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Margarita D. Tsiros, Emily J. Ward, Sophie Lefmann and Susan Hillier

service for children with possible motor skill difficulties. Hence, the aim of this study was to describe the physiotherapy in preschools (PIPS) program and undertake an initial evaluation to see if the program was a feasible and sustainable option to assist children with possible motor skill difficulties

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Andy Marshall, Maggie Donovan-Hall and Steve Ryall

Objective:

To explore athletes’ perceptions of the factors that they feel may affect their adherence to a physiotherapy intervention.

Design:

A qualitative design using semistructured interviews.

Setting:

Participants were interviewed at home or their athletic club.

Participants:

8 participants, 5 men and 3 women with a mean age of 30.4 y.

Results:

Thematic analysis revealed 2 main categories of themes. The first relates to the athlete’s perceptions of factors affecting his or her own adherence, with themes including the impact of injury, justification of adherence, and strategies used by the patient. The second relates to perceptions of the physiotherapist’s impact on adherence, with themes relating to characteristics of and strategies used by the physiotherapist.

Conclusions:

Findings demonstrate the importance of exploring patients’ perceptions of adherence. A number of factors that affect adherence are identified, and strategies that may enhance adherence suggested.

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Daniel L. Borges, Mayara Gabrielle Silva, Luan Nascimento Silva, João Vyctor Fortes, Erika Thalita Costa, Rebeca Pessoa Assunção, Carlos Magno Lima, Vinícius José da Silva Nina, Mário Bernardo-Filho and Danúbia Sá Caputo

Background:

Physical activity is beneficial in several clinical situations and recommended for patients with ischemic heart disease, as well as for those undergoing cardiac surgery.

Methods:

In a randomized controlled trial, 34 patients underwent coronary artery bypass grafting. A randomized control group (n = 15) submitted to conventional physiotherapy. The intervention group (n = 19) received the same protocol plus additional aerobic exercise with cycle ergometer. Pulmonary function by spirometry, respiratory muscle strength by manovacuometry, and functional capacity through 6-minute walking test was assessed before surgery and at hospital discharge.

Results:

There was significant reduction in pulmonary function in both groups. In both groups, inspiratory muscle strength was maintained while expiratory muscle strength significantly decreased. Functional capacity was maintained in the intervention group (364.5 [324.5 to 428] vs. 348 [300.7 to 413.7] meters, P = .06), but it decreased significantly in control group patients (320 [288.5 to 393.0] vs. 292 [237.0 to 336.0] meters, P = .01). A significant difference in functional capacity was also found in intergroup analyses at hospital discharge (P = .03).

Conclusion:

Aerobic exercise applied early on coronary artery bypass grafting patients may promote maintenance of functional capacity, with no impact on pulmonary function and respiratory muscle strength when compared with conventional physiotherapy.

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Noureddin Nakhostin Ansari, Soofia Naghdi, Hadi Karimi-Zarchi, Zahra Fakhari and Scott Hasson

Context:

Whole-body vibration (WBV) is a type of weight-bearing exercise used in the field of sport and rehabilitation. There is no study on the effects of WBV on muscle recovery after a fatiguing activity.

Objective:

To determine the effects of a single WBV session on lower-extremity fatigue.

Design:

Randomized controlled pilot study.

Setting:

University Physiotherapy Clinic.

Subjects:

A total of 13 healthy young men volunteered to participate in this study. Subjects were randomly assigned into the WBV group (n = 7, mean age: 21 y) or control group (CG; n = 6, mean age: 20 y).

Intervention:

Subjects in the WBV group participated in a single-session WBV (30 Hz, amplitude 4 mm, 2 min) after lower-extremity fatigue.

Main Outcome Measures:

Peak force of quadriceps muscle, single leg hop test, and Y-test were measured before inducing muscle fatigue (T0), immediately after completing the fatigue protocol (T1), after WBV (T2), and 15 min following the application of WBV (T3). The same method was applied in the CG while the WBV machine was turned off.

Results:

Repeated-measure ANOVA revealed no significant differences between groups in any of the outcomes.

Conclusions:

The findings indicated that WBV was not effective in the recovery of lower-extremity fatigue in healthy young men.

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Andrea Kay Bailey, Claire Minshull, James Richardson and Nigel P. Gleeson

Context:

Autologous chondrocyte implantation (ACI) aims to restore hyaline cartilage. Traditionally, ACI rehabilitation is prescribed in a concurrent (CON) format. However, it is well known from studies in asymptomatic populations that CON training produces an interference effect that can attenuate strength gains. Strength is integral to joint function, so adopting a nonconcurrent (N-CON) approach to ACI rehabilitation might improve outcomes.

Objective:

To assess changes in function and neuromuscular performance during 48 wk of CON and N-CON physical rehabilitation after ACI to the knee.

Setting:

Orthopedic Hospital NHS Foundation Trust.

Design:

Randomized control, pilot study.

Participants:

11 patients (9 male, 2 female; age 32.3 ± 6.6 y; body mass 79.3 ±10.4 kg; time from injury to surgery 7.1 ± 4.9 mo [mean ± SD]) randomly allocated to N-CON:CON (2:1).

Interventions:

Standardized CON and N-CON physiotherapy that involved separation of strength and cardiovascular-endurance conditioning.

Main Outcome Measures:

Function in the single-leg-hop test, patient-reported outcomes (Knee injury and Osteoarthritis Outcome Score [KOOS], International Knee Documentation Committee subjective questionnaire [IKDC]), and neuromuscular outcomes of peak force (PF), rate of force development (RFD), electromechanical delay (EMD), and sensorimotor performance (force error [FE]) of the knee extensors and flexors of the injured and noninjured legs, measured presurgery and at 6, 12, 24, and 48 wk postsurgery.

Results:

Factorial ANOVAs with repeated measures of group by leg and by test occasion revealed significantly superior improvements for KOOS, IKDC, PF, EMD, and FE associated with N-CON vs CON rehabilitation (F 1.5, 13.4 GG = 3.7−4.7, P < .05). These results confirm increased peak effectiveness of N-CON rehabilitation (~4.5−13.3% better than CON over 48 wk of rehabilitation). N-CON and CON showed similar patterns of improvement for single-leg-hop test and RFD.

Conclusions:

Nonconcurrent strength and cardiovascular-endurance conditioning during 48 wk of rehabilitation after ACI surgery elicited significantly greater improvements to functional and neuromuscular outcomes than did contemporary concurrent rehabilitation.

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Amanda L. Ager, Dorien Borms, Magali Bernaert, Vicky Brusselle, Mazarine Claessens, Jean-Sébastien Roy and Ann Cools

cord injuries, nerve, or plexus injuries) Connective tissue disorders (Ehlers–Danlos syndrome and Marfan syndrome) Systematic disorders (diabetes, lupus, fibromyalgia, rheumatoid arthritis, and chronic fatigue syndrome) Healthy population Intervention Physiotherapy/conservative rehabilitation

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Natalia Romero-Franco, Juan Antonio Montaño-Munuera, Juan Carlos Fernández-Domínguez and Pedro Jiménez-Reyes

-analysis . Physiotherapy . 2014 ; 100 ( 3 ): 187 – 195 . PubMed ID: 24690442 doi:10.1016/j.physio.2013.11.002 10.1016/j.physio.2013.11.002 24690442 5. Romero-Franco N , Martnez-López EJ , Hita-Contreras F , Lomas-Vega R , Martnez-Amat A . Short-term effects of anaerobic lactic exercise on knee

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Andrea Bailey, Nicola Goodstone, Sharon Roberts, Jane Hughes, Simon Roberts, Louw van Niekerk, James Richardson and Dai Rees

Objective:

To develop a postoperative rehabilitation protocol for patients receiving autologous-chondrocyte implantation (ACI) to repair articular-cartilage defects of the knee.

Data Sources:

careful review of both basic science and clinical literature, personal communication with colleagues dealing with similar cases, and the authors’ experience and expertise in rehabilitating numerous patients with knee pathologies, injuries, and trauma.

Data Synthesis:

Postoperative rehabilitation of the ACI patient plays a critical role in the outcome of the procedure. The goals are to improve function and reduce discomfort by focusing on 3 key elements: weight bearing, range of motion, and strengthening.

Conclusions:

The authors present 2 flexible postoperative protocols to rehabilitate patients after an ACI procedure to the knee.

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Murat Tomruk, Melda Soysal Tomruk, Emrullah Alkan and Nihal Gelecek

Context: Ankle proprioception is one of the crucial components contributing to postural control. Although the effects of Mulligan’s mobilization with movement (MWM) on postural control, ankle dorsiflexion range of motion (DFROM), and muscle strength in people with ankle disorders have previously been investigated, it is still unclear whether ankle MWM had ability to change postural control, DFROM, and muscle strength. Objectives: To reveal pure effects of MWM on postural control, ankle DFROM, and muscle strength in healthy individuals. Design: A prospective, randomized, double-blinded, sham-controlled study. Setting: Musculoskeletal laboratory, Dokuz Eylul University, Turkey. Participants: Forty students in good health recruited from a local university. Interventions: Mulligan’s MWM or sham application over ankle joint. Main Outcome Measures: The primary outcome was postural control and measured using limits of stability (LOS) test. The secondary outcomes were tibialis anterior muscle strength and ankle DFROM, which were measured using handheld dynamometer and weight-bearing lunge test, respectively. All outcomes were assessed before and immediately after intervention. Results: Left and right ankle DFROM and LOS overall score showed a statistically significant improvement compared with first measurement in both groups (P < .05). However, LOS time was significantly improved only in the MWM group (P < .05). Statistical analyses of between-group mean differences showed that Mulligan’s MWM provided significant improvement in the LOS in forward–right direction compared with sham application (P = .03). Conclusions: The results of this study suggest that the application of Mulligan’s MWM on ankle joint might be beneficial to improve postural control in forward right direction in individuals with healthy ankles. On the other hand, both MWM and sham application were able to increase overall postural control and DFROM, and MWM had no superiority over sham application for increasing these 2 variables.

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Myles Murphy, Marshall Stockden, Ken Withers, William Breidahl and Jonathon Charlesworth

Introduction: Anterior shoulder dislocation is a common injury in many sports, resulting in extended time lost from play with an extremely high recurrence rate in young athletes playing a high-risk sport. Latarjet shoulder reconstruction is a common surgical procedure used to prevent subsequent dislocation with an expected rehabilitation time frame of between 4 and 6 months before return to play. Case Description: A 21-year-old male Australian football player experienced 2 left-sided shoulder dislocations before undergoing a left Latarjet shoulder reconstruction. He was assessed clinically and with magnetic resonance imaging, which revealed significant tearing of the anterior labrum. The authors theorized that maximal glenohumeral stability occurs after bony healing of the coracoid onto the glenoid at 6 weeks. The patient then underwent an 8-week structured and graduated rehabilitation program aimed at preventing loss of shoulder range of motion, muscle, and functional capacity and returned to play at 8 weeks postinjury with no complications or recurrence at 12-month follow-up. Discussion: This is the first time an 8-week rehabilitation following Latarjet shoulder reconstruction has been reported. In athletes with anterior glenohumeral dislocation who require accelerated return to play, a Latarjet reconstruction with an 8-week rehabilitation protocol may be considered.