An Investigation Into the Use of mHealth in Musculoskeletal Physiotherapy: Scoping Review

BACKGROUND: Musculoskeletal physiotherapy provides conservative management for a range of conditions. Currently, there is a lack of engagement with exercise programs because of the lack of supervision and low self-efficacy. The use of mobile health (mHealth) interventions could be a possible solution to this problem, helping promote self-management at home. However, there is little evidence for musculoskeletal physiotherapy on the most effective forms of mHealth. OBJECTIVE: The aim of this review is to investigate the literature focusing on the use of mHealth in musculoskeletal physiotherapy and summarize the evidence. METHODS: A scoping review of 6 peer-reviewed databases was conducted in March 2021. No date limits were applied, and only articles written in the English language were selected. A reviewer screened all the articles, followed by 2 additional researchers screening a random sample before data extraction. RESULTS: Of the 1393 studies, 28 (2.01%) were identified. Intervention characteristics comprised stretching and strengthening exercises, primarily for degenerative joint pain and spinal conditions (5/28, 18%). The most reported use of mHealth included telephone and videoconferencing calls to provide a home exercise program or being used as an adjunct to physiotherapy musculoskeletal assessment (14/28, 50%). Although patient satisfaction with mHealth was reported to be high, reasons for disengagement included a lack of high-quality information and poor internet speeds. Barriers to clinical uptake included insufficient training with the intervention and a lack of time to become familiar. CONCLUSIONS: mHealth has some benefits regarding treatment adherence and can potentially be as effective as normal physiotherapy care while being more cost-effective. The current use of mHealth is most effective when ongoing feedback from a health care professional is available

Kinesiology taping for breast lymphoedema after breast cancer treatment: A feasibility randomised controlled tria

PURPOSE: The primary aim of this study was to determine the feasibility of conducting a randomised controlled trial (RCT) to evaluate the effectiveness of kinesiology tape (KT) and usual care versus usual care alone in the treatment of breast lymphoedema (BLE). METHODS: Fourteen participants with BLE were randomly assigned to either the KT and usual care group or usual care alone group. Both groups received three sessions of manual lymphatic drainage (MLD) once per week for three weeks, with the KT group additionally wearing the KT for two seven-day periods in between MLD sessions. Safety and acceptability of the KT were assessed by recording adverse events, skin changes and compliance with KT. Outcomes included were: ease of recruitment, attrition and acceptability of KT, percentage breast tissue water, patient-reported breast heaviness/fullness, breast discomfort and breast redness. RESULTS: Recruitment for this study was an average of 2.8 participants per month. There were no dropouts from either group. No adverse events or major skin side effects were recorded in either group. Minor skin redness was the most common dermal change (n  = 5). Compliance with KT was excellent. Percentage tissue water in the worst affected breast quadrant reduced, on average, by 15.14% and 10.43% in both the KT group and the usual care group respectively. CONCLUSION: This feasibility RCT into the use of KT in BLE has shown that recruitment to a larger scale RCT is feasible. It has been demonstrated that KT is a safe and acceptable intervention with no adverse events and minor dermal changes. A large, multi-centred RCT is now necessary to accurately assess the effect of KT in BLE

Musculoskeletal Pain:Current and Future Directions of Physical Therapy Practice

Musculoskeletal (MSK) pain is 1 of the most common problems managed by clinicians in MSK care. This article reviews current frameworks for the assessment and management of MSK pain within evidence-based physical therapy practice. Key considerations related to the biopsychosocial model of pain, evidence-based practice, assessment, treatment, physical activity/movement behavior, risk stratification, communication as well as patient education and self-management skills within physical therapy and physical and rehabilitation medicine are addressed. The future direction of MSK pain management is also discussed, including strategies to promote evidence-based practice, behavior change, social prescribing, and the use of technologies.status: Published onlin

Emotional intelligence impairments in women with fibromyalgia: Associations with widespread pain.

This study aimed at testing the differences in emotional intelligence ability between women with fibromyalgia (cases) and their age-matched counterparts not with fibromyalgia from the general population (controls) and analysing the association between emotional intelligence ability and widespread pain in women with fibromyalgia. A total of 133 cases and 77 controls participated in this cross-sectional study. Controls performed better than cases on emotion understanding. Higher emotion perception and management were significantly associated with lower widespread pain. Therefore, women with fibromyalgia may experience difficulties in understanding emotional information. In fibromyalgia, higher emotion perception and management abilities are independently related to lower widespread pain.pre-print424 K

Design and development of an eHealth intervention to support self-management in people with musculoskeletal disorders - ‘eHealth: It’s TIME’: a study protocol [version 2; peer review: 2 approved]

Background: Musculoskeletal disorders (MSDs) are a leading cause of global morbidity, with the burden expected to increase in the near future. Self-management, with the support of healthcare professionals, is recommended for many MSDs. However, frequent clinical contact is not feasible. Previous research has highlighted the need for a co-designed eHealth-mediated self-management follow-up support intervention which integrates remote monitoring and behavioural change. Thus, the current study aims to develop and design a user-centred, eHealth-mediated self-management support prototype for people with MSDs. Methods: A three-step, iterative system development cycle will be utilised to develop and design the “eHealth: It’s TIME prototype”. The three-step process will include creating website features and content using two sequential focus groups with people with MSDs (n = 6 – 8); heuristic testing using the 10 heuristic principles of Nielsen (n = 5); and usability testing through in-person 60-minute interviews with people with MSDs (n = 3 – 5) and musculoskeletal physiotherapists (n = 3 – 5). Conclusion: The eHealth: It’s TIME prototype will be a systematically developed, follow-up self-management support intervention guided by behavioural change theory and the preferences of end users

Effectiveness of Exercise on Fatigue and Sleep Quality in Fibromyalgia: A Systematic Review and Meta-analysis of Randomized Trials

Objectives: To determine the effects of exercise on fatigue and sleep quality in fibromyalgia (primary aim) and to identify which type of exercise is the most effective in achieving these outcomes (secondary aim). Data Sources: PubMed and Web of Science were searched from inception until October 18, 2018. Study Selection: Eligible studies contained information on population (fibromyalgia), intervention (exercise), and outcomes (fatigue or sleep). Randomized controlled trials (RCT) testing the effectiveness of exercise compared with usual care and randomized trials (RT) comparing the effectiveness of 2 different exercise interventions were included for the primary and secondary aims of the present review, respectively. Two independent researchers performed the search, screening, and final eligibility of the articles. Of 696 studies identified, 17 RCTs (nZ1003) were included for fatigue and 12 RCTs (nZ731) for sleep. Furthermore, 21 RTs compared the effectiveness of different exercise interventions (nZ1254). Data Extraction: Two independent researchers extracted the key information from each eligible study. Data Synthesis: Separate random-effect meta-analyses were performed to examine the effects from RCTs and from RTs (primary and secondary aims). Standardized mean differences (SMD) effect sizes were calculated using Hedges’ adjusted g. Effect sizes of 0.2, 0.4, and 0.8 were considered small, moderate, and large. Compared with usual care, exercise had moderate effects on fatigue and a small effect on sleep quality (SMD, e0.47; 95% confidence interval [CI], e0.67 to e0.27; P<.001 and SMD, e0.17; 95% CI, e0.32 to e0.01; PZ.04). RTs in which fatigue was the primary outcome were the most beneficial for lowering fatigue. Additionally, meditative exercise programs were the most effective for improving sleep quality. Conclusions: Exercise is moderately effective for lowering fatigue and has small effects on enhancing sleep quality in fibromyalgia. Meditative exercise programs may be considered for improving sleep quality in fibromyalgi