Mantana Vongsirinavarat

Effects of Strength and Endurance Training of Superficial and Deep Neck Muscles on Muscle Activities and Pain Levels of Females with Chronic Neck Pain

[Purpose] To compare muscle activities and pain levels of females with chronic neck pain receiving different exercise programs. [Subjects and Methods] One hundred females with chronic neck pain participated in this study. They were randomly allocated into 4 groups (n = 25) on the basis of the exercises performed as follows: strength-endurance exercise, craniocervical flexion exercise, combination of strength-endurance and craniocervical flexion exercise and control groups. Pain, disability levels and changes in the muscle activities of the cervical erector spinae (CE), sternocleidomastoid (SCM), anterior scalenes (AS) and upper trapezius (UT) muscles were evaluated before and after the interventions. [Results] After 12 weeks of exercise intervention, all three exercise groups showed improvements in pain and disability. The muscle activities during the typing task were significantly different from the control group in all three exercise groups for all muscles except those of the extensor muscles in the craniocervical flexion exercise group. [Conclusion] The results of this study indicate that exercises for the cervical muscles improve pain and disability. The exercise programs reduced the activities of almost all cervical muscles.

Effect of speed on the upper and contralateral lower limb coordination during gait in individuals with stroke

The purposes of this study were to investigate the upper and contralateral lower limb coordination and to study the effect of speed on the upper and contralateral lower limb coordination in individuals with stroke and control groups. Thirty individuals with stroke who were able to walk independently without using any assistive devices and 30 control individuals were recruited for the study. Upper and contralateral lower limb coordination was analyzed using the shoulder and contralateral hip displacements in the sagittal plane. All data were analyzed by three‐dimensional gait analysis. Results demonstrated high degrees of coordination in the upper and contralateral lower limbs of the controls and in the unaffected upper and affected lower limbs of individuals with stroke. Gait speed was found to be associated with the upper and contralateral lower limb coordination in individuals with stroke but not in the controls. The findings implied that the affected upper limb plays an important role for improving gait coordination and is necessary for gait performance in individuals with stroke. Thus, health professionals should exercise the affected arm to increase efficiency of walking in individuals with stroke.

PREDICTING COMMUNITY PARTICIPATION AFTER SPINAL CORD INJURY IN THAILAND

OBJECTIVE To identify the predictors of community participation after spinal cord injury. DESIGN Cross-sectional design. METHODS A total of 139 persons with spinal cord injury living in the community completed 4 instruments: the Impact on Participation and Autonomy (IPA-Thai version), the Craig Hospital Inventory of Environmental Factors (CHIEF-SF-Thai version), the Personal Resource Questionnaire (PRQ2000-Thai version), and a personal history questionnaire. Functional performance was assessed using the Functional Independence Measure (FIM) motor subscale. RESULTS Participants comprised 79% males. Fifty-one percent of variance in community participation was explained by social support, functional performance, age, and age at time of injury. CONCLUSION Key predictors of community participation were the availability of social support and the individuals functional performance. These predictors should be emphasized when developing interventions in rehabilitation and community settings.

Capacity of Physiotherapy Workforce Production in Thailand: Public–Private Mix, Secular Trend and Geographic Distribution

BACKGROUND AND PURPOSE In Thailand, the shortage of physiotherapists has been an increasing concern because of increased health burden from demographic and epidemiologic changes. This study aims to analyse the current situation of the physiotherapy workforce production system, secular trend, geographical distribution and comparison of public and private physiotherapy training institutes. METHODS Longitudinal data related to production capacity of the physiotherapy institutes were applied. Data from 2008 to 2012 were obtained from all 16 physiotherapy institutes in Thailand. Data during 2000-2007 were also retrieved from annual reports from the Ministry of Education. Descriptive statistics were initially used. Comparison was made between public and private physiotherapy institutes in terms of the number of students admitted and graduated, number of teachers, annual tuition fee, student-teacher ratio and dropout rate within 1 year. Predictive factors for graduation within 4 years were determined using logistic regression. RESULTS In Thailand, there was an average of 800 physiotherapy graduates per year. New private institutes have been recently established and have steadily increased student admission rates. However, this has resulted in a high student-teacher ratio (median 7.1, inter-quartile range (IQR) 5.9-10.0). The first-year dropout rate in 2012 was 29.1%. Geographically, the majority of the institutes are clustered in the central region. Multivariate analysis revealed significantly lower probability of graduation within 4 years among students admitted to the private institutes and those in non-north-east region. CONCLUSION The production capacity of the physiotherapy workforce is below an estimated need. Private physiotherapy institutes need more support to improve the situation of staff shortages and student graduation rates. The non-central regions should be encouraged to produce more physiotherapists. Copyright

Home-Based Physical Therapy for Individuals With Stroke in Thailand

In Thailand, individuals with stroke prefer to return home after being discharged from hospital and most of them have inconveniences to get to hospitals or clinics to receive physical therapy. Thus, home-based physical therapy (HBPT) might be an option. A retrospective pre-test and post-test study was conducted among 2,412 individuals with first stroke after receiving HBPT. It showed significant (p < .0001) improvement in voluntary movement, postural balance, and activities of daily living (ADLs) in individuals with after-stroke duration of ≤20 years. Those with after-stroke duration of >20 years demonstrated significant development in voluntary movement (p = .005) and postural balance (p = .037), but not ADLs. In conclusion, HBPT improves voluntary movement, postural balance, and ADL in individuals following any period of first stroke, and might be an alternative service for them in Thailand.