50 aniversario Asociación Española de Fisioterapeutas: pasado, presente y futuro / 50th anniversary of the Spanish Association of Physiotherapists: past, present and future

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El liderazgo en Fisioterapia / The leadership in Physiotherapy

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Development of physiotherapy inherent requirement statements - an Australian experience.

BACKGROUND: The United Nations Convention on the Rights of People with Disabilities promotes equal rights of people with a disability in all aspects of their life including their education. In Australia, Disability Discrimination legislation underpins this Convention. It mandates that higher education providers must demonstrate that no discrimination has occurred and all reasonable accommodations have been considered and implemented, to facilitate access and inclusion for a student with a disability. The first step to meeting legislative requirements is to provide students with information on the inherent requirements of a course. This paper describes the steps which were taken to develop inherent requirement statements for a 4-year entry-level physiotherapy program at one Australian university. CASE PRESENTATION: Inherent requirement statements were developed using an existing framework, which was endorsed and mandated by the University. Items which described inherencies were extracted from Australian physiotherapy professional standards and statutory regulatory requirements, and units contained in the physiotherapy program. Data were integrated into the 8 prescribed domains: ethical behaviour, behavioural stability, legal, communication, cognition, sensory abilities, strength and mobility, and sustainable performance. Statements for each domain were developed using a 5-level framework (introductory statement, description of the inherent requirement, justification for inherency, characteristics of reasonable adjustments and exemplars) and reviewed by a University Review Panel. Refinement of statements continued until no further changes were required. Fifteen physiotherapy inherent requirement statements were developed. The eight domains identified in the existing framework, developed for Nursing, were relevant to the study of physiotherapy. CONCLUSIONS: The inherent requirement statements developed in this study provide a transparent, defensible position on the current requirements of physiotherapy study at one Australian university. These statements are transferable to other physiotherapy programs in Australia due to standardised physiotherapy accreditation requirements. The model and framework could be applied to other health professional courses and used to explore the physiotherapy inherent requirements from an international perspective.

Complicated billing requirements challenge physical therapy industry, creating inefficiencies and confusion.

This article is designed to explain the subtle differences between the reimbursement requirements for coverage of physical therapy services in physician-based settings under the Medicare benefit policy manual chapter 15--covered medical and other health services. These billing challenges have a profound financial impact on the physical therapy industry. This article includes: (1) a general back ground of the reasons surrounding the increased regulations in the physical therapy industry; (2) general definitions within the physical therapy industry; (3) a discussion of the confusing and complicated bill ing requirements for physical therapy services; (4) a discussion of the "incident to" billing requirements within the physical therapy billing requirements; (5) an explanation of differing rules or policies within the physical therapy billing requirements; and (6) a discussion of why these rules regarding physical therapy billing requirements are essential to the delivery of quality of care within the physical therapy industry.

Attitudes of European physiotherapy students towards their chosen career in the context of different educational systems and legal regulations pertaining to the practice of physiotherapy: implications for university curricula.

OBJECTIVES: Differences in the organisation of educational systems and regulations pertaining to the practice of a profession can influence the attitudes of students towards their chosen career and their perceptions of employment possibilities. The aim of this paper was to discuss the different educational systems and legal regulations pertaining to the practice of physiotherapy in selected countries of the European Union (EU), and to present some conclusions regarding the influence of these differences on the perceptions of first-year physiotherapy students on their chosen career. DESIGN: Quantitative questionnaire-based study. SETTING: Twenty-one university-level schools in the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. PARTICIPANTS: Six hundred and sixty-seven first-year physiotherapy students. RESULTS: The mean response rate was 74%. Most students (79%) reported that a personal interest was the main reason why they had decided to study physiotherapy (79%). Most students from Spain and the Czech Republic reported that, on completion of their studies, they would like to work as physiotherapists (61/120, 51% Czech Republic; 140/250, 56% Spain), compared with only 4% of Polish students (P<0.001). Most students from Poland and Spain were not familiar with employment opportunities in their respective countries (202/250, 81% Spain; 212/250, 85% Poland), and claimed that it is difficult to find employment as a physiotherapist in their country. Most students from the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. claimed that it is easy to find a job in other EU countries. CONCLUSION: Most physiotherapy students chose their course because of an interest in physiotherapy. They were not familiar with employment possibilities for graduates, and believed that it is easier to find work in other EU countries. Both factors may further aggravate the problem of unemployment among physiotherapists.

Physical therapist practice and the role of diagnostic imaging.

SYNOPSIS: For healthcare providers involved in the management of patients with musculoskeletal disorders, the ability to order diagnostic imaging is a beneficial adjunct to screening for medical referral and differential diagnosis. A trial of conservative treatment, such as physical therapy, is often recommended prior to the use of imaging in many treatment guidelines for the management of musculoskeletal conditions. In the United States, physical therapists are becoming more autonomous and can practice some degree of direct access in 48 states and Washington, DC. Referral for imaging privileges could increase the effectiveness and efficiency of healthcare delivery, particularly in combination with direct access management. This clinical commentary proposes that, given the American Physical Therapy Association's goal to have physical therapists as primary care musculoskeletal specialists of choice, it would be beneficial for physical therapists to have imaging privileges in their practice. The purpose of this commentary is 3-fold: (1) to make a case for the use of imaging privileges by physical therapists, using a historical perspective; (2) to discuss the barriers preventing physical therapists from having this privilege; and (3) to offer suggestions on strategies and guidelines to facilitate the appropriate inclusion of referral for imaging privileges in physical therapist practice. J Orthop Sports Phys Ther 2011;41(11):829-837. doi:10.2519/jospt.2011.3556.

Evidencia en el manejo del dolor de espalda crónico con el método McKenzie / Evidence in the management of chronic back pain with the McKenzie method

Objetivo Revisar la evidencia científica publicada sobre el método McKenzie en dolor lumbar. Estrategia de búsqueda Búsqueda en la base de datos Medline, en la página web del Instituto McKenzie y análisis de la evidencia publicada por May y Donelson (2008). Selección de estudios y datos Se limita la búsqueda a los últimos 5 años. Se realiza una búsqueda inversa y un filtrado manual centrado en extraer resultados estrechamente relacionados con la temática de búsqueda y en función del nivel de evidencia de los artículos. Síntesis de resultados Se encuentra evidencia sobre diversos aspectos del método McKenzie: fiabilidad interobservador como método exploratorio, especificidad del fenómeno de centralización y eficacia comparado con otros tratamientos. Conclusiones El método McKenzie presenta eficacia similar a los ejercicios de estabilización y una tendencia favorable comparándolo con los ejercicios de fortalecimiento. El fenómeno de centralización tiene valor pronóstico positivo. Presenta una alta fiabilidad como método de exploración(AU)

Objective To review the scientific evidence published on the McKenzie method for back pain. Research strategy A search was made in the Medline database, and on the McKenzie Institute website, and the evidence published by May and Donelson (2008) was analyzed. Studies and data selection The search was limited to the last five years. A reverse search and a manual filtering (as a function of the level of evidence) focused on extracting results closely related to the subject under research were performed. Results summary Evidence on the different aspects of the McKenzie method has been found: inter-examiner reliability as exploratory method, specificity of the centralization phenomenon, and effectiveness compared to other treatments. Conclusions The McKenzie method has similar effectiveness as that of stabilization exercises with a favorable tendency in comparison with strengthen-building exercises. The centralization phenomenon has a positive prognostic value. The method present high reliability as an exploratory method(AU)

Physiotherapists in under-resourced South African communities reflect on practice.

Increasing access to health services and the introduction of primary health care are the cornerstones of transforming healthcare initiatives in South Africa. Sustainability of healthcare provision in rural and under-resourced areas is secured by legislation of a year-long community service (CS) contract with graduating healthcare practitioners. This study explored how the first cohort of physiotherapists experienced their year-long CS and how they felt their undergraduate training prepared them for practice. A survey was conducted at the end of 2003 amongst the first cohort of CS physiotherapists who emerged from the physiotherapy programme of a South African university. All 23 of the graduates from the 2002 final year class were invited to participate in the study. A self-administered open-ended questionnaire was faxed to the participants. Twenty of the 23 questionnaires were completed and returned within a month. The questionnaires were coded and the data were analysed using content analysis methodology. The results were categorised into emerging patterns. CS physiotherapists assessed their preparation for practice largely in relation to the technical skills that were acquired through the curriculum. Community-based physiotherapy practice in under-resourced areas was under-emphasised in the curriculum in relation to practice opportunities within hospital and institution-based settings. The curriculum was found not to advance the role of physiotherapists as socially responsive agents and appeared to pay little attention to knowledge underpinning socio-cultural and inter-professional relations. Physiotherapy academic knowledge alone was inadequate to support novice physiotherapists within under-resourced communities in their multiple roles as clinician, manager of physiotherapy department, as member of a multidisciplinary team, health educator and advocate for social justice.

An electronic registry for physiotherapists in Belgium.

This paper describes the results of the KINELECTRICS project. Since more and more clinical documents are stored and transmitted in an electronic way, the aim of this project was to design an electronic version of the registry that contains all acts of physiotherapists. The solution we present here, not only meets all legal constraints, but also enables to verify the traceability and inalterability of the generated documents, by means of SHA-256 codes. The proposed structure, using XML technology can also form a basis for the development of tools that can be used by the controlling authorities. By means of a certification procedure for software systems, we succeeded in developing a user friendly system that enables end-users that use a quality labeled software package, to automatically produce all the legally necessary documents concerning the registry. Moreover, we hope that this development will be an incentive for non-users to start working in an electronic way.

Legal issues affecting ancillaries and orthopedic practice.

The federal and state governments have imposed significant regulations on health care generally and on ancillary services in particular. This article focuses on how state and federal laws shape the ability of an orthopedic physician to offer ancillary services, whether as an individual, through a group practice, or as part of a joint venture. It focuses on how the Stark law, the Medicare anti-kickback statute, state anti-kickback, fee-splitting provisions, certificate of need laws, and various Medicare billing and supervision requirements impact the provision of ancillary services. It also briefly discusses how physicians should prepare for and respond to government investigations.

Updated competencies for physical therapists working in schools.

PURPOSE: The purpose of this project was to update the 1987 competencies for physical therapists who work in schools and their content to reflect present practice, legislation, and terminology. METHODS: A review of the literature and competencies for professionals working in schools was completed. Four focus groups of school physical therapists were formed to ascertain their perspectives of the roles and responsibilities of school therapists and what knowledge and skills enabled them to be effective. This information was integrated into a listing of competencies. The competencies were reviewed regionally and nationally by experts in the field. RESULTS: Nine content areas with specific competencies were identified for physical therapists working in schools. These competencies reflect an expanded role of school-based therapists compared with previous competencies. CONCLUSION: Physical therapists who work in schools require specific skills and knowledge to effectively serve children with disabilities. Competencies help guide professional development.