The effect of concurrent image projection technique on gait training for post total knee arthroplasty patients

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Research Report Poster Presentation Number: RR-PO-12-20-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 PREVALENCE OF WORK-RELATED MUSCULOSKELETAL DISORDERS AMONGST PHYSIOTHERAPISTS IN THE KINGDOM OF BAHRAIN D.N. Aljairan, H.K. Al Maeeli, A.R. Al Fadhel, E.S. Al Saeedi, L. Shibu, E. Rajab Ahlia University, Physiotherapy Department, Manama, Bahrain Background: Physiotherapists are prone to work-related musculoskeletal disorders (WRMDs), especially lower back pain, due to the physically demanding and repetitive nature of their job. However, there is a lack of published data regarding WRMDs amongst physiotherapists in the Kingdom of Bahrain. Purpose: To determine the prevalence of WRMDs, associated work risk factors and impact of work related musculoskeletal disorders amongst physiotherapists in the Kingdom of Bahrain. Methods: The study design was a cross-sectional survey. A total of 180 self-administered questionnaires were distributed to physiotherapists at 34 health institutions across the country. The inclusion criteria were an ability to communicate in English, >1 year of physiotherapy professional experience, working in any clinical specialty, and full- or part-time employment within the last year. All physiotherapists with a history of chronic musculoskeletal condition(s) since qualifying were excluded. The questionnaire consisted of three parts: demographics and occupational profile, characteristics of work-related tasks, and the Nordic Musculoskeletal Questionnaire. Descriptive statistics, frequency and Chi squared analyses were calculated using SPSSTM version 16. Results: A total of 141 questionnaires were completed, giving a response rate of 78.3%. A total of n = 127 physiotherapists met the inclusion criteria, equivalent to ∼40% of all employed physiotherapists in the country, based on available information. Ninety one percent of physiotherapists reported pain in at least one body region during the last year; 78% reported pain in two or more regions. The most common region affected was the lower back with a prevalence of 72.4%. Prevalence of lower back pain was highest amongst injured males >30 years old with >5 years of experience (45.8%); prevalence amongst females was not different for those ≤30 years old and with ≤5years of experience (31.6%), compared to those >30 years old and with >5 years of experience (31.6%). Physiotherapists reported that frequent standing (40.2%), manual handling techniques (35.4%), walking frequently (32.3%) and applying repetitive

movements (32.3%) were the four most common workrelated risk factors for development of WRMDs. Of those physiotherapists with lower back pain, 53.6% were unable to accomplish their work duties, and 54.8% complained of pain during the seven days prior to completing the questionnaire. Conclusion(s): The prevalence of WRMDs amongst physiotherapists in the Kingdom of Bahrain was high in comparison to many other countries. The lower back was the most common region affected, and prevalence was related to age and professional experience in males but not females. Work duties were significantly affected by lower back pain. Implications: Further research is needed to identify why the prevalence of WRMDs is high amongst physiotherapists in the Kingdom of Bahrain and what changes should be implemented in the work place in order to minimize the risk of injury. Keywords: Work-related musculoskeletal disorders; Physiotherapists; Bahrain Funding acknowledgements: This study was funded by Ahlia University, Kingdom of Bahrain. Ethics approval: The study was approved by the Ethics Committee, Ahlia University, and the Ministry of Health, Kingdom of Bahrain. http://dx.doi.org/10.1016/j.physio.2015.03.172 Research Report Poster Presentation Number: RR-PO-15-15-Sat Saturday 2 May 2015 12:15 Exhibit halls 401–403 THE EFFECT OF CONCURRENT IMAGE PROJECTION TECHNIQUE ON GAIT TRAINING FOR POST TOTAL KNEE ARTHROPLASTY PATIENTS Y. Alkhabbaz 1 , A.T. Tsutou 2 , M. Honjo 2 1 University

of Bahrain, Physiotherapy, Sukheer, Bahrain; 2 Kobe University, Graduate School of Health Science, Kobe City, Japan Background: During Total Knee Arthroplasty (TKA) post-operative (Post-OP) Gait training, patient postural correction is usually provided through oral instruction from a physical therapist or through watching a mirror image of him/her. Positive therapeutic effects to a certain degree have been attained through these methods, but the scientific bases of these results have not been well reviewed. On the other hand, concurrent image projection technique is a new selfcorrection method in which the patient’s rear view is captured and projected onto a screen in front of him/her simultaneously during gait training. Purpose: Given these circumstances, the purpose of this study is to compare between the therapeutic effects of conventional therapeutic methods of verbal instruction and mirror

WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS26–eS426

stimuli, and concurrent image projection technique for gait training and rehabilitation. Methods: 22 TKA Post-OP patients participated in the present study (conventional treatment group; n = 13, concurrent image projection group; n = 9). Joint angle and momentum of the hip, knee, and ankle were recorded for both groups before operation and before discharge from the hospital. Ground reaction force plates and a three-dimension motion analysis system were utilized for data collection. In addition, both groups’ data were compared with the control healthy groups’ (n = 6) gait data. Results: Concurrent image projection groups’ hip extension/external rotation, knee joint extension/external rotation, and ankle joint dorsi flexion/eversion momentums were significantly higher than the conventional treatment groups’ respective results. Moreover, apart from the hip extension momentum, no significant difference was found between the concurrent image projection group’s ‘before discharge momentum’ results and the control group’s momentum results. Conclusion(s): Present study suggests that concurrent image projection technique, which could be considered a feedback technique, is useful for the improvement of the gait abilities for post TKA patients. Implications: Concurrent image projection technique is a very effective technique for gait training and it is recommended to apply it in a clinical setting. Further studies should be conducted on the long-term (3 months and 6 months) effects of TKA Post-OP gait training and rehabilitation. The same technique efficiency should be tested for other procedures that require gait training such as, total hip replacement, and below-above knee amputation clinical cases. Keywords: TKA; Gait training; Concurrent image projection Funding acknowledgements: The researchers would like to state that no external fund was received to perform or sponsor the present study. Ethics approval: Ethical committee consists of the Shiga Medical Center administrative board and external experts consent was obtained before starting this research. http://dx.doi.org/10.1016/j.physio.2015.03.173

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Special Interest Report Poster Presentation Number: SI-PO-18-12-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 THE RATIONALE FOR EXERCISE IN THE MANAGEMENT OF PAIN IN PEOPLE WITH PARKINSON’S DISEASE: A NARRATIVE REVIEW N.E. Allen 1 , V. van Vliet 1 , C.G. Canning 1 , N. Moloney 2 1 The

University of Sydney, Clinical and Rehabilitation Sciences Research Group, Sydney, Australia; 2 The University of Sydney, Arthritis and Musculoskeletal Disorders Research Group, Sydney, Australia Background: Parkinson’s disease (PD) is a multisystem neurodegenerative condition resulting in diffuse central nervous system pathology and numerous motor and non-motor impairments. Pain is a distressing non-motor impairment experienced by up to 85% of people with PD, yet it is often untreated. The pathophysiology of this pain is complex, with numerous subtypes of pain suggested. Expert opinion recommends that exercise is included as one component of pain management programs, however the effect of exercise on pain, in this population is unclear. Purpose: The purpose of this review is to present evidence describing: (1) the potential influence of exercise on the neurophysiology of pain in PD and (2) the potential role of exercise in the clinical management of pain in PD. Methods: Five electronic databases were searched in January 2014 as well as the reference lists of relevant published articles. Published journal articles exploring the neurophysiology of pain in PD, as well as the impact of exercise on neuroplasticity and neurorestoration and on dopaminergic and non-dopaminergic pathways were reviewed. A search was also conducted for trials of exercise interventions which included pain as an outcome measure. Results: Pain in PD can be directly attributable to the disease process, sensitisation of the nervous system or to structural or biomechanical abnormalities, which may or may not be exacerbated by PD impairments. Emerging evidence from both animal and human studies suggests that exercise might contribute to neuroplasticity and neuro-restoration by increasing brain neurotrophic factors, synaptic strength and angiogenesis as well as stimulating neurogenesis and improving metabolism and the immune response. These changes may be beneficial in improving the central processing of pain. There is also evidence that exercise can activate both the dopaminergic and non-dopaminergic pain inhibitory pathways, suggesting that exercise may help to modulate the experience of pain in PD. Two uncontrolled trials that