Hong Kong Physiotherapy Journal

Ataxia telangiectasia (AT) is a rare neurodegenerative condition with a prevalence of 1 in 40,000 to 1 in 300,000 worldwide. It involves a genetic mutation of chromosome 11q.26. The condition is inherited in an autosomal recessive manner causing atrophy of the cerebellum due to loss of Purkinje fibres. AT presents early in childhood and the clinical features depend on the type of mutation. The study is a case report of a rare genetic disorder of a 9-year-old female who came to the physiotherapy clinic with a diagnosis of AT. The patient was presented with progressively worsening gait problems with frequent falls, with complete dependence on assistance and impaired balance and coordination. The treatment program was 12 months divided into an intense physiotherapy program for two months followed by 10 months of two times per week of physiotherapy sessions. The program was divided into four elements which are: (1) Lifestyle changes, (2) Strengthening exercises, (3) Coordination exercises, and (4) Balance training exercises. The result showed a positive outcome in increasing the patient’s independence, increased muscle strength, reduced ataxia symptoms intensity, and the patient can carry out complex activities with the help of accessory orthosis devices.

Background: Correct goal setting for patients is one of the most important aspects of physical therapy.

Objective: The purpose of this study was to investigate the effect of physical therapy using goal attainment scaling (GAS) scores to assess the gait function in patients with subacute stroke and related factors.

Methods: This retrospective cohort study was conducted using the medical records of 129 patients with subacute stroke who had been treated with intensive rehabilitation intervention. This study was approved by the Institutional Review Board of Bundang Cha Hospital (2021-06-008). The functional ambulation category (FAC) was used to set goals with the involvement of patients and their caregivers after the initial assessment, and raw GAS scores were calculated according to whether the goals were achieved through assessment one month later based on the FAC score. The groups were then divided according to the raw GAS scores (−1, 0, 1, or 2), and the general characteristics and clinical assessment scores were statistically analysed.

Results: From our results, there were differences in clinical assessment scores based on raw scores on the GAS ($p<0.05$) and correlation between raw scores on the GAS and improvement scores on the clinical assessment items ($p<0.05$). Moreover, when the gait function measured by FAC was used as a GAS in subacute stroke patients, the better the function of Rivermead mobility index ($\beta =0.613$, $p<0.05$) and Korean-mini-mental state examination ($\beta =0.217$, $p<0.05$) than the other clinical factors, the higher the goal attainment raw score.

Conclusion: Functions, including cognitive function, should be included when setting goals to improve the gait function and should be considered when developing the neurological physiotherapy programmes. This study helps physicians and physical therapists who first apply functional gait assessment as a GAS to set the initial goals and improves patient and caregiver motivations by applying GAS to patients with lower initial cognitive levels.

Background: Stress and sedentary lifestyles negatively impact the physical fitness of overweight and obese female university students. Physical activity has been shown to promote psychological as well as physical wellness. However, the effects of Surya Namaskar (SN) yoga on stress and physical fitness remain unclear.

Objective: This study aimed to compare the physical fitness, anthropometric measures, and perceived stress between the SN yoga training program group and the control group.

Methods: In a randomized controlled study, 44 overweight and obese female university students participated. For 8 weeks, the exercise group received training in SN yoga, whereas the control group was not permitted to participate in any form of exercise. At baseline and after 8 weeks of training, all participants completed the Thai Perceived Stress Scale-10 (T-PSS-10), and assessed the body mass index (BMI), waist–hip ratio, body fat percentage, maximum oxygen consumption (VO₂max), and muscle strength and flexibility. We used the dependent t-test or Wilcoxon sign rank test to examine the differences between the T-PSS-10 and physical fitness within each group. The statistical differences of all parameters between the two groups were compared using an independent t-test or a Mann–Whitney U test. A p-$\mathrm{\text{value}}<0.05$ was considered statistically significant.

Results: Compared to the baseline, the SN yoga group’s post-training period had a significant increase ($p<0.05$) in forward back flexibility, hand grip strength, leg strength, and VO₂max, while a significant decrease ($p<0.05$) in T-PSS-10 scores and BMI. In addition, we found a significant difference between the both groups in forward back flexibility and T-PSS-10 scores in the post-training period ($p=0.015$ and $p=0.009$, respectively).

Conclusion: This study’s findings demonstrated that SN yoga is a useful exercise for enhancing overweight and obese female university students’ perceived stress scales and physical fitness.

Background/Objective: Office workers are exposed to high levels of sedentary time. This sedentary time may have impacts on office workers which affect the normal movement patterns of sitting position caused by muscle tightness and weakness. The aims of this study were to investigate postural changes in lower crossed syndrome (LCS) on a head tilt angle (HTA), craniovertebral angle (CVA), sagittal shoulder angle (SSA), and trunk flexion angle (TFA) during 30 min sitting in female office workers.

Methods: Fifty-four office workers who use computer for at least 4 h/day, work for at least 5 years were recruited. All subjects were evaluated their posture, muscle length and power and assigned into three groups: healty group ($n=18$), LCS type A ($n=18$), and LCS type B ($n=18$). Testing posture was 30min sitting at computer workstation and typing on standardized with video record. Then three pictures were captured at four points of time from VDO records. All angles were measured two-way mixed ANOVA and post-hoc Tukey test was used to analyse the data.

Results: Subjects with LCS type B have less CVA, SSA, and TFA than healthy and participants with LCS type A significantly during sitting at 0, 10, 20 and 30min. There was no significant difference in HTA among the three groups.

Conclusion: Subjects with LCS type B showed significant the upper body posture changes compared with other groups.

Background: Handball affects the spinal anterior–posterior curvatures and disturbs the foot plantar pressure which provides insights into alterations in an individual’s posture. However, little is known about how the mal-alignment affects the distribution of plantar pressure.

Objective: To investigate the relationship between the thoracic kyphosis angle, and plantar pressure distribution among handball players.

Methods: Sixty male handball players were distributed into two groups based on their thoracic kyphosis angles. Group A: 28 handball players with an angle greater than 44^∘ (kyphotic group), and group B: 32 handball players with an angle equal to or less than 44^∘ (normal group). The Formetric III 4D spine and DIERS Pedoscan devices were used to measure the trunk anthropometry and plantar pressure distribution. The Pearson correlation test was used to explore the relationship between the kyphosis angle and plantar pressure distribution.

Results: Group A was significantly taller, had longer trunk length, greater lumbar lordosis angles, and forefoot plantar pressure (FPP), and less rearfoot plantar pressure (RPP) than group B ($p<0.05$). They showed a highly significant positive correlation between the thoracic kyphosis angle and FPP, and a highly significant negative correlation with the RPP ($r=0.672$, $-0.650$, respectively). There was no correlation between the lumbar lordosis angle and FPP or RPP ($r=0.025$, $-0.045$, respectively).

Conclusion: Handball players with greater thoracic kyphosis angle have greater lumbar lordosis angle. Increasing the thoracic kyphosis angle is strongly associated with increased FPP and decreased RPP. While there is no relationship between the lumbar lordosis angle and FPP or RPP.

Background: Mobile health (M-health) has emerged as a promising solution for enhancing the management of low back pain. However, the feasibility of M-health among the Chinese population and its influencing factors remain unclear.

Objective: This study aimed to assess the acceptance of M-health among people with chronic low back pain (CLBP) and physiotherapists in Shanghai, China, and to explore the influencing factors of its utility in the treatment of CLBP.

Methods: Semi-structured interviews and focus groups were conducted with 25 participants with CLBP and 20 physiotherapists, utilising a combination of group discussion and individual interview. Thematic analysis, supported by NVivo software, was employed to identify and examine the themes regarding the facilitators and barriers to the utility of M-health in Shanghai, China.

Results: The focus group discussions revealed a broad spectrum of factors that drive or hinder participants’ acceptance of M-health. Three main themes related to the feasibility of M-health were identified from the interviews: (1) Reasons for embracing M-health; (2) Reasons for resisting M-health; (3) Recommendations to enhance the feasibility of M-health. In general, participants exhibited enthusiasm towards the prospect of offering M-health as a viable treatment.

Conclusions: The findings of this study indicate that the feasibility of M-health depends on many factors in Shanghai, China. Efforts to promote the establishment of M-health policy or laws, rational integration of M-health and face-to-face model and improvement of the functions of M-health applications may increase its feasibility in Shanghai, China.

Background: Improvements for knee osteoarthritis (OA) care models are carried out widely. Yet, patient attendance behaviours in present care models are not fully understood, without the readily available localised evidence.

Objective: Hence, we examined the relationships of patient-specific factors with the physiotherapy attendance for patients with knee OA.

Methods: A retrospective, cohort study was conducted. Primary data from a randomised controlled trial of a community-based, individualised, multidisciplinary programme for patients with knee OA was analysed. Patient-specific factors like demographics, medical factors, self-reported knee function, physical function testing, activity levels and psychological factors were considered. We ran multiple ordered logistic models to examine the relationships between these factors and patients’ physiotherapy attendance.

Results: We found that factors like gender, BMI, pain during physical function, previous knee injections and psychological symptoms were associated with the physiotherapy attendances of patients with knee OA.

Conclusion: There’s evidence to suggest that patient-specific factors are associated with different levels of physiotherapy attendance among the patients with knee OA. Our results further the understanding of physiotherapy attendance patterns of patients with knee OA, and reinforces the need to consider these factors when developing informed treatment strategies that optimises the physiotherapy attendance of these patients.