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Physiotherapists
Selected AbstractsIncreased physiotherapy in sheltered housing in Sweden: a study of structure and process in elderly careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2003Gunilla Fahlström BSc Abstract The effect of increasing the level of physiotherapy services in elderly care was studied using an intervention and a control unit. The units had 20 and 2 hours of physiotherapy services per week, respectively. Physiotherapy and occupational therapy records were reviewed before and during the project. Physiotherapists also kept extended documentation over an 11-month period. Data analyses employed the chi-square test and content analysis. There was a significant increase in the number of patients receiving physiotherapy and occupational therapy within both units. No significant differences between the units were found for the number of patients receiving physiotherapy. The number of patients receiving occupational therapy differed significantly between units before as well as during the intervention. Primarily care assistants and auxiliary nurses initiated contact with the physiotherapists mainly for patient-orientated errands. Fifty per cent of the instructions given by the physiotherapist at the 20-hour unit related to movement-orientated activities of daily living. At the 2-hour unit, the majority of instructions (52%) were programme-orientated. [source] Factors with independent influence on the ,timed up and go' test in patients with hip fracturePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2009Morten Tange Kristensen Abstract Background and Purpose.,Data on performance times for the ,timed up and go' (TUG) test with analyses of factors, that eventually could affect the result in patients with hip fracture, have not been published to date. The aims of the present study, therefore, were to assess normative reference values of TUG performances and determine the influence of individual and clinical factors on TUG-test scores in patients with hip fracture.,Method.,In this prospective, descriptive study, a total of 196 consecutive patients over the age of 60, and able to perform the TUG when discharged directly to their own homes from a specialized orthopaedic hip fracture unit, were evaluated. The association between TUG scores and categorical variables were examined, and linear regression was used to investigate the factors influencing performance times.,Results.,Univariate analysis showed significant differences between all categorical variables, except gender, but multivariate linear regression analyses showed that only a high pre-fracture function level, evaluated by the New Mobility Score (B = ,11), was independently associated with having a good TUG score, while older age (B = 0.49), having an intertrochanteric fracture (B = 7), performing TUG with a walker (B = 15), and performing TUG in the later postoperative period (B = 0.39) were independently associated with having a poorer TUG score.,Conclusions.,These preliminary normative reference values of TUG performances in patients with hip fracture can be used as references, to which individuals can expect to perform. Multivariate testing suggests that clinicians should use age, pre-fracture function, fracture type and walking-aid specific data when interpreting the TUG test results. Physiotherapists should be aware of this if TUG scores are to be used predictively or as an outcome measure in patients with hip fracture, especially in research. Copyright © 2008 John Wiley & Sons, Ltd. [source] Psychological interventions for long-term conditions: a review of approaches, content and outcomesPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2008Carol Doyle Background.,People living with long-term conditions are more likely to see their GP and experience limitations in their daily activities (Department of Health, 2005). Psychological interventions, specifically cognitive behavioural therapy (CBT), aimed at helping people to cope and self-manage these conditions, are popular. This review aims to summarize the evidence from good-quality systematic reviews of psychological interventions to inform the management of, and future research in, patients with chronic musculoskeletal pain. Cochrane reviews were used as these are considered to be of good quality (Handoll et al., 2002).,Method.,We identified Cochrane reviews of psychological interventions for common chronic health conditions in adults across all healthcare settings. Data on intervention approach, content, delivery and outcomes were extracted and summarized.,Results.,Nine Cochrane reviews, in asthma (n = 1), diabetes (n = 2), coronary heart disease (n = 1) and chronic musculoskeletal pain (n = 5) were identified. These reviews included 131 clinical trials and over 20,200 patients. Psychological interventions were wide ranging, many using a variety of CBT, mostly delivered in secondary care settings by nurses or psychologists. Physiotherapists were involved in some studies as part of multidisciplinary teams. Due to the complexity and diversity of the interventions, individually effective components could not be identified. Interpretation of studies was difficult because of heterogeneity in intervention content, delivery and outcomes measured. Conclusion.,Physiotherapists involved in the management of long-term conditions, particularly chronic musculoskeletal pain, can perhaps learn from this evidence base. Future research should investigate the effectiveness of individual components of CBT and the role of physiotherapists in delivering this type of intervention. Copyright © 2008 John Wiley & Sons, Ltd. [source] Assessment of the importance of glenohumeral peripheral mechanics by practicing physiotherapistsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2007Kenneth Kirby Abstract Background and Purpose.,Physiotherapists develop clinical reasoning theories and applied manual therapy skills through a variety of educational exposures. No studies have assessed the importance of selected theories such as the convex,concave rule, capsular pattern and scapulohumeral rhythm during clinical decision-making by physiotherapists. The present study investigated which variables physiotherapists considered were associated with the importance of these theories during practice and investigated physiotherapists' perception of translational motion biomechanics of the glenohumeral (GH) joint.,Method.,Six hundred and sixty physiotherapists in the USA volunteered to participate in this study. Using ologit regression analyses, the identifier themes and clinical background characteristics were associated with importance of peripheral biomechanics in manual therapy application and reliability/validity of the scapulohumeral rhythm theory in predicting pathological sequences of the shoulder complex. An intraclass correlation coefficient (ICC) was used to determine agreement regarding necessary translation of the GH joint for normal movement.,Results.,The majority of physiotherapists indicated that all theories were important or very important during treatment decision-making and reported frequent utilization. Regression models identified that the importance placed on peripheral biomechanics was negatively influenced by academic qualification (bachelors and masters degrees) and gender (men were less likely to report that scapulohumeral rhythm was a reliable/valid predictor of shoulder pathology). ICC values identified excellent agreement among clinicians regarding translational motion.,Conclusions.,The importance of biomechanics of the periphery for use, validation and frequency was based heavily on adoption of selected theories of glenohumeral movements despite evidence that suggests the theories lack validity. Copyright © 2007 John Wiley & Sons, Ltd. [source] Physiotherapists' perceptions and use of medical imaging information in practicePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 1 2006Tamara Little Abstract Background and Purpose. Physiotherapists must take responsibility for all aspects of patient care. Information from medical imaging studies can influence clinical decisions. The purpose of the present study was to gather information about physiotherapists' perceptions and use of medical imaging information in clinical practice. Method. A survey questionnaire was developed, validated and pilot tested. Subjects were randomly selected from a pool of licensed physiotherapists practising in four California Physical Therapy Association Districts. The survey was sent to 500 physiotherapists. Data gathered from the survey were transcribed to spreadsheets for analysis. Results. One hundred and twenty participants completed and returned the survey. Information from radiographs was most frequently available, followed by MRI and CT scan information, respectively. Respondents reported more use of information from reports than from images. Respondents also indicated that it was important to be able to review medical imaging information (70%), that they use medical imaging information in their practice when it is available (83.4%), that physiotherapists have the necessary knowledge and skills to use this type of information (77.3%), and that medical imaging should be covered in entry-level educational programmes (84.2%). Respondents additionally indicated that medical imaging information could be used to understand a patient's disease process (85%), improve communication about patient care (90%), improve diagnosis, prognosis and interventions for patients (81.6%), and identify contraindications to examination and interventions (87.5%). Conclusions. Physiotherapists have access to some medical imaging information and perceive that this information could be valuable in patient care; however, not all therapists are confident in their ability to interpret this information. Curricula in entry-level physiotherapist educational programmes should include information about medical imaging. Copyright © 2006 John Wiley & Sons, Ltd. [source] Cryotherapy after total knee replacement: a survey of current practicePHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2003Simon Barry Abstract Background and Purpose Cryotherapy is commonly used during physio-therapeutic rehabilitation after total knee replacement (TKR). Evidence for treatment effectiveness is contradictory and there are no clinical guidelines to inform treatment protocols within this patient group. The present survey investigated current cryotherapy practice after TKR throughout the United Kingdom (UK). Method A postal survey, containing open and closed questions, was distributed to senior inpatient orthopaedic physiotherapists (n = 453). Results The response rate was 67% (304/453) and 58% (263/453) of the responses were completed by physiotherapists who treated TKR patients in the acute phase. Of these, 33% (85/263) routinely applied some form of cryotherapy after TKR. Physiotherapists working in the private sector were more likely to use cryotherapy and had greater access to Cryocuff equipment. The two main methods of cryotherapy application were the Cryocuff device, 59% (155/263) and crushed ice, 30% (79/263). Treatments were applied most frequently between 24 and 48 hours post-surgery, for 20 minutes, twice a day. Lack of proven efficacy was the most frequently stated reason for not applying cryotherapy treatment, and swelling was the most common indicator for treatment. There was particular uncertainty about the physical management of the Cryocuff device. Conclusions There was little consensus with regard to treatment indicators, method of application and the management of cryotherapy after TKR. The results highlight a lack of consistency in the application of cryotherapy after TKR, indicating a need for further research. Copyright © 2003 Whurr Publishers Ltd. [source] Physiotherapists in Balint group trainingPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2000Dr Madeleine Abrandt Dahlgren Abstract Background and Purpose Balint group training (BGT) is a method widely used for enhancing understanding of the relationship and communication between health professionals and their patients. Participants meet in small groups, on a regular basis, with a tutor to discuss their experiences of problem cases. The method was originally developed in the 1950s for enhancing understanding of the doctor,patient relationship. Few studies have focused on BGT and physiotherapists. The aim of the present study was to describe and analyse physiotherapists' experiences of participation in BGT as a means of learning and understanding the physiotherapist,patient relationship. Method Semi-structured, in-depth interviews were conducted with three physiotherapists working in private practice, all participating in BGT. The intervews were transcribed and subjected to a qualitative analysis. Results The results are presented in a sequential model, featuring eight themes in which the physiotherapists' experiences of the training process are portrayed. Conclusions The results suggest that BGT and sharing the experiences of others may be considered a way of enhancing understanding of the patient encounter in clinical practice, possibly to the benefit of physiotherapists and their patients. Copyright © 2000 Whurr Publishers Ltd. [source] Reliability of the V-scope system in the measurement of arm movement in children with obstetric brachial plexus palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2006Andrea E Bialocerkowski PhD BApp Sc (Physio) MApp Sc (Physio) This study reports on a novel methodology using the V-scope to quantify elbow and shoulder movement in young children with obstetric brachial plexus palsy (OBPP), and the intra-and interreliability of this method. The V-scope, a portable, inexpensive movement analysis system, was configured in an L-shape, with two transmitting towers placed on the floor and one 1.35m off the ground. These towers received ultrasonic pulses from buttons that were placed over standardized landmarks of the child's trunk, chest, and upper limb. Two physiotherapists (a paediatric and a generalist) facilitated the maximum range of active elbow flexion/extension and shoulder abduction/flexion in 30 children with OBPP (18 females, 12 males; age range 6mo-4y 7mo; mean age 2y 6mo [SD 1y 2mo]). Assessments were conducted on two occasions, one week apart. The V-scope was found to be feasible to use by a specialist and a generalist physiotherapist, demonstrating moderate to high reliability coefficients, small measurement errors, and lack of missing data. The pediatric physiotherapist was more reliable in measuring elbow and shoulder movement compared with the generalist physiotherapist, which suggests that the same experienced, pediatric physiotherapist should assess elbow and shoulder movement across all occasions of testing. [source] Stimulant medication in 47,XYY syndrome: a report of two casesDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 8 2005Anne Ruud MD In two males, 11 and 12 years of age, referred for attention-deficit-hyperactivity disorder (ADHD), 47,XYY syndrome was diagnosed. A team that included a neuropsychologist, a physiotherapist, and a physician examined them. Stature (patients were above 97.5% height for age), muscle consistency, and tremor indicated chromosome analysis. Psychological tests results did not fully fit the ADHD diagnosis. On the basis of our clinical observation we felt that stimulant medication was indicated. Administration of methylphenidate led to improved motor and cognitive functions as well as social adaptation in both patients. We suggest that this treatment might well be considered in clinically similar patients with XYY sex chromosomes; we further suggest that learning problems in such individuals may be related to ADHD. [source] Randomized controlled trial of physiotherapy in 56 children with cerebral palsy followed for 18 monthsDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 1 2001E Bower PhD MCSP Senior Research Fellow This study aimed to determine whether motor function and performance is better enhanced by intensive physiotherapy or collaborative goal-setting in children with cerebral palsy (CP). Participants were a convenience sample of 56 children with bilateral CP classified at level III or below on the Gross Motor Function Classification System (GMFCS), aged between 3 and 12 years. A 2 × 2 factorial design was used to compare the effects of routine amounts of physiotherapy with intensive amounts, and to compare the use of generalized aims set by the child's physiotherapist with the use of specific, measurable goals negotiated by the child's physiotherapist with each child, carer, and teacher. Following the six-month treatment period there was a further six-month period of observation. Changes in motor function and performance were assessed by a masked assessor using the Gross Motor Function Measure (GMFM) and the Gross Motor Performance Measure (GMPM) at three-month intervals. There was no statistically significant difference in the scores achieved between intensive and routine amounts of therapy or between aim-directed and goal-directed therapy in either function or performance. Inclusion of additional covariates of age and severity levels showed a trend towards a statistically significant difference in children receiving intensive therapy during the treatment period. This advantage declined over the subsequent six months during which therapy had reverted to its usual amount. Differences in goal-setting procedures did not produce any detectable effect on the acquisition of gross motor function or performance. [source] Is there a role for physiotherapy during deep brain stimulation surgery in patients with Parkinson's disease?EUROPEAN JOURNAL OF NEUROLOGY, Issue 5 2006E. Chevrier In our center, a physiotherapist is present in the operative room to bring relief to the Parkinsonian patient during subthalamic nucleus stimulation surgery under local anesthesia. This study searched to determine the causes of pain and suffering during bilateral electrode implantation and to assess the role of physiotherapy. Ninety-two consecutive patients operated on between 2001 and 2004 were included in this retrospective study. A questionnaire with eight items was developed and mailed to the patients. Seventy-five responses to questionnaires were available. All patients except one experienced physical pain and psychological suffering, alleviated by physiotherapy. These preliminary results need to be confirmed in a prospective randomized study. [source] The utility of the Dutch Arthritis Impact Measurement Scales 2 for assessing health status in individuals with haemophilia: a pilot studyHAEMOPHILIA, Issue 6 2000N. L. U. Van Meeteren The aim of this pilot study was to examine the usefulness of the Dutch version of the Arthritis Impact Measurement Scales 2 (D-AIMS2)in assessing the health status of Dutch individuals with haemophilia. Sixty-eight individuals with mild, moderate, and severe haemophilia attending our clinic for their annual check-up participated. They first completed the Canadian Occupational Performance Measure (COPM). The D-AIMS2 was filled in afterwards at home. With the COPM, individuals rated their specific problematic activities of daily life (ADL), as well as the severity and importance of each problem. The D-AIMS2 is a comprehensive, self-administered questionnaire that evaluates functional health status. Fifty-seven individuals completed and returned the D-AIMS2. Reliability analysis demonstrated good internal consistency for the scales (Cronbach's ,=0.76,1.00), as well as for the components (,=0.80,0.88), except for the component ,social interaction' (,=0.44). Criterion validity of the D-AIMS2 was assessed by comparison with COPM outcomes; 80% of the problematic ADLs were included in the questionnaire, 20% were missing. Correlations between the D-AIMS2 components ,physical health' and ,symptoms' with predicted scores of those individuals by a highly experienced physiotherapist (r=0.63 and 0.53, respectively) substantiated its concurrent validity. Based on these results we concluded that the D-AIMS2, with minor adjustments, can be an appropriate tool for assessing the health status of Dutch haemophilia patients. [source] Increased physiotherapy in sheltered housing in Sweden: a study of structure and process in elderly careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2003Gunilla Fahlström BSc Abstract The effect of increasing the level of physiotherapy services in elderly care was studied using an intervention and a control unit. The units had 20 and 2 hours of physiotherapy services per week, respectively. Physiotherapy and occupational therapy records were reviewed before and during the project. Physiotherapists also kept extended documentation over an 11-month period. Data analyses employed the chi-square test and content analysis. There was a significant increase in the number of patients receiving physiotherapy and occupational therapy within both units. No significant differences between the units were found for the number of patients receiving physiotherapy. The number of patients receiving occupational therapy differed significantly between units before as well as during the intervention. Primarily care assistants and auxiliary nurses initiated contact with the physiotherapists mainly for patient-orientated errands. Fifty per cent of the instructions given by the physiotherapist at the 20-hour unit related to movement-orientated activities of daily living. At the 2-hour unit, the majority of instructions (52%) were programme-orientated. [source] The experiences of non-medical health professionals undertaking community-based health assessments for people aged 75 years and overHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 2 2002Julie E. Byles BMed PhD Abstract Our objective was to explore the perceptions of allied health professionals who conducted over 3000 home-based health assessments within the general-practice-dominated Australian primary healthcare system. A series of semistructured qualitative interviews were carried out within the Department of Veterans' Affairs ,Preventive Care Trial', where health assessments are undertaken by health professionals in the homes of participating veterans and war widows. Health professionals were employed within the Preventive Care Trial to conduct assessments in 10 areas of New South Wales and Queensland. Subjects were mainly registered nurses, but also included a social worker, an occupational therapist, a physiotherapist and a psychologist. The health professionals described positive attitudes towards the health assessments, and showed that they have the broad range of necessary personal and professional skills to undertake them. Home visits were seen as an essential component and the most useful aspects included direct observation of home safety and medications. This study demonstrates that health assessments for older people can be acceptably and competently undertaken by suitably qualified allied health professionals, and that an effective collaborative approach to patient care can be achieved through such a system. [source] Increased health care utilization among long-term cancer survivors compared to the average Dutch population: A population-based studyINTERNATIONAL JOURNAL OF CANCER, Issue 4 2007Floortje Mols Abstract In the present study, self-reported health care utilization of cancer survivors is compared with those of an age- and gender-matched normative population and predictors of health care utilization are identified. A population-based, cross-sectional survey among 1893 long-term survivors of endometrial and prostate cancer and malignant lymphomas (Hodgkin's and non-Hodgkin's) diagnosed between 1989 and 1998 was conducted using the cancer registry of the Comprehensive Cancer Centre South. Cancer survivors visited their general practitioner somewhat more often compared to the age and gender-matched general Dutch population but this effect was not always statistically significant. In addition, they visited their medical specialist significantly more often. Survivors only sporadically (0,3%) visited or required a dietician, sexologist, oncology nurse, pastor, creative therapy or recovery program. Contact with a psychologist, physiotherapist and other cancer survivors took place somewhat more often. Patients visited a medical specialist less often if they were diagnosed with endometrial cancer (OR = 0.2; 95% CI = 0.1,0.5), if they were diagnosed between 10,15 years ago (OR = 0.6; 95% CI = 0.1,0.5) and if they were not married or divorced (OR = 0.5; 95% CI = 0.3,0.9). Contact with a psychologist was related to having a university or college degree (OR = 3.6; 95% CI = 1.3,9.4). Cancer survivors visited their specialist more often compared to the normative population. Changes in health care, such as less administrative work for the specialist and more efficiency, are probably necessary in order to cope adequately with the increasing demand on the system. © 2007 Wiley-Liss, Inc. [source] Comprehensive health assessments during de-institutionalization: an observational studyJOURNAL OF INTELLECTUAL DISABILITY RESEARCH, Issue 10 2006N. Lennox Abstract Background People with intellectual disability (ID) leaving institutions pass through a transition stage that makes them vulnerable to inadequate health care. They enter into community care under general practitioners (GPs) who are often untrained and inexperienced in their needs. Specifically designed health reviews may be of assistance to both them and their new GPs as they go through that phase. Methods This research aimed to investigate the effectiveness of a specially designed health review, the comprehensive health assessment program (CHAP) health review, in a group of adults as they transitioned out of the care of the last institution for people with ID in Tasmania. There were 25 residents reviewed by their GPs. Results The CHAP reviews picked up a number of health conditions and stimulated health promotion activities. Some of the findings were: a high number of abnormal Body Mass Indexes (19/23), immunizations given (13/23), vision impairment reported (2/23), mental health issues recorded (4/23) and skin abnormalities described (17/23). There were 22 referrals made to other health professionals (Australian Hearing Service 4, dentists 3, optometrists 3, psychiatrists 2, neurologists 2, ophthalmologist 1, urologist 1, ultrasound 1, mammogram 1, family planning 1, physiotherapist 1, continence nurse 1 and respiratory physician 1). These were in addition to various requests for pathology. Conclusions The CHAP health review was effective in identifying a number of health issues in the population of people with ID as they transitioned out of institutional care into the general community. [source] Retraining cervical joint position sense: The effect of two exercise regimesJOURNAL OF ORTHOPAEDIC RESEARCH, Issue 3 2007Gwendolen Jull Abstract This study compared the effects of conventional proprioceptive training and craniocervical flexion (C-CF) training on cervical joint position error (JPE) in people with persistent neck pain. The aim was to evaluate whether proprioceptive training was superior in improving proprioceptive acuity compared to another form of exercise, which has been shown to be effective in reducing neck pain. This may help to differentiate the mechanisms of effect of such interventions. Sixty-four female subjects with persistent neck pain and deficits in JPE were randomized into two exercise groups: proprioceptive training or C-CF training. Exercise regimes were conducted over a 6-week period, and all patients received personal instruction by an experienced physiotherapist once per week. A significant pre- to postintervention decrease in JPE, neck pain intensity, and perceived disability was identified for both the proprioceptive training group (p,<,0.001) and the C-CF training group (p,<,0.05). Patients who participated in the proprioceptive training demonstrated a greater reduction in JPE from right rotation compared to the C-CF training group (p,<,0.05). No other significant differences were observed between the two groups. The results demonstrated that both proprioceptive training and C-CF training have a demonstrable benefit on impaired cervical JPE in people with neck pain, with marginally more benefit gained from proprioceptive training. The results suggest that improved proprioceptive acuity following intervention with either exercise protocol may occur through an improved quality of cervical afferent input or by addressing input through direct training of relocation sense. © 2006 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 2007 [source] Reliability of knee joint range of motion and circumference measurements after total knee arthroplasty: does tester experience matter?PHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2010Thomas Linding Jakobsen Abstract Background and Purpose.,Two of the most utilized outcome measures to assess knee joint range of motion (ROM) and intra-articular effusion are goniometry and circumference, respectively. Neither goniometry nor circumference of the knee joint have been examined for both intra-tester and inter-tester in patients with total knee arthroplasty (TKA). The purpose of this study was to determine the intra-tester and inter-tester reliability of active and passive knee joint ROM and circumference in patients with TKA when administered by physiotherapists (testers) with different clinical experience.,Method.,The design was an intra-tester, inter-tester and intra-day reliability study. Nineteen outpatients (10 females) having received a TKA were examined by an inexperienced and an experienced physiotherapist. Following a standardized protocol, active and passive knee joint ROM and circumference measurements were obtained using a universal goniometer and a tape measure, respectively. To establish reliability, intraclass correlation coefficients (ICC2,1) and smallest real difference (SRD) were calculated.,Results.,The knee joint ROM and circumference measurements were generally reliable (ICC > 0.8) within and between physiotherapists (except passive knee extension). Changes in knee joint ROM of more than 6.6° and 10° (except active knee flexion) and knee joint circumference of more than 1.0,cm and 1.63,cm represent a real clinical improvement (SRD) or deterioration for a single individual within and between physiotherapists, respectively. Generally, the experienced tester recorded larger knee joint ROM and lower circumference values than that of the inexperienced tester.,Conclusions.,In clinical practice, we suggest that repeated knee goniometric and circumferential measurements should be recorded by the same physiotherapist in individual patients with TKA. Tester experience appears not to influence the degree of reliability. Copyright © 2009 John Wiley & Sons, Ltd. [source] Development pathways in learning to be a physiotherapistPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2006Ingrid Lindquist Abstract Background and Purpose.,Few studies have examined the experiences of students' professional socialization in physiotherapy. This international longitudinal study aimed to study experiences of situated learning and change in a student cohort during a physiotherapy education programme.,Method.,A phenomenographic design with semi-structured interviews was carried out with a cohort of physiotherapy students from two sites, strategically selected for variation in gender, age, educational background, work experience and academic level. Interviews were carried out after each of the first five semesters in the programme by a team of researchers. Seventy-six interviews explored students' learning experiences. Analysis identified the variation in experiences seen as important to becoming a physiotherapist.,Results.,Distinct perceptions of professional growth and progression are identified in four pathways of development: ,Reflecting on Practice'; ,Communicating with Others'; ,Performing Skills'; and ,Searching Evidence'. These pathways demonstrate qualitative differences in the focus of learning experiences and preferred learning context, and include learning in a context which supports reflection, learning as agreed by others in a context with patients and other professionals, learning physiotherapy skills in a practice context and learning formal knowledge in a context where theory can be linked with practice.,Conclusions.,In a cohort of students professional growth can be seen in a variety of development pathways. Each shows progress of professional growth in the ,what' as changes in experiences and the ,how' as ways of learning from them. In addition, the pattern of pathways in a cohort may change from one semester to another suggesting individuals may adopt different learning pathways throughout their education. Teaching staff are challenged to consider how they recognize a variation in development pathways in their student cohorts and how they purposefully ensure experiences to guide students through different learning pathways in socialization to become a physiotherapist. Copyright © 2006 John Wiley & Sons, Ltd. [source] Influence of standardized mobilization on the posteroanterior stiffness of the lumbar spine in asymptomatic subjectsPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 3 2001Dr Garry Allison Abstract Background and Purpose Spinal mobilization is commonly used to relieve pain and assist recovery of mobility in individuals with low back pain. Fundamental to this concept is the belief that spinal mobilization will influence the mechanical properties of the symptomatic motion segment. The objective of the present study was to examine the segmental effects of a standardized mobilization procedure on the posteroanterior (PA) stiffness of the lumbar spine. Method Audio and visual feedback was used to train a physiotherapist to perform PA mobilization at a consistent load and frequency. After training, twenty-four subjects without low back pain were recruited for the intervention phase of the study. The spinal posteroanterior mobilization (SPAM) apparatus was used to measure the PA stiffness of the lumbar spine at three measurement sites (L1, L3 and L5). The trained physiotherapist then applied the standardized PA mobilization technique via the L3 spinous process for two minutes. Following mobilization, PA stiffness was measured three times at the three locations. Results The physiotherapist was able to apply a standardized mobilization with a mean force of 146 N (standard deviation (SD) 8 N) at a frequency of 1.5 Hz. The first trial on each assessment demonstrated a pre-condition effect. Two minutes' PA mobilization resulted in no significant change in the PA stiffness of the lumbar spine at the level to which the mobilization was applied, or at the L1 and L5 segments. The 95% confidence intervals (CI) of the difference in PA stiffness before and after testing included zero at each measurement site. Conclusions Clinicians should pre-condition the spine when assessing PA stiffness both before and after interventions. A standardized mobilization of 150 N at 1.5 Hz for two minutes had no segmental effect on spinal PA stiffness. Subsequent studies need to consider other mechanisms that may contribute to the changes that occur after PA spinal mobilization. Copyright © 2001 Whurr Publishers Ltd. [source] Physiotherapists in Balint group trainingPHYSIOTHERAPY RESEARCH INTERNATIONAL, Issue 2 2000Dr Madeleine Abrandt Dahlgren Abstract Background and Purpose Balint group training (BGT) is a method widely used for enhancing understanding of the relationship and communication between health professionals and their patients. Participants meet in small groups, on a regular basis, with a tutor to discuss their experiences of problem cases. The method was originally developed in the 1950s for enhancing understanding of the doctor,patient relationship. Few studies have focused on BGT and physiotherapists. The aim of the present study was to describe and analyse physiotherapists' experiences of participation in BGT as a means of learning and understanding the physiotherapist,patient relationship. Method Semi-structured, in-depth interviews were conducted with three physiotherapists working in private practice, all participating in BGT. The intervews were transcribed and subjected to a qualitative analysis. Results The results are presented in a sequential model, featuring eight themes in which the physiotherapists' experiences of the training process are portrayed. Conclusions The results suggest that BGT and sharing the experiences of others may be considered a way of enhancing understanding of the patient encounter in clinical practice, possibly to the benefit of physiotherapists and their patients. Copyright © 2000 Whurr Publishers Ltd. [source] SENSATION RECOVERY IMPROVED BY GREAT AURICULAR NERVE PRESERVATION IN PAROTIDECTOMY: A PROSPECTIVE DOUBLE-BLIND STUDYANZ JOURNAL OF SURGERY, Issue 5 2007Dacita T. K. Suen Background: The great auricular nerve (GAN) is frequently sacrificed during parotidectomy and causes sensory disturbance of the auricle. Our study is to investigate whether GAN preservation can improve the sensory recovery. Methods: Patients undergoing superficial or total conservative parotidectomy for benign tumours were recruited consecutively from November 1998 to September 2001. Different sensory methods (light touch, two-point discrimination and sharp pain) of the auricle were evaluated by a designated physiotherapist preoperatively as well as at 1, 3, 6 and 12 months postoperatively. The patients and the physiotherapist were blinded to the integrity of the GAN. Long-term subjective assessment was also carried out beyond 2 years postoperatively. Results: A total of 21 patients were recruited for the study. GAN were preserved in 10 patients. The mean follow up was 16 months (12,42 months). There was no difference in sex distribution, type of operation and pathology of parotid tumour between the two groups. No postoperative mortality occurred and postoperative morbidity did not differ between the two groups. Patients with GAN preserved had significantly better light touch and sharp pain recovery at 1 year postoperatively. Subjective assessment of sensory dysfunction also favoured GAN preservation. Conclusion: Great auricular nerve preservation minimizes the postoperative sensory disturbance and should be considered whenever tumour clearance is not compromised. [source] A break-even analysis of a community rehabilitation falls prevention serviceAUSTRALIAN AND NEW ZEALAND JOURNAL OF PUBLIC HEALTH, Issue 3 2009Tracy Comans Abstract Objective: To identify and compare the minimum number of clients that a multidisciplinary falls prevention service delivered through domiciliary or centre-based care needs to treat to allow the service to reach a ,break-even' point. Method: A break-even analysis was undertaken for each of two models of care for a multidisciplinary community rehabilitation falls prevention service. The two models comprised either a centre-based group exercise and education program or a similar program delivered individually in the client's home. The service consisted of a physiotherapist, occupational therapist and therapy assistant. The participants were adults aged over 65 years who had experienced previous falls. Costs were based on the actual cost of running a community rehabilitation team located in Brisbane. Benefits were obtained by estimating the savings gained to society from the number of falls prevented by the program on the basis of the falls reduction rates obtained in similar multidisciplinary programs. Results: It is estimated that a multi-disciplinary community falls prevention team would need to see 57 clients per year to make the service break-even using a centre-based model of care and 78 clients for a domiciliary-based model. Conclusions and Implications: The service this study was based on has the capability to see around 300 clients per year in a centre-based service or 200-250 clients per year in a home-based service. Based on the best available estimates of costs of falls, multidisciplinary falls prevention teams in the community targeting people at high risk of falls are worthwhile funding from a societal viewpoint. [source] Validity and reliability of a Swedish version of the Non-Communicating Children's Pain Checklist , Postoperative VersionACTA PAEDIATRICA, Issue 6 2010M Johansson Abstract Aim:, To test the validity and reliability of a Swedish version of the Non-Communicating Children's Pain Checklist , Postoperative Version (NCCPC-PV). Methods:, Thirty-two consecutive children/adolescents (2,20 years of age) with cognitive impairment and no verbal communication from four habilitation centres were admitted to the study. Each child's behaviour was observed by a parent or a caregiver and by a physiotherapist in two calm and two painful situations within the child's everyday life. The raters independently assessed and graded the child's behaviour during 5 min according to the translated Swedish version of the NCCPC-PV. The intrarater and interrater reliability were determined, and the construct validity was examined. Results:, The results from 202 assessments showed that the construct validity was good: children's behavioural signs differed significantly between situations of pain and situations of calm (p < 0.001). Repeated assessments showed poor agreement both within and between raters [intraclass correlation coefficient (ICC) 0.51,0.65]. The agreement for pain was good (ICC 0.83). Conclusion:, The Swedish version of the NCCPC-PV can be used for pain assessment in children with cognitive impairments who lack verbal communication. Aspects of reliability need to be further analysed. [source] Reliability of the V-scope system in the measurement of arm movement in children with obstetric brachial plexus palsyDEVELOPMENTAL MEDICINE & CHILD NEUROLOGY, Issue 11 2006Andrea E Bialocerkowski PhD BApp Sc (Physio) MApp Sc (Physio) This study reports on a novel methodology using the V-scope to quantify elbow and shoulder movement in young children with obstetric brachial plexus palsy (OBPP), and the intra-and interreliability of this method. The V-scope, a portable, inexpensive movement analysis system, was configured in an L-shape, with two transmitting towers placed on the floor and one 1.35m off the ground. These towers received ultrasonic pulses from buttons that were placed over standardized landmarks of the child's trunk, chest, and upper limb. Two physiotherapists (a paediatric and a generalist) facilitated the maximum range of active elbow flexion/extension and shoulder abduction/flexion in 30 children with OBPP (18 females, 12 males; age range 6mo-4y 7mo; mean age 2y 6mo [SD 1y 2mo]). Assessments were conducted on two occasions, one week apart. The V-scope was found to be feasible to use by a specialist and a generalist physiotherapist, demonstrating moderate to high reliability coefficients, small measurement errors, and lack of missing data. The pediatric physiotherapist was more reliable in measuring elbow and shoulder movement compared with the generalist physiotherapist, which suggests that the same experienced, pediatric physiotherapist should assess elbow and shoulder movement across all occasions of testing. [source] Treatment for upper-limb and lower-limb lymphedema by professionals specializing in lymphedema careEUROPEAN JOURNAL OF CANCER CARE, Issue 6 2008D. LANGBECKER bhsc Up to 60% of patients with cancer of the vulva, and between 20 and 30% of patients with breast or abdominal cancers may develop lymphedema following treatment. The aims of this study were to assess health professionals' knowledge about treatment, diagnostic procedures, advice and confidence in treatment of patients with either upper-limb (ULL) or lower-limb lymphoedema (LLL), and whether these differed by health professionals' background or for patients with ULL compared with LLL. A cross-sectional telephone interview was undertaken in 2006, of 63 health professionals (response rate 92.6%) known to treat lymphedema. Sixty-three per cent of the health professionals were physiotherapists; the majority were university-trained, with 20 years' experience or more. Ninety-five per cent of health professionals used circumferential measurements to establish lymphedema status, and most health professionals advised avoiding scratches and cuts (100%), insect bites (98.4%), sunburn (98.4%) and excessive exercise (65.1%) on the affected limb. Health professionals reported that compared with patients with LLL, patients with ULL were more likely to present within the first 3 months of being symptomatic (P < 0.01). Patients with LLL were more likely to present with swelling (P = 0.001), heaviness (P = 0.003), tightness (P = 0.007) and skin problems (P < 0.001) compared with patients with ULL. Treatment and advice differed according to health professionals' background, but not location of lymphedema (ULL vs. LLL). Assessment, treatment and advice for lymphedema vary across professional groups. Our results suggest that improvements should be attempted in the early detection of lymphedema, in particular of LLL among cancer patients. [source] Orthopaedic surgery of haemophilia in the 21st century: an overviewHAEMOPHILIA, Issue 3 2002E. C. RODRIGUEZ-MERCHAN Close co-operation between haematologists, orthopaedic surgeons, rehabilitation physicians and physiotherapists is essential for obtaining satisfactory results after orthopaedic procedures that are performed on haemophilic patients. Although continuous prophylaxis could avoid the development of the orthopaedic complications of haemophilia that we still see in the 21st century, such a goal has not been achieved so far, not even in developed countries. Therefore, orthopaedic surgeons are still required to carry out many different surgical procedures, such as arthrocentesis, synoviorthesis, synovectomies, tendon lengthening, articular debridements, alignment osteotomies, joint arthroplasties, nerve releases, opening of compartment syndromes, removal of pseudotumours and osteosynthesis of fractures. Furthermore, the emergence of human immunodeficiency virus has meant that immunosuppressed patients in developed countries sometimes require an arthrotomy for the treatment of spontaneous septic arthritis, or the surgical drainage of a spontaneously infected haematoma (abscess). In addition, they have a high risk of postoperative infection after any surgical procedure, particularly a joint arthroplasty. [source] Increased physiotherapy in sheltered housing in Sweden: a study of structure and process in elderly careHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2003Gunilla Fahlström BSc Abstract The effect of increasing the level of physiotherapy services in elderly care was studied using an intervention and a control unit. The units had 20 and 2 hours of physiotherapy services per week, respectively. Physiotherapy and occupational therapy records were reviewed before and during the project. Physiotherapists also kept extended documentation over an 11-month period. Data analyses employed the chi-square test and content analysis. There was a significant increase in the number of patients receiving physiotherapy and occupational therapy within both units. No significant differences between the units were found for the number of patients receiving physiotherapy. The number of patients receiving occupational therapy differed significantly between units before as well as during the intervention. Primarily care assistants and auxiliary nurses initiated contact with the physiotherapists mainly for patient-orientated errands. Fifty per cent of the instructions given by the physiotherapist at the 20-hour unit related to movement-orientated activities of daily living. At the 2-hour unit, the majority of instructions (52%) were programme-orientated. [source] Oral self-care habits of dental and healthcare providersINTERNATIONAL JOURNAL OF DENTAL HYGIENE, Issue 4 2008Y Zadik Abstract:, Objective:, To evaluate the self-care level of dental and healthcare providers regarding prevention of oral diseases Methods:, Healthcare providers (dental assistants and surgeons, laboratory personnel, biologists, medics, paramedics, corpsmen, nurses, pharmacists, physicians, physiotherapists, psychologists, social workers, speech therapists, X-ray technicians) and non-health care providing adults (the general population) were asked to respond to a questionnaire regarding their routine measures for maintaining oral health Results:, Three hundred and twenty-six healthcare providers and 95 non-healthcare providers participated in the study. Regarding toothbrushing, flossing, undergoing periodic dental examinations and professional scaling/polishing, dental practitioners have better, but not perfect, maintenance habits than other healthcare providers. Non-dental healthcare providers have better dental habits than the general population, and nurses and medical practitioners have better dental habits than medics, paramedics, corpsmen and para-medical professionals. Among non-dental healthcare providers, nurses have a relatively high frequency of toothbrushing and flossing but a low frequency of periodic examinations and scaling/polishing. Generally, females reported significantly higher frequencies of toothbrushing and flossing than males did. The toothpaste selection of the participants was primarily influenced by dentists' recommendations, the flavour of the toothpaste, and its anti-malodour effect were the most dominant factors. Conclusion:, The compliance of health professionals, especially dental practitioners, with appropriate oral health measures is relatively high. However, the dental team cannot always assume that the dental patient, who also happens to be a healthcare provider, has meticulous oral habits. The dental hygienist and surgeon have to educate and motivate their patients, especially healthcare providers because of the influence of the latter on their own patients. [source] A comparison study on nurses' and therapists' perception on the positioning of stroke patients in Singapore General HospitalINTERNATIONAL JOURNAL OF NURSING PRACTICE, Issue 4 2007Lilian Yew Siew Mee Adv. Before developing a study to evaluate the effect of positioning on outcome after stroke, it was important to explore whether there were differences in perception between neurology/neurosurgery nurses, nurses from other wards, occupational therapists (OTs) and physiotherapists (PTs) over the positioning of stroke patients in Singapore General Hospital (SGH). Questionnaires were sent to 227 nurses, seven PTs and six OTs from six wards where more stroke patients are cared for in SGH. Seventy-two per cent of the respondents identified bed positioning as their positioning strategy. ,Sitting in a chair' was selected as the best position by most of the respondents in the three specialty groups for nursing conscious hemiplegic stroke patients. ,A 30 degree propped-up angle in bed' was selected as the best position by the majority of the nurses from the neuroscience wards while ,lying horizontally on the unaffected side' of the body was selected as the best position by most of the nurses from other wards, PTs and OTs for nursing unconscious hemiplegic stroke patients. However, no significant difference was found between the groups in what they considered the best position for stroke patients. The lack of consensus between these respondents is probably because there are few studies to guide nursing practices for the positioning of stroke patients. Hence, research to confirm which positions improve or hinder outcome after stroke is indispensable. 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