Role of virtual reality distraction technique to improve chest burns with acute respiratory distress syndrome (ARDS) following smoke inhalation in middle-aged adults - A randomized controlled study.

BACKGROUND: Burns of the chest region constitute a common burn and develops skin contractures around the thorax region. Inhalation of toxic gases and chemical irritants during the fire leads to Acute Respiratory Distress Syndrome (ARDS). Breathing exercises are painful but are needed to help counteract contractures and increase lung capacity. These patients are usually in pain and extremely anxious about chest physiotherapy. Virtual reality distraction is one such technique that is gaining immense popularity when compared to other pain distraction techniques. However, studies examining the efficacy of the virtual reality distraction technique in this population are lacking. OBJECTIVES: To find and compare the effects of the virtual reality distraction technique as a pain alleviation tool for reducing pain during chest physiotherapy in chest burns patients with ARDS in middle-aged adults. METHODS: A randomized controlled study was conducted at the physiotherapy department between 1st Sep 2020 and 30th Dec 2022. The eligible sixty subjects were randomized into two groups: The virtual reality distraction group (n = 30) received virtual reality distraction technique and the control group (n = 30) received progressive relaxation technique before chest physiotherapy as a pain distraction technique. All the participants received chest physiotherapy as a common treatment (treatment as usual). Primary (Visual Analogue Scale - VAS) and secondary (forced vital capacity (FVC), forced expiratory volume in 1 s (FEV1), FEV1/FVC, peak expiratory flow (PEF), residual volume (RV), functional residual capacity (FRC), total lung capacity (TLC), RV/TLC, and diffusing capacity for carbon monoxide of the lungs (DLCO) outcome measures were measured at baseline, after four weeks, eight weeks and at six months follow up. The effects between the two groups were analyzed using the independent t-test and chi-square test. The intra-group effect was analyzed with a repeated measure ANOVA test. RESULTS: Baseline demographic characters and study variables show homogenous distribution between the groups (p > 0.05). Four weeks following two different training protocols virtual reality distraction group shows more significant changes in pain intensity, FVC, FEV1, FEV1/FVC, PEF, RV, FRC, TLC, RV/TLC, and DLCO (p = 0.001) but not in RV (p = 0.541). The similar improvements were noted in the 8 weeks and 6 months follow up. CONCLUSION: The reports of the study concluded that virtual reality distraction is an effective and useful technique in reducing pain and increasing lung capacity in chest burn patient with ARDS following smoke inhalation in community-dwelling middle-aged adults. In the virtual reality distraction group, the patients reported significantly less pain and clinically meaningful changes in pulmonary functions as compared to the control group (physiotherapy + relaxation).

Role of Tele-Physical Therapy Training on Glycemic Control, Pulmonary Function, Physical Fitness, and Health-Related Quality of Life in Patients with Type 2 Diabetes Mellitus (T2DM) Following COVID-19 Infection-A Randomized Controlled Trial.

The use of tele-rehabilitation (TR) in type 2 diabetes mellitus (T2DM) following COVID-19 infection remains unexplored. Hence, the purpose of this study was to determine the clinical effects of tele-physical therapy (TPT) on T2DM following COVID-19 infection. The eligible participants were randomized into two groups, a tele-physical therapy group (TPG; n = 68) and a control group (CG; n = 68). The TPG received tele-physical therapy for four sessions a week for eight weeks, and the CG received patient education for 10 min. The outcome measures were HbA1c levels, pulmonary function (forced expiratory volume in the first second (FEV1), forced vital capacity (FVC), FEV1/FVC, maximum voluntary ventilation (MVV), and peak exploratory flow (PEF)), physical fitness, and quality of life (QOL). The difference between the groups in HbA1c levels at 8 weeks was 0.26 (CI 95% 0.02 to 0.49), which shows greater improvement in the tele-physical therapy group than the control group. Similar changes were noted between the two groups after 6 months and at 12 months resulting in 1.02 (CI 95% 0.86 to 1.17). The same effects were found in pulmonary function (FEV1, FVC, FEV1/FVC, MVV, and PEF), physical fitness, and QOL (p = 0.001). The reports of this study show that tele-physical therapy programs may result in improved glycemic control and improve the pulmonary function, physical fitness, and quality of life of T2DM patients following COVID-19 infection.

Physiotherapy research on low back pain in the Indian context: A bibliometric analysis using the Scopus database.

BACKGROUND: Low back pain (LBP) is a common musculoskeletal condition that necessitates public health concerns. It also attracts considerable research interest among physiotherapists. OBJECTIVE: This study conducted a bibliometric analysis to reveal the affinity of Indian physiotherapists toward research on LBP using the Scopus database. METHODS: An electronic search was performed on December 23, 2020, using specific keywords. The data was downloaded in a Scopus plain text file (.txt) format and were analyzed using R studio (biblioshiny) software. RESULTS: Two hundred and thirteen articles concerning LBP published from 2003 to 2020 were retrieved from the Scopus database. Among those articles (N= 213), 85.45% (n= 182) were published between 2011 and 2020. An article published by "James SL (2018)" in the Lancet had the highest citation of 1439. The highest collaboration was between India and the United Kingdom, and India and the United States of America jointly accounted for 12.2% (n= 26) of the entire articles (N= 213). CONCLUSION: Indian physiotherapists have shown an interest through gradually increasing their research output on LBP since 2015. They contributed effectively to various journals and international collaboration. Nevertheless, there is room to improve the quality and quantity of LBP articles in high-quality journals, thereby enhancing the citation count. This study recommends improving the scientific output of Indian physiotherapists on LBP by expanding their international networks.

Effectiveness of Kinesio taping and conventional physical therapy in the management of knee osteoarthritis: a randomized clinical trial.

BACKGROUND: Knee osteoarthritis (OA) is the most common kind of arthritis that occurs due to degeneration of the joint articular cartilage, producing pain, stiffness, and impaired movement. The objective of the study was to evaluate the short-term effectiveness of Kinesio taping (KT) plus conventional physical therapy (CPT) and CPT alone in subjects with knee OA. MATERIALS AND METHODS: Forty male subjects were divided into two groups at random using a parallel assignment, double-blinded study design, viz., KT with CPT (transcutaneous electrical nerve stimulation and exercise therapy), and CPT alone for the period of 6 weeks of treatment. At baseline, third, and sixth weeks, the following outcome measures were taken, such as pain intensity (NPRS), knee range of motion (goniometry), Western Ontario and McMaster Osteoarthritis Index (WOMAC), and the Time Up and Go (TUG) test. STATISTICAL ANALYSIS: To reveal the patient's demographic profile concerning the outcome parameters, a descriptive statistic was applied. Furthermore, two-way mixed ANOVA and Tukey HSD post hoc tests were used to analyze within and between-group comparisons in SPSS 20.0. RESULTS: In both groups, pain and knee flexion were significantly improved during the 6-week period of interventions (p < 0.05). WOMAC and TUG test scores improved only in the KT plus CPT group. CONCLUSION: KT combined with CPT was found to be more effective than CPT alone in the third and sixth weeks of the treatment. In knee OA, this combination of treatments was found to reduce pain, enhance range of motion, and improve physical functioning.

MRI and Ultrasound Analysis of Corticosteroid Injection Combined with Extracorporeal Shockwave Therapy in Lateral Epicondylitis-A Prospective, Randomized, Double-Blinded, Placebo-Controlled Trial.

OBJECTIVE: The knowledge about the effective implementation of corticosteroid injection and extracorporeal shockwave therapy on radiological changes in chronic lateral epicondylitis is lacking. Therefore, the objective of this study is to find and compare the effects of corticosteroid injection and extracorporeal shockwave therapy on radiological changes in chronic lateral epicondylitis. METHODS: A randomized, double-blinded controlled study was conducted on 60 LE participants at a university hospital. The active extracorporeal shockwave therapy group (n = 30) received a corticosteroid injection with active extracorporeal shockwave therapy one session a week for 4 weeks, and the placebo extracorporeal shockwave therapy group received a corticosteroid injection with placebo extracorporeal shockwave therapy. The primary outcome was pain intensity, measured with the visual analog scale. The other outcome measures were the percentage of injury measured by magnetic resonance imaging and ultrasound, functional disability, handgrip strength, patient perception, kinesiophobia, depression status, and quality of life. RESULTS: The between-group difference in pain intensity at 4 weeks was 1.4 (CI 95% 0.77 to 2.02), which shows more improvement in the active group than in the placebo group. Improvements in the effects were noted after 8 weeks and at 6 months (1.8; CI 95% 1.50 to 2.09) follow-up. Similar improvements were also found in the percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status, and quality of life. CONCLUSION: Extracorporeal shockwave therapy has added effects on corticosteroid injection for improving pain, percentage of injury, functional disability, handgrip strength, patient perception, kinesiophobia, depression status and quality of life in people with chronic lateral epicondylitis.

Impact of automated drug dispensing system on patient safety.

Objectives: Automated drug dispensing system (ADDs) is an emerging technology positively impacts drug dispensing efficiency by minimizing medication errors. However, the pharmacist perception of the impact of ADDs on patient safety is not well-established. This cross-sectional observational study aimed to evaluate the dispensing practice and pharmacist perception of ADDs towards patient safety through a validated questionnaire. Methods: A self-designed questionnaire was validated and the pharmacist perception of dispensing practice was compared between two hospitals adopting ADDs and traditional drug dispensing system (TDDs). Results: The developed questionnaire had an excellent internal consistency (both Cronbach's α and McDonald's ω coefficients were >0.9). Factor analysis retained three significant factors (subscales) that explained pharmacist perception of dispensing system, dispensing practice, and patient counseling (p<0.001 for each factor). The average number of prescriptions dispensed per day, drugs contained in each prescription, average time for labeling each prescription and inventory management were significantly varied between ADDs and TDDs (p=0.027, 0.013 0.044 and 0.004, respectively). The perception of pharmacists using ADDs on three domains were higher than the TDDs. The pharmacists in ADDs agreed that they had enough time to review the medications before dispensing than TDDs and this difference was found to be statistically significant (p=0.028). Conclusions: ADDs was highly effective in improving dispensing practice and medication review; however, the pharmacists need to emphasize the importance of ADDs to translate the pharmacists' freed-time towards patient care.