Introduction: Osteoarthritis (OA) is a chronic condition. Physiotherapy is known to be beneficial for people with OA. Patient adherence to physiotherapy exercise is essential for the effective management of OA. Objectives: To determine different methods used to enhance physiotherapy exercise adherence for a period of more than 12 months among patients with OA and to report the most effective methods to enhance exercise adherence among people with lower limb OA. Design: Systematic review. Methods: PubMed, Pedro, Web of Science, and EMBASE databases were searched for randomized controlled trials, cohort studies, case-control studies, and cross-sectional studies published in the English language from 2000 to 2020. The literature search was done on 27 August 2020. Two researchers independently conducted the screening, eligibility assessment, data extraction, methodology quality assessment using the PEDro scale, and risk of bias assessment using RoB2. A narrative synthesis of key outcomes is presented, percentage of adherence rate; Preferred Reporting Items for Systematic Review was used to report the review. Meta-analysis was not performed due to heterogeneity of studies. The study protocol was registered in Prospero (Prospero ID: CRD42020205653). Results: The primary search strategy identified 5839 potentially relevant articles, of which 5157 remained after discarding duplicates. After screening based on title and abstract, 40 papers were potentially eligible for inclusion. Five of these papers met all predefined eligibility criteria. Introducing methods to enhance exercise adherence has caused a significant increase in exercise adherence for less than 6 or 12 months. There were no significant differences in adherence for more than 12 months with different methods. The results indicate that booster-sessions (89.69%) and telephone-linked communication (86%) had higher percentages for exercise adherence. Secondary outcomes such as pain, stiffness and function show positive outcomes with increasing exercise adherence. However, there were no significant differences on these secondary outcomes. Conclusion: The booster sessions and telephone-linked communication appear to enhance exercise adherence for more than 12 months among patients with OA. However, the number of high-quality studies is inadequate to confirm our findings. Therefore, more studies with higher methodological quality are needed to determine the best strategies to enhance long-term exercise adherence among people with OA.

Dysmenorrhea is menstrual pain of uterine origin that can be classified as primary (PD) or secondary (SD). The worldwide prevalence of dysmenorrhea has been estimated in previous systematic reviews; however, these results are often limited by the focus on specific populations, or the inclusion of studies published only in English. Therefore, we estimated the worldwide prevalence of dysmenorrhea of both PD and SD. In this systematic review, we searched 6 databases for studies reporting the prevalence of dysmenorrhea published between 2000 and 2024, without language restriction. The risk of bias of the included studies was assessed using the Joana Briggs Institute tool. Meta-analysis was conducted in Rstudio. The heterogeneity within meta-analyses was evaluated by I ² statistics. Subgroup analyses were performed by PD, SD, age group, and study setting to investigate sources of heterogeneity as well. The certainty of evidence was assessed using GRADE modified for prevalence studies. A total of 336 studies were included in this systematic review. Most of them were conducted in Asia (49.4%). The pooled worldwide prevalence of dysmenorrhea, PD, and SD were 71.3% (95% CI 68.7%-73.8%), 73% (95% CI 68%-78%), and 35% (95% CI 19%-56%), respectively. Dysmenorrhea was more prevalent in Central America (89.6%), Sri Lanka (97.7%), among adults (73.3%), and at universities (78.4%). All subgroup analyses showed high heterogeneity (I ² = 99.5%-100%) with very low certainty of evidence. This high prevalence of dysmenorrhea worldwide highlights the need for healthcare providers and public health organizations to address menstrual pain's global burden.

The use of external fixators (EFs) dates back to 377 BC Hippocrates’ time, and it has a wide range of orthopaedic applications. External fixator has expanded its use in the management of fractures and other musculoskeletal conditions. It is widely used all over the world to manage complex musculoskeletal injuries. It has many advantages as compared to internal fixation in some trauma scenarios. However, the cost of the external fixators presents a dilemma to the healthcare system in developing countries. The goals of this review article are to explain the importance of EFs in developing countries in managing fractures, to determine the problems encountered at present during external fixation by developing countries, to identify solutions that could be used to address these issues, expand the use of external fixation into other domains of treatment, the impact of COVID-19 pandemic on fracture management based on existing literature. In conclusion, EFs are very expensive, researches have been conducted to overcome these barriers in developing countries. However, there are limitations in implementing in developing countries. It is important to have affordable and clinically acceptable EFs available in developing countries.

There is a lack of evidence about the ways in which balance ability influences the kinematic and kinetic parameters and muscle activities during gait among healthy individuals. The hypothesis is that balance ability would be associated with the lower limb kinematics, kinetics and muscle activities during gait. Twenty-nine healthy volunteers (Age 32.8 ± 9.1; 18 males and 11 females) performed a Star Excursion Balance test to measure their dynamic balance and walked for at least three trials in order to obtain a good quality of data. A Vicon^® 3D motion capture system and AMTI^® force plates were used for the collection of the movement data. The selected muscle activities were recorded using Delsys^® Electromyography (EMG). The EMG activities were compared using the maximum values and root mean squared (RMS) values within the participants. The joint angle, moment, force and power were calculated using a Vicon Plug-in-Gait model. Descriptive analysis, correlation analysis and multivariate linear regression analysis were performed using SPSS version 23. In the muscle activities, positive linear correlations were found between the walking and balance test in all muscles, e.g., in the multifidus (RMS) (r = 0.800 p < 0.0001), vastus lateralis (RMS) (r = 0.639, p < 0.0001) and tibialis anterior (RMS) (r = 0.539, p < 0.0001). The regression analysis models showed that there was a strong association between balance ability (i.e., reaching distance) and the lower limb muscle activities (i.e., vastus medialis–RMS) (R = 0.885, p < 0.0001), and also between balance ability (i.e., reaching distance) and the lower limb kinematics and kinetics during gait (R = 0.906, p < 0.0001). In conclusion, the results showed that vastus medialis (RMS) muscle activity mainly contributes to balance ability, and that balance ability influences the lower limb kinetics and kinematics during gait.

Background The effectiveness of Problem Based Learning (PBL) in physiotherapy education is not clearly studied. This systematic review was to determine the effectiveness of PBL compared to traditional methods (TM) or using other methods. Methodology PubMed, Pedro, Science direct, and Google Scholar Databases were searched on 11 January 2022 for randomized controlled trials, Non-randomized control trials, Quasi-experimental trials, before and after study design and cohort studies published in English from 2000 to 2022. Two reviewers conducted screening, eligibility assessment, data extraction, and risk of bias assessment. A narrative synthesis of outcomes is presented, Preferred Reporting Item for Systematic Review was used to report the review. Meta-analysis was not performed due to the heterogeneity of studies. This protocol was registered in Prospero (CRD 42022301693). Results The primary search strategy identified 2826 potentially relevant articles, of which 1666 remained after removing duplicates. After title and abstract screening 22 potentially eligible studies were identified, 2 of those papers met all the predefined eligibility criteria. The total population size is 291. The results indicate that PBL was effective compared to the TM in terms of promoting early Evidence Based Practice (EBP); PBL facilitates learning strategies and study preference was high for PBL in comparison to TM. Conclusion PBL is effective in developing different competencies, especially promoting early EBP, in physiotherapy undergraduates and is reported as a preferred method compared to TM. However, there is a lack of evidence to confirm this finding. Research studies with high methodological quality need to be conducted in future.