6 research outputs found
Physiotherapy Management in Adults with Pompe Disease
This thesis aimed to investigate whether physiotherapeutic care of patients with Pompe disease can be a valuable addition to the existing ERT and how this care can be organised. The studies included in this thesis explore the referral patterns to contemporary physiotherapeutic care and their content (both regular physiotherapy and pelvic floor physiotherapy), the use of exercise training to improve patients’ functioning (beyond any improvements obtained from ERT), as well as risk factors influencing patients’ walking performance
Safety and efficacy of exercise training in adults with Pompe disease: Evalution of endurance, muscle strength and core stability before and after a 12 week training program
Background: Pompe disease is a proximal myopathy. We investigated whether exercise training is a safe and useful adjuvant therapy for adult Pompe patients, receiving enzyme replacement therapy. Methods: Training comprised 36 sessions of standardized aerobic, resistance and core stability exercises over 12 weeks. Before and after, the primary outcome measures safety, endurance (aerobic exercise capacity and distance walked on the 6 min walk test) and muscle strength, and secondary outcome measures core stability, muscle function and body composition, were evaluated. Results: Of 25 patients enrolled, 23 successfully completed the training. Improvements in endurance were shown by increases in maximum workload capacity (110 W before to 122 W after training, [95 % CI of the difference 6 · 0 to 19 · 7]), maximal oxygen uptake capacity (69 · 4 % and 75 · 9 % of normal, [2 · 5 to 10 · 4]), and maximum walking distance (6 min walk test: 492 meters and 508, [-4 · 4 to 27 · 7]). There were increases in muscle strength of the hip flexors (156 · 4 N to 180 · 7 N [1 · 6 to 13 · 6) and shoulder abductors (143 · 1 N to 150 · 7 N [13 · 2 to 35 · 2]). As an important finding in secondary outcome measures the number of patients who were able to perform the core stability exercises rose, as did the core stability balancing time (p < 0.05, for all four exercises). Functional tests showed small reductions in the time needed to climb four steps (2 · 4 sec to 2 · 1, [- 0 · 54 to -0 · 04 ]) and rise to standing position (5 · 8 sec to 4 · 8, [-2 · 0 to 0 · 0]), while time to run, the quick motor function test results and body composition remained unchanged. Conclusions: Our study shows that a combination of aerobic, strength and core stability exercises is feasible, safe and beneficial to adults with Pompe disease
Frozen shoulder: The effectiveness of conservative and surgical interventions-systematic review
Background A variety of therapeutic interventions
is available for restoring motion and diminishing pain
in patients with frozen shoulder. An overview article
concerning the evidence for the effectiveness of these
interventions is lacking.
Objective To provide an evidence-based overview
regarding the effectiveness of conservative and surgical
interventions to treat the frozen shoulder.
Methods The Cochrane Library, PubMed, Embase,
Cinahl and Pedro were searched for relevant systematic
reviews and randomised clinical trials (RCTs). Two
reviewers independently selected relevant studies,
assessed the methodological quality and extracted data.
A best-evidence synthesis was used to summarise the
results.
Results Five Cochrane reviews and 18 RCTs were
included studying the effectiveness of oral medication,
injection therapy, physiotherapy, acupuncture,
arthrographic distension and suprascapular nerve block
(SSNB).
Conclusions We found strong evidence for the
effectiveness of steroid injections and laser therapy in
short-term and moderate evidence for steroid injections
in mid-term follow-up. Moderate evidence was found in
favour of mobilisation techniques in the short and long
term, for the effectiveness of arthrographic distension
alone and as an addition to active physiotherapy in
the short term, for the effectiveness of oral steroids
compared with no treatment or placebo in the short
term, and for the effectiveness of SSNB compared with
acupuncture, placebo or steroid injections. For other
commonly used interventions no or only limited evidence
of effectiveness was found. Most of the included
studies reported short-term results, whereas symptoms
of frozen shoulder may last up to 4 years. High quality
RCTs studying long-term results are clearly needed in
this fi eld