Objectives There are growing evidence that exercise improves sacroiliac dysfunction symptoms in pregnant women; but no data about the effect of expert advice regarding this matter. The aim of this ...study was to assess the effectiveness of expert advice about therapeutic exercise on sacroiliac dysfunction in pregnancy. Methods A total of 500 women with sacroiliac dysfunction diagnosed in pregnancy were randomized in study and control group. Study group has conducted expert advice on therapeutic exercise; while control group continued with their normal lifestyle. Pain intensity by Visual Analog Scale (VAS) and degree of functional disability by Quebec scale were assessed at enrolment and after 3 and 6 weeks. Results Significantly better reduction in pain intensity assessed by VAS (p=0.001) and degree of functional disability assessed by Quebec scale (p=0.001) was noted in study compared to control group. Better results for both outcome measures were obtained if intervention was implemented earlier i.e., in second (p=0.001; p=0.001) compared to third (p=0.005; p=0.001) trimester. Strong positive correlation was found between pain intensity and degree of functional disability in both groups. Conclusions Expert advice on therapeutic exercise is effective in reduction of sacroiliac dysfunction symptoms during pregnancy. Trial registration ACTRN12617000556347.
Electronic health record can facilitate everyday clinical practice of physiotherapists. The aim of this study is to determine attitude of physiotherapists towards implementation of information ...technology in their work and the differences in attitude in relation to gender, age, level of education and type of health institutions.
This study is a cross-sectional survey of Croatian physiotherapists. The questionnaire ″Attitude of physiotherapists towards implementation of electronic health record included 12 items scored on a Likert-type scale from 1 to 5 and presented the award values as "Disagree", "Neither agree nor disagree" and "Agree". Croatian physiotherapists were (
= 267) recruited from 13 health care institutions. For analysis chi square test, t-test, one-way analysis of variance and as a post-hoc Tukey test were used.
Explanatory factorial analysis confirmed two factors: Satisfaction in the work of physiotherapists using computers (SAT) and Necessity of computers in the work of physiotherapists (NEC). Most physiotherapists agree on (SAT) (47.9%) and on (NEC) (51.3%). Male physiotherapists were significantly more likely to disagree with statements related to SAT (
< 0.001) and NEC (
= 0.035) than female physiotherapists. Physiotherapists aged between 46 and 55 years were significantly more like to disagree on NEC in comparison to all the other groups of participants (
< 0.001). Physiotherapists with secondary school degree were significantly more like to disagree on NEC as compared with participants with bachelor's degree (
= 0.009), as well as in comparison with physiotherapists with a university degree (
= 0.002). Most of the physiotherapists who are employed in Clinical hospitals and in the Speciality hospital agree with that statement (all
> 0.05).
The attitude of Croatian physiotherapists towards electronic health record differs according to the age, gender, level of education and type of health care institutions. This finding can facilitate implementation of electronic health record in physiotherapy.
Not applicable.
: Functional status of the mother after delivery is crucial for performing activities of daily living and caring for the newborn. It is important to assess functional abilities after childbirth in ...order to improve the quality of postpartum care. The aim of this study is to determine the psychometric properties of the questionnaire and assess the functional abilities after childbirth.
: This study is observational. Postpartum Functional Assessment Questionnaire includes eleven items. 301 women after childbirth, 234 after vaginal birth and 67 after caesarean section participated in the study. An assessment of pain intensity and functional abilities was performed on the first and third day after childbirth. The Factor and Cronbach's alpha analyses were performed to determine the factor structure and internal consistency.
: The analysis reveals two factors, with seven items loading on factor 1 and four on factor 2. Cronbach's alpha for construct I (Mobility) at the first day was 0.927 and at the third day was 0.913; and for Factor II (Self-care) at the first day was 0.846 and at the third day was 0.894. All between-group differences in pain intensity and functional abilities were highly statistically significant (
< 0.001). Differences between the first and third postpartum day were statistically significant for all variables and all subgroups (
< 0.001).
: Postpartum Functional Assessment Questionnaire has good psychometric properties and is a valuable tool for use in clinical practice.
•Sacroiliac dysfunction during pregnancy is a primary cause of pain and disability.•There is wide heterogeneity in approaches to sacroiliac dysfunction in pregnancy.•Expert advice is effective for ...the reduction of symptoms of sacroiliac dysfunction.
To assess primiparous and multiparous women, and singleton and multiple pregnancies in a recently published randomized trial.
Secondary analysis of a randomized clinical trial was performed. In total, 500 women with sacroiliac dysfunction diagnosed in pregnancy were randomized into a study group (who received expert advice about therapeutic exercise) and a control group (who continued with their normal lifestyle habits). The outcome measures assessed were: pain intensity visual analogue scale (VAS) and degree of functional disability (Quebec scale) at enrolment and after 3 and 6 weeks. Primiparous and multiparous women, and singleton and multiple pregnancies in the study and control groups were analysed separately.
Sacroiliac dysfunction was more common in primiparous women compared with multiparous women (84.70% vs 77.16%), and in multiple pregnancies compared with singleton pregnancies (86.53% vs 80.07%). For all four subgroups analysed in this secondary analysis, the reduction in pain intensity (p = 0.001) and the degree of functional disability (p = 0.001) were better in the study group compared with the control group. Better results for the two outcome measures were found when comparing primiparous and multiparous women in the study group at follow-up, but the difference in functional disability disappeared 6 weeks after enrolment (p = 0.383). There was no difference in the two outcome measures between singleton and multiple pregnancies 3 and 6 weeks after enrolment (p = 0.061, p = 0.489 and p = 0.741, p = 0.353, respectively).
Expert advice about therapeutic exercise is effective for the reduction of symptoms of sacroiliac dysfunction in all four subgroups (primiparous and multiparous women, singleton and multiple pregnancies). Earlier reduction of pain intensity and degree of functional disability were obtained in primiparous women compared with multiparous women in the study group.
Objectives
To determine the incidence of sacroiliac dysfunction in pregnancy and assess its progress during the course of the pregnancy.
Methods
The present prospective cohort study, performed ...between April 1, 2013, and May 31, 2016, enrolled primigravidae aged 25–35 years before 13 weeks of pregnancies who were experiencing back pain and did not have prior symptoms of sacroiliac dysfunction. Participants attended regular follow‐up over 6 months and clinical functional tests were used to diagnose sacroiliac dysfunction. Women with sacroiliac dysfunction were assessed at 3‐week intervals with a numeric pain rating scale (NPRS) and the pregnancy mobility index (PMI).
Results
Among 1500 women who fulfilled the inclusion criteria, 1181 (78.7%) were diagnosed with sacroiliac dysfunction and 1143 completed all follow‐up. Pain assessed by the NPRS gradually worsened from the first toward the third trimester (P<0.001). The level of disability assessed by the PMI also increased from the beginning to the end of pregnancy (P<0.001).
Conclusion
Sacroiliac dysfunction represents an important problem during pregnancy; pain severity and mobility problems increased during the course of pregnancy in the present study.
Australian New Zealand Clinical Trials Registry
ACTRN12613000246785
The incidence of sacroiliac dysfunction in early pregnancy was 78.7% and the associated pain and mobility increased during the course of pregnancy.
Sindrom karpalnog kanala u trudnoći odnosi se na kompresiju n.medianusa u karpalnom
kanalu što rezultira pojavom parestezija, boli i utrnulosti u području inervacije n. medianusa.
Etiologija je ...nepoznata, međutim smatra se da na pojavu i razvoj simptoma utječe
edem u karpalnom kanalu uzrokovan hormonalnim promjenama tijekom trudnoće. U
fizioterapijskoj procjeni koriste se klinički funkcijski testovi (Phanelov test, Tinelov znak,
kompresijski test n. medianusa, test zatvorene šake, kombinirani test fleksije ručnog zgloba
i karpalne kompresije, stres test n. medianusa, Pinč test, „Flick” manevar, Wormserov
test i Okutsu test), skala za procjenu intenziteta boli (eng. Numeric Pain Rating Scale), skala
za procjenu težine simptoma (eng. Hi-Ob skala) i Boston upitnik za procjenu utjecaja sindroma
karpalnog kanala na izvođenje aktivnosti svakodnevnog života (eng. Boston Carpal
Tunnel Questionnaire). Fizioterapijska intervencija usmjerena je na tehnike mobilizacije,
vježbe za sindrom karpalnog kanala, primjenu rasteretnih udlaga i edukaciju o zaštitnim
položajima tijekom aktivnosti svakodnevnog života.
Odrediti i usporediti učinkovitost vježba kao vrlo važne terapijske intervencije za stabilizaciju sakroilijakalnih zglobova i potpornog pojasa kod sakroilijakalne disfunkcije u trudnoći. Metode: ...Randomizirana kontrolna studija koja uključuje 240 trudnica sa sakroilijakalnom disfunkcijom u trudnoći. Ispitanice su metodom slučajnog izbora podijeljene u dvije skupine po 120 u svakoj te po 40 u svakome tromjesečju. Ispitivana skupina provodila je vježbe za stabilizaciju sakroilijakalnih zglobova 3 puta na tjedan po 45 minuta, dok je kontrolna skupina nosila potporni pojas tijekom svakodnevnih aktivnosti. Nakon dva tjedna procijenjen je intenzitet boli numeričkom skalom za procjenu boli, dok je za procjenu stupnja onesposobljenosti prilikom svakodnevnih aktivnosti upotrijebljena Kvibečka skala. Rezultati: Intenzitet boli i stupanj onesposobljenosti uzrokovani sakroilijakalnom disfunkcijom rastu od početka prema kraju trudnoće. Prisutna je statistička značajnost u smanjenju intenziteta boli (P < 0,01; P < 0,05) i stupnja onesposobljenosti (P < 0,01; P < 0,05) nakon obje primijenjene intervencije. Postoji povezanost intenziteta boli i stupnja onesposobljenosti u ispitivanoj skupini (r < 0,56). Ta je skupina imala statistički značajno veće smanjenje boli i stupnja onesposobljenosti od kontrolne skupine (P < 0,05). Zaključak: Rezultati upućuju na bolju učinkovitost vježba za stabilizaciju sakroilijakalnih zglobova od nošenja potpornog pojasa kod sakroilijakalne disfunkcije u trudnoći, što naglašava ulogu fizioterapeuta kod ovog poremećaja
DISPAREUNIJA- PRIKAZ SLUČAJA Jadanec, Marinela; Filipec, Manuela
Physiotherapia Croatica,
10/2016, Letnik:
14(Suppl), Številka:
1.
Paper
Odprti dostop
UVOD: Dispareunija predstavlja čest problem te ima
negativan utjecaj na emocionalno i psihičko zdravlje kao
i na partnerske odnose. Dispareunija se u žena defi nira
kao ponavljajuća ili ...perzistirajuća bol za vrijeme spolnog
odnosa. Prijevremena ejakulacija predstavlja čest problem
kod muškaraca koji još uvijek prati tabu.
MATERIJALI I METODE: U radu je prikazan slučaj
bračnih partnera: pacijentice s postpartalnim vaginizmom i
pacijenta sa sekundarnim oblikom prijevremene ejakulacije.
Fizioterapijska procjena usmjerena je na procjenu funkcije i
snage muskulature zdjeličnog dna putem vaginalne i analne
palpacije korištenjem PERFECT skale, sposobnosti relaksacije
muskulature zdjeličnog dna i procjenu boli kod oba partnera.
Fizioterapijska intervencija usmjerena je na trening
muskulature zdjelično dna s naglaskom na relaksacijsku
komponentu kod pacijentice te na trening muskulature
zdjeličnog dna s naglaskom na kontrakcijsku komponentu
kod pacijenta. Također, proveden je trening muskulature
zdjeličnog dna prilikom spolnog odnosa partnera.
REZULTATI: Evaluacija rezultata fi zioterapijske procjene
upućuje na značajno poboljšanje u svim komponentama
procjene muskulature zdjeličnog dna te na manji intenzitet
vaginizma kod pacijentice i povećanje IELT-a kod pacijenta.
ZAKLJUČAK: Nužno je podizanje svijesti i edukacija o
spolnom zdravlju i važnosti prepoznavanja dispareunije kod
žena i muškaraca. Od iznimne je važnosti u fi zioterapijski
proces uključiti oba partnera s ciljem poboljšanja spolne
funkcije i kvalitete spolnog života. Trening muskulature
zdjeličnog dna predstavlja učinkovitu metodu koja ima
pozitivan učinak na sve komponente muskulature zdjeličnog
dna kao i na kvalitetu spolnog života žena i muškaraca.
PDF
