https://www.um.edu.mt/library/oar/handle/123456789/117808 Thu, 28 May 2026 08:07:00 GMT 2026-05-28T08:07:00Z https://www.um.edu.mt/library/oar/handle/123456789/129796 Title: Effectiveness of acupuncture type interventions compared to pharmacological interventions for pain reduction in lateral epicondylitis Abstract: Background: Lateral epicondylitis (LE) is a widely known condition characterised by reduced productivity and economic losses, particularly in middle-aged individuals. The first-line treatment for LE is conservative, using oral and topical NSAIDs as well as brace use. When first-line treatment fails, invasive second-line treatment options such as steroid injections and acupuncture-type interventions are offered. The author hypothesised that acupuncture-type interventions would be at least as effective as pharmacological interventions for LE in pain-relieving effects. Research question: Are acupuncture-type interventions more effective than pharmacological interventions in reducing pain in lateral epicondylitis? PICO elements: The population studied (P) was individuals with Lateral Epicondylitis. The intervention (I) was acupuncture-type interventions, whilst the comparison (C) was pharmacological interventions. The final outcome (O) was pain reduction. Inclusion and exclusion criteria: Inclusion criteria: ages 18-70, both genders, LE diagnosis, afflicted for more than 1 month, acupuncture-type interventions, pharmacological interventions, pain relief was measured. Exclusion criteria: languages other than the English language, contraindications to any type of acupuncture/pharmacological intervention, other elbow pathologies, secondary research. Outcomes of the search: Searches to identify relevant studies were done in 7 databases. A total of 7 RCTs and 1 Retrospective cohort study involving 755 individuals were included in this PICO study. Methods of the appraisal used: The CASP Tool was used to assess and critical appraise the methodological quality of the studies. Results: 6 out of the 8 articles chosen reported that acupuncture-type interventions outperformed pharmacological interventions in pain reduction in the long-term. 1 study’s results were statistically insignificant, and the other study reported that pharmacological interventions outperformed acupuncture. Conclusions: Although no definitive conclusion could be reached, it can be stated that acupuncture-type interventions do reduce pain in LE based on the evidence gathered. Further research, however, is required to answer the research question. Implications and recommendations: More research with larger sample sizes is required for consistent results. Description: B.Sc. (Hons)(Melit.) Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/129796 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/129676 Title: The effect of habitual exercise using resistance training or nordic walking on the rate of progression of Parkinson’s disease : a PICO study Abstract: Introduction: "Exercise is medicine" is a commonly used phrase in rehabilitation. This PICO study aims to understand the impact of physical activity on Parkinson's Disease (PD) patients. Nearly one million Americans and seven million people worldwide are living with Parkinson's. In Malta, 600 new PD cases may be diagnosed annually (Fiorini 2022). By 2040, the number of people with Parkinson's Disease is projected to exceed 12 million worldwide (Dorsey and Bloem 2018). “The Parkinson pandemic is fuelled by ageing populations, increasing longevity, declining smoking rates, and the by-products of industrialization. The incidence of Parkinson disease increases with age and rises sharply at around age 65” (Van Den Eeden, Tanner et al. 2008). It is important to keep in mind that patients under 50 years of age may still develop early-onset PD. Although to date, there is no cure for Parkinson's, research shows that exercise can help delay some of the mobility problems associated with disease progression (Mischley, Lau et al. 2017). Studies have demonstrated that PD patients benefited from exercising, no matter at which stage they started exercising (Farley 2020). This research aims to enrich the discussion around the importance of having an effective habitual exercise routine and the difference it makes in the progression rate of Parkinson's Disease with particular reference to two specific types of exercise interventions, that is, resistance training and Nordic walking. Method: The search string used was Parkinson* AND ("nordic walking" OR "resistance training") AND (randomized OR randomised). Databases used include EBSCO, AgeLine, CINAHL Complete, Cochrane Central Registry of Controlled Trials, Cochrane Database of Systematic Reviews, MEDLINE Complete, ProQuest, and Scopus. Study Findings: PD patients need whole-body training to address fine motor, respiration, gait, speech, and postural control, which impacts overall brain health and protection (disease progression). Specific skill training reinforces the dopamine circuits, leading to brain repair and adaptation. Based on the literature reviews, resistance training, and Nordic walking positively affect the PD progression rate. However, the long-term effects have not been studied for more than 3 or 6 months from the initial training starting point. Further, multicenter longitudinal studies with larger sample sizes need to be conducted to understand better the long-term impacts. Conclusion: This study suggests that it is time for a new paradigm in PD treatment. Studies have shown that prescribing exercise immediately after diagnosis slows motor deterioration and disease progression, and prevents end-stage PD. Not all exercises demonstrate the same effect on PD. Timing matters – evidence shows that the sooner someone starts exercising, the better for disease modification. Similarly exercise intensity matters. Evidence reviewed in this study shows that exercise complexity should include task switching, problem solving, inhibition, dual tasks and focused attention. Exercises should be reward-based, use music, encourage social interaction, and be relevant. Exercises also need to be continuously repeated to reach sustained health benefits. Lastly, specificity also matters; when the same exercise is practised multiple times, the PD movement patterns improve. Description: B.Sc. (Hons)(Melit.) Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/129676 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/129675 Title: A comparison of outcomes of bone-patellar tendon-bone grafts versus other grafts following anterior cruciate ligament surgery Abstract: Anterior cruciate ligament ruptures are a very common musculoskeletal injury that can be treated surgically using several different grafts, such as the bone-patellar tendon-bone, hamstring tendon and quadriceps tendon graft. The aim of this PICO study was to determine if the BPTB graft was the best alternative, with the research question being, “do Bone Patellar Tendon Grafts in patients who have undergone ACL surgery offer a higher risk of failure compared to other grafts?” Population – Patients that underwent ACL reconstruction, Intervention – Bone-Patellar Tendon-Bone graft, Comparison – other graft types, Outcome – risk of graft failure. The inclusion criteria consisted of adult males and females up to 65 years of age, athletes, and general population, BPTB used as a comparison, systematic reviews, meta-analyses, RCTs and cohort studies. Studies were excluded if they were of low-quality, if patients were under 18 or over 65, or if they had other knee injuries. The search was carried out using four different databases, PubMed, MEDLINE (PROQUEST), Taylor and Francis Online and CINAHL Complete (EBSCO). From the 328 studies obtained, eight were chosen as the key studies. The Critical Appraisal Skills Programme Checklist was used to assess the reliability, validity, and applicability of the key studies. Most studies found that in terms of failure rates and knee stability, the BPTB graft offers the best results. In terms of kneeling and anterior knee pain, BPTB grafts were more prone to this complication, but show favourable strength results following ACLR. In conclusion, there is no one graft which performs the best in all the outcomes investigated, and there were some conflicting results. The results of this study show that there is trend towards better outcomes with the BPTB for most of the outcomes however, more research is needed, especially locally. Younger, more active patients, such as the majority of ACL patients in Malta, would benefit from BPTB grafts. Description: B.Sc. (Hons)(Melit.) Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/129675 2023-01-01T00:00:00Z https://www.um.edu.mt/library/oar/handle/123456789/129674 Title: Benefits and challenges of telehealth use by patients with neurological conditions during the COVID-19 pandemic Abstract: Background/Aim: The COVID-19 pandemic has brought about numerous changes in our healthcare system. In order to continue healthcare delivery whilst also ensuring social distancing, telehealth was adopted. This approach allowed different healthcare workers to ensure the patient's needs were met. For this reason, the author aimed to investigate the benefits and challenges brought about by this new healthcare delivery method during the COVID-19 pandemic from a neurological patient's point of view. Method: The author developed a questionnaire to gather the necessary data. This questionnaire was composed of a mixture of open and closed-ended questions and was distributed to neurological patients at the Neurological Rehabilitation Unit in St Luke's Hospital. Data was then analysed using the chi-squared test on SPSS and scrutinised using thematic analysis. Results: A total of 18 participants completed the questionnaire, having a 69.23% completion rate. The majority of participants were overall very satisfied or satisfied with the telerehabilitation sessions during the pandemic (n=16) however, despite this high satisfaction rate, only 17% of the participants (n=3) would opt to continue telerehabilitation sessions when face-to-face sessions resumed. Furthermore, participants agreed that telerehabilitation allowed for continuity of care during the pandemic; however, the lack of physical touch was a significant barrier identified. Of the questions, none had a significant correlation with age and condition. Conclusion: Telerehabilitation was a suitable option to replace face-to-face sessions during the pandemic; however, patients prefer the conventional method over telerehabilitation. Participants also proposed a possible option of hybrid physiotherapy, where a combination of remote and physical sessions are adopted. Description: B.Sc. (Hons)(Melit.) Sun, 01 Jan 2023 00:00:00 GMT https://www.um.edu.mt/library/oar/handle/123456789/129674 2023-01-01T00:00:00Z