Physio ‘Bites’

Interesting, informative & amusing ‘bites’ of Physiotherapy & General Health information – regularly updated and taken from current and up-to-date research.

fatpersonCould diabetes medication be reduced with an intensive lifestyle change programme?

A small French study suggests that a programme combining vigorous exercise, calorie restriction and education could cut the amount of routine medication needed in patients with type 2 diabetes and could reduce strain and costs on the NHS. Adherence to the programme was an issue – lifestyle changes aren’t easy – but overall pill ingestion was reduced by 1.5/day, blood glucose fell by 22% average and waist circumference by 7%. With diabetes care predicted to account for 10% of NHS costs, every small study that shows how lifestyle changes could reduce these costs should be paid attention to.

Lanhens, C. et al ‘Long term cost reduction of routine medications following a residential programme combining physical activity and nutrition in the treatment of type 2 diabetes: a prospective cohort study.’ BMJ Open 2017

Elderly people benefit from doing seated exercise – do what you can! (15/05/2017)

A pilot study has shown that more that 60% of older participants experienced an improvement in physical function after taking part in a seated exercise class run by the Royal Voluntary Service and exercise specialists – whatever your level of (dis)ability – exercise can help improve it!

‘Source: Nursing Times’

Running: lower loading in less cushioned shoes? (04/04/2017)

A study of 29 runners found that there were much lower loading rates (i.e. le20170404_083016ss force through hips/knees/feet) for runners who wore trainers with LITTLE cushioning. The evidence field for running shoe choice is still somewhat muddled and unclear but there is now a suggestion that the mainstream ‘cushioned, heel-raised, supportive’ shoe is not necessarily any better for you/your injury rate than almost any old shoe – more relevant maybe to just find a shoe that you, the runner, feels comfortable in! Watch this space as more studies are done and more evidence comes to light…

‘Medicine & Science in Sport & Exercise’ journal; source ‘Guardian’ http://bit/ly/2f2ry8c

Singing really IS good for you… & Music is too! (21/03/2017)

Singing boosts immune system activity, reduces stress and lifts mood in people affect by cancer, according to a study of 193 patients, carers and bereaved carers who sang regularly with choirs in Wales. A separate study found that Music Therapy increases the good effects of exercise in people with fibromyalgia – low impact aerobic exercise to standard music eased depression and discomfort, but the group exercising to melodic music they had chosen had greater improvements and were more inclined to continue.

Fancourt, D. et al. Ecancer Medical Science 2016; and Espi-Lopez, FV. et al Complementary Therapies in Medicine 2016;

Cycle helmets do make a significant difference  (10/11/2016)cyclingyorkshire

Cyclists who wear a helmet are much less likely than those not wearing a helmet to suffer injuries to the face or head, say researchers who reviewed 40 studies covering 64.000 bicycle accidents. Helmet-wearers reduced their risk of a facial injury by one third, any head injury by half and a serious or fatal head injury by two thirds.

Olivier, J. & Creighton, P. International Journal of epidemiology 2016;

Back pain: exercise aids prevention   (24/04/2016)

There’s pretty good evidence that exercise can relieve LBP (lower back pain) but new research suggests that it can also reduce the risk of developing LBP in the first place. A review of data involving more that 30,000 people has found that “exercise alone or in combination with education is effective for preventing LBP”. Other interventions, including education alone, back belts and shoe insoles do not prevent LBP.

Steffens, D. et al. “Prevention of Low Back Pain: A Systematic Review and Mta-analysis.” JAMA Internal Medicine 2016:

Get outdoors, improve your eyesight… (08/03/2016)

20160309_161934There is increasing research to suggest that spending more time outdoors may reduce the chance of myopia (short-sightedness) developing. Myopia tends to develop in late childhood and adolescence with progression in early adulthood and there has been a sharp increase in its prevalence over recent years. Risk factors for myopia include urbanised environments, education, reading and intelligence – these factors being most influential in childhood. But encouragingly, those children that spend more time outdoors are less likely to develop myopia; 2% reduced odds for every additional hour spent outdoors per week. Why? It’s not entirely clear, possibly the effect of sports and exertion, also light intensity, UV radiation, distant focus and vitamin D may all play a role. So get those kids outdoors!

Rose, K.A. et al ‘Outdoor activity reduces the prevalence of myopia in children.’ Ophthalmology 2008; 115(8):1279-85. Shewin, J.C. et al ‘The association between time spent outdoors and myopia in children and adolescents.’ Ophthalmology 2012; 119(10) 2141-51. Guggenheim, J.A. et al. ‘Time outdoors and physical activity as predictors of incident myopia in childhood.’ Invest Ophthalmol Vis Sci 2012; 53(6) 2856-65.

Is Treatment better than Advice for Back Problems? (19/02/2016)

backache websiteA recent trial has shown that specific Physiotherapy treatment can be more effective in treating back pain than just advice. 300 adults with back pain lasting 6 weeks – 6 months received either Physiotherapy or Advice and were followed up at 10 weeks, 6 months and 1 year, with the Physiotherapy group demonstrating clinically important improvements, being better able to take part in a variety of daily activities and having earlier improvement in back and leg pain.

Chan, A. et al. “One-year results of a randomized controlled trial comparing subgroup-specific physiotherapy against advice for people with low back disorders.” Physiotherapy 2015;

Can Physiotherapy outweigh Fear?  (22/09/2015)

Physiotherapy may be especially helpful to people with sciatica (nerve pain) who are frightened that movement will make their symptoms worse. A study that assigned 135 sciatica patients to either just GP care or GP and Physiotherapy care found that after 12 months the most fearful patients who had received physiotherapy had significantly less pain than thse who had only received GP care.

Verwoerd, A.J.H. et al. “Does Kinesiophobia Modify the Effects of Physical Therapy on Outcomess in Patients with Sciatica in Primary Care?” Physical Therapy 2015;

Manual Job? Eight times more likely to have back pain..  (09/09/2015)

People doing manual work in awkward positions are eight times more likely to develop back pain. Working whilst tired or distracted also increases the risk, and back injuries are more likely to occur in the morning (if you’ve a theory on why this is then let me know!) BUT when doing heavy lifting, older people are at lower risk than younger ones – age-induced experience at work?

Steffens, D. et al. Arthritis Care and Research 2015;

Exercise DOES reduce risk of fall in older adults  (26/08/2015)

A large-scale review of the available research which looked at falls risk & prevention in older adults has found “consistent evidence that exercise could prevent falls“. The authors say that the review supports the notion that exercise should be provided to community-living older adults to prevent falls and that a balanced programme including endurance, balance and strength work could be recommended.

Stubbs, B. et al. “What Works to Prevent Falls in Community-Dwelling Older Adults? An Umbrella Review of Meta-analyses of RCTs.” Physical Therapy 2015;

Excess weight increases risk of cancer  (26/09/2014)Overweight-BMI

Yet another study has shown that excess body weight increases a person’s risk of developing 10 of the most common cancers and is linked with more than 12,000 cases of cancer a year in the UK.

Bhaskaran, K. et al. Lancet 2014;


New pelvic-floor programme shows great results  (26/09/2014)

A Polish study of men left incontinent after surgery has shown great results. The men were split into three groups – two treatment groups given pelvic floor training (group 1 with and group 2 without biofeedback) home exercises & physio sessions and one untreated control group. Results showed that in the treatment groups, 39% (without biofeedback) & 92% (with biofeedback) of patients cured their incontinence, compared with only 12.5% of the control group. The findings suggest that a physiotherapy programme can improve or fully restore continence.

Rajkowska-Labon, E. et al. ‘Efficacy of Physiotherapy for Urinary Incontinence following Prostate Cancer Surgery.’ BioMed Research International 2014;


Treatment for Whiplash may be simpler than previously thought… (26/06/2014)

A single session of physiotherapy with advice on self-management is as effective as long-term programmes in treating chronic pain after whiplash injuries, Australian researchers have found. Researchers studied 172 patient who had suffered whiplash pain for three months to five years in duration and split them into two groups – one to receive a single session consultation including advice and a taught exercise routine and the other to receive 20 individual physiotherapy sessions. There were no significant differences between the groups over the following year. This suggests that physiotherapists need to carefully assess the individual needs of the patient presenting with chronic whiplash pain and consider how and when to exercise such patients.

Michaleff, Z.A. et al ‘Comprehensive physiotherapy exercise programme or advice for chronic whiplash (PROMISE): a pragmatic randomised controlled trial.’ Lancet 2014:

Low back pain is biggest cause of disability worldwide (25/06/2014)

An international study reviewing 117 studies found that 8.7% of women and 10.1% of men experienced low back pain (LBP). The rate was highest in western Europe (15%) and lowest in the Caribbean and Latin America.

Hoy, D. et al. ‘The global burden of low back pain: estimates from the Global Burden of Disease 2010 study.’ Annals of the Rheumatic Diseases 2014;


Increased risk of Multiple Sclerosis (MS) may be due to a lack of Vitamin D, so get eating those sardines  (02/03/2014)sardines1

MS appears to be related to geographical latitude and exposure to ultraviolet (UV) light and abnormally low levels of vitamin D may increase the risk of developing the disease says Ruth Dobson (researcher at St. Bartholomew’s Hospital in London). MS currently affects 1 in 200 people in the UK and studies have shown that the further from the equator people live, the higher the risk they have of developing MS. In the UK for example, there are more hospital admissions in the north compared to the south, a pattern that is repeated in all other European countries except Norway, where rates of admission do not increase with higher latitude – possibly due to a fresh, oily fish-rich diet. So get eating those sardines!


Which injury prevention exercises reduce risk of injury in sports people? Interestingly the answer is possibly not stretching… (10/12/2013)

Researchers in Copenhagen analysed 25 studies covering 26,610 participants playing a range of sports. Participants  were assigned to do either strength training, proprioception work, stretching or a combination of these three. A control group practised their sport with no preventative exercise prescribed. Consistently favourable estimates were obtained for all injury prevention measures except for stretching – the three studies focused on stretching found it made no difference to the risk of injury.

Lauersen J.B. et al. ‘The effectiveness of exercise interventions to prevent sports injuries: a systematic review and meta-analysis of randomised controlled trials’. BJSM 2013; doi:10.1136/bjsports-2013-092538.


Rocker shoes perhaps not as good as they claim to be… (01/11/2013)

A recent study has found that people with low back pain experienced no difference in pain levels after a year of wearing MBT’s (Masai Barefoot Technology) rocker shoes when compared with people wearing normal running shoes.

The study, which was commissioned by the companies that manufacture the shoes, gave half its participants rocker shoes and the other half normal flat trainers and all were asked to wear the shoes for two hours every day. Levels of disability were then measured at six weeks, six months and one year.

The study found that patients wearing normal running shoes experienced lower levels of disability when compared with those wearing Rockers.

MacRae et al. ‘Effectiveness of Rocker Sole Shoes in the Management of Chronic Low Back Pain: RCT’.  Spine:15 October 2013 – Volume 38 – Issue 22 – p 1905–1912

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