postural drainage, autogenic drainage, ETGOL, Huffing & Puffing. The treatment protocol is used in patients with pulmonary disease, intensive therapy, cardiopathy, neurological diseases and damage to the locomotor apparatus, which change the rhythm and the respiratory balance.
Objective: The main objective of the study is to identify the effects of respiratory physiotherapy in patients with pneumological problems in enhancing vital capacity and improving the patient's overall condition.
Methodology: The study is a prospective, experimental type, realised over a six-month period from January to June 2017 at the Vlora Regional Hospital and Fizio Life Clinic with 40 patients in the pneumology and pediatric ward. Treated diseases include bronchial asthma, bronchitis and pneumonia. The rehabilitation protocol used is the postural and autogenic drainage techniques 2 times a day for 20 minutes; and 30 minutes Huffing & Puffing for children. The measurement is used with spirometry for vital capacity and BORG scale for dispnea.
Results: Of the patients studied, the most affected are children 50% of the cases, and the highest prevalence is in males with 60% of cases. After physiotherapy, respiratory frequency normalization, increased vital capacity, and reduction of hospital stay were observed.
Conclusions: Postural and autogenic drainage regulate the respiratory cycle, improve ventilation, aspirate secretions, and normalize the general condition of the patient. Huffing & Puffing techniques are ideal in treating pediatric patients with pulmonary problems.
Keywords: respiratory physiotherapy, postural drainage, pneumology

Introduction: The assessment of the health-care system by its beneficiaries is based on evaluation of the public perception in regards to the performance of healthcare workers, the functioning of the health system, the effectiveness of health policy measures, and a number of other components. The aim of this study was to determine patients' trust in the work of physiotherapists and the health-care system; determine the quality of communication between the patient and the physiotherapist; and determine the quality of cooperation between healthcare workers in the provision of health services. Methods: The study is descriptive, conducted in five cities: Banja Luka, Bihać, Herceg Novi, Nikšić, and Podujevo. The confidence in health-care questionnaire developed by Calnan and Sanford (2004) was used as a research instrument, containing six areas of research: Attitude toward the patient, Health policy and patient care, Professionalism and expertise, Quality of health care, Communication and information, and Quality of cooperation. Results: The mean age of the subjects was 41 years, 24 females and 26 males. Subjects expressed the greatest satisfaction on subscales I-Attitude toward the patient (27.44 ± 3.59 out of 30) and IV-Quality of health care (36.60 ± 4.19 out of 40), which represents 91.5% of the possible maximum. This is followed by subscale V-Communication and information (20.8 ± 3.17 out of 25) corresponding to 83.2% of the possible maximum, followed by subscale III-Professionalism and expertise (15.68 ± 3.29 out of 20) which represents 78.4% of the possible maximum. Subjects showed the least satisfaction on subscales II-Health policy and patient care (16.94 ± 5.56 out of 25), which represents 67.8% of the possible maximum, and subscales VI-Quality of cooperation (9.94 ± 0.42 out of 15) which corresponds to 66.3% of the possible maximum. Conclusions: The research showed a high degree of satisfaction of subjects in various fields, which indicates a high degree of confidence in the work of physiotherapists and the health-care system. Research on a larger sample in needed for creation and implementation of the guidelines in the strategic documents of the countries in the region and for improvement of health policies and patient care.

Objective: To find the effect of physiotherapy on Pain, Range of Motion, Grip strength and Function of hand in case of distal radius fracture with Volkmann's Ischemic Contracture, Grade II Seddon Classification. Design: A case report. Setting: Physiotherapy department at Almedica Clinic, Kolkata, India Subject: A female aged 43yrs had right distal radius fracture following road traffic accident and later developed Volkmann's Ischemic Contracture, Grade II, presented with pain, weakness and contracture of the right hand. Intervention: A 6 weeks schedule of physiotherapy containing wax bath, passive movement, stretching and strengthening exercises of the hand (1) to decrease pain (2) to increase ROM and (3) to increase grip strength thus improving function of the hand. Outcome measures: Pain, Range Of Motion, Grip strength and Function of the affected hand. Result: There was significant decrease of pain following two weeks of treatment with moderate improvement in range of motion and grip strength at the end of six weeks of treatment, thus improving functional status of the hand. Conclusion: Significant improvement of the function of the hand was seen in this case following physiotherapy. Further study is required to establish generalisation.

Abstract
Introduction: Scoliosis is a three-dimensional deformative abnormality of the spine, defined by the Cobb's angle of spine curvature in the coronal plane, and is often accompanied by vertebral rotation in the transverse plane and hypokyphosis in the sagittal plane. Based on the age of presentation, scoliosis is further categorized as infantile, juvenile or adolescent idiopathic. Adolescent idiopathic scoliosis (AIS) has the highest prevalence of the three categories. This type of scoliosis is present at age ten and lasts till the end of growth. Its prevalence is dependent on the curvature of the spine and gender of the patient. Objective: The purpose of this review is to evaluate the role of physiotherapy in reducing curve progression and pain, postponing or avoiding invasive treatment and improve the quality of life in adolescents with AIS. Methodology: The study is a Systematic Review, meta-analytic type, consisting of 5 studies (RCT) of the last ten years, which focus on the impact of physiotherapy in AIS. Studies include 210 patients evaluated and treated by physiotherapist, divided into 2 groups: experimental and control group. The measurement and rehabilitation includes Cobb angle, pain and quality of life. Data was extracted from medical websites and scientific journals. The evaluation was realized with the PEDro scale, which shows the validity of each study. Results: The literature used in the study claimed that physiotherapist in AIS reduces pain and Cobb angle and improve QoL (p<0.05). The 5 studies had an average PEDro score of 5.6/10. Conclusions: Evidence suggests that physiotherapy is good at reducing the Cobb angle, pain and improving the quality of life in patients with AIS. Scientific research on this topic is limited, so it is suggested to increase research, especially now that AIS incidence is higher.

Background and Purpose: Plantar fasciitis is most common cause for plantar foot pain and affects both male and female. Previous studies have reported that MTrP release along with stretching of the calf muscle and the plantar fascia are effective management strategies for plantar heel pain. This study was designed to evaluate the effect of two different techniques i.e. Muscle Energy Technique (MET) and Myofascial Trigger Point (MTrP) release in subjects with chronic plantar fasciitis. Methods: 45 subjects of chronic plantar fasciitis were included and randomly assigned in to three different groups. Group-A received 12 sessions of MET along with self stretching, Group-B received 12 sessions of MTrP release along with self stretching and Group-C received 12 sessions of self stretching program for 4 weeks. Self stretching of calf and plantar fascia were given as supervised, as well as home exercise program for all three groups. Outcome measures: Pain intensity was measured by VAS; Tenderness was assessed by PPT at MTrP of calf (PPT-Calf) and at medial calcaneal tubercle of heel (PPT-Heel) and functional status was evaluated by FFI scale at base line and at the end of fourth week. Result: Statistically significant improvement (p<0.05) was noticed in all the three groups for all the outcomes. In between group comparison all the outcomes showed statistically significant changes except FFI score in favor of Group-B than Group-A and Group-C. Conclusion: The present study showed that MTrP release is more effective than MET in alleviation of pain & tenderness in subjects with chronic plantar fasciitis.

The main aim of this review article is to identify the evidence-based diagnosis and physiotherapy management of musculoskeletal disorder of cervical spine. Neck pain from cervical spine disorders is the most common cause of musculoskeletal disorders. Neck pain can exist alone or with the presence of upper-extremity symptoms.

Various questionnaires have been described which evaluate the quality of life in patients undergoing cancer treatment, but most were originally developed in English and have not been adequately validated for other languages. To evaluate the process of translation and cross-cultural adaptation and the measurement properties of the Functional Assessment of Cancer Therapy-Bone Marrow Transplantation (FACT-BMT) questionnaire, a systematic review was conducted with two independent evaluators. The search for articles was carried out in four databases: MEDLINE, EMBASE, CINAHL and SCIELO, using the terms "questionnaire", "quality of life", "oncology", and "valid" and their descriptors according to MeSH and DeCs. The searches yielded 6,877 studies, of which only three performed the stages of translation, cross-cultural adaptation, and evaluation of the measurement properties of the FACT-BMT questionnaire. The instruments in Arabic, Chinese, Korean and Portuguese showed and presented good methodological quality, but none of the four studies followed all the validation criteria for the questionnaire. The adapted versions of the FACT-BMT have methodological weaknesses in their process of translation and cross-cultural adaptation and evaluation of measurement properties, therefore the questionnaires possibly being used inadequately in other languages.

Introduction: Competitive swimming is a rigorous sport being engaged in by an increasing number of young athletes. In swimmers, shoulder pain and neck pain is the most common musculoskeletal complaint and is usually due to Supraspinatus, biceps tendinitis, scapular muscles. Scapular position on the thorax and control during motion is a critical component of normal shoulder function. During elevation of the arm overhead, scapula should upwardly rotate and posterior tilt on the thorax. Upward rotation is the predominant Scapulothoracic motion. Methodology: A total number of 120 subjects (including male and female) who fulfilled the inclusion criteria were included in the study. 120 Swimming Athletes were taken from a government affiliated swimming pool complex, and from a reputed school of Delhi. Two groups were included in the study; Study group-with neck pain and Control group-without neck pain. Scapular protraction measurements were taken with the participant standing with normal, relaxed posture. The measurements were performed at 3 different positions (at rest, hands on hip, 90 degree glenohumeral abduction). Statistical test: Independent t test was used to compare the mean in terms of distance of right and left side in study and control group, also test was used to compare the mean difference of scapular position at three different positions between study and control group Result: The result shows there is significant difference of scapular position among study and control group in all three positions. Conclusion: In the present study, it was seen that scapular position is altered in swimmers who are suffering from neck pain in all three positions that is at rest, hands on hip, and 90 degree abduction.