• 제목/요약/키워드: Evidence- based physical therapy

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A Systematic Review on the Management of Cortical Visual Impairment

  • Myunghwa Oh;Hyunjoong Kim
    • Physical Therapy Rehabilitation Science
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    • 제13권2호
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    • pp.196-204
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    • 2024
  • Objective: Cortical Visual Impairment (CVI) is a leading cause of pediatric blindness and the most common form of pediatric visual disability, particularly prevalent among children with cerebral palsy (CP). This systematic review synthesizes the latest research on various interventions for managing CVI, focusing on studies published in the last decade. Design: A systematic review Methods: A comprehensive search was conducted in March 2024 across several databases including MEDLINE, CINAHL, Embase, and Web of Science. Studies were selected based on inclusion criteria set under the PICOSD framework and were limited to those involving human subjects, published in English, and conducted within the past ten years. The selected studies included randomized controlled trials, observational studies, and case reports focusing on rehabilitation, therapy, and surgical interventions for CVI. Results: Out of 221 studies screened, 5 met the inclusion criteria and were reviewed in detail. These studies covered a range of interventions including physiotherapy, sensory integration training, visual training programs, neuromotor rehabilitation, and surgical procedures aimed at improving visual function and overall quality of life for CVI patients. Conclusions: The studies demonstrate the potential benefits of structured, early intervention programs that incorporate family involvement and are tailored to the unique needs of children with CVI. However, there remains a significant need for further research to establish evidence-based practices in this field.

Core Stabilization With the Lumbar Extension Exercise in Low Back Pain

  • Noh, Dong-koog;Cha, Young-joo;Kim, Dae-hun;You, Joshua (Sung) H.
    • 한국전문물리치료학회지
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    • 제25권4호
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    • pp.27-36
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    • 2018
  • Background: We developed a novel integrative lumbar stabilization technique that combines lumbar extension (LE) exercise with abdominal drawing-in maneuver (ADIM) to ameliorate low back pain (LBP) associated with neuromuscular imbalance and instability, based on the collective evidence of contemporary spinal rehabilitation. Objects: The specific aim of the present study was to investigate the effects of LE exercise with and without ADIM on core muscle strength, lumbar spinal instability, and pain, as well as functional characteristics in individuals with LBP using advanced radiographic imaging techniques. Methods: patients with mechanical LBP (N = 40, 6 males; $35.1{\pm}7.6years$) were recruited and randomly assigned either to the combined LE and ADIM (experimental group) or the LE alone (control group). Outcome measures included the visual analog scale, the modified Oswestry Disability Index, muscle strength imbalance (MSI), and radiographic imaging. The lumbar intervertebral displacement (LID), intervertebral (IV) and total lumbar extension (TLE) angles were calculated to evaluate the lumbar segmental instability. Results: The experimental group showed significant differences in the L3-L4, L5-S1 LIDs, L4-L5 and L5-S1 IV angles, and TLE angle as compared to the controls (p<.05). Immediate pain reduction and muscle strength imbalance ratio were significantly different between the groups (p<.05). Conclusion: These results suggest that the addition of ADIM significantly increased lumbar spinal stabilization in individuals with LBP, thereby reducing pain associated with functional lumbar flexion during daily activities.

Changes in upper limb muscle activity during smartphone usage while in stable and unstable positions and during gait

  • Kim, You Lim;Lee, Suk Min;Lee, Hyun-Soo;Song, Juyeong;Song, Si-On;Seol, Min-Ji;Jang, Yu-Mi;Im, Jin-Sik;Im, Ji-Woo
    • Physical Therapy Rehabilitation Science
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    • 제7권3호
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    • pp.119-126
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    • 2018
  • Objective: The objective of this study was to describe the influence of smartphone usage on the upper limb muscles while in stable and unstable positions and during gait. Design: Cross-sectional study. Methods: The study was conducted with 20 right-handed university students between 20 and 27 years of age. Experiments were carried out on students who have used cell phones for more than a year. In this study, experiments were performed with one-handed and two-handed smartphone operations while on stable ground, and the same parameters were measured during smartphone use on unstable ground and during gait. Subjects were instructed to write a text message in Korean on the smartphone for 3 minutes. This was repeated 3 times, with a rest period of 10 seconds given between each 3-minute period. Electromyography was used to record the muscle activity of the upper trapezius, extensor carpi radialis, extensor pollicis longus, and abductor pollicis (AP) during phone operation. Results: The muscle activity value for the right AP in one-handed and the left-AP in two-handed operations was statistically higher than the other muscles in the stable position and during gait (p<0.0001). Also, the right AP in the one- handed operation condition was statistically higher than the two-handed condition (p<0.0001). Conclusions: The use of smartphones while in a stable position resulted in high muscle activity of the right upper limb AP. However, in an unstable position, there were no significant differences from the other muscle activities. Using smartphone while assuming various positions may lead to musculoskeletal disorders in different places.

Analytical Approach to the Literature of Cupping Therapy

  • Koran, Serhat;Irban, Arzu
    • 대한물리의학회지
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    • 제16권3호
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    • pp.1-14
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    • 2021
  • PURPOSE: This study aims to reveal the prevalence, therapeutic efficacy and undesirable side effects of cupping therapy all over the world from past to present. METHODS: This meta-analysis is based on the data obtained by scanning the keyword "cupping therapy" from the Pub-Med system, which is an international database. The date range has been set as 1950-2019. Local databases were not included. Cupping therapy studies combined with other complementary therapies such as acupuncture, moxa and hirudotherapy are also included in the meta-analysis. RESULTS: A total of 381 scientific studies were found on cupping therapy. Of these studies 127 wererandomized controlled trials (RCSs). Cupping treatment has been found effective in studies of painful conditions such as herpes zoster pain, fibromyalgia, back pain, neck pain, headache and acute injury pain. In addition, the effectiveness of cupping therapy was found to be high in studies related to bone / muscular system diseases such as osteoarthritis, rheumatoid arthritis, ankylosing spondylitis, gout, carpal tunnel syndrome, cervical spondylosis. In addition, cupping treatment is also promising in studies on skin diseases, neurological diseases, respiratory system diseases and cardiovascular system diseases. CONCLUSION: Recently, there has been an increase in the number of RCSs related to cupping therapy. The vast majority of this increase has been made in European and American countries rather than in Far Eastern countries. Studies on cupping therapy, which have been and will be carried out in the future, will provide evidence-based indication of whether cupping therapy is effective. and it will allow more patients to benefit from this treatment, which has a very low rate of side effects and complications.

월 슬라이드와 슬링 슬라이드 운동이 어깨뼈 아래쪽 돌림 증후군의 어깨뼈 주변 근육의 활성도에 미치는 영향 (Effects on Muscle Activities around Scapula for Wall Slide and Sling Slide Exercises in Subjects with Scapular Downward Rotation syndrome)

  • 임진용;김병곤;서현규
    • 대한정형도수물리치료학회지
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    • 제22권1호
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    • pp.51-58
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    • 2016
  • Background: Evidence for effective management of scapular downward rotation syndrome is limited. The present study was performed to compare the scapular muscle activation through 4weeks wall slide exercise and sling slide exercise in subjects with scapular downward rotation syndrome. Methods: Twenty-two subjects with scapular downward rotation syndrome participated in the study. Surface electromyography data were collected from the upper and lower trapezius, serratus anterior and pectoralis major during shoulder flexion of $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ in the sagittal plane. The alignment of the scapula was measured using radiographic analysis. Subjects were assessed pre and post a 4 weeks exercise (wall slide, sling slide). The significance of the difference in pre- and post-exercise within each groups was assessed using a paired t-test. The significant difference between wall- and sling-exercise was used a independent t-test. Results: In the wall slide group, the muscle activity of upper trapezius decreased significantly during shoulder flexion at $60^{\circ}$, $90^{\circ}$ and $120^{\circ}$ after 4 weeks, and the muscle activity of serratus anterior increased significantly at all angles. Also, the muscle activity of pectoralis major decreased significantly at $90^{\circ}$ and $120^{\circ}$. Conclusions: Based on such results, it can be said that wall slide exercise is effective than sling slide exercise for the subjects with scapular downward rotation syndrome.

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The effects of virtual reality training on gait, balance, and upper extremity function in patients with stroke: A meta-analysis

  • Lee, Hyun soo;Kim, You Lim;Lee, Hae ji;Lee, Byounghee
    • 대한물리치료과학회지
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    • 제28권3호
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    • pp.11-29
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    • 2021
  • Background: The purpose of this study is to investigate the effects of virtual reality on gait, balance, and upper extremity functions compared to other independent variables or no variables. Additionally, the possibility of virtual reality for stroke patients was discussed. Design: Meta-analysis. Methods: The search for this study was a search term that combined stroke, virtual reality, and training, and the electronic search was conducted through EMBASE, MEDLINE, and Cochrane Library. As a result of the search, 21 studies satisfying the selection criteria of the target study were confirmed as the final analysis target. This study consisted of 21 randomized experimental studies and 21 randomized controlled trials, and the total number of participants was 642. [Experimental group (n=314), control group (n=328); total 642]. As a result of the study, upper extremity function was assessed using a box and block test, a modified Ashworth scale, and a scale including range of motion. The balance was evaluated by the berg balance scale. Gait was a Timed Up and Go test (TUG), stride length, and gait function. Scales including a walking rate scale were evaluated. The effect size for the intervention of the analytical study was meta-analyzed with the RevMan 5.3.3 program of the Cochrane library. Results: The results of the study showed that the function of walking was statistically significant. Balance showed statistically significant results. The upper extremity function showed no statistically significant results. Conclusion: Through this rehabilitation treatment by applying virtual reality environment to the rehabilitation of stroke patients in the future can be proposed as an effective intervention method for the balance and gait function of stroke patients.

Effects of Nature-Based Programs for Workers in Korea: A Systematic Review

  • Shin, Jong-Yeon;Shin, Won-Sop
    • 인간식물환경학회지
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    • 제23권2호
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    • pp.125-138
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    • 2020
  • The aim of this study was to review previous literature to determine the effects of nature-based program for workers. This systematic review was conducted in accordance with National Evidence-based Healthcare Collaborating Agency's guidance for undertaking systematic reviews for intervention. Literature search was performed using National Assembly Digital Library, Korean Studies Information Service System, and Korea Education & Research Information Service for literature published until March 2019. The participants were full-time workers, and intervention of nature-based programs was conducted in the outdoor, indoor, and indirect nature contact exposures, with comparators in the control group who did not receive the treatment. The results showed that the programs were effective in physical, psychological, and social health. The methodological quality of randomized controlled trials (RCT) was assessed using the Cochrane Risk of Bias(RoB) tool, while non-randomized controlled trials (N-RCT) were assessed using the Cochrane Risk of bias assessment tool for non-randomized studuies (RoBANS). A total of 16 studies were selected for assessment: two RCTs, 10 N-RCTs, and four one-group pretest-posttest designs. Most interventions were provided at the workplace and in the community. There were many kinds of nature-based interventions, and forest therapy and horticultural therapy programs were most common. Various interventions for workers effectively improved job stress, depression, serum cortisol and stress-response. However, the included studies lacked methodological rigor. Future research is needed to evaluate the long-term effectiveness of nature-based programs for workers using rigorous research designs.

선택적 기능 동작 평가의 연구 동향 분석 (Investigation of Research Trends in the Selective Functional Movement Assessment (SFMA))

  • 김재은;도광선
    • 대한통합의학회지
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    • 제9권2호
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    • pp.63-73
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    • 2021
  • Purpose : Selective functional movement assessment(SFMA) is a movement-based assessment tool designed for clinicians to diagnose and treat pain and functional physical problems. This concept is used for assistance in occupations related to movement, including clinical medical personnel, such as physical therapists, physical education instructors, and athlete coaches. Although this concept is widely used by clinicians, research and scientific proofs are relatively insufficient. This study aimed to review the literature on the understanding, reliability and effectiveness of SFMA, and to consider its role in the future of rehabilitation. Methods : In this review, a total of nine articles were selected according to the eligibility criteria of three major thesis topics. The main topics covered in the literature are reliability and effectiveness of clinical use of SFMA. To gather research articles, we searched official term 'Selective Functional Movement Assessment'. Among the searched 60 studies, nine were mentioned in this study that contained overlapping information and matched our desired topic. We reviewed four reliability analyses, four case reports, and one experimental study. Results : Reliability has an intermediate degree between high raters and within raters. The validity of the SFMA system is influenced by a combination of experience and logic; hence, further improvement is needed. Therefore, if the intervention was effective based on the diagnosis result, then biomechanical evidence is necessary to further support the claim. Conclusion : In future research, to use SFMA as a diagnostic tool with high accuracy, it is necessary to improve the reliability of the main problem through breakout, support for guidelines and validity and efficiency.

뇌졸중 환자의 상지 기능에 기능적 전기 자극이 미치는 영향: 무작위대조군연구에 기초한 체계적 고찰 (Effect of Electrical Stimulation on Upper Extremity Function in Stroke Patients: A Systematic Review Based on Randomized Controlled Trials)

  • 황수진;서연주
    • PNF and Movement
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    • 제20권2호
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    • pp.147-156
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    • 2022
  • Objective: Electrical stimulation is an assistive technology used to aid the recovery of upper limb use after stroke. The purpose of this systematic review was to determine the effects of electrical stimulation on upper extremity function in individuals with hemiparetic stroke and to develop an evidence base that supports the use of electrical stimulation for upper limb recovery after stroke. Design: A systematic review based on randomized controlled trials (RCTs). Methods: Studies published before April 20 2021 were collected for this review by searching PubMed, four other databases, and RCTs that reported the effects of electrical stimulation on upper extremity function in individuals with the characteristic stroke type. Information on the following parameters was extracted from each study: surname of first author, published year, country, participants, intervention, intervention's intensity, comparison, outcomes, additional therapy, and summary of results. This review also evaluated the bias within each study, including any selection bias, performance bias, detection bias, attrition bias, and reporting bias. Results: This review included five RCTs, and 208 stroke patients were included in the analysis. Stroke patients who underwent electrical stimulation showed significantly improved grip and pinch strengths, wrist range of motion, and basic daily living compared to those in the control group; however, there was no improvement in upper extremity function. Of the selected papers, 60% showed a "high risk" of performance bias, and 20% showed a "high risk" of detection bias. Conclusions: The results of this systematic review suggest that electrical stimulation provides some benefits to stroke patients, such as improved hand strength and range of motion. However, future studies are needed to provide clinical evidence of the effects of electrical stimulation on upper extremity function in stroke patients.

Effects of Task-Specific Obstacle Crossing Training on Functional Gait Capability in Patients with Cerebellar Ataxia: Feasibility Study

  • Park, Jin-Hoon
    • The Journal of Korean Physical Therapy
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    • 제27권2호
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    • pp.112-117
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    • 2015
  • Purpose: The purpose of this study was to examine the effects of a task-specific obstacle crossing rehabilitation program on functional gait ability in patients with cerebellar ataxia. Overall, we sought to provide ataxia-specific locomotor rehabilitation guidelines for use in clinical practice based on quantitative evidence using relevant analysis of gait kinematics including valid clinical tests. Methods: Patients with cerebellar disease (n=13) participated in obstacle crossing training focusing on maintenance of dynamic balance and posture, stable transferring of body weight, and production of coordinated limb movements for 8 weeks, 2 times per week, 90 minutes per session. Throughout the training of body weight transfer, the instructions emphasized conscious perception and control of the center of body stability, trunk and limb alignment, and stepping kinematics during the practice of each walking phase. Results: According to the results, compared with pre-training data, foot clearance, pre-&post-obstacle distance, delay time, and total obstacle crossing time were increased after intervention. In addition, body COM measures indicated that body sway and movement variability, therefore posture stability during obstacle crossing, showed improvement after training. Based on these results, body sway was reduced and stepping pattern became more consistent during obstacle crossing gait after participation in patients with cerebellar ataxia. Conclusion: Findings of this study suggest that task-relevant obstacle crossing training may have a beneficial effect on recovery of functional gait ability in patients with cerebellar disease.