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Physio Dynamics Albania

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België
Mechelen
Physio Dynamics Albania

Kjo faqe eshte ndertuar per te ju ardhur ne ndihme fizioterapisteve ne Shqiperi.

Ndarja e informacionit dhe te qenurit update me studimet shkencore me te fundit te fushes eshte nje nder qellimet tona kryesore.

15/06/2020

♦️Psychosocial factors affecting outcomes after shoulder arthroplasty: a systematic review⁣♦️
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⛳This systematic review shows that psychosocial factors may play just as important role in affecting patient outcomes after total shoulder arthroplasty as technical factors⁣
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👉Sixteen studies met the inclusion criteria.
1. Six reviewed mental health disorders as predictors of postoperative outcome after shoulder arthroplasty.⁣
- Of these, 4 found that disorders such a depression and anxiety were associated with increased risk of perioperative complications and lower final functional outcome scores. ⁣
- Two studies evaluated workers' compensation status as a possible predictor of outcomes and found that patients with claims had lower satisfaction and outcome scores at final follow-up compared with those without claims. ⁣
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2. Two studies showed that preoperative opioid use was associated with lower outcome scores and overall satisfaction rate after shoulder arthroplasty. ⁣
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3. Three studies showed that higher patient confidence and preoperative expectations were correlated with better outcomes.⁣
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Ref art. https://www.jshoulderelbow.org/article/S1058-2746(19)30704-9/fulltext⁣
⁣

08/06/2020

📍⁣Evidence of low certainty suggests that eccentric exercise may provide a small but likely not clinically important reduction in pain post-treatment compared with other types of exercise in patients with subacromial impingement syndrome. ⠀ ⠀ ⠀

📎At intermediate to long-term follow-up, eccentric exercise may result in little or no important difference in pain compared with other types of exercise. It is uncertain whether eccentric exercise improves function more than other types of exercise post-treatment and at intermediate to long-term follow-up in patients with subacromial impingement syndrome (very low certainty of evidence). ⠀ ⠀ ⠀

📍Pain during exercise does not seem to provide greater improvement in pain or function compared with pain-free exercise. On the other hand, no negative effects have been observed. Eccentric training regimens have shown both similarities and diversity. Intervention durations of six to 8 weeks have been shown to be similar in effectiveness as an intervention duration of 12 weeks. ⠀

🖇For frequency and intensity no conclusions can be made, but it seems that exercise at higher intensities might yield better results. When it comes to exercise type, only shoulder external rotation with neutral shoulder and the full can exercise have been studied. It is likely that the optimal exercise will vary depending on underlying tendinopathy. ⠀ ⠀ ⠀

📝Further research as outlined above is necessary.⠀ ⠀ ⠀

🚩 Ref article: httpp://bmcmusculoskeletdisord.biomedcentral.com/articles/10.1186/s12891-019-2796

01/06/2020

♦️Type III AC Injuries have raised lots of discussions when it comes to treatment approach. Consevative vs Surgical Intervention. This due to lots of pros and cons that these two treatment options have.

♦️The literature seems to slightly favor conservative rehab first and in case it fails than surgical treatment should be considered as an option.♦️

👉In this post you will find a list of pros and cons of both approaches about Type III AC injuries.👈

23/05/2020

Different classification systems have been proposed for AC injury to aid diagnosis and management. ⠀
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👉The most popular of these systems is the Rockwood classification, which expanded on the previously proposed three-tiered classification system to include three more types. ⠀
🧐Even more recently, the ISAKOS (International Society of Arthroscopy, Knee Surgery & Orthopedic Sports Medicine) Upper Extremity Committee provided a modified Rockwood classification, suggesting the addition of Grade IIIA and Grade IIIB injuries.⠀
⠀
💢Type III injuries involve complete tear of both the AC and CC ligaments, with % superior displacement of the distal clavicle. => Horizontally and vertically translated. AC joint would be considered dislocated. Type III AC injuries are recently subclassified into Grade IIIA and Grade IIIB. ⠀
⠀
1. Grade IIIA injuries- Stable injury⠀
⠀
⛳Grade IIIA would be defined by a stable AC joint without overriding of the clavicle on the cross-body adduction view and without significant scapular dysfunction. ⠀
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2. Grade IIIB injury - Unstable injury⠀
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⛳Grade IIIB would be further defined by therapy-resistant scapular dysfunction and an overriding clavicle on the cross-body adduction view⠀
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💢Type IIIB lesions can be associated with:⠀
- Significant weakness and pain during rotator cuff testing,⠀
- Decreased range of motion during abduction and flexion, ⠀
- Scapular dyskinesis.⠀
⠀
♦️Reference article: https://pubmed.ncbi.nlm.nih.gov/24485119/

04/05/2020

👉🤓According to a longitudinal cohort study of Pallis et al., 2012, where 162 AC joint injuries were registered on a period of 4 years (2005-2009) showed that:

🏃‍♂️AC injuries are very common in young athletes!!!

🤼‍♀️🤾‍♂️Sport: Mostly on rugby, wrestling, hockey..,

A study conducted on athletes of the English professional rugby union showed that 32% of injuries during a match affect the AC joint.

🏃‍♂️> 🏃‍♀️M>F

🤞Return to sport depends on the type of injury (89% low grade injury) =>
- Averagely the time to return to sports is around 18 days
- At low grade injuries 10 days

-At high grade injuries 68 days (up to 16 weeks after surgical intervention). 71% elected to undergo surgical repair/reconstruction (Pallis et al., 2012)

‼There are two main injury mechanisms known:
1. Direct => the most frequent mechanism. Direct impact on acromion with the shoulder adducted. Acromion will translate medial-inferiorly and combined with insufficient lig stabillity (AC/CC/ deltotrapezial fascia) will lead to AC Injury, most likely dislocation.
2. Indirect => very rare but happens, fall on outstretched hand.

‼Soon we will upload a new post about the classifications of AC injuries 🤗

Follow us for more 🤗

02/05/2020

The Dunning-Kruger effect tek fizioterapistet gjithashtu?

👉The Dunning–Kruger effect is a cognitive bias in which people with low ability at a task overestimate their ability. It is related to the cognitive bias of illusory superiority and comes from the inability of people to recognize their lack of ability. Without the self-awareness of metacognition, people cannot objectively evaluate their competence or incompetence. ‼‼

👉Ky efekt është studiuar nga dy psikologe sociale David Dunning dhe Justin Kruger , të cilet kanë fituar edhe çmimin Ig Nobel Prize.

👉Efekti i Dunning-Kruger është një formë e bias cognitiv në te cilin njerezit kanë një iluzion intern superoriteti, se janë më të afte se ne të vertete janë. Në fakt, pa vete-njohje “self-awarness” dhe zvillim metacognitiv, njerezit nuk mund të vleresojne në mënyre objektive aftesitë e tyre kompetente dhe inkompetente. Shpesh ky grafik i drejtohet profesionisteve te rijn, por jo gjithmone.😊

🤓Interested to know more? Check this article 👇👇👇 https://www.researchgate.net/publication/12688660_Unskilled_and_Unaware_of_It_How_Difficulties_in_Recognizing_One's_Own_Incompetence_Lead_to_Inflated_Self-Assessments

25/04/2020

⚠️Patient education is a very important part of the rehab ‼ 🤓👨‍🎓

25/04/2020

‼‼Informimi i pacientit në mënyren e duhur profesionale dhe edukimi i tij persa i takon patologjise, ndërhyrjes terapeutike dhe pritshmerive janë faktorë thelbësore në REHABILITIM ‼‼

23/04/2020

👩‍🏫 Fuzioni i zones lumbare eshte nje procedure relativisht e zakonshme me kosto te larte dhe me mundesi serioze komplikacionesh. Zakonisht behet per te trajtuar simptomat qe lindin nga gjendje degjenerative si semundjet e diskut intervertebral dhe stenoza e kanalit spinal. Me rralle perdoret per te trajtuar spondilolistezen, traumat dhe tumoret.

Evidencat ne dispozicion:

👉Nuk suportojne pretendimin qe fuzioni spinal siguron nje perfitim klinik ne krahasim me alternativat jo kirurgjikale per dhimbjet e shpines te shoqeruara me semundjet degjenerative te diskut apo forma te tjera gjendjeve degjenerative.�

👉Nuk suportojne pretendimin se fuzioni spinal ishte me i mire se ushtrimet e stabilitetit per frakturat burst torako-lumbare.�

👉Sportim I paqarte qe fuzioni lumbar eshte me i mire se trajtimi konservativ per spondilistezes iskemike (kishte vetem nje studim me nje rrisk shume te larte bias).

👉Mbeshtetje e limituar per pretendimin qe kirurgjia ne karcinomat metastazike te shpines permireson levizshmerine dhe symptomat neurologjike (kishte vetem nje studim)

Pavarsisht nga kostoja e larte dhe rrisku i nderhyrjes se fuzionit spinal , ky studim nuk ka gjetur asnje evidence qe mbeshteste perdoriminn e tij per dhimbjen e shpines i lidhur me gjendjet degjenerative. Ekzistojne evidenca te limituara per patologjite e tera dhe ne pergjithesi baza e evidencave eshte e dobet. Rrisku i bias ne keto studime pergjithesisht ishte i larte dhe nuk ekzistojne ende systematic reviews me cilesi te larte persa i takon kesaj nderhyrje kirurgjikale.

‼‼Conclusion: Better and high quality research is needed!!!

https://www.ncbi.nlm.nih.gov/pubmed/30517997

20/04/2020

Syndroma e dhimbjes patelo-femorale dhe roli i aktivizimit muskular te Gluteus Medius ne shfaqjen e symptomave.

Nje nga symptomat me te shpeshta qe keta paciente manifesojne eshte dhimbja difuse unilatrale ose bilaterale ne art. e gjurit gjate ngjitjes dhe zbritjes se shkalleve ose gjate vrapimit.

Studimet e fundit sugjerojne qe pacientet me dhimbje patelo-femorale manifestojne nje aktivizim te vonuar muskular te Gluteus Medius ne EMG gjate ngjitjes ose zbritjes se shkalleve (moderate-strong evidence). Gjithashtu gjate vrapimit eshte vene re nje aktivizim i vonuar muscular i Gluteus Medius dhe qe zgjat me pak ne kohe. Nderkohe ne anen tjeter eshte vene re nje rritje e aktivizimit muskular te Gluteus Maximus gjate zbritjes se shkalleve (limited evidence).

Pra si perfundim mund te themi se aktivizimi i vonuar muskular i Gluteus Medius mund te luaje nje rol te rendesishem ne kontrollimin jo optimal te mobilitetit te art. gleno-femoral ne plan frontal dhe transversal dhe per pasoje mund te kemi nje influencim ne shfaqjen e symptomave patelo-femrorale ne art. e gjurit. Prandaj eshte e keshillueshme qe disa ushtrime specifike per Gluteus Medius te perfshihen planin rehabilitues

Duhet marre parasysh qe keto kerkime kane limitime shkencore dhe kerkime te tjera shkencore jane te nevojshme per te konfirmuar perfundimet e mesiperme.

Artikulli reference: https://bjsm.bmj.com/content/47/4/207.short

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