ABSTRACT
OBJECTIVE: To evaluate learning results of critical care physiotherapists participating in a muscle ultrasound (MUS) educational program. DESIGN: Cross-sectional study. SETTING: A custom-made 20-hour MUS course was performed over a 2-week time period, including knobs familiarization, patient positioning, anatomic landmarks, image acquisition, and limb muscle measurements. PARTICIPANTS: Nineteen critical care physiotherapists with little to no prior experience in ultrasound (N=19). INTERVENTIONS: Not applicable. MAIN OUTCOME MEASURES: Theoretical knowledge, hands-on skills acquisition, and satisfaction were assessed. Inter- and intrarater reliability on landmarks, thickness, and pennation angle of quadriceps between participants was evaluated using intraclass correlation coefficients (ICCs). Reliability among instructors measured prior to the course was also reported as a reference. RESULTS: The percentage score (mean±SD) of knowledge questionnaires was 69±11 (pre-course), 89±10 (post-course), and 92±9 (hands-on skills). Course satisfaction scores ranged from 90%-100%. Pooled interrater reliability of participants (median ICC [interquartile range]) was good (0.70 [0.59-0.79]) for thickness, moderate (0.47 [0.46-0.92]) for landmarks, and absent (0.00 [0.00-0.05]) for pennation angle and the intrarater reliability was good (0.76 [0.51-0.91]) for thickness and weak (0.35 [0.29-0.52]) for pennation angle. Interrater ICC values for instructors were excellent (0.90) for thickness, good (0.67) for landmarks, and moderate (0.41) for pennation angle and intrarater ICC values were excellent (0.94) for thickness and good (0.75) for pennation angle. CONCLUSIONS: Although our sample was quite small and homogeneous, increased theoretical knowledge, high hands-on performance acquisition, and good satisfaction of physiotherapists were observed. Reliability was moderate to excellent for thickness and landmarks and absent to weak for pennation angle. Landmarking and pennation angle remain challenges for physiotherapist training in the application of MUS. Further studies are needed to identify variables that could modify reliability during MUS training.
ABSTRACT
Respiratory physiotherapists have a key role within the integrated care continuum of patients with respiratory diseases. The current narrative review highlights the profession's diversity, summarises the current evidence and practice, and addresses future research directions in respiratory physiotherapy. Herein, we describe an overview of the areas that respiratory physiotherapists can act in the integrated care of patients with respiratory diseases based on the Harmonised Education in Respiratory Medicine for European Specialists syllabus. In addition, we highlight areas in which further evidence needs to be gathered to confirm the effectiveness of respiratory therapy techniques. Where appropriate, we made recommendations for clinical practice based on current international guidelines.
Subject(s)
Physical Therapists , Physical Therapy Modalities , Forecasting , Humans , Respiratory TherapyABSTRACT
OBJECTIVE: The present study aimed to translate and cross-culturally adapt the Physical Function in ICU Test-scored (PFIT-s) and the De Morton Mobility Index (DEMMI) to Brazilian Portuguese. METHODS: This study consisted of the translation, synthesis, and back-translation of the original versions of the PFIT-s and DEMMI, including revision by the Translation Group and pretesting of the translated version, assessed by an Expert Committee. The Brazilian versions of these instruments were applied to 60 cooperative patients with at least 48 h of mechanical ventilation at ICU discharge. The interrater reliability of both scales was tested using the Intraclass Correlation Coefficient (ICC). RESULTS: The authors of both original scales have approved the cross-culturally validated versions. Translation and back-translation attained consensus, and no item was changed. Both scales showed good interrater reliability (ICC>0.80) and internal consistency (α>0.80). CONCLUSION: The versions of the PFIT-s and DEMMI adapted to Brazilian Portuguese proved to be easy to understand and apply clinically in the ICU environment.
OBJETIVO: O objetivo do presente estudo foi traduzir e adaptar culturalmente o PFIT-s e o DEMMI ao português brasileiro. MÉTODOS: Este estudo consistiu na tradução, síntese e retrotradução da versão original do PFIT-s e DOMMI, incluindo a revisão pelo Grupo de Tradução e o pré-teste da versão traduzida, avaliada pelo comitê especializado. A versão brasileira do DEMMI e do PFIT-s foi aplicada em 60 pacientes cooperativos com pelo menos 48 horas de ventilação mecânica na alta da UTI. A confiabilidade interavaliador das duas escalas foi testada usando um coeficiente de correlação intraclasse (CCI). RESULTADOS: Os autores originais de ambas as escalas aprovaram a versão transcultural validada. A tradução e a retrotradução obtiveram consenso; e nenhum item foi alterado. As duas escalas apresentaram uma boa confiabilidade interavaliador (CCI>0,80) e consistência interna (α > 0,80). CONCLUSÃO: As versões adaptadas para o português brasileiro do PFIT-s e do DEMMI mostraram-se fácil de compreender e aplicar clinicamente no ambiente da UTI.
Subject(s)
Cross-Cultural Comparison , Intensive Care Units/standards , Physical Therapy Modalities/standards , Surveys and Questionnaires/standards , Translations , Brazil , Disability Evaluation , Humans , Language , Mobility Limitation , Predictive Value of Tests , Psychometrics , Reproducibility of ResultsABSTRACT
RESUMO Objetivo O objetivo do presente estudo foi traduzir e adaptar culturalmente o PFIT-s e o DEMMI ao português brasileiro. Métodos Este estudo consistiu na tradução, síntese e retrotradução da versão original do PFIT-s e DOMMI, incluindo a revisão pelo Grupo de Tradução e o pré-teste da versão traduzida, avaliada pelo comitê especializado. A versão brasileira do DEMMI e do PFIT-s foi aplicada em 60 pacientes cooperativos com pelo menos 48 horas de ventilação mecânica na alta da UTI. A confiabilidade interavaliador das duas escalas foi testada usando um coeficiente de correlação intraclasse (CCI). Resultados Os autores originais de ambas as escalas aprovaram a versão transcultural validada. A tradução e a retrotradução obtiveram consenso; e nenhum item foi alterado. As duas escalas apresentaram uma boa confiabilidade interavaliador (CCI>0,80) e consistência interna (α > 0,80). Conclusão As versões adaptadas para o português brasileiro do PFIT-s e do DEMMI mostraram-se fácil de compreender e aplicar clinicamente no ambiente da UTI.
ABSTRACT Objective The present study aimed to translate and cross-culturally adapt the Physical Function in ICU Test-scored (PFIT-s) and the De Morton Mobility Index (DEMMI) to Brazilian Portuguese. Methods This study consisted of the translation, synthesis, and back-translation of the original versions of the PFIT-s and DEMMI, including revision by the Translation Group and pretesting of the translated version, assessed by an Expert Committee. The Brazilian versions of these instruments were applied to 60 cooperative patients with at least 48 h of mechanical ventilation at ICU discharge. The interrater reliability of both scales was tested using the Intraclass Correlation Coefficient (ICC). Results The authors of both original scales have approved the cross-culturally validated versions. Translation and back-translation attained consensus, and no item was changed. Both scales showed good interrater reliability (ICC>0.80) and internal consistency (α>0.80). Conclusion The versions of the PFIT-s and DEMMI adapted to Brazilian Portuguese proved to be easy to understand and apply clinically in the ICU environment.