ASEAN Journal of Rehabilitation Medicine

Comparison of the Sit-to-Stand Test with the 6-Minute Walk Test in Post-Coronary Artery Bypass Graft Patients

Radchaphoom Anukul — 2024-09-02

Objectives: To compare the sit-to-stand test and the 6-minute walk test in cardiac rehabilitation patients who had undergone coronary artery bypass graft (CABG) surgery

Study design: Cross-sectional study

Setting: Department of Physical Medicine and Rehabilitation, Phramongkutklao Hospital, Ratchathewi District, Bangkok

Subjects: Thai adults aged between 20 and 79 years who had undergone CABG and came to the hospital to receive cardiac rehabilitation as an outpatient

Methods: Participants started with the 6-minute walk test. After adequate rest, the participants then performed the sit-to-stand test. The 6-minute walk distance and sit-to-stand test results were recorded, along with blood pressure, heart rate and the rating of the perceived exertion scale before and after the tests.

Results: There were a total of 43 participants. The correlation coefficient (r) between the 6-minute walk test and the sit-to-stand test was 0.58 (p < 0.001), indicating a moderately significant correlation. The exercise intensities from both the sit-to-stand and 6-minute walk tests were light were considered safe.

Conclusions: A moderately significant correlation was demonstrated between the sit-to-stand test and the 6-minute walk test in post-CABG patients. The intensity of both tests was light and safe. The sit-to-stand test should be considered an alternative submaximal exercise test in outpatient cardiac rehabilitation services.

The Efficacy of Ultrasound-Guided Capsule-Preserving Hydrodilatation with Corticosteroid Versus Conventional Corticosteroid Injection in Shoulder Adhesive Capsulitis: A Randomized, Double-Blinded, Controlled Trial

Wannapa Poonnark — 2024-09-02

Objectives: To compare the outcomes of treating subacute adhesive capsulitis (AC) using capsule-preserving hydrodilatation with corticosteroid (CPHC) versus intra-articular corticosteroid injection (IACI)

Study design: A randomized, double-blinded, controlled trial

Setting: Chaophrayayommarat Hospital, Suphanburi, Thailand

Subjects: Fifty-two participants with AC and shoulder pain who had a numeric rating scale (NRS) of at least four after having received physical therapy for at least one month.

Methods: Eligible patients were randomly allocated either to the study group treated with CPHC or to the control group treated with IACI. The CPHC group (n=26) received a mixture of 4 mL of triamcinolone (10 mg/mL), 6 mL of 1% lidocaine, and 10 mL of normal saline, whereas the IACI group (n=26) received a mixture of 4 mL of triamcinolone (10 mg/mL) and 1 mL of 1% lidocaine. Following that, all participants underwent physical therapy at the hospital and a participated in a home exercise program. The primary outcome was shoulder passive range of motion (PROM). Secondary outcomes were subjective numeric rating scale (NRS), the Shoulder Pain and Disability Index (SPADI), and the Oxford Shoulder Score (OSS). Assessments were conducted at baseline and at 1- and 6-weeks post-treatment.

Results: At one week post-treatment, all outcomes were significantly different from baseline in both groups. The SPADI-disability and SPADI-total scores were significantly different between groups. At six weeks, all outcomes showed a strongly significant improvement in both groups and significant differences between groups except the internal rotation.

Conclusions: Capsule-preserving hydrodilatation with corticosteroid combined with physical therapy and a home exercise program demonstrated superior efficacy to intra-articular corticosteroid injection combined with the same physical therapy and a home exercise program for treating subacute adhesive capsulitis, resulting in improved ROM, reduced pain, and restored shoulder function

A Preliminary Report of the Effects of Dharma Creative Art Therapy on Psychological Impacts and Quality of Life of Thai Cancer Patients: A Non-Randomized Trial

Jenya Jutakeo — 2024-09-02

Objectives: To determine the effects of Dharma Creative Art Therapy (CAT) on psychological impacts and quality of life

Study design: Non-randomized trial

Setting: Department of Medicine, Siriraj Hospital

Subjects: Cancer patients during chemotherapy

Methods: This preliminary study recruited eighty-two patients into an experimental group which participated in a 90-minute Dharma CAT session for two consecutive days, while the control group received only a leaflet on holistic approach of cancer palliative treatment. Psychological outcomes of the Dharma CAT were measured using the Hospital Anxiety and Depression Scale (HADS), the Thai Stress Test (TST), the Thai Mental Health Index-15 (TMHI-15), and the EQ-5D-5L, which were evaluated before, immediately after, and one month after the intervention.

Results: After the intervention, the CAT group had significantly improved positive TST and TMHI-15 scores compared to the control (p=0.006 and p=0.018, respectively). The effect size of Dharma CAT on positive TST was moderate (0.568) and was minimal for TMHI-15 (0.373). The success rate of patients after receiving Dharma CAT therapy on anxiety, depression, stress, and mental health presented with a relative risk (RR) of 3.0 (95%CI: 0.64, 14.00), 1.5 (95%CI: 0.46, 4.92), 2.5 (95%CI: 0.85, 7.33), and 0.8 (95%CI: 0.23, 2.77), respectively but the changes were not statistically significant. All outcomes were analyzed and compared between groups at baseline, at the end of the study, and at the 1-month follow-up. No statistically significant differences between the groups for any of the outcomes were found.

Conclusions: Dharma CAT reduces stress and improves mental health but does not affect anxiety, depression, or quality of life. It may be considered an adjunctive therapy for reducing stress and improving mental health of cancer patients during chemotherapy.

A Pilot Study of End-Effector Robotic Gait Training for Improving Gait and Balance Abilities in the Older Patients after Hip Fracture Surgery

Panya Ngamwongsanguan — 2024-09-02

Objectives: To assess the effect of ‘SensibleSTEP’ end-effector type robotic gait training on gait and balance abilities in the older patients after hip fracture surgery

Study design: A quasi-experimental pilot study

Setting: The Department of Rehabilitation Medicine, Lerdsin Hospital, Bangkok, Thailand

Subjects: Older patients (aged ≥ 60) who underwent hip fracture surgery between March - September 2023.

Methods: Ten older subjects who had undergone hip fracture surgery were recruited for a robotic gait training program. The program consisted of 30-minute training sessions conducted twice weekly for four consecutive weeks, a total of eight sessions. The investigator evaluated the Functional Ambulation Category (FAC), Timed Up and Go (TUG), Single Leg Stance (SLS), Four Step Square (FSS), gait speed, stride length, cadence, visual analogue scale (VAS), gait aid use, and level of assistance both before and after the training program.

Results: Robotic gait training with SensibleSTEP showed statistically significant improvements in FAC, TUG, FSS, gait speed, and stride length. Trends of improvement were observed in SLS, cadence, VAS, gait aid use, and level of assistance.

Conclusions: End-effector robotic gait training for eight sessions can improve gait and balance abilities in the older patients who had undergone hip fracture surgery

Predicting the Functional Status of Post-Cardiac Surgery Patients at Six Months After Discharge from Hospital : Utilizing the 6-Minute Walk Test Distance (6-MWT) and Clinical Characteristics at Hatyai Hospital

Nattaya Phitukjinda — 2024-09-02

Objectives: To evaluate the use of the 6-minute walk test (6-MWT) in predicting the functional status of post-cardiac surgery patients six months after discharge

Study design: Prognostic prediction research and retrospective observational cohort design

Setting: Hatyai Hospital, Thailand

Subjects: Post-cardiac surgery pateints at six months after discharge from Hatyai Hospital

Methods: The study retrospectively reviewed pre- and post-cardiac surgery data records. Patients’ functional status at six months was assessed using the New York Heart Association (NYHA) Classification. Multivariable logistic regression analysis was employed to identify variables to predict the patients’ functional status. The predictive scores were assigned based on coefficient values derived from the regression equation.

Results: A total of 272 post-cardiac surgery patients were followed up six months after discharge, of whom 181 patients (66.5%) exhibited good functional status (NYHA Classification 1). Six variables were predictive of NYHA Classification 1: pre-surgery ejection fraction (EF), length of hospital stay (LOS), metabolic equivalences (METs) pre-discharge, duration of daily exercise at two weeks, duration of daily exercise at six weeks, and the six-minute walk test (6-MWT) at three months. The constructed prediction scores ranged from 0 to 23. The prediction score performed well in predicting the functional status at six months with an area under the receiver operating characteristic curve (AUROC) 0.89, 95%CI: 0.85-0.93. The clinical risk scores were categorized into two groups: low-good functional status scores (< 14) with a positive predictive value (PPV) of 37.5 (95%CI: 20-40, p < 0.001) and high-good functional status scores (≥ 14) with a PPV of 95.6 (95%CI: 0.91-0.98, p < 0.001).

Conclusions: The combination of pre-surgery EF, METs pre-discharge, LOS, duration of daily exercise at two weeks and six weeks, and the 6-MWT distance at three months can serve as a predictor of the good functional status of post-cardiac surgery patients at six months after discharge.

Reliability and Validity of a Thai Version of a Modified Frenchay Activities Index for Use with Stroke Patients

Niparath Triloga — 2024-09-02

Objectives: To evaluate the reliability and validity of the Thai version of the modified Frenchay Activities Index (mFAI) questionnaire for use with stroke patients

Study design: Descriptive study

Setting: Department of Rehabilitation Medicine and Neurology Division, Department of Medicine, Faculty of Medicine, Siriraj Hospital, Mahidol University, Bangkok, Thailand

Subjects: Stroke patients visiting the Outpatient Department of the Rehabilitation Medicine and Neurology Division, Department of Medicine, from March 2020 to August 2020

Methods: Data were collected using a Thai version of the modified Frenchay Activities Index (Thai-mFAI). Of 75 patients, 70 met the inclusion criteria. After the initial assessment, all 70 participants were reassessed 3-7 days later to determine test-retest reliability. Validity was assessed from 59 participants by evaluating the correlation between the Stroke-Impact Scale (SIS) and the timed up-and-go test (TUG).

Results: The Thai-mFAI showed good content validity (CVI = 0.95), fair construct validity (convergent validity; r=0.287-0.310, discriminant validity; r=-0.259), excellent test-retest reliability (ICC3,1=0.929) and excellent internal consistency (Cronbach’s alpha = 0.936).

Conclusions: The Thai-mFAI was found to have good content validity, fair construct validity, excellent test-retest reliability, and excellent internal consistency. These suggested that Thai-mFai is suitable for evaluating how well active stroke patients can perform activities of daily living.

Notes from the Editor-in-Chief

Kingkaew Pajareya — 2024-09-02