Physiotherapy effectiveness on muscle strength, flexibility, pain and function in patients with patellofemoral pain syndrome

Study objectives: To evaluate the effectiveness on muscle strength, flexibility, pain and function of a six-week physiotherapy treatment for patients with Patellofemoral Pain Syndrome delivered in a district North-West Wales National Health Service Hospital. Methods: 26 patients with Patellofemoral Pain Syndrome (9 males, 16 females) who were referred to the NHS physiotherapy department where asked to complete an AKP Scale and two VASs along with a series of clinical tests that measure lower limb isometric strength and flexibility in two different occasions; The first occasion took place directly after the first treatment session with the physiotherapist; the second occasion took place directly after the last physiotherapy visit which was approximately after 5-8 weeks. Results: The data showed that physiotherapy treatment in patients with PFPS did not improve strength (measured by the lower limb isometric strength tests or flexibility (measured by the modified Thomas and hamstrings flexibility test) however; pain measured by two VASs (one for usual pain and one for pain on the day of the assessment) and function measured by the AKP Scale function, were significantly improved (VASs p<0.02 & AKP Scale p<0.01 ). Conclusions: This study reported that physiotherapy treatment in patients with PFPS works, not through strength and flexibility but through other components. There are several possible explanations for the results of this study. Future studies should aim to identify the different treatment components and which of these really work for patients with PFPS

Cleavage of Ge–S and C–H bonds in the reaction of electron-deficient [Os₃(CO)₈(μ-H)(μ₃-Ph₂PCH₂P(Ph)C₆H₄)] with Ph₃GeSPh: Generation of thiophenol derivatives [Os₃(CO)₈(μ-H)(μ-SPh)(μ-dppm)] and [Os₃(CO)₇(μ-H)(μ-SPh)(μ₃-SC₆H₄)(μ-dppm)]

Heating the electron-deficient [Os₃(CO)₈(μ-H)(μ₃-Ph₂PCH₂P(Ph)C₆H₄)] (1) and Ph₃GeSPh in benzene at 80 °C led to the thiolato bridged compounds, [Os₃(CO)₈(μ-H)(μ-SPh)(μ-dppm)] (2) and [Os₃(CO)₇(μ-H)(μ-SPh)(μ₃-SC₆H₄)(μ-dppm)] (3), formed by cleavage of Ge–S and C–S bonds of the ligand, in 40% and 17% yields, respectively. Both compounds 2 and 3 have been characterized by a combination of elemental analysis, infrared and ¹H NMR spectroscopic data together with single crystal X-ray crystallography. Compound 3 contains an open triangle of osmium atoms bridged by a SPh and SC₆H₄ ligands on opposite sides of the cluster with a dppm ligand bridging one of the Os–Os edges. Compound 2 consists of a closed triangular cluster of osmium atoms with a bridging SPh, and a bridging hydride ligand on the same Os–Os edge, and a dppm ligand bridging one of the remaining Os–Os edges

Perceptions of physiotherapists of their role in reducing pain and increasing, function, strength and flexibility in patients with Patellofemoral Pain Syndrome

Study objectives: The purpose of this focus group study was to establish the physiotherapy treatment of Patellofemoral Pain Syndrome in North-West Wales. In addition the study aimed to report the barriers that stopped physiotherapists from increasing strength and flexibility and the contradictions of physiotherapists’ beliefs regarding their practice. Methods: The investigation was based on specific and priori designed questions. Two focus groups were conducted, where physiotherapists discussed the results of a feasibility study conducted in their department. 11 hypotheses discussed whilst 13 evidence statements reported by the merger of the answers to the hypotheses. A level of consensus was described using the moderator’s notes. Results: Patellofemoral Pain Syndrome physiotherapy works; not through strength and flexibility but through pain and function improvement. However, this practice often only has a short-term effect. Conclusions: Group classes and better education on the importance of specific exercises and self-managing should be researched whilst the long-term effect of these treatment components should also be assessed

Comparing primary prevention with secondary prevention to explain decreasing Coronary Heart Disease death rates in Ireland, 1985-2000.

BACKGROUND: To investigate whether primary prevention might be more favourable than secondary prevention (risk factor reduction in patients with coronary heart disease(CHD)). METHODS: The cell-based IMPACT CHD mortality model was used to integrate data for Ireland describing CHD patient numbers, uptake of specific treatments, trends in major cardiovascular risk factors, and the mortality benefits of these specific risk factor changes in CHD patients and in healthy people without recognised CHD. RESULTS: Between 1985 and 2000, approximately 2,530 fewer deaths were attributable to reductions in the three major risk factors in Ireland. Overall smoking prevalence declined by 14% between 1985 and 2000, resulting in about 685 fewer deaths (minimum estimate 330, maximum estimate 1,285) attributable to smoking cessation: about 275 in healthy people and 410 in known CHD patients. Population total cholesterol concentrations fell by 4.6%, resulting in approximately 1,300 (minimum estimate 1,115, maximum estimate 1,660) fewer deaths attributable to dietary changes(1,185 in healthy people and 115 in CHD patients) plus 305 fewer deaths attributable to statin treatment (45 in people without CHD and 260 in CHD patients). Mean population diastolic blood pressure fell by 7.2%, resulting in approximately 170 (minimum estimate 105, maximum estimate 300) fewer deaths attributable to secular falls in blood pressure (140 in healthy people and 30 in CHD patients), plus approximately 70 fewer deaths attributable to antihypertensive treatments in people without CHD. Of all the deaths attributable to risk factor falls, some 1,715 (68%) occurred in people without recognized CHD and 815(32%) in CHD patients. CONCLUSION: Compared with secondary prevention, primary prevention achieved a two-fold larger reduction in CHD deaths. Future national CHD policies should therefore prioritize nationwide interventions to promote healthy diets and reduce smoking

Child Mortality Inequalities and Linkage with Sanitation Facilities in Bangladesh

Principal component analysis (PCA) was applied to assets and other household data, collected as part of the Bangladesh Demographic and Health Survey (BDHS) in 2004, to rank individuals according to a household socioeconomic index and to investigate whether this predicts access to the sanitation system or outcomes. PCA was used for determining wealth indices for 11,440 women in 10,500 households in Bangladesh. The index was based on the presence or absence of items from a list of 13 specific household assets and three housing characteristics. PCA revealed 35 components, of which the first component accounted for 18% of the total variance. Ownership of assets and housing features contributed almost equally to the variance in the first component. In this study, ownership of latrines was examined as an example of sanitation-intervention access, and rates of mortality of neonates, infant, and children aged less than five years (under-five mortality) as examples of health outcomes. The analysis demonstrated significant gradients in both access and outcome measures across the wealth quintiles. The findings call for more attention to approaches for reducing health inequalities. These could include reforms in the health sector to provide more equitable allocation of resources, improvement in the quality of health services offered to the poor, and redesigning interventions and their delivery to ensure that they are more pro-poor