Objective: The aim of this study was to assess at 6-month and 1-year follow-up the effect of graded motor imagery (GMI) in addition to usual care on the affective and clinical outcomes in patients with chronic shoulder pain. Methods: A pre-post-intervention single-group study was conducted. One hundred forty-eight patients with chronic shoulder pain were included. All participants received a 6-week GMI program in addition to usual care. The primary outcome assessed was pain intensity using visual analog scale (VAS), the secondary outcomes were fear of movement with the Tampa Scale of Kinesiophobia (TSK), catastrophization with the pain catastrophization scale (PCS), shoulder flexion active range of motion (AROM) with a goniometer, and central sensitization with the central sensitization inventory (CSI). All outcomes were assessed at baseline and 6-month and 1-year follow-up. Results: At 6 months, GMI showed to be statistically significant for all outcomes assessed (p < 0.001). At 1-year follow-up, the VAS showed a decrease of 3.3 cm (p < 0.001), TSK showed a decrease of 16.1 points (p < 0.001), PCS showed a decrease of 17.4 points (p < 0.001), AROM showed an increase of 29.9° (p < 0.001), and CSI showed a decrease of 17.9 (p < 0.001). Conclusions: At medium- and long-term follow-up, the individuals who received the GMI program in addition to usual care showed a clinically and statistically significant change for all outcomes assessed. Further studies, including clinical trials, are needed to confirm our findings.
Background: Handheld dynamometers provide an accurate measurement of muscle strength and have been shown to have good interrater reliability. The proximal stabilization and fulcrum are two methods of manual muscle testing; however, there is uncertainty about which method may be better for obtaining muscle strength measures. Objective: The purposes were to determine if there was a difference in hamstring strength and to determine the interrater reliability of DPT students using a handheld dynamometer when comparing the proximal stabilization and the fulcrum methods. Methods: A descriptive-comparative research study that examined two methods of manual muscle testing with the use of a Microfet 2 MMT-Wireless digital handheld dynamometer. In prone, each participant was instructed to bend their knee to 90° of knee flexion, where the handheld dynamometer was placed on the lower leg for 5 s. Each technique was performed three times, and an average of the series was calculated. Results: Twenty-nine participants volunteered for this study. The mean scores for Raters 1 and 2 between hamstring testing using the proximal stabilization and fulcrum methods were, respectively, t(28) = -2.041, p = 0.051, and t(28) = -1.990, p = 0.056. The interrater reliability showed good reliability between Rater 1 and Rater 2 for hamstring testing for the proximal stabilization method and fulcrum methods, respectively, ICC = 0.742 (95% CI: 0.452, 0.879), p ≤ 0.001, and ICC = 0.752 (95% CI: 0.472, 0.884), p ≤ 0.001. Conclusion: There are no statistically significant differences between the uses of these two methods in healthy adults; however, there is good interrater reliability of DPT students.
Socioeconomic status (SES) tends to influence an individual’s access to health care. It is commonly assumed that a poorer SES is associated with a weaker physical health status, especially in disadvantaged populations such as people with cerebral palsy (CP). However, to our knowledge, no study has looked at this assumption. Therefore, the aim of this study was to describe and compare the physical health status of ambulant adults with bilateral CP with different SES backgrounds. In addition, the physical health status of the ambulatory adults with CP was compared to well-matched, typically developing adults. Twenty-eight ambulatory adults with CP (gross motor functional classification system Level I/II/III: n=11/12/5; SES low/middle/high: n=10/9/9), and 28 matched typically developing adults were recruited for this study. No differences were observed between adults with CP from different SES backgrounds. Differences in physical health status between typically developing adults and ambulatory adults with CP in all SES backgrounds were found in passive range of motion (p<0.05), muscle strength (p<0.001), selectivity (p<0.001), and muscle tone (p<0.001) and balance (p<0.05). The main finding of this study is that physical health status did not differ between ambulatory adults with CP from different SES backgrounds. This finding shows that SES does not always directly impact physical health status in ambulatory adults with CP and highlights the importance of an individual approach. Future research should determine the impact of SES on nonambulatory adults with CP.
Purpose: To compare physiological responses during a treadmill cardiopulmonary exercise test (CPX), 6-minute walk test (6MWT), and timed up and go test (TUGT) in individuals referred for unexplained breathlessness and symptom limited treadmill exercise testing. Methods: Heart rate (HR), oxygen consumption (VO2), carbon dioxide production (VCO2), respiratory exchange ratio (RER), minute ventilation (VE), systolic blood pressure (SBP), and rating of perceived exertion (RPE) were recorded throughout each test. Results: Each test demonstrated a significant increase (p<0.01) in the cardiopulmonary (VO2, VCO2 and VE, RPE, SBP, and HR) and perceptual (RPE) responses from rest to end exercise. The increase in cardiopulmonary and perceptual responses was greatest for the CPX with significantly smaller responses demonstrated during the 6MWT (p<0.01) and even smaller responses for the TUGT (p<0.01 vs CPX and 6MWT). Conclusion: Not surprisingly, the treadmill CPX results is the greatest physiological response in our group. Despite being of short duration, the TUGT results in an increased physiological response.
Virtual reality (VR) has significantly expanded the possibilities of medical treatment, particularly in the realm of rehabilitation. VR utilizes advanced technologies to create simulated environments that users perceive as analogous to the real world. Researchers have demonstrated that VR can effectively train motor, sensory, and cognitive functions. This manuscript offers a concise review of recent evidence concerning the effects of VR training on key clinical symptoms in people with multiple sclerosis (pwMS), with the aim of highlighting VR’s potential as a complementary rehabilitative tool for improving ubiquitous symptoms of multiple sclerosis (MS)—a neurodegenerative, often disabling, disease. In addition to presenting a brief overview of recent literature on VR for pwMS, this narrative review seeks to provide health professionals with a foundational understanding of VR as a rehabilitative tool in MS. Furthermore, it may aid in identifying gaps in the literature and stimulate the development of new hypotheses and theories regarding the use of VR in patients with a neurodegenerative disease.
