International Journal of Physical Therapy Research & Practice

Design and Validation of a Motor Intervention Regime for Managing Co-Morbid ADHD and Developmental Co-ordination Disorder (DCD): A Descriptive Study

Pamela Dawson — 2025-03-01

Background: Attention Deficit and Hyperactivity Disorder (ADHD) is a common neurobehavioral disorder. Children with ADHD, frequently experience motor difficulties. ADHD is treated with neuro-pharmacological medication and psycho-therapy; this seems to have little effect on the motor symptoms. Studies have investigated managing comorbid ADHD and Developmental Co-ordination Disorder (DCD), using neuro-motor treatments. However, a “gold standard” treatment, for managing co-morbid ADHD and DCD, is non-existent. This study fills this gap in the knowledge. Physical exercises have significant somatic benefits but equally important; cognitive, educational and behavioural benefits; which are produced by the increase in the cerebral blood flow and the increased release of endorphins, which in turn stabilize other neurotransmitters, such as dopamine, which enhance cognition and other executive functions. Objectives: To design and validate a motor intervention, that addresses both motor and cognitive symptoms of co-morbid ADHD and DCD. Intervention consists mainly of motor co-ordination exercises and balance exercises, which stimulate focus, attention and planning; hence also enhancing the cognitive. Methods: A motor intervention was designed, based on 5 conceptual frameworks: 1. International Classification of Function, Disability and Health (ICF). 2. Symptoms of co-morbid ADHD and DCD. 3. Neuroanatomy and neurophysiology affected in both conditions. 4. Effect of Physical exercises. 5. Motor Interventions previously administered to children with cognitive and motor deficits. Literature and clinical experience were also considered in the design of the prototype of the motor intervention. This was validated by a three-phase, modified Delphi process (Using Likert scales and polar questions), by a total of 17 experts, namely: neuro-paediatricians, educational psychologists, physiotherapists and Occupational Therapists (OT). Results: Consensus on structure and content of the motor intervention was achieved. A well-designed, motor intervention (content, structure, frequency, duration, repetitions and equipment needed) was the result. This intervention carries clinical significance, in the management of comorbid ADHD and DCD. Conclusion: A motor intervention is presented, which is innovative (the first of its kind) and useful (a “gold-standard” treatment for comorbid ADHD and DCD, which at present, is non-existent).

Comparative Efficacy of Intra-Articular PRP vs. Placebo Injections for Pain Management in Patients with Osteoarthritis of the Lower Limbs: A Systematic Review and Meta-Analysis

Adel Alghamdi — 2025-03-01

Background: Osteoarthritis (OA) is a prevalent degenerative joint disease that causes pain, disability, and a reduced quality of life. Traditional management strategies often provide limited relief, prompting the exploration of alternative therapies such as platelet-rich plasma (PRP). PRP has gained attention for its potential to reduce pain and improve functional outcomes in OA patients. This review aimed to compare the efficacy of intra-articular PRP versus placebo for pain management in OA patients. Methods: This study conducted a systematic review and meta-analysis to evaluate the clinical outcomes of PRP compared to placebo in OA treatment. A total of 10 randomized controlled trials (RCTs) were included, involving 1323 patients. The primary outcomes assessed were pain reduction (Visual Analog Scale, VAS), functional improvement (WOMAC and KOOS scores), and quality of life (SF-36). Data were extracted from studies that used different PRP preparation techniques, including leukocyte-rich and leukocyte-poor formulations. Statistical analyses were performed using a random-effects model to calculate the pooled effects including effect sizes (e.g., mean differences or confidence intervals). Results: PRP treatment demonstrated significant improvements in pain relief and functional outcomes. At 3 months, VAS scores showed better reduction in pain for PRP-treated patients compared to placebo. WOMAC scores also favored PRP at 3 months. Quality of life, assessed by SF-36, improved significantly in the PRP group, particularly in physical function (p<0.01). However, while PRP provided significant early improvements, the benefits were less pronounced at 6 months, and some variability was observed depending on PRP preparation and administration protocols. Considering safety profile, PRP has a significant higher incidence of mild side effects. Conclusion: PRP has gained attention for its potential to reduce pain and improve functional outcomes in OA patients. While results suggest PRP is more effective than placebo in the short term, the long-term efficacy remains uncertain due to varying study protocols and follow-up durations.

Psychological Interventions within Physiotherapy: A Qualitative Exploration of the Perspectives of Paediatric Physiotherapists in the Kingdom of Saudi Arabia

Wafaa Hakami — 2025-03-01

Background: Children with physical disabilities may struggle psychologically and socially. The biopsychosocial model can be implemented in paediatric physiotherapy as an approach to consider all these aspects. Physiotherapists implement psychologically informed physiotherapy (PIP) to integrate the biopsychosocial model into physiotherapy practice. A previous study found that many physiotherapists had positive attitudes and beliefs about PIP. However, there remains a significant need for further development and enhancement of PIP both globally and within the Kingdom of Saudi Arabia (KSA). The study aims to explore psychological interventions within physiotherapy practice from the perspective of PPTs working in KSA, including their knowledge, implementation experiences and future learning and training needs.Methods: A qualitative study was conducted to explore the research aims and objectives. Paediatric physiotherapists in the KSA were invited to focus groups to discuss their experiences of psychological interventions within physiotherapy. Qualitative data were transcribed and analysed using hybrid thematic analysis. Data collection took place between June and July 2023. Results: Ten participants in four focus groups, with three to two participants in each group. Thematic analysis identified three themes: knowledge, implementation, and future needs. While PPTs demonstrated a good understanding of PIP and implemented a variety of psychological interventions, they often did not acknowledge the psychological elements involved. To address this gap, recommendations were made to further enhance paediatric physiotherapy practice in KSA. Conclusion: This study was the first to explore and provide valuable insights into PPTs’ perspectives on psychological interventions and PIP in KSA. The results may inform development of future training to support enhanced use of PIP and holistic treatment.