Introduction Chronic cervical radiculopathy is a common condition characterised by neck and arm pain, numbness and weakness. Both neck muscle activation and strengthening exercises are widely recognised treatments for cervical radiculopathy, but there is a research gap on the efficacy of neck muscle activation versus strengthening. This protocol will determine the efficacy of neck muscle activation alongside conventional care versus strengthening exercise and conventional care for cervical radiculopathy. Methods and analysis We planned a 5-week parallel, two-arm randomised clinical trial on 80 participants with chronic cervical radiculopathy (lasting over 3 months) between July and December 2023. Participants will be recruited from Dhaka’s Agrani Specialised Physiotherapy Centre in Bangladesh and randomly assigned to two groups in a 1:1 ratio. Both groups will receive 14 sessions, each lasting 30–45 min. Post-treatment evaluations will be employed on Brief Pain Inventory (BPI), range of motion, craniovertebral angle (CVA), strength, endurance and Neck Disability Index (NDI) after 5 weeks and follow-up after 12 weeks of post-test analysis. Primary outcomes (strength, endurance and CVA) will be measured using a handheld dynamometer, digital inclinometer and goniometer. Secondary outcomes (pain, range of motion and disability) will be assessed through the BPI scale, digital inclinometer and NDI. Ethics and dissemination The Institute of Physiotherapy Rehabilitation and Research of Bangladesh Physiotherapy Association has approved the study. All participants will provide informed consent, and data will be anonymised and accessible only to authorised personnel. The study’s findings will be disseminated in peer-reviewed journals and conferences. Clinical trial registry India CTRI/2023/09/057587 (13/09/2023)
Abstract Background Pain is one of the prevalent Long COVID Symptoms (LCS). Pain interferes with the quality of life (QoL) and induces disease burden. Purpose The study aimed to elicit the clinical presentation of pain and determine the relationships between QoL and pain in LCS. Methods This household cross-sectional study of 12,925 SARS-CoV-2 cases between July and December 2021 was carried out in eight administrative divisions of Bangladesh. Stratified random sampling from the cases retrieved from the Ministry of Health was employed. Symptom screening was performed through COVID-19 Yorkshire Rehabilitation Scale, and long COVID was diagnosed according to World Health Organization (WHO) criteria. The analyses were conducted using IBM SPSS (Version 20.00). Results The prevalence of pain in long COVID was between 01 and 3.1% in the studied population. The study also found five categories of pain symptoms as LCS in Bangladesh: muscle pain 3.1% (95% CI; 2.4–3.8), chest pain 2.4% (95% CI; 1.8–3.1), joint pain 2.8% (95% CI; 2.2–2.3), headache 3.1% (95% CI; 2.4–3.8), and abdominal pain 0.3% (95% CI; 0.01–0.5). People with LCS as pain, multiple LCS, and longer duration of LCS had significantly lower quality of life across all domains of the WHOQOL-BREF ( P < 0.001) compared to asymptomatic cases. Conclusion Three out of ten people with long COVID experience painful symptoms, which can significantly reduce their quality of life. Comprehensive rehabilitation can improve the symptoms and reduce the burden of the disease.
Abstract Background Adhesive capsulitis (AC) is a progressive inflammatory condition of the shoulder that causes functional limitations and leads to long-term disability. The study aimed to elicit the effectiveness of Proprioceptive neuromuscular facilitation (PNF) compared to standard physiotherapy approaches on AC. Methods An assessor-blinded single-centre Randomized control trial (RCT) was carried out on 80 AC patients between May and December 2023 in Bangladesh. Random assigned and concealed allocated patients were recruited equally (n = 40) to each PNF and conventional capsular stretching group. The experimental group received a PNF approach, and the control group received capsular stretching to the affected shoulder for 24 sessions in 6 weeks. Both groups received electrical modalities as standard treatment. The primary outcome was pain measured by the Numeric pain rating scale (NPRS) and range of motion in a universal goniometer. The secondary outcome was functional limitation measured by the Shoulder pain and disability index (SPADI). As per the distribution of data, non-parametric tests were employed to analyse the superiority between and within groups with intention-to-treat analysis. Results Baseline compatibility was noted in all the key variables (P > 0.05). Both PNF and capsular stretching had a decrease in pain compared to baseline in all capsular pattern positions (P < 0.001), and PNF had more significant improvement compared to control (P < 0.001). Both groups had equal improvement in shoulder ROM (P < 0.001) except abduction (P < 0.05). Both groups had improvements in disability (P < 0.05), and PNF had statistical superiority of improvement (P < 0.001). Conclusions The findings of this study support the potential of PNF intervention for 6 weeks as a treatment for shoulder Adhesive capsulitis, showing improvements in pain, ROM, and functional disability. However, further multicentre trials with a follow-up design are needed to fully understand the superiority of PNF on shoulder AC, encouraging continued engagement in this area of research. Trial registration: The Australian New Zealand Clinical Trial Registry (http://www.anzctr.org.au) (ACTRN12621001299897).
Background: A diverse spectrum of long COVID symptoms (LCS) have the scope of physical rehabilitation. Due to limited resources, very little is known about the physiotherapy and rehabilitation interventions for LCS and their clinical application. This study aims to explore the role of physiotherapy and rehabilitation interventions in the management of musculoskeletal, neurological, cognitive, cardiorespiratory, mental health, and functional impairments of LCS.Methods: The study was a systematic scoping review of the literature published between April 2020 and July 2022.Results: 87 articles were extracted followed by a standard process of The Preferred Reporting Items for Systematic reviews and meta-analysis (PRISMA) extension for Scoping reviews (PRISMA-ScR). The included studies had a 3223 LCS population. All types of primary and secondary articles were retrieved except for qualitative studies. The evidence was evaluated by an appraisal scoring tool followed by the guidelines of the “Enhancing the Quality and Transparency of Health Research ( EQUATOR) network”. The included papers had a mean appraisal score of 0.7807 on a 0 to 1 scale (SD 0.08), the minimum score was for study protocols (0.5870), and the maximum score was for Cohort studies (.8977). Sixty seven (67) evidence-based interventions were documented from 17 clinical categories. The most weighted interventions were treating underlying symptoms of long COVID (Adjusted score 1/1), management of fatigue (Adjusted score 0.963/1), aerobic exercise and balance training (Adjusted score 0.951/1), multidisciplinary rehabilitation (Adjusted score 0.926/1), and low resistance training and aerobic exercise (Adjusted score 0.889/1).Conclusion: We recommend Long COVID rehabilitation in a multidisciplinary approach by treating the individual symptoms, especially fatigue. Physiotherapy interventions play a significant role as most of the recommended interventions were exercise, modalities, patient education, respiratory rehabilitation, and telerehabilitation Scoping reviews do not require protocol registration from PROSPERO.
Objective: Group therapy involves multiple people being treated by one or more health professionals. It can cure physical and psychological conditions; such as attention-deficit/hyperactivity disorder (ADHD), emotional trauma, anxiety, despair, and post-traumatic stress disorder (PTSD). This study investigates whether community-based group therapy helps older women with chronic low back pain. Material and Methods: The study was a randomized controlled trial, with 40 patients divided into control and intervention groups. The control group received conventional treatment in an institute-based rehabilitation (IBR) facility, while the intervention group received the same exercise program in a community-based rehabilitation (CBR) setting. Both groups received supervised 30-minute sessions five days a week for eight weeks. The numeric pain rating scale (NPRS) was used to measure the severity of pain and the Roland-Morris Disability Questionnaire (RMDQ) measured physical disability due to low back pain in older women. Results: The average age of the participants was 56 (53 to 58.50). The BMI findings were 7.5% (n=3) of participants being underweight and 45% (n=18) of participants being overweight. In terms of pain and physical disability due to low back pain, the CBR group showed significant improvement (p-value<0.05) in cases of both inter- and intra-group comparison using the IBR treatment facility.Conclusion: Group therapy treatment reduces low back pain and prevents the severity of back pain in older women, thereby improving their quality of life. This study shows that group-based physical therapy helps relieve chronic low back pain. Strengthening, stretching, and flexion exercises in groups improve quality of life and minimise discomfort.
Musculoskeletal disorders are debilitating conditions that significantly impact the state of health, especially in older people. The study, which employed a cross-sectional design and practical sampling, included 206 participants among them 124 (62.2%) were men and 82 (39.8%) were women, from all over Bangladesh with musculoskeletal issues of varying severity and impact. The mean age of the participants was 64.9 (SD 4.3). The study was carried out between January and June of 2022. The majority of participants experienced musculoskeletal pain. Back pain was the most commonly complained of symptom among the participants (74.9%). It was also common to have limited mobility as a result of arthritic change, which eventually affected daily activities like taking care of oneself. To improve the health of the older adult population, more studies must be conducted to identify the many factors that contribute to musculoskeletal issues. The development of effective prevention and rehabilitation programs must then be based on this knowledge.
Spinal cord injury (SCI) is a consequence of significant disability and health issues globally, and long COVID represents the symptoms of neuro-musculoskeletal, cardiovascular and respiratory complications.
Background: Adaptive pacing improved fatigue and physical functioning in non-COVID patients with chronic fatigue syndrome. Safe long COVID-19 rehabilitation recommends patient-centred, customised, and safer approaches. There is a research gap on the effectiveness of telerehabilitation versus institution-based Adapted Physical Activity and Therapeutic Exercise Program (APTE) on long COVID-19 patients with chronic fatigue syndrome (CFS). Methods: We planned a three-arm prospective randomised control trial on 124 long COVID-19 cases with chronic fatigue syndrome to determine the effectiveness of APTE in institution-based care versus the telerehabilitation approach compared to active control. Participants will be recruited from a population based on the inception cohort and assigned to three groups with the concealed location process with an enrollment ratio of 1:1:1. Between May and July 2023, Participants will be assessed by blinded assessors and during the baseline evolution posttest. After two months and follow-up after six months post-intervention, the Chalder Fatigue Scale will measure primary outcome fatigue. SF-36 and the DALYs will measure the secondary outcome of physical functioning and episodic disability. Discussion: Previous studies suggest that adapted physical activity effectively manages fatigue symptoms in CFS cases in 12 sessions. In Long COVID-19, chronic fatigue syndrome is a prominent symptom that causes episodic disability and impacts a person's physical functioning, activities, and participation. To manage patients with long COVID-19, Telerehabilitation is a widely accepted process. This study will fill the research gap to determine the appropriate approach to APTE compared to active control. The future direction of the study will guide the determination of interventions in long COVID-19 rehabilitation. Trial registration: The trial is registered prospectively from a primary Clinical Trial Registry side of WHO CTRI/2023/03/050808 [Registered on: 17/03/2023] Keywords: Long COVID, Chronic Fatigue Syndrome, Adapted physical activity and Therapeutic exercise program, Telerehabilitation
Background:A diverse spectrum of long COVID symptoms (LCS) have the scope of physical rehabilitation. Due to limited resources, very little is known about the physiotherapy and rehabilitation interventions for LCS and their clinical application. This study aims to explore the role of physiotherapy and rehabilitation interventions in the management of musculoskeletal, neurological, cognitive, cardiorespiratory, mental health, and functional impairments of LCS.Methods:The study was a systematic scoping review of the literature published between April 2020 and July 2022.Results:87 articles were extracted followed by a standard process of The Preferred Reporting Items for Systematic reviews and meta-analysis (PRISMA) extension for Scoping reviews (PRISMA-ScR). The included studies had a 3223 LCS population. All types of primary and secondary articles were retrieved except for qualitative studies. The evidence was evaluated by an appraisal scoring tool followed by the guidelines of the “Enhancing the Quality and Transparency of health Research (EQUATOR) network”. The included papers had a mean appraisal score of 0.7807 on a 0 to 1 scale (SD 0.08), the minimum score was for study protocols (0.5870), and the maximum score was for Cohort studies (.8977). Sixty seven (67) evidence-based interventions were documented from 17 clinical categories.Conclusion:LCS can be treated by physiotherapy, exercise, and physical rehabilitation for musculoskeletal, neurological, cognitive, cardio-respiratory, mental health, and functional impairments at home or in clinical setups such as primary care settings by in-person care or telerehabilitation.
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