Physiotherapy New Zealand

Climate change worry is increasingly recognized as a significant psychological response to environmental threats; however, research in older adults has largely focused on climate-related anxiety or isolated health outcomes. Studies examining climate change worry from a multidimensional health perspective are limited, particularly among older adults living in communities. This study aimed to investigate the relationships between climate change worry and multidimensional health characteristics in older adults. A cross-sectional study included 148 community-dwelling older adults in Türkiye. Participants were assessed using the Climate Change Worry Scale, Standardized Mini Mental State Examination (SMMSE), Athens Insomnia Scale (AIS), World Health Organization Well-Being Index (WHO-5), Geriatric Depression Scale–15 items (GDS-15), and International Physical Activity Questionnaire–Short Form (IPAQ-SF). Multiple linear regression analyses were performed to examine factors associated with climate change worry. The overall regression model was statistically significant (R² = 0.221, F (9,138) = 4.36, p < 0.001). Higher AIS scores (β = 0.279, p = 0.004), higher education level (β = 0.193, p = 0.027), and living in urban areas (β =-0.173, p = 0.039) were significantly associated with greater climate change worry. Age was negatively associated with climate change worry (β =-0.164, p = 0.044), indicating lower worry in older participants. SMMSE, WHO-5, GDS-15, IPAQ-SF, and sex were not significantly associated with climate change worry in the present model. Among community-dwelling older adults, climate change worry was associated with specific sociodemographic and lifestyle-related factors, including sleep quality, educational level, urban residence, and age. In the present model, cognitive status, general well-being, depressive symptoms, and physical activity were not significantly associated with climate change worry. These findings support the need for further research on climate-related concern in later life, particularly in relation to contextual factors.

Functional asymmetry and sensorimotor control impairments often persist in patients following total knee arthroplasty (TKA), yet they remain under-evaluated in routine clinical settings using simple, scalable tools. Understanding the relationship between these deficits and postoperative outcomes is critical for optimizing rehabilitation strategies. To assess the prevalence and degree of functional asymmetry in individuals 6-12 months post-TKA using standardized physical therapy assessments, and to evaluate the predictive value of asymmetry and sensorimotor deficits on both functional performance and patient-reported outcomes. A cross-sectional study was conducted on 125 patients aged 55-80 years, 6-12 months after unilateral primary TKA. Functional asymmetry was measured using the Single-Leg Sit-to-Stand (SLSST), Step-Down Test, and modified Star Excursion Balance Test (mSEBT). Functional outcomes included the Timed Up and Go (TUG) and 30-Second Chair Stand Test (30CST). In contrast, self-reported outcomes were assessed he KOOS-ADL and the KOOS-Function in Sport and Recreation (KOOS-Sport/Rec) subscales were administered. Correlations and multiple regression models were used to analyze relationships between asymmetry measures and outcomes. Significant correlations were found between asymmetry measures and both functional and self-reported outcomes (e.g., SLSST asymmetry and TUG: r = 0.47, p = 0.005; KOOS-ADL: r = -0.45, p = 0.007). Regression models identified SLSST, Step-Down, and mSEBT asymmetry as significant predictors of TUG (R2 = 0.48, p < 0.001) and KOOS-ADL (R2 = 0.53, p < 0.001). Patients with high asymmetry exhibited significantly poorer outcomes across all measures (all p < 0.01). Functional asymmetry and sensorimotor deficits are independently associated with poorer mobility and self-reported function post-TKA and can be effectively identified using clinically accessible tools, supporting their integration into routine postoperative assessment and rehabilitation planning.

Background Foot-drop impacts negatively on ability to walk and quality of life. Evidence indicates that there are benefits and drawbacks to commonly used orthotic devices: ankle foot orthoses (AFOs) and functional electrical stimulation (FES). Further exploration is needed of the foot-up brace and newly-developed ‘footwear for foot-drop.’ Objective This study explored users’ perspectives on four devices that support foot-drop. Method Secondary analysis was conducted of semi-structured qualitative interview data ( n = 18) collected during a prototyping process relating to new ‘footwear for foot-drop.’ Interpretative Phenomenological Analysis explored people’s experiences of different orthotic devices. Participants (Female n = 12; Male n = 6) had foot-drop due to multiple sclerosis (MS) ( n = 14), Guillain-Barre syndrome ( n = 1), cerebral palsy ( n = 1), chronic stroke ( n = 1) or post spinal surgery ( n = 1). Results Positive and negative experiences were reported for the functionality and design features of each device. Decision-making about device use was affected by foot-drop severity, personal preferences and context of use. Ease of use, comfort and appearance of devices were valued by participants. Conclusions Enhanced insights into different device options will support more informed, person-centred decision-making for device-users and prescribers. This may reduce device abandonment, improving experiences and outcomes. Study findings support the need for further research into the foot-up brace and ‘footwear for foot-drop.’

Cognitive decline and dementia represent a growing global health burden, particularly among older adults and populations with cardiopulmonary and vascular risk factors. While physical exercise has been shown to exert protective effects on cognition, the role of respiratory muscle training (RMT) remains unclear. The aim of this review was to investigate the effects of RMT on cognitive function and cognitive decline. Respiratory muscle training has been implemented in older adults with elevated blood pressure, post–COVID-19 patients, patients with chronic obstructive pulmonary disease (COPD), and patients with obstructive sleep apnea (OSA). There is only preliminary evidence regarding the effectiveness of inspiratory muscle training (IMT) on cognitive function, with only one study reporting statistically significant between-group differences (i.e., respiratory muscle training vs. control) in specific cognitive domains. Although respiratory muscle training appears to be a potentially promising intervention for improving cognitive function, the current evidence is limited. Further well-designed randomized controlled trials are required to draw definitive conclusions regarding its preventive role in cognitive decline and dementia.

FIRE Syndrome stands for Febrile Infection-Related Epilepsy Syndrome, it is a rare condition causing epileptic encephalopathy with a known febrile infection precedes the onset of epilepsy, but without any identified cause of infectious encephalitis. Management of the syndrome poses a challenge with less success and paucity of precise guidelines. Physiotherapy intervention which forms part of multi-disciplinary management, focuses to improve the lung function of patient, maintaining joint mobility and improving muscle function and functional capacity. We present a case of 12-year-old male diagnosed with FIRE Syndrome, showing the impact of physiotherapy intervention in collaboration with medical management which outlines the scope of multi-disciplinary treatment in this rare syndrome. Keywords: FIRE Syndrome, Physiotherapy intervention, Case report.

Objective: Although Maitland joint mobilization (MJM) of the cervical spine has been widely studied in the treatment of temporomandibular disorders (TMD), limited research exists on its direct application to the temporomandibular joint (TMJ), particularly in patients with bruxism. This study aimed to explore the effectiveness of TMJ-targeted MJM in improving pain pressure threshold (PPT), functional limitation (FL), sleep quality (SQOL), and maximal mouth opening (MMO) in individuals with myofascial TMD associated with bruxism. Material and Methods: This is a single blind, quasi-experimental study with 40 participants allocated to either the control group (Group A; N=20), receiving only conventional exercises, or the experimental group (Group B; N=20), receiving MJM of TMJ with conventional exercises for 4 weeks; 10-cm metal scale was used to measure MMO, a dolorimeter to assess PPT of the masseter, the Mandibular Function Impairment Questionnaire to evaluate FL, and Pittsburgh Sleep Quality Index to assess SQOL. Results: 35 out of the 40 who completed the 4-week intervention were included in the analysis. Baseline demographics were similar between the groups in gender and age (p-value&gt;0.05). The experimental group showed significantly greater improvements in PPT (p-value&lt;0.05), MMO (p-value=0.000), and FL (p-value&lt;0.05) post-intervention. SQOL did not differ significantly between the groups (p-value&gt;0.05). Strong positive correlations were found between PPT and MMO (r=0.873, p-value&lt;0.05), and between FL and SQOL (r=0.715, p-value&lt;0.05). Conclusion: MJM in Bruxism with myofascial TMD effectively improved MMO, PPT (masseter), and FL, but the groups did not exhibit any significant differences in SQOL.

Parkinson’s disease is a progressive neurodegenerative disorder characterised by motor symptoms like tremors, rigidity, and bradykinesia, which affect daily activities such as eating. Tremors, especially in the hands, can cause difficulties with tasks requiring dexterity, including eating, leading to reduced independence. A smart spoon device has been developed to minimise food spillage. This study aims to evaluate the effectiveness of this smart spoon in improving eating tasks for patients with Parkinson’s disease who have moderate tremors. A pilot cross-sectional study was conducted at RV College of Physiotherapy. Eight participants were screened based on the inclusion and exclusion criteria. Participants performed a timed rice transfer task with the smart spoon in both on and off states. Data on rice spillage were collected and analysed. In its current design, all the participants with the smart spoon failed to significantly reduce food spillage during eating tasks for individuals with Parkinson’s disease. The current design of the smart spoon does not significantly reduce food spillage during eating tasks for individuals with Parkinson’s disease. This suggests that while the technology aims to assist users with motor control challenges, further refinement and development of the device are necessary. Major Findings: The smart spoon device did not significantly reduce food spillage during eating tasks for individuals with Parkinson’s disease. All participants showed similar spillage levels with and without the device. Further design improvements are needed to enhance its effectiveness for users with moderate tremors.

The treatment of pain in the prehospital setting is suboptimal. The scope of paramedic practice is broadening, with more medicines becoming available to these professionals, including ketamine for pain management. A systematic literature review was carried out to examine the safety and efficacy of ketamine for adult trauma in a prehospital setting and its suitability for paramedics working outside an enhanced care scope of practice. Ketamine is effective in hypovolaemic patients and a preferred option for critically ill and hypotensive patients; it is particularly effective in alleviating trauma-based pain when used with opiates such as morphine or fentanyl. Side effects are rare and easily managed. Ketamine is a safe and effective addition to prehospital analgesia for adult trauma patients and safe for paramedics working outside an enhanced care scope of practice to administer. Advancing paramedics' understanding of the co-administration of ketamine and morphine versus ketamine alone would support decision-making in trauma-based patient.

Introduction: Intensive Care Units (ICUs) provide advanced, evidence-based care for critically ill patients. Physiotherapy is a vital component of ICU care but is often unavailable or insufficiently standardized. This study examined physicians’ and nurses’ satisfaction with physiotherapy care in Croatian ICUs and identified potential areas for improvement. Methods: A 26-item digital questionnaire was disseminated throughout Croatian ICUs to physicians and nurses. The items addressed included physiotherapy availability, equipment accessibility, satisfaction with the quality and effectiveness of care, and their perspectives on improvement. Responses were rated on a 5-point Likert scale or by selecting predefined options. Data analysis was performed using descriptive statistics in R Studio. Results: In total, 120 participants from 12 Croatian counties were included. The majority of responses (105) were from nurses/technicians, and only 15 from physicians. Physiotherapists were available in all ICUs, mainly on a consultative basis and mostly during morning shifts. Participants reported that physiotherapy interventions were effective in reducing pain, improving joint mobility, and enhancing respiratory function. Despite high overall satisfaction, participants emphasized the need for extended physiotherapist availability, improved ICU-specific training, and greater professional autonomy. Conclusion: Physicians and nurses expressed general satisfaction with ICU physiotherapy care but suggested improvements in physiotherapy availability and staff competence. Implementing standardized physiotherapy practices across ICUs could improve treatment outcomes and contribute to earlier patient discharge.