Physio findings: Physiotherapy Journal

First published in June 1914, the journal has metamorphosed into the research publication you see today. This has been an interesting journey – from a parochial news magazine, with didactic articles based on the experience of the founding members of the profession, to an international publication, evidencing some of the finest research relevant to today’s physiotherapist.  The milestones of the journal mirror those of the educational pathway, from diploma to bachelor of science degree, master of physiotherapy and, most recently, the professional doctorate.

The prominence of the profession and the importance of the work undertaken by physiotherapists is showcased in the current issue of the journal, which demonstrates the vital role of the physiotherapist in combatting the burden of non-communicable diseases (NCDs).  These include NCDs with the highest incidence of mortality, commonly assessed and managed by physiotherapists; including cardiovascular disease, chronic respiratory disease, diabetes and cancer.  

Embracing the focus of the World Health Organisation (WHO) and the United Nations (UN), Tracy Bury, Director of Professional Policy and Marilyn Moffat, President of the World Confederation for Physical Therapy (WCPT) discuss the global importance of the management of these diseases and report on the development of a policy statement to ‘emphasise the important role that physiotherapists play in health promotion and disease prevention as well as improving and maintaining physical activity, movement potential and functional independence.’ (₁)
₁Bury T, Moffat M Physiotherapists have a vital part to play in combatting the burden of noncommunicable diseases.Physiotherapy Volume 100, Issue 2,June 2014,Pages 94–96 DOI: 10.1016/j.physio.2014.03.004

Exercising with cancer

When patients are diagnosed with cancer, physical activity may be the last thing on their minds. However, many who go on to have curative surgery are concerned about the risks of disability associated with that surgery.  Arbane et al report on the results of a large randomised controlled trial involving 131 subjects with non-small cell lung cancer.  They set out to compare usual care, comprising of routine physiotherapy including mobilisation and an upper limb component, with a hospital plus home exercise programme. Those in the latter group undertook a once-daily cycle (aiming for 30 minutes/session) and strength training, and on discharge participated in a home walking programme.  They found that both groups had recovered their pre-operative walking distance four weeks after surgery but that there were no differences between the groups in quadriceps strength, exercise tolerance or quality of life. Arbane G et al. Effect of postoperative physical training on activity after curative surgery for non-small cell lung cancer: a multicentre randomised controlled trial. Physiotherapy Volume 100, Issue 2, June 2014, Pages 100–107 DOI: 10.1016/j.physio.2013.12.002

Risk of lifestyle-related disease

Physiotherapists assess and manage risk factors on a daily basis, educating patients and minimising the effects of these risk factors on health.  A group of researchers in Ireland conducted a cross-sectional survey of current activities, barriers and perceived training needs of primary care physiotherapists.  Their focus was on practices related to risk factors associated with lifestyle-related disease. A total of 136 primary care physiotherapists provided questionnaire data. The researchers found that physiotherapists frequently assessed level of physical activity and dietary status and although the majority recognised smoking status and alcohol consumption as significant risk factors, few included details of these in their assessment.

The authors conclude that physiotherapists have a valuable role in risk assessment and management but that a number of strategies are required to improve their systematic inclusion in clinical practice.
G. O’Donoghue et al.  Assessment and management of risk factors for the prevention of lifestyle-related disease: a cross-sectional survey of current activities, barriers and perceived training needs of primary care physiotherapists in the Republic of Ireland. Physiotherapy Volume 100, Issue 2, June 2014, Pages 116–122 DOI: 10.1016/j.physio.2013.10.004

Inspiratory muscle training chart

Research from the Netherlands has allowed researchers to develop a useful tool to monitor the effects of pre-operative training on inspiratory muscle strength. The chart can be downloaded here.  It has been developed specifically for patients at high risk of developing postoperative pulmonary complications awaiting coronary artery bypass graft (CABG) surgery.  The reference values were produced by measuring patients who performed inspiratory muscle training seven times per week for at least two weeks before surgery; from this data the researchers developed a non-linear time trend model. van Buuren S, et al Reference chart of inspiratory muscle strength: a new tool to monitor the effect of pre-operative training. Physiotherapy Volume 100, Issue 2,June 2014, Pages 128–133 DOI: 10.1016/j.physio.2013.08.007

The Wii and Parkinson’s disease

Following a previous issue of Physiotherapy devoted to technological developments (Physiotherapy Volume 98, Issue 3, Pages 181-272), the use of the Wii as an exercise and motivational tool in the treatment of various conditions has been further investigated.   In this issue, the feasibility, safety and outcomes of playing Kinect Adventures!™ for people with Parkinson’s disease are explored in a pilot study in preparation for a randomised control trial (RCT).   A small group of patients in Brazil, graded at Hoehn and Yahr Stages 2 and 3 of the disease, played 14 sessions, each of 60-minutes on the Wii, attending three times per week.  Patients were assessed at a late period of their ‘on’ phase, following medication.
The researchers tested the six-minute walk test, Balance Evaluation System Test, Dynamic Gait Index and Parkinson’s Disease Questionnaire (PDQ-39) as their outcome measures.  Early indications are that the performance on the games improved, all outcome measures improved and there were no serious adverse effects. Pompeu JE, et al. Feasibility, safety and outcomes of playing Kinect Adventures!™ for people with Parkinson’s disease: a pilot study Physiotherapy Volume 100, Issue 2,June 2014, Pages 162–168 DOI: 10.1016/j.physio.2013.10.003

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