MSc in Advancing Physiotherapy Practice

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/9509

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WHOLE BODY VIBRATION EXERCISES FOR CHILDREN WITH CEREBRAL PALSY
(2018)
Background: Cerebral Palsy (CP) is defined as long-lasting non-progressive damage to the foetal or developing brain which may affect the individual’s movement and posture. A new physiotherapy intervention has been introduced in order to help treat children with CP which is called Whole Body Vibration (WBV). WBV helps to improve walking, muscle strength, bone mineral density (BMD), decrease tone and improve motor function in children with CP. However, research into the effectiveness of WBV has produced inconsistent results. An up-to-date systematic review is therefore necessary to appraise and synthesise all the available evidence. Objective: The aim of this systematic review was to evaluate the effectiveness of WBV exercises in children with CP on strength, walking, function, bone mineral density (BMD) and spasticity. Search Strategy: Five databases were searched during the month of May 2018 using a pre-determined selection of key words. The databases were: Cochrane Library, PubMed, CINAHL Plus with Full Text, MEDLINE and PEDro. The reference lists of all articles selected for inclusion were also searched to identify any additional studies. Selection Criteria: All randomised controlled trials (RCTs) including randomized cross-over trials were included in this systematic review. Data Collection and Analysis: The articles were selected based on the inclusion criteria. The methodological quality of all the final selected studies was assessed using The Cochrane Risk of Bias Tool. Results: Twelve articles were selected for inclusion in this review. The results of all six studies that focused on walking indicated that WBV has a positive effect on walking in children with CP who either walk alone or with a walking aid. Similarly, improvement in strength was found in four studies out of five, improvement in BMD was found in two studies out of only three and improvement in spasticity was found in three studies only. Four studies focusing on function resulted in an equal amount of conflicting results. The methodological quality of the studies included was variable. Conclusion: Results of the selected studies suggest that WBV as an adjunct to other treatment may improve walking who can walk with or without a walking aid. It may also improve muscle strength in children with CP. WBV may also improve spasticity and BMD. However, further high quality research is recommended to validate improvement in muscle strength, spasticity and BMD. Conflicting evidence for function has been found, therefore, further high quality studies are also recommended to investigate this further.
Surveying perceived confidence and competence of Allied Health Professionals in the Edinburgh City area (in relation to provision of 24 hour posture management).
(2018)
Background Participants: the Allied Health Professionals working with people with various advanced physical disabilities. In the all four health and social care localities of the Edinburgh City area 50-100 members of staff will take part in research. Allied Health Professionals views will be collected to investigate the level of awareness and confidence of providing 24 hours postural management. In addition to explore perceptions of the importance of the 24 hour Posture Management training which might potentially be useful to service. Design: Cross-sectional survey design. Procedure: The survey will be send out to Allied Health Professions (AHP) managers by email using Survey Monkey link. The email sent out by AHP managers in all four health and social care localities of the Edinburgh City area (appropriate ethical and management permissions obtained). Analysis: Descriptive analysis will be carried on by using the Excel, The responses will be compare within created professional groups. The responses will be divided in criteria/ themes accordingly. The data protection and confidentiality are carefully addressed in the study design, procedures, publication. Aim: The aim of the study is to investigate the level of awareness and confidence of delivering the 24 hour Posture Management across the Lothians. Search Strategy The research will use an electronic databases: CINAHL, MEDline, SCOPUS, PUBmed. Key words: postural care; posture management; 24h posture/postural management; body distortion AND postural care; body shape AND posture management; seating AND lying positioning; sleep system.
THE EFFECT OF TIME OF DAY, THE TEST-RETEST RELIABILITY AND THE RELATIONSHIP OF GAIT OUTCOME MEASURES WITH FATIGUE IN PERSONS WITH MULTIPLE SCLEROSIS
(2018)
One of the biggest challenges persons with multiple sclerosis (pwMS) are facing is difficulty in walking and this is related to decrease in quality of life (QOL). The throughout day variability of walking capacity and everyday unpredictability of symptoms, along with perceptions of fatigue may be related to the reduced walking ability and participation in functional activity. Aims and Hypotheses: The aims were to analyse the effect of time of day on walking and determine the between-day retest reliability of the tested 3D gait kinematics analysis and the 10-meter (10mWT) walking performance test. This study also aimed to determine the correlation between perceived fatigue severity (Fatigue Severity Score, FSS) and the walking performance outcome measures; 10mWT and 6MWT. We hypothesized that there is no effect of time of day on walking. A high test-retest reliability (ICC > 0.7) is hypothesized for gait kinematics and the 10mWT. And, the third hypothesis is that there is no significant correlation between perceived fatigue and walking performances. Methodology: In this secondary data study, within day differences of gait tested between morning (AM) and afternoon (PM) were analysed using paired t-test and Wilcoxon Signed Rank test; while test-retest reliability of the outcome measures assessed for between-day repeatability was evaluated using Intraclass Correlation Coefficient (ICC). The correlation between fatigue score and the walking measures were tested with Pearson Correlation Coefficient. Results: There is no difference in gait kinematics and walking performance assessed in AM and PM sessions. We found moderate to good reliability of gait kinematics and 10mWT as indicated by the ICC. Lastly, there is no statistically significant correlation between self-reported fatigue and measures of walking capacity. Conclusion: Based on the results, this study suggests that pwMS do not necessarily walk differently in the afternoons compared to mornings. The retest reliability offered fulfilment in knowledge gap regarding between-day reliability testing. Self-reports of fatigue are less likely to associate with objective walking ability suggesting that there may be other influences to walking performance in pwMS, and this requires further research.