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Abstract: Aim: The aim of this study was to verify the effects of a multisensory exercise programme on the cognition and functionality of institutionalized older adults. Methods: Forty‐five volunteers were randomly allocated to 2 groups, the multisensory exercise programme (n = 24) and the control group that received no treatment (n = 21). The programme consisted of 3 50‐min sessions of progressive exercises per week for 16 weeks that challenged their strength, balance, coordination, multisensory stimulation, and flexibility in different tasks. Cognition (Montreal Cognitive Assessment), balance (Berg Scale), mobility (Timed Up and Go), and functional performance (Physical Performance Test) were measured preintervention and postintervention. Statistical analyses were performed using Student's t test and 2‐way ANOVA. Results: The multisensory exercise programme showed statistically significant improvements (p < .05) on cognition (effect size [ES]: 0.92), balance (ES: 0.77), mobility (ES: 0.51), and functional performance (ES: 0.86) as compared with the control group, which showed no statistical significant differences at the postintervention time point. Conclusions: The multisensory exercise programme improved the cognition and functionality of institutionalized older adults. The introduction of a motor and multisensory‐based approach in care routines may improve residents' health and engagement to the environment. [ABSTRACT FROM AUTHOR]

Background and purpose The most effective treatment approach to improve walking in people with multiple sclerosis (MS) is not known. The aim of this trial was to assess the efficacy of treadmill training and progressive strength training on walking in people with MS. Methods A single blinded randomized parallel group trial was carried out. Eligible participants were adults with MS with Expanded Disability Status Scale score ≤6. A total of 29 participants were randomized and 28 received the allocated exercise intervention, treadmill ( n = 13) or strength training ( n = 15). Both groups exercised 30 minutes, three times a week for 8 weeks. Primary outcome was The Functional Ambulation Profile evaluated by the GAITRite walkway. Secondary outcomes were walking work economy and balance control during walking, measured by a small lightweight accelerometer connected to the lower back. Testing was performed at baseline and the subsequent week after completion of training. Results Two participants were lost to follow-up, and 11 (treadmill) and 15 (strength training) were left for analysis. The treadmill group increased their Functional Ambulation Profile score significantly compared with the strength training group ( p = .037). A significant improvement in walking work economy ( p = .024) and a reduction of root mean square of vertical acceleration ( p = .047) also favoured the treadmill group. Discussion The results indicate that task-specific training by treadmill walking is a favourable approach compared with strength training to improve walking in persons with mild and moderate MS. Implications for Physiotherapy practice, this study adds knowledge for the decision of optimal treatment approaches in people with MS. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose This study sought to answer the following questions: What are the outcomes of physiotherapy post lumbar total disc replacement (LTDR) compared with patient self-mediated rehabilitation? Is a difference in outcomes related to the number of physiotherapy sessions? Methods This is a retrospective observational study of 600 patients post TDR. Patient outcomes for self-mediated rehabilitation (Group 1), 1-3 sessions of clinic-based physiotherapy (Group 2) and ≥4 sessions of clinic-based physiotherapy (Group 3) were analysed. Outcomes measures included the Oswestry Disability Index (ODI), Roland Morris Disability Questionnaire (RMQ), Short Form-36 Physical (SF-36 PCS) and Mental Subscale Components (SF-36 MCS), Visual Analogue Scale (VAS) for back and leg pain intensity. Patient's pre-operative baseline measures and post-operative follow-up measures at 3, 6, 12 and 24 months post-operatively were analysed. Results Oswestry Disability Index and RMQ had significantly lower scores in Group 3 compared with Group 1 at 3, 6, 12 and 24 months follow-up. Significantly lower scores for Group 2 compared with Group 1 were observed for the ODI at 3 months follow-up and for the RMQ at 3 and 6 months follow-up. Significantly lower scores were observed in Group 3 compared with Group 1 for VAS back pain at 3 months and VAS leg pain at 6 months follow-up. Significantly higher scores in Group 3 compared with Group 1 were also observed in the SF-36 PCS at 6, 12 and 24 months. Significantly higher scores in Group 2 compared with Group 1 were observed at 6 months follow up. These trends were also observed when investigating the percentage of patients with a greater 50% improvement in the outcome measure. Conclusions Physiotherapy post-LTDR produces statistically significant and possibly clinically important improvements in functional disability, pain and quality of life outcomes compared with self-mediated rehabilitation. Copyright © 2015 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose Playing an instrument implies neuroplasticity in different cerebral regions. This phenomenon has been described in subjects with stroke, suggesting that it could play a role in hand rehabilitation. The aim of this study is to analyse the effectiveness of playing a musical keyboard in improving hand function in subjects with multiple sclerosis. Methods Nineteen hospitalized subjects were randomized in two groups: nine played a turned-on musical keyboard by sequences of fingers movements (audio feedback present) and 10 performed the same exercises on a turned-off musical keyboard (audio feedback absent). Training duration was half an hour per day for 15 days. Primary outcome was the perceived hand functional use measured by ABILHAND Questionnaire. Secondary outcomes were hand dexterity, measured by Nine-Hole Peg Test, and hand strength, measured by Jamar and Pinch dynamometers. Two-way analysis of variance was used for data analysis. Results The interaction time × group was significant ( p = 0.003) for ABILHAND Questionnaire in favour of experimental group (mean between-group difference 0.99 logit [IC95%: 0.44; 1.54]). The two groups showed a significant time effect for all outcomes except for Jamar measure. Discussion Playing a musical keyboard seems a valid method to train the functional use of hands in subjects with multiple sclerosis. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and Purpose. Patellofemoral pain (PFP) is associated with a wide range of local and global physical factors possibly contributing to pain and thus requires detailed assessment and individualized treatment. Yet, no cohort study was found that assessed the value of individualized physiotherapy, probably because this approach lends itself to clinical practice but not to scientific research. Most studies focus on a 'knee' or 'hip' treatment approach irrespective of individual global differences in lower limb alignment, movement patterns and muscle tightness. Therefore, this study aimed to determine the effectiveness of supplementing local treatment of PFP with individualized treatment targeting global contributing factors. Secondarily it aimed to subgroup the patients according to variations in lower limb alignment/laxity, movement patterns, biarticular muscle tightness and joint degeneration. Method. Forty-one patients (60 knees) with PFP who had followed a programme of local quadriceps strengthening, quadriceps stretching and taping for one fortnight were prescribed an individualized programme based on assessment. This global assessment included lower limb postural alignment, movement patterns, muscle tightness and range of motion. Another fortnights treatment was prescribed accordingly and included specific, individualized postural and movement retraining, stretching and functional weight-bearing, strengthening exercises. Seven outcome measures, namely four pain measures, isokinetic quadriceps strength, quadriceps length and eccentric knee control, assessed improvement. Results. All outcome measures showed further significant improvement following individualized treatment ( p < 0.03). Patients fell into four broad physical subgroups: hypermobility (often with malalignment), hypomobility (with three of four tight muscle groups), faulty movement patterns (mostly dynamic knee valgus) and patellofemoral osteoarthritis. Conclusions. Individualized treatment supplementing local standard physiotherapy for PFP leads to further significant improvement over 2 weeks. This study highlights the importance of assessing patients globally in order to optimize treatment and ongoing improvement. Recognition of different subgroups may guide treatment that should include both local and deficit-targeted global treatment. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background and purpose Functional limitations in stroke survivors are sometimes associated with fatigue. This study assessed the functional limitations due to fatigue in community-dwelling stroke survivors undergoing physiotherapy. The differences in functional limitations due to fatigue were determined between sexes, stroke types, sides of affectation, age categories and levels of disability. Relationships between functional limitation due to fatigue and these variables were also determined. Methods This was a cross-sectional study involving 63 stroke survivors (35 male survivors and 28 female survivors) with ages ranging from 45 to 79 years (mean = 53.68 ± 10.95 years). Functional limitation due to fatigue was assessed with the modified fatigue impact scale (MFIS). Modified Rankin scale was used to categorize the disability of the participants. Data were analysed using descriptive (mean, standard deviation, percentage and frequency) and inferential (Mann-Whitney U-test and Spearman correlation analysis) statistics. Significance was set at 0.05 α level. Results/findings The mean MFIS score was 31.74 ± 12.39. Many participants (58.7%) had moderate functional limitations due to fatigue. The result of Mann-Whitney U-test showed significant difference in functional limitation due to fatigue between participants with slight disability and those with moderate disability ( p = 0.000), with participants with moderate disability having higher MFIS scores (more functional limitations). There was also a significant correlation between functional limitation due to fatigue and level of disability ( ρ = 0.625, p = 0.000). Discussion Functional limitation due to fatigue occurs frequently in stroke survivors and is related to level of disability. Functional limitations due to fatigue should be assessed frequently in all stroke survivors with varying degrees of disability and the outcome should be considered during rehabilitation and retraining of physical function. Copyright © 2014 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]