Knowledge and Awareness of Osteoporosis: A Survey of Physical Therapy Providers in Saudi Arabia.

Background: Osteoporosis "OP" is classified as one of the most serious health conditions worldwide. OP increases the skeletal fracture risk by 35%, particularly at hip, spine, and wrist joints. Healthcare professionals should be aware of OP clinical signs and have good knowledge while managing all patients. Objectives: This study aims to investigate the current level of osteoporosis knowledge and awareness among physical therapy providers in Saudi Arabia. Methods: One hundred and sixty-eight physical therapy providers participated in this cross-sectional electronic survey from February to July of 2021. The participants completed the Osteoporosis Knowledge Assessment Tool questionnaire (OKAT). Descriptive analysis was utilized to assess the current level of osteoporosis knowledge among physical therapy providers. Results: Among the 168 participants, 55% (n = 92) were over 31 years old and 45% (n = 76) were 30 years old or under. The majority of participants 37% (n = 62) had more than 10 years of experience, 45% (n = 76) mainly treat orthopedic conditions, and 70% (n = 117) live in the western region. The results showed that 67.9% (n = 114) of participants had good knowledge about osteoporosis, while 19.6% (n = 33) had poor knowledge, and only 12.5% (n = 21) had excellent knowledge. Conclusion: Physical therapy providers in Saudi Arabia have a good knowledge of osteoporosis. The overall OP preventive measure knowledge questions were poor. It is crucial for physical therapy providers to act appropriately to prevent falls and mitigate any potential risks.

Influence of an 8-Week Exercise Program on Physical, Emotional, and Mental Health in Saudi Adolescents: A Pilot Study.

Background and Objectives: Physical activity is essential for adolescents to maintain a healthy lifestyle. The aim of this study was to assess the influence of an 8-week exercise program and motivation on physical activity levels, self-motivation, and mental well-being of adolescents in Saudi Arabia. Moreover, the impact of virtual coaching on physical, emotional, and mental health after an eight-week exercise program was examined. Materials and Methods: Twenty-seven participants, 18 females (67%) and 9 males (33%), with a mean age of 14 ± 2.38 years, were enrolled in eight weeks of pre- and post-intervention between June and August of 2021. The physical activity scale, situational motivation scale, mental health continuum short form, and baseline assessments were completed before and after the eight-week program. The program recommended that adolescents practice aerobic, resistance, and weight-bearing exercises for 60 min daily. Paired mean t-tests were used to compare pre-and post-test results. Results: Participants showed an acceptable physical activity level (5.5 ± 1.4) on a 10-point scale with a significant improvement after the eight-week program (7 ± 1.5; p = 0.013). The situational motivation scale improved from 38.1 ± 16 to 26 ± 19.6 (p = 0.042). The mental health continuum (social and psychological well-being) also significantly improved. Participants who received weekly phone calls showed similar improvement patterns but were not significantly different from those who did not receive calls. Conclusions: A virtually delivered 8-week exercise program for adolescents improved their physical, motivational, and mental health. Providing additional weekly phone calls does not provide additional improvement. Providing adolescents with the needed supervision and motivation enhances their physical activity and mental health.

Parents' Perspectives on the Application of Home Activities in Early Intervention.

Aims: This study explored parents' successes, challenges, and recommendations in relation to the application of home activities in early intervention.Methods: An electronic survey was prepared with Qualtrics software and distributed to parents of children with motor delays. Three open-ended questions were included at the end of the survey. Participants were the child's primary caregiver or guardian and their child must be currently receiving early intervention services or have received early intervention services from a physical or an occupational therapist in the United States in the past 5 years. Two coders used content analysis to analyze parents' responses to open-ended questions.Results: A total of 252 participants responded to at least one of the open-ended questions that were included in the survey. Responses were grouped into codes and categories that lead to the emergence of four themes. The themes indicated parent-reported challenges, successes, and recommendations in relation to team collaboration, individualization of activities, developmental gains, and parental support.Conclusions: The results of this study suggest that more focus should be directed toward parent-therapist partnership, multidisciplinary collaboration, and personalization of activities in early intervention. Parents-reported experiences and recommendation could assist early intervention personnel in advancing services provided for children with motor delays.

Challenges Faced by Therapists Providing Services for Infants With or at Risk for Cerebral Palsy.

OBJECTIVE: The purpose of this study was to identify the challenges physical therapists (PTs) and occupational therapists (OTs) have in providing early intervention (EI) for infants with or at risk for cerebral palsy. METHODS: Therapists' responses to an open-ended question were collected via survey that was distributed to EI providers and analyzed using content analysis. RESULTS: The primary self-reported barriers to PT/OT EI services had 5 themes: (1) inadequate communication and collaboration, (2) challenges in coordination with family, (3) policy limitations, (4) meeting the child's individual medical needs, and (5) unequal access to resources. CONCLUSION: Respondents reported that barriers are complex and exist at the individual, family, team, and societal levels. Further research is needed to explore barriers and solutions at each of these levels, from meeting a child's individual medical needs to improving interprofessional communication to increasing equitable access to resources.

Early Intervention Therapy Services for Infants With or at Risk for Cerebral Palsy.

OBJECTIVE: The purpose of this study was to explore the practices physical therapists and occupational therapists use in early intervention (EI) for infants with or at risk for cerebral palsy (CP). METHODS: A survey was disseminated nationally to EI providers using an online anonymous link. RESULTS: Two hundred sixty-nine therapists completed at least 50% of the survey. Four percent of therapists use the General Movement Assessment to predict CP, 57% reported infants at risk for CP receive therapy once a week, 89% identified parents' goals as the most important factor in customizing the EI program, and 75% provide parents with home programs. However, 73% never or rarely use outcome measures to prioritize parents' goals; 31% provide parents with individualized home program and more than 60% never assess environmental enrichment. CONCLUSION: Therapists do not incorporate sufficient strategies for goal-oriented interventions, comprehensive parent education, and optimum environmental enrichment.

Relationship between Pain, Physical Activity, Screen Time and Age among Young Children during the COVID-19 Pandemic.

INTRODUCTION: During the COVID-19 pandemic, many countries implemented restrictions, social distancing measures, and lockdowns to limit the spread of the disease. These lockdowns have affected children's screen time (ST), pain, and physical activity (PA) levels. The present study aimed to explore the relationships between ST, pain, age, and PA before, during, and after the COVID-19 pandemic. METHODS: The caregivers of 329 children (median age = 8 years) filled out an online self-reported survey about the children's PA, ST, and pain before, during, and after the COVID-19 curfew. Spearman's rank correlation coefficient was used to explore the associations between these variables. RESULTS: After the curfew, pain that existed before the pandemic had a weak negative relationship with PA intensity (-0.11, p = 0.04) and a weak positive relationship with ST (r = +0.12, p = 0.04). There was a strong positive relationship between ST in all time periods (p > 0.01). PA and ST had a weak negative relationship (p > 0.05) during the curfew and after the curfew but not before the COVID-19 pandemic. Age had a weak positive correlation with ST in all time periods (p > 0.01). In addition, ST was affected by the curfew. CONCLUSION: The study findings indicated that young children had longer ST during the curfew and after the curfew compared with before the curfew. Increasing PA could lessen children's ST, which could, in turn, increase the probability that their general pain would decrease.

Physical Therapists' Attitudes, Beliefs, and Barriers Regarding Fall Screening and Prevention among Patients with Knee Osteoarthritis: A Cross-Sectional Study.

Falls are commonly associated with knee osteoarthritis and represent a significant financial burden on the healthcare system. Therefore, the discovery of physical therapists' attitudes and practices regarding fall screening and prevention among patients with osteoarthritis should be investigated. Moreover, this study aimed to identify barriers that might limit its implementation among this population. A cross-sectional study design was used to collect the data. The electronic survey targeted licensed physical therapy professionals who currently work in clinical or academic settings in Saudi Arabia. The data were analyzed descriptively and inferentially using chi-square. Two hundred and six licensed physical therapists completed the survey, 119 females (57.8%) and 87 males (42.2%). The results of the structural equation modelling analysis showed that intention to use fall screening and management strategies was positively associated with the history of falls, identifying risk factors of falls, and documentation of risk factors of falls (p ≤ 0.0001). The most reported barriers to implement fall screening and prevention were lack of knowledge (n = 92, 45%), lack of training/skills (n = 84, 41%), and time constraints (n = 57, 45%), followed by patient compliance with 38% of the responses. The findings highlighted the importance of identifying the key opportunities for knowledge translation in clinical practices to enhance the sufficient implementation of fall screening and management in osteoarthritis care.

The effect of post-match fatigue on physical performance in adolescent soccer players.

BACKGROUND: Soccer involves many physically challenging actions and engaging in such activities can induce a decline in performance due to physical fatigue which predisposes players to develop injuries. The present study aimed to examine the impact of post-match fatigue on functional performance and Inter-Limb Asymmetry Index (LSI) in adolescent soccer players. METHODS: Thirty-eight adolescent male soccer players (15-18 years) completed a battery of functional performance measures (Rate of Perceived Exertion (RPE) scale, 10 m sprint, agility T-test, and Single leg hop for distance (SLHD) test). The data collection started prior to a soccer match and consisted of two testing sessions; two hours before the match, while the subsequent testing session was performed within two hours immediately following the match. RESULTS: The study results revealed a significant effect of post-match fatigue on change of direction abilities and SLHD (moderate effect size). However, no significant differences were observed in the 10 m sprint test and LSI (P>0.05). CONCLUSIONS: Functional performance measures such as agility test and SLHD test can detect physical ability changes due to post-match fatigue in adolescent soccer players. The study findings offer insightful and practical information on the importance of employing field-based functional performance measures in monitoring players' recovery following a game.

Diagnosis and referrals to physical therapy among caregivers of children with genetic disorders: a qualitative inquiry.

PURPOSE: Genetic disorders are common in Saudi Arabia. Impaired motor development is one of the major characteristics associated with genetic disorders. Early identifications and referrals are key to receiving physical therapy. This study aims to explore caregivers of children with genetic disorders' experience with early identification and referrals to physical therapy. MATERIALS AND METHODS: An inductive qualitative design of 16 caregivers of children with genetic disorders was done to investigate the identification and referral process to physical therapy. A thematic analysis was used to analyze the data and multiple coders coded the data to increase the trustworthiness of the analysis. RESULTS: The analysis led to emergence of four main themes. Caregivers revealed their struggle with the detection process. They struggled with the vague information related to their children's condition. They also expressed a desperate need for guidance to clarify the process for genetic testing, counseling, and rehabilitation. Although their overall experience with physical therapy was satisfactory, they encountered a number of issues related to scheduling appointments, delayed referrals, and unconfirmed diagnoses. CONCLUSION: The results of this study could indicate that more efforts are required to expedite and elucidate the identification and referral of children with genetic disorders in Saudi Arabia.IMPLICATIONS FOR REHABILITATIONThe process of referring children with genetic disorders to physical therapy (PT) is not clearly understood by caregivers. Providing caregivers with information about the benefits of PT for children with genetic disorders is needed to encourage adherence to PT sessions and rehabilitation plan.Caregivers expressed the need for further education on the wide spectrum of genetic disorders.Caregivers experienced costly and lengthy genetic testing process that often lead to inconclusive results which could delay the referral process. Alternative solutions should be considered to provide these children with early access to rehabilitation services including PT. One of these solutions could be implementing regular screening and monitoring as well as parent education to aid in detecting delays and expedite the referral process.

Perceptions of Healthcare Providers and Caregivers Regarding Procedures for Early Detection of Developmental Delays in Infants and Toddlers in Saudi Arabia.

BACKGROUND: This study aimed to explore current practices adopted by frontline healthcare providers for the early detection of developmental delays in infants and toddlers in Saudi Arabia, with a specific focus on motor and speech delays and caregivers' perceptions of early detection of developmental delays and their awareness of well-child visits. METHODS: Two cross-sectional surveys were conducted and distributed. The first survey was performed among healthcare providers who worked directly with infants and toddlers in the first 3 years of life, and the second survey was performed among caregivers of infants and toddlers who received healthcare services. Participants were recruited via online groups, social media platforms, and clinics. RESULTS: Overall, 60% of the healthcare providers played a role in identifying medical conditions that could be associated with delays and disabilities. However, they did not consistently check for normal development or developmental delays. Furthermore, the healthcare providers reported low frequencies of documenting developmental growth. The caregivers' survey results showed that 67% were familiar with the concept of "well-child visits", and the most frequently discussed topic by the healthcare providers was motor development. CONCLUSIONS: Well-defined, government-supported standards are needed to encourage regular well-child visits and implement efficient practices for the early detection of developmental delays.

Parental Adherence to Home Activities in Early Intervention for Young Children With Delayed Motor Development.

OBJECTIVE: The purpose of this study was to investigate the relationship between characteristics of home activities and coaching practices with the adherence of parents of children with motor delays to home activities provided by physical therapists and occupational therapists in early intervention. METHODS: An online survey study was developed and distributed to physical therapists and occupational therapists across the United States. A survey flier was posted online in parent support groups, physical and occupational therapy groups, newsletters, and organizations supporting parents of children with disabilities. RESULTS: A total of 720 respondents participated in the survey, and 446 participants from 49 states met the inclusion criteria and were included in the analysis. Parents indicated that physical therapists and occupational therapists applied the 5 coaching practices (joint planning, observation, practice, reflection, and feedback). However, parents (63%) reported more time was needed on coaching. Parents stated that therapists' modeling the activities was the most helpful teaching technique that enhanced their adherence to home activities. Coaching practices, appropriateness of the home activities to daily routines and home environment, provision of home activities enjoyed by the child, and parent self-efficacy were all significantly associated with adherence to home activities. CONCLUSIONS: Parents' adherence to home activities is affected not only by the type of coaching used by the therapists but also by the characteristics of the home activities provided for young children with delayed motor development. IMPACT: The results of this study provide additional evidence supporting individualization of home activities to promote parents' continuous provision of learning opportunities to promote their children's development. There was also support of the therapists' use of the 5 coaching practices in early intervention to support the parent's application of home activities when the therapists are not present. LAY SUMMARY: This study explored the use of home activities from the parents' perspective and provided valuable recommendations to therapists to improve parents' adherence to the recommended home activities in early intervention.