The impact of COVID-19 on neck pain intensity and onset: A systematic review.

BACKGROUND: The COVID-19 pandemic has had significant impacts on most aspects of life, including physical and psychological wellbeing. Neck pain is a very common musculoskeletal complaint worldwide, and one that has been impacted by COVID-19. Such impacts have been studied by a few researchers, but not without inconstancies. Moreover, understanding those impacts in relation to rehabilitation is not fully comprehended. OBJECTIVE: The aim of this study was to systematically examine the impacts of COVID-19 on neck pain intensity and onset pre and post the pandemic. METHODS: This study was developed following the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A systematic literature search was conducted on PubMed-MEDLINE, EMBASE, and Cochrane Library. Keywords used were "COVID-19" and "Neck Pain". Risk of bias was assessed using the Joanna Briggs Institute Checklist for prevalence studies. RESULTS: A total of five studies were included with an overall sample size of 2618 participants. Three studies were at moderate risk and two were at high risk of bias. Results from three studies reported an increase in neck pain intensity and onset, while the other two did not report an increase. CONCLUSION: The impact of COVID-19 on neck pain is unclear. The inconsistency in results sheds the light on the importance of having future research (including longitudinal studies) to help guide us towards understanding the real impacts of COVID-19 on neck pain.

Physiotherapists' Understanding of Shortwave Diathermy Contraindications: A Questionnaire Survey.

Purpose: It is known that electromagnetic fields and heat generated by shortwave diathermy (SWD) can have adverse effects on living tissue. The purpose of this research is to evaluate Jordanian physiotherapists' knowledge of pulsed and continuous SWD contraindications. And investigate the potential contraindications about which Jordanian physiotherapists may have limited knowledge. Subjects and Methods: This cross-sectional study investigates Jordanian physiotherapists' knowledge of SWD contraindications. In 38 private and public hospitals, a self-administered questionnaire survey was carried out. Participants were asked to classify 32 conditions as "always, sometime, or never" contraindicated or "I do not know". Participants are physiotherapists with two or more years of postgraduate experience. Two forms comprised the survey. The first consisted of assessing their reaction to the contraindications of pulsed shortwave diathermy (PSWD), while the second consisted of continuous shortwave diathermy (CSWD). Results: Approximately 270 physiotherapists were eligible to participate in this investigation. Only 150 questionnaires were distributed to the therapists who agreed to the study. One hundred twenty-eight were returned for an average response rate of 85.3% (128/150). Respondents had good agreement about using SWD for cardiovascular condition, however, 24 respondents (19%) thought PSWD can be used over venous thrombosis. Only 64% of the respondents was aware that pacemakers are contraindicated for PSWD. Approximately 14% to 32% seem unaware that tuberculosis and osteomyelitis are contraindicated for both CSWD and PSWD. About 21% to 28% have been unaware that the use of PSWD is contraindicated for specialized tissues (eg, eyes, gonads, or malignant tissues) and 29% during pregnancy. Conclusion: Jordanian physiotherapists generally agreed on the widely acknowledged contraindications of CSWD for specific conditions. However, there was considerable uncertainty among Jordanian physical therapists about the contraindications of PSWD. This discrepancy highlights the need to improve physiotherapist awareness and for more fact-based research to the contraindication of SWD modality.

Physiotherapy interventions and profile of practice for COVID-19 patients in Jordan.

BACKGROUND: Physiotherapy plays an essential role in combating the complications of coronavirus disease 2019 (COVID-19). Profiling the experiences and challenges of physiotherapy practice in a country will help in customizing the competencies needed for physiotherapy education and regulations of practice. OBJECTIVE: To explore the experiences, knowledge, training, and barriers of practice for Jordanian physiotherapists who worked with COVID-19 cases at different work settings. METHODS: An online survey was distributed to physiotherapists working at different Jordanian rehabilitation settings. Physiotherapists who had experience in dealing with COVID-19 cases were eligible to participate in the study. RESULTS: The survey showed that only 38% of participants had received specialized training in dealing with COVID-19. Respiratory exercises were mostly used in the intensive care units or isolation wards (60%), and with patients having long-term complications (74%). Inadequate patients' referral to physiotherapy was reported by 88.6% of eligible participants. The majority of participants (68%) reported lack of adequate personal protective equipment (PPE) for physiotherapists. Challenges at the level of treatment skills, techniques, and communication were the most frequently reported by participants (44%), followed by challenges at the level of work policies (32%), then by challenges at the level of knowledge about the disease (28%). CONCLUSION: The study showed gaps in knowledge, training, and work-related policies that all created challenges for physiotherapists dealing with COVID-19 cases in Jordan. We hope our data can help in providing a basis for developing educational and training programs, in addition to revising work-related policies, to promote physiotherapy management of COVID-19 in Jordan.

The Relationship Between Using Smartphones andText Neck Syndrome in Online Learning Among University Students in Jordan: A Survey Study.

BACKGROUND: The use of online learning methods has expanded considerably in many countries since the declaration of COVID-19 as a global pandemic by the World Health Organization. Smartphones are widely used for voice and text messaging, checking emails, and distance learning. The aim of this study was to investigate the relationship between using smartphones and text neck syndrome. MATERIAL AND METHODS: A cross-sectional study was conducted among university students in Jordan between February and March 2023. All undergraduate students were invited to participate. A self-administered online (Google forms) questionnaire was distributed by posting the link to the questionnaire on students' groups through social media websites such as Facebook, Twitter, and WhatsApp. RESULTS: A total of 171 students responded to the survey. The participants included 103 (60%) females and 68 (40%) males. Approximately 79% of the participants were less than 22 years old. Almost half of the participants reported pain at neck (54%) and shoulder (51%), while about 61% of participants suffered from upper back pain. CONCLUSIONS: 1. Smartphones are widely becoming essential in educational technology, and more concern should be expended to increase the awareness about optimal and healthy usage of smartphones by restricting usage duration in order to reduce neck and shoulder pain and associated poor functioning in daily living activities. 2. Poor patterns of smartphone use increase the likelihood of neck pain. 3. Neck movement limitations are not associated with age or gender. 4. Students who did not report limitation in neck movement were less likely to have difficulty with reading.

Low Back Pain Prevalence among Distance Learning Students.

Background: Low back pain as a symptom affects many individuals around the globe regardless of their economic status or sociodemographic characteristics. During the 2019 COVID-19 pandemic, students found themselves obligated to sit down for long periods of time. The aim of this current study is to investigate the impact of these prolonged periods of sitting down in front of computers on developing a new episode of low back pain. Methods and Materials: This research adopted an observational cross-section study design. Students who are currently enrolled or had experienced distance learning classes in the last 6 months were eligible to participate. An online-based questionnaire was developed by the investigators through reviewing the literature with relevant objectives. McNemar's test was used to compare certain variables between two periods before and during online distance learning. We used paired t-tests to compare pain intensity before, during, and after online learning, while a chi-square test was used to investigate correlations between factors influencing low back pain. Results: A total of 84 students participated in the study­46 (54.8%) females and 38 (45.2%) males. Before online distance learning, only 42.9% of participants reported low back pain, while only 20% had a back injury. The mean pain scores before, during, and after online distance learning were (2.85 ± 2.16, 4.79 ± 2.6, and 4.76 ± 2.7), respectively. The pain scores before online learning were significantly lower than pain scores during and after online distance learning (p < 0.05), respectively. Conclusion: The study findings suggested that low back pain prevalence increased among students during the COVID-19 pandemic. Future research should study participants' behavior during the online learning and assess the long-run impact of distance learning among high-school and undergraduate students.

A novel approach to improve hamstring flexibility: A single-blinded randomised clinical trial.

BACKGROUND: The hamstrings play a major role in body posture. Shortening or tightness of the hamstrings affects postural alignment and results in possible musculoskeletal pain. OBJECTIVES: The aim of this study was to develop a novel approach to improve hamstring flexibility in young adults. METHOD: A single-blinded randomised clinical trial included 60 participants aged 18-24 with shortened hamstrings recruited from the Hashemite University, Zarqa, Jordan. The range of motion of knee extension was measured with the hip at 90° flexion using a simple goniometer to detect the level of hamstring flexibility. Participants received either a passive hamstring stretch (PS), followed by two sets of 10 tibial nerve neurodynamic technique (ND), or PS followed by three sets of 10 repetitions of active knee extension-quadriceps activation (QA), or PS only. RESULTS: There was a significant improvement of hamstring flexibility in the QA group compared to the PS group (13.4 ± 12.1° vs. 6.2 ± 6.4°, p = 0.05). There was a significant improvement in hamstring flexibility post-intervention compared to pre-intervention in the PS group by 6.2 ± 6.4 (30.5 ± 10.8° vs. 36.6 ± 9.5°, p = 0.001), ND group by 9.3 ± 6.2 (26.7 ± 10.9° vs. 36.0 ± 9.5°, p = 0.001) and QA group by 13.4 ± 12.1 (20.3 ± 9.0° vs. 33.4 ± 8.9°, p = 0.001). CONCLUSION: Quadriceps muscle activation following passive stretching of the hamstrings appears to be superior to the PS and ND techniques in improving hamstring muscle flexibility. CLINICAL IMPLICATIONS: Quadriceps activation following passive hamstring stretching can be used in physiotherapy settings to improve hamstring muscle flexibility.

Physical therapy practice in intensive care units in Jordanian hospitals: A national survey.

OBJECTIVE: A national survey was conducted to determine the current status of physical therapy practice in the intensive care units (ICUs) of Jordanian hospitals. METHODS: An online survey was sent via email to physical therapists working at Jordanian hospitals. Questions of the survey addressed the physical therapy demographics, staffing, education, training, and barriers of practice. The responses were compared among four different hospital sectors in the country. RESULTS: The response rate was 31% (50/161). Thirty-six percent of participants had more than 10 years of experience in physical therapy, and 26% had less than 1 year of experience in the intensive care practice. Staffing of physical therapists working in ICUs relative to the total ICU beds was the highest in public hospitals compared with other hospital sectors. Among all participants, only 4% had received specialized postgraduate ICU training. The barriers to ICU physical therapy practice in Jordan included insufficient staffing, inadequate training, and lack of understanding of physical therapy role for ICU patients. CONCLUSION: The study showed the main barriers to ICU physical therapy practice in Jordan. There is a need for well-structured strategies to overcome these barriers to help improve the delivery of physical therapy services in Jordan.

Effectiveness of Physiotherapy Interventions on Spasticity in People With Multiple Sclerosis: A Systematic Review and Meta-Analysis.

OBJECTIVE: The aim of the study was to examine the effectiveness of physiotherapy (PT) interventions on spasticity in people with multiple sclerosis. DESIGN: A systematic search was performed using PRISMA guidance. Studies evaluate the effect of PT interventions on spasticity were included. People with multiple sclerosis, spasticity, disability and PT interventions characteristics were extracted in included studies. Level of evidence was synthesized by the Grade of Recommendation, Assessment, Development and Evaluation approach. Meta-analyses were performed by calculating Hedges g at 95% confidence interval. RESULTS: A total of 29 studies were included in the review, and 25 were included in the meta-analyses. The included PT interventions were exercise therapy, electrical stimulation, radial shock wave therapy, vibration, and standing. The review and meta-analyses showed different evidences of benefits and nonbenefits for PT interventions on some spasticity outcomes. The best quality evidences were for beneficial effects of exercise therapy especially robot gait training and outpatient exercise programs on self-perceived spasticity and muscle tone respectively. The review results were positive regarding the acute effects, follow-up measurements, safety, progressive MS, and nonambulatory people with multiple sclerosis. The included articles were heterogeneous and badly reported in PT interventions and people with multiple sclerosis characteristics. CONCLUSIONS: Physiotherapy interventions can be a safe and beneficial option for spasticity in people with multiple sclerosis. No firm conclusion can be drawn on overall spasticity. Further researches in different spasticity aspects are needed.

Constraint-induced movement therapy as a rehabilitation intervention for upper extremity in stroke patients: systematic review and meta-analysis.

Constraint-induced movement therapy (CIMT) is a neurorehabilitation technique designed to improve upper extremity motor functions after stroke. This review aimed to investigate evidence of the effect of CIMT on upper extremity in stroke patients and to identify optimal methods to apply CIMT. Four databases (MEDLINE, EMBASE, CINHAL, and PEDro) and reference lists of relevant articles and reviews were searched. Randomized clinical trials that studied the effect of CIMT on upper extremity outcomes in stroke patients compared with other rehabilitative techniques, usual care, or no intervention were included. Methodological quality was assessed using the PEDro score. The following data were extracted for each trial: patients' characteristics, sample size, eligibility criteria, protocols of CIMT and control groups, outcome measurements, and the PEDro score. A total of 38 trials were identified according to the inclusion criteria. The trials included were heterogeneous in CIMT protocols, time since stroke, and duration and frequency of treatment. The pooled meta-analysis of 36 trials found a heterogeneous significant effect of CIMT on upper extremity. There was no significant effect of CIMT at different durations of follow-up. The majority of included articles did not fulfill powered sample size and quality criteria. The effect of CIMT changed in terms of sample size and quality features of the articles included. These meta-analysis findings indicate that evidence for the superiority of CIMT in comparison with other rehabilitative interventions is weak. Information on the optimal dose of CIMT and optimal time to start CIMT is still limited.