Management of noncommunicable diseases requires the adoption of multidisciplinary interventions that targets the modification of risk factors. Cardiovascular and respiratory diseases are amongst the four main killers of noncommunicable diseases. Physiotherapists specializing in cardiorespiratory physiotherapy are in a critical position in the management of health behaviors associated with noncommunicable diseases. However, the current context of health service in Jordan does not provide sufficient support and recognition for the delivery of specialized physiotherapy services. Objectives. The primary aim of this study was to describe cardiorespiratory physiotherapy service in Jordan. The secondary aims of this study were to: (i) Identify benchmarks from international contexts and guidelines for the delivery of cardiorespiratory physiotherapy service. (ii) Identify gaps and areas for development in the current delivery of cardiorespiratory physiotherapy service. Methods. This two phase study included a survey and a conceptual review with benchmarking. Following ethics approval, a cross sectional survey of physiotherapists practicing in Jordan was conducted. In phase 1, a survey was developed to describe the relevant dimensions of cardiorespiratory physiotherapy service. In phase 2 a conceptual review of the literature was performed to identify domains of service delivery and criteria required for optimal delivery of cardiorespiratory physiotherapy service. In the discussion we integrated the results of the survey within the benchmarks that emerged from the conceptual review of literature in order to identify gaps and areas for development in the current delivery of cardiorespiratory physiotherapy service. Results. Phase 1: Data emerging from the survey suggests that Physiotherapists in Jordan lack training and autonomy, preventing them from acquiring advanced roles particularly cardiorespiratory physiotherapy that requires specialised knowledge and skills. The current delivery of the service is limited to acute interventions, and is based on limited, unstructured referral from physicians depriving the patients from the service. The context of health service in Jordan does not provide sufficient recognition for physiotherapy; neither does it support the delivery of multidisciplinary interventions by appropriate regulations and policies. Phase 2: The following three domains emerged from the literature and were used for describing cardiorespiratory physiotherapy in Jordan: people, scope of practice, and context of practice. Conclusion. Advancing practice requires developing competencies relevant to cardiorespiratory physiotherapy particularly diagnosis, health promotion, and prevention. It is recommended that health authorities should develop regulations and policies that promote the recognition and integration of physiotherapists in the healthcare system, as well as facilitating the implementation of patient centred, multidisciplinary interventions.

Rasha Okasheh

Emad Al-Yahya

Lara Al-Khlaifat

Nihad Almasri

Jennifer Muhaidat

Dania Qutishat

Advancing Cardiorespiratory Physiotherapy Practice in a Developing Country: Surveying and Benchmarking

Objective. To date there is only limited knowledge about the wearing time of orthoses. Ankle-foot orthoses (AFOs) have not been studied with this research question. Additional influences of the orthotic design as well as weekdays and the weekend are also unknown. Design. Monocentric, clinically prospective intervention study. Patients. Inclusion of 10 patients with bilateral spastic cerebral palsy. Methods. Equipment of all subjects with a dynamic ankle-foot orthosis (DAFO) and modular shank supply (MSS, dynamic elastic shank adaptation or ground reaction AFO). Integration of temperature sensors for recording the wearing time for a period of 3 months. Results. The actual wearing time was below the recommendations on actually worn days as well as the average of the entire study period. In addition, the actual usage in terms of days and hours was well below the recommendations. The wearing time showed differences between weekdays and weekend. Differences between DAFO and MSS were not detectable. Conclusion. The actual usage behavior of ankle-foot orthoses differs from the recommendations of the prescriber. This applies to both DAFOs and modular use with shank supplies. Environmental factors may have a significant impact on wearing times on weekdays and the weekend.

M. Schwarze

L. Horoba

J. Block

C. Putz

M. Alimusaj

S. I. Wolf

T. Dreher

Wearing Time of Ankle-Foot Orthoses with Modular Shank Supply in Cerebral Palsy: A Descriptive Analysis in a Clinically Prospective Approach

Objective. In our study, we wanted to identify the number of existing deformities of the spine and posture in primary schoolers. Methods. The sample consisted of 311 healthy pupils aged 6-7. We used Klein, Thomas, and Mayer method to evaluate the posture. The spine curvature was evaluated by plumb line. Muscle imbalance was evaluated by standardized manual tests by Professor Janda. The results were evaluated by the basic population abundance and the use of the ANOVA program. We determined the level of statistical significance at p = 0.05. Results. The statistically significant occurrence of poor posture was found. Poor posture occurred in more than 50&#x25; of the pupils studied. Spine deformities in the sagittal plane have exceeded 30&#x25; (C = 37.94212&#x25;; Th = 32.15434&#x25;; L = 30.22508&#x25;). In the frontal plane deformities were present in 13.18328&#x25; of pupils. Spinae and postural disorders were accompanied by the muscle imbalance (muscle stiffness and weakness). Conclusion. Screening is a well-founded technique for the early detection of spinae and posture disorders. Based on the results of screening, professionals can take preventive measures. As in our research prevalence of spine deformities and poor posture in children was high, we recommend regular screening in clinical practice.

R&#xf3;bert Rusn&#xe1;k

Marina Kolarov&#xe1;

Ivana A&#x161;taryov&#xe1;

Peter Kuti&#x161;

Screening and Early Identification of Spinal Deformities and Posture in 311 Children: Results from 16 Districts in Slovakia

Objective. To analyse the effect of the manual ischemic compression (IC) on the upper limb motor performance (MP) in patients with LTrPs. Materials and Methods. A quasiexperimental study was performed in twenty subjects allocated to either patients group with LTrPs (PG, n=10) or healthy group with no symptoms (HG, n=10). Subjective pain and linear MP (movement time and Fitts&#x2019; Law) were assessed before and after a linear tapping task. Data were analysed with mixed factorial ANOVA for intergroup linear motor performance differences and dependent t-student test for intragroup pain differences. Results. PG had a linear MP lower than the HG before treatment (p &#x3c; 0.05). After IC, the PG showed a significant decrease of pain (4.07 &#xb1; 1.91 p &#x3c; 0.001). Furthermore, the movement time (15.70 &#xb1; 2.05 p &#x3c; 0.001) and the Fitts&#x2019; Law coefficient (0.80 &#xb1; 0.53 p &#x3c; 0.001) were significantly reduced. However, one IC session did not allow the PG to get the same MP than the HG (p &#x3c; 0.05). Conclusion. The results suggest the IC effectiveness on pain and MP impairment in subjects with LTrPs. However, the MP of these patients is only partially improved after the IC application.

Danilo Esparza

Arian R. Aladro-Gonzalvo

Yves Rybarczyk

Effects of Local Ischemic Compression on Upper Limb Latent Myofascial Trigger Points: A Study of Subjective Pain and Linear Motor Performance

Purpose. The purpose of this study was to quantify ipsilesional upper extremity (UE) stand-reaching performance (kinematics and kinetics) among chronic stroke survivors. Method. Community-dwelling chronic stroke survivors (n=13) and age-similar healthy adults (n=13) performed flexion- and abduction-reaching tasks. Surface EMG and acceleration were sampled using wireless sensors from the prime movers (anterior and middle deltoid) and provided performance-outcome (reaction time, burst duration, movement time, and movement initiation time) and performance-production (peak acceleration) measures and were then evaluated. Results. Individuals with chronic stroke demonstrated significantly reduced performance outcomes (i.e., longer reaction time, burst duration, movement time, and movement initiation time) and performance production ability (i.e., smaller peak acceleration) compared to their healthy counterparts (p &#x3c; 0.05) for both flexion- and abduction-reaching movements. Conclusion. Our results are suggestive of post-stroke deficits in ipsilesional motor execution during a stand-reaching task. Based on these findings, it is essential to integrate ipsilesional UE training into rehabilitation interventions as this might aid functional reaching activities of daily living and could ultimately help community-dwelling chronic stroke survivors maintain their independent living.

Savitha Subramaniam

Rini Varghese

Tanvi Bhatt

Influence of Chronic Stroke on Functional Arm Reaching: Quantifying Deficits in the Ipsilesional Upper Extremity

Background. Stroke is the most common cause of long-term disability in the United States (US). Assisted Cycling Therapy (ACT) at cadences of about 80 rpm has been associated with improvements in motor and clinical function in other clinical populations. The acute effects of ACT on motor function of persons with stroke have not been investigated. Objectives. The primary purpose of this cross-over trial was to compare the effects of ACT, voluntary cycling (VC), and no cycling (NC) on upper (Box and Blocks Test) and lower extremity motor function (Lower Extremity Motor Coordination Test) in adults with chronic stroke (age: 60 &#xb1; 16 years; months since stroke: 96 &#xb1; 85). The secondary purpose was to examine average cycling cadence and ratings of perceived exertion as predictors of change in motor function following the exercise session. Methods. Twenty-two participants (female = 6, male = 16) completed one 20-min session each of ACT (mean cadence = 79.5 rpm, VC (mean cadence = 51.5 rpm), and NC on separate days in quasi-counterbalanced fashion). Results. Main effects of intervention did not differ between ACT and VC. Within-intervention analyses revealed significant (p &#x3c; 0.05) pre- to posttest changes in all outcome measures for ACT but only in the Lower Extremity Motor Coordination Test on the non-paretic side for VC. Trend analyses revealed a positive relationship between average ACT cadences and improvements in upper and lower extremity motor function (p &#x3c; 0.05). A positive relationship between average VC cadences and lower extremity function was also revealed (p &#x3c; 0.05). Conclusion. ACT and VC produced similar acute improvements in paretic and non-paretic lower extremity motor function whereas changes in upper extremity motor function were more limited. Faster cycling cadences seem to be associated with greater acute effects.

Simon D. Holzapfel

Pamela R. Bosch

Chong D. Lee

Patricia S. Pohl

Monica Szeto

Brittany Heyer

Shannon D. Ringenbach

Acute Effects of Assisted Cycling Therapy on Post-Stroke Motor Function: A Pilot Study

This research sets out to explore, uncover, and understand the experiences and perspectives of people who care for patients with Parkinson&#x2019;s disease (PD). To this end, 20 participants who accompanied patients with PD to a training organized by Parkinson Patients Support Organization-Ethiopia (PPSO-E) provided the data required. Analysis of the data produced several themes such as delay in PD diagnosis and intervention, differing reactions to PD diagnosis, toughness of caring for PD patients, community&#x2019;s limited understanding and distortion of PD, lack of specific name and clear expression for PD in local languages, lack of sufficient support to the caregivers, caregivers&#x2019; compassion and patient&#x2019;s courageousness, and shortage and expensiveness of PD prescriptions. The themes produced have been discussed in light of existing literature. Based on the findings of this research, recommendations were forwarded and direction for future research was indicated.

Tamene Keneni Walga

Understanding the Experience and Perspectives of Parkinson&#x2019;s Disease Patients&#x2019; Caregivers

Objectives. The recovery process is reported by stroke survivors to be a change process fraught with crises and hazard. Interaction with health professionals and others may play a central role in establishing renewed control over life. Research Questions. (1) How do patients handle and overcome experienced changes after stroke? (2) How do they experience the support to handle these changes during the first year after stroke? (3) How do the similarities and differences transpire in Danish and Norwegian contexts? Methodology. A qualitative method was chosen. Six patients from Denmark and five patients from Norway (aged 25-66) were followed up until one year after stroke, by way of individual interviews. The data were analyzed (using NVivo 11) by means of phenomenological analysis. Findings. The participants described four main issues in the recovery process that impacted the experienced changes: (i) strategies and personal factors that promote motivation, (ii) the involvement of family, social network, and peers, (iii) professionals&#x2019; support, and (iv) social structures that limit the recovery process. There was a diversity of professional support and some interesting variations in findings about factors that affected recovery and the ability to manage a new life situation between Central Denmark and Northern Norway. Both Norwegian and Danish participants experienced positive changes and progress on the bodily level, as well as in terms of activity and participation. Furthermore, they learned how to overcome limitations, especially in bodily functions and daily activities at home. Unfortunately, progress or support related to psychosocial rehabilitation was almost absent in the Norwegian data.

Hanne Pallesen

Lena Aadal

Siri Moe

Cathrine Arntzen

Gateway to Recovery: A Comparative Analysis of Stroke Patients&#x2019; Experiences of Change and Learning in Norway and Denmark

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Rehabilitation Research and Practice publishes original research articles and review articles in all areas of physical medicine and rehabilitation.

Rehabilitation Research and Practice