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1.
BMJ Open ; 12(6): e057993, 2022 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-35672069

RESUMEN

INTRODUCTION: International guidelines recommend the use of exercise, education and weight reduction, when appropriate, as first-line treatment for the conservative management of knee osteoarthritis (OA). These guidelines have not been applied systematically in Switzerland, resulting in an evidence-performance gap. After an analysis of available programmes, the Good Life with osteoArthritis Denmark (GLA:D) programme was determined as the most applicable exercise and education programme for its implementation in Switzerland. The implementation of GLA:D Switzerland OA was initiated to encourage the wider implementation of the clinical guideline recommendations and to improve conservative management of knee OA. The aim of this study protocol is to describe the evaluation of the implementation strategy and its impact on implementation, service and clinical outcomes; as well as to identify contributing barriers and facilitators. METHODS AND ANALYSIS: The Implementation Research Logic Model will be used to evaluate the strategy and analyse its impact on the implementation outcomes by means of a mixed methods approach. This protocol outlines the proposed measures, data sources and strategies for the evaluation. Predefined implementation outcomes will help to identify the implementation impact and analyse barriers and facilitators systematically. The study population will be the healthcare professionals who are involved in the conservative management of knee OA in Switzerland, that is, physiotherapists and medical doctors, and their patients. ETHICS AND DISSEMINATION: The use of the registry data containing data of patients participating in the GLA:D Switzerland OA programme does not fall within the scope of the Swiss Human Research Act (BASEC-Nr. Req-2019-00274). However, all participants involved in the evaluation will be asked to give informed written consent and all measures are taken to protect data and privacy of participants. Research findings will be submitted to journals relevant for the topic. TRIAL REGISTRATION NUMBER: Not applicable.


Asunto(s)
Osteoartritis de la Rodilla , Fisioterapeutas , Terapia por Ejercicio/métodos , Humanos , Osteoartritis de la Rodilla/terapia , Proyectos de Investigación , Suiza
2.
BMC Med Educ ; 22(1): 440, 2022 Jun 07.
Artículo en Inglés | MEDLINE | ID: mdl-35672778

RESUMEN

BACKGROUND: As a result of the COVID-19 pandemic a rapid transformation from face-to-face curriculum delivery to an online teaching and learning environment, was adopted in a number of higher education institutions globally. Allied Health Profession courses such as physiotherapy, traditionally utilising an in person teaching model to prepare students for practice, needed to swiftly adopt new methods of delivery, involving both synchronous and asynchronous approaches. Understanding physiotherapy student perceptions of this transition is important to allow faculty to develop their delivery of online teaching and provide an evidence base for future course curricula. METHODS: Cross-sectional survey of UK higher education students studying either an undergraduate or post-graduate pre-registration degree in physiotherapy was conducted between October 2020 and February 2021. The survey investigated the student's perception of the transition to either an online or hybrid model of learning during the COVID-19 pandemic. A mixed method approach was adopted allowing respondents to share their experiences and facilitate the exploration of questions which required in-depth thought. RESULTS: Two hundred thirty-six respondents completed the questionnaire. Online learning was perceived to be a flexible (49%, n=116,CI 95% 43 to 55) and convenient (49, 116, 43 to 55) method of learning. Despite this, 79% of the students surveyed felt that the online learning experience had a negative impact on their understanding of the subject and were disadvantaged compared to traditional face-to-face teaching provision (mean 4.14 ± SD 1.06). Online physiotherapy delivery produced low student satisfaction, leaving respondents feeling disadvantaged. Decreased levels of engagement and the lack of ability to practice 'hands-on' skills were detrimental aspects of the online approach, with 55% (n=106) reporting they did not perceive the academic staff had the necessary skills to deliver effective online content. CONCLUSIONS: The majority of UK physiotherapy students surveyed were dissatisfied and lacked engagement with an online learning approach within the curricula, compared with the traditional face-to-face delivery. Although several positives of both a synchronous and asynchronous delivery were highlighted, faculty must consider how they best deliver online learning content, making use of pedagogical strategies that will create as many learning and engagement opportunities as possible.


Asunto(s)
COVID-19 , Fisioterapeutas , COVID-19/epidemiología , Estudios Transversales , Curriculum , Humanos , Pandemias , Estudiantes
3.
Front Public Health ; 10: 877232, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35646793

RESUMEN

Due to the COVID-19 pandemic, physical therapists have had to adopt a set of specific protection measures, which have had an impact on their clinical activity and economy. The objective was to evaluate the impact of the COVID-19 pandemic on the work of Spanish physical therapists, as well as their attitudes and predisposition to vaccination. An online questionnaire was divided into five sections: (1) demographic and professional data; (2) labor impact; (3) precautions and infection-control measures; (4) economic impact; and (5) vaccine acceptance and adverse effects. Of the 666 participants, 62.1% showed a reduction in their working hours motivated by: fear of infection (p = 0.007), financial issues (p = 0.002) and being in quarantine or isolation (p < 0.001). Of these, 36.4% were forced to close the clinic, 62.7% requested help from the government, but only 12.04% mentioned that it was adequate. The main prevention measures adopted were the use of gels and masks and, in the private sector, disinfection with ozone or ultraviolet light (p < 0.05). The acceptance of the vaccine was high, 87.5%, being lower among the group over 40 years of age, self-employed, widowed or separated. More adverse effects were mentioned after receiving the AstraZeneca-Oxford vaccine, compared to Pfizer-BioNTech or Moderna. In conclusion, this study assessed for the first time that the COVID-19 pandemic in Spain had a negative impact on work and finances of physical therapists. The vaccine was widely accepted, in part by the economic impact that an infection in the work setting could signify.


Asunto(s)
COVID-19 , Gripe Humana , Fisioterapeutas , Adulto , COVID-19/epidemiología , COVID-19/prevención & control , Humanos , Gripe Humana/epidemiología , Persona de Mediana Edad , Pandemias , Vacunación
4.
Cien Saude Colet ; 27(6): 2175-2186, 2022 Jun.
Artículo en Portugués | MEDLINE | ID: mdl-35649007

RESUMEN

In view of the expanded view of health proposed by the Unified Health System (SUS), the approach given to the illness process required a prism focused on the biopsychosocial view and no longer on the biomedical model, which led to a reorganization in the training of health professionals. Thus, the National Curriculum Guidelines were established guiding the pedagogical projects of the courses towards the biopsychosocial model, so that the International Classification of Functionality, Disability and Health contributes to this scenario through its multidimensional and non-reductionist approach. However, physiotherapy has historically been strongly influenced by the biomedical model, distancing it from primary care (PC). This is an exploratory, descriptive and quantitative study, with secondary data source obtained through the National Register of Health Establishments in Brazil, whose objective was to verify, within a 10-year interval, at which level of health care most physiotherapists and their representation in PC are concentrated. The findings indicated that PC represents the minority scenario of jobs occupied by physical therapists, reflecting the hegemony of the biomedical model and reinforcing the rehabilitation character historically given to the profession.


Tendo em vista o olhar ampliado de saúde proposto pelo SUS, a abordagem dada ao processo do adoecimento exigiu um prisma voltado à visão biopsicossocial, e não mais ao modelo biomédico, o que levou a um reordenamento na formação dos profissionais de saúde. Assim, as Diretrizes Curriculares Nacionais foram instituídas norteando os projetos pedagógicos dos cursos rumo ao modelo biopsicossocial, de forma que a Classificação Internacional de Funcionalidade, Incapacidade e Saúde contribui para esse cenário por meio de sua abordagem multidimensional e não reducionista. Entretanto, historicamente, a fisioterapia tem forte influência do modelo biomédico, distanciando-a da atenção básica (AB). Este é um estudo exploratório, descritivo e quantitativo, com fonte de dados secundários obtidos por meio do Cadastro Nacional dos Estabelecimentos de Saúde do Brasil, e cujo objetivo foi verificar, dentro de um intervalo de dez anos, em qual nível de assistência à saúde está concentrada a maior parte dos fisioterapeutas e sua representatividade na AB. Os achados indicaram que a AB representa o cenário minoritário dos postos de trabalho ocupados pelos fisioterapeutas, refletindo a hegemonia do modelo biomédico e reforçando o caráter reabilitador dado historicamente à profissão.


Asunto(s)
Fisioterapeutas , Curriculum , Humanos , Modalidades de Fisioterapia , Atención Primaria de Salud , Lugar de Trabajo
5.
BMC Musculoskelet Disord ; 23(1): 559, 2022 Jun 09.
Artículo en Inglés | MEDLINE | ID: mdl-35681162

RESUMEN

BACKGROUND: We have developed a model of stratified exercise therapy that distinguishes three knee osteoarthritis (OA) subgroups ('high muscle strength subgroup', 'low muscle strength subgroup', 'obesity subgroup'), which are provided subgroup-specific exercise therapy (supplemented by a dietary intervention for the 'obesity subgroup'). In a large clinical trial, this intervention was found to be no more effective than usual exercise therapy. The present qualitative study aimed to explore experiences from users of this intervention, in order to identify possible improvements. METHODS: Qualitative research design embedded within a cluster randomized controlled trial in a primary care setting. A random sample from the experimental arm (i.e., 15 patients, 11 physiotherapists and 5 dieticians) was interviewed on their experiences with receiving or applying the intervention. Qualitative data from these semi-structured interviews were thematically analysed. RESULTS: We identified four themes: one theme regarding the positive experiences with the intervention and three themes regarding perceived barriers. Although users from all 3 perspectives (patients, physiotherapists and dieticians) generally perceived the intervention as having added value, we also identified several barriers, especially for the 'obesity subgroup'. In this 'obesity subgroup', physiotherapists perceived obesity as difficult to address, dieticians reported that more consultations are needed to reach sustainable weight loss and both physiotherapists and dieticians reported a lack of interprofessional collaboration. In the 'high muscle strength subgroup', the low number of supervised sessions was perceived as a barrier by some patients and physiotherapists, but as a facilitator by others. A final theme addressed barriers to knee OA treatment in general, with lack of motivation as the most prominent of these. CONCLUSION: Our qualitative study revealed a number of barriers to effective application of the stratified exercise therapy, especially for the 'obesity subgroup'. Based on these barriers, the intervention and its implementation could possibly be improved. Moreover, these barriers are likely to account at least partly for the lack of superiority over usual exercise therapy. TRIAL REGISTRATION: The Netherlands National Trial Register (NTR): NL7463 (date of registration: 8 January 2019).


Asunto(s)
Osteoartritis de la Rodilla , Fisioterapeutas , Terapia por Ejercicio , Humanos , Obesidad/terapia , Osteoartritis de la Rodilla/diagnóstico , Osteoartritis de la Rodilla/terapia , Investigación Cualitativa
6.
PLoS One ; 17(6): e0269460, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35658062

RESUMEN

Evidence-Based Practice (EBP) is a cost-effective approach for improving the quality of clinical care and implementing only well-tested evidence. Health professions, especially physiotherapy, must embrace EBP principles. This paper presents normative data from the Spanish physiotherapist population using the Health-Sciences Evidence-Based Practice questionnaire and explores EBP clusters/profiles of professionals in practice. An intentional sample of 419 practicing physiotherapists was recruited from the Spanish Professional Council of Physiotherapy. Participants completed a cross-sectional online survey with 60 Likert items (scale 1-10) measuring 5 dimensions: 1) Beliefs and attitudes, 2) Results from literature, 3) Professional practice, 4) Assessment of results, and 5) Barriers and Facilitators. The protocol also included sociodemographic, training, and practice-related contrast variables. Normative data were estimated and tabulated for each dimension and then a K-means clustering procedure was implemented using the contrast variables. Results for normative data showed, in descending order, the following 50th percentile values for the five EBP factors: Beliefs and attitudes (8.25), Professional practice (8.00), Assessment of results (7.42), Results from literature (6.71), and EBP Barriers and Facilitators (5.17); all expressed on a scale of 1 to 10. Academic degree, EBP training level, and work time shared in healthcare activity, research, or teaching activity were all statistically significant for discriminating EBP dimension scores. Finally, six different clusters showed that when EBP level is low, the scores in all dimensions are equally low, and vice-versa. The EBP dimensions "Beliefs and attitudes", "Professional practice", and "Evaluation of results" obtained better normative scores overall than "Search for bibliographic evidence and its inclusion in practice" and especially "Perception of EBP barriers", which had the worst score. Normative data are useful for comparing individual scores and the reference population, and information about clusters will enable appropriate global EBP intervention programs to be designed and implemented.


Asunto(s)
Fisioterapeutas , Actitud del Personal de Salud , Estudios Transversales , Práctica Clínica Basada en la Evidencia , Conocimientos, Actitudes y Práctica en Salud , Humanos , España , Encuestas y Cuestionarios
7.
Artículo en Inglés | MEDLINE | ID: mdl-35710147

RESUMEN

OBJECTIVES: The rising prevalence of musculoskeletal disorders increases pressure on primary care services. In France, patients with musculoskeletal disorders are referred to physiotherapist (PT) by family physician (FP). To improve access to musculoskeletal care, a new model of task sharing and shifting is implemented between FPs and PTs for patients with acute low back pain. This new model enables French PTs to expand their usual scope of practice by receiving patients as first-contact practitioner, diagnosing low back pain, prescribing sick leave and analgesic medication. The aim of this study is to investigate the acceptability of FPs and PTs regarding this new model. DESIGN: A cross-sectional survey design was used. Acceptability was measured using a questionnaire on the perception of the model and the perception of PTs' skills to manage low back pain. Descriptive analyses were performed to compare results among participants. SETTING: French FPs and PTs working in multidisciplinary primary healthcare centres were invited to complete an online survey. PARTICIPANTS: A total of 174 respondents completed the survey (81 FPs and 85 PTs). RESULTS: A majority of participants had a positive perception of the task sharing and shifting model. A majority of the participants were mostly or totally favourable towards the implementation of the model (FPs: n=46, 82% and PTs: n=40, 82%). The perceived level of competencies of PTs to manage acute low back pain was high. The confidence level of FPs was higher than that of PTs regarding PTs' ability to adequately diagnose low back pain, refer patient to physiotherapy and prescribe sick leave or analgesic medication. CONCLUSION: Based on this limited sample of participants, there appears to be good acceptability of the task sharing and shifting model for acute low back pain. Additional studies are needed to better determine the factors affecting the acceptability of such a model.


Asunto(s)
Dolor de la Región Lumbar , Enfermedades Musculoesqueléticas , Fisioterapeutas , Estudios Transversales , Humanos , Dolor de la Región Lumbar/diagnóstico , Dolor de la Región Lumbar/terapia , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/terapia , Médicos de Familia , Atención Primaria de Salud
8.
BMJ Open ; 12(6): e059736, 2022 Jun 20.
Artículo en Inglés | MEDLINE | ID: mdl-35725255

RESUMEN

BACKGROUND: Stratified care has the potential to be efficient in addressing the physical and psychosocial components of low back pain (LBP) and optimise treatment outcomes essential in low-income countries. This study aimed to investigate the perceptions of physiotherapists and patients in Nigeria towards stratified care for the treatment of LBP, exploring barriers and enablers to implementation. METHODS: A qualitative design with semistructured individual telephone interviews for physiotherapists and patients with LBP comprising research evidence and information on stratified care was adopted. Preceding the interviews, patients completed the Subgroups for Targeted Treatment tool. The interviews were recorded, transcribed and analysed following grounded theory methodology. RESULTS: Twelve physiotherapists and 13 patients with LBP participated in the study (11 female, mean age 42.8 (SD 11.47) years). Seven key categories emerged: recognising the need for change, acceptance of innovation, resistance to change, adapting practice, patient's learning journey, trusting the therapist and needing conviction. Physiotherapists perceived stratified care to be a familiar approach based on their background training. The prevalent treatment tradition and the patient expectations were seen as major barriers to implementation of stratified care by the physiotherapists. Patients see themselves as more informed than therapists realise, yet they need conviction through communication and education to cooperate with their therapist using this approach. Viable facilitators were also identified as patients' trust in the physiotherapist and adaptations in terms of training and modification of the approach to enhance its use. CONCLUSION: Key barriers identified are the patients' treatment expectations and physiotherapists' adherence to the tradition of practice. Physiotherapists might facilitate implementation of the stratified care by communication, hierarchical implementation and utilisation of patients' trust. Possibilities to develop a consensus on key strategies to overcome barriers and on utilisation of facilitators should be tested in future research.


Asunto(s)
Dolor de la Región Lumbar , Fisioterapeutas , Adulto , Actitud del Personal de Salud , Femenino , Humanos , Dolor de la Región Lumbar/psicología , Dolor de la Región Lumbar/terapia , Nigeria , Fisioterapeutas/psicología , Investigación Cualitativa
9.
Musculoskelet Sci Pract ; 60: 102569, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35533597

RESUMEN

STUDY DESIGN: A cross-sectional inter-examiner agreement and reliability study on fresh frozen cadaver shoulders. BACKGROUND: Musculoskeletal ultrasound (MSU) is frequently used by physical therapists and radiologists to improve specific diagnosis in rotator cuff related pathology. The evaluation of the rotator cable seems to be important as stabilizing structure when cuff tears occur. OBJECTIVES: To evaluate the inter-examiner agreement and reliability of MSU of the shoulder to detect rotator cuff-pathology and the involvement of the rotator cable in comparison to "dissection". METHODS: Physical therapists, a radiologist and an orthopedic surgeon (dissection) investigated 40 fresh frozen cadaver shoulders in order to detect shoulder pathology including rotator cable involvement. Examiners were blinded to each other's findings. RESULTS: We found a strong and significant agreement between the raters: PTs, the radiologist and the dissector in this cadaver study for all rotator cuff, the long head of the biceps pathologies and in detecting abnormalities of the rotator cable. The kappa value was substantial to (almost) perfect agreement for all diagnostic outcome categories. CONCLUSIONS: This study shows that among a limited group of physical therapists, one radiologist and a dissector a strong level of agreement with kappa values from substantial to (almost) perfect in finding subacromial pathology.


Asunto(s)
Fisioterapeutas , Hombro , Cadáver , Estudios Transversales , Humanos , Radiólogos , Reproducibilidad de los Resultados
10.
Musculoskelet Sci Pract ; 60: 102573, 2022 Aug.
Artículo en Inglés | MEDLINE | ID: mdl-35533598

RESUMEN

BACKGROUND: The International Classification of Functioning, Disability, and Health (ICF) provides a coherent biopsychosocial view of health states. The ICF Core Sets were developed to facilitate and encourage the use of the ICF in clinical practice and research. OBJECTIVE: To examine the level of knowledge and use of the ICF and ICF Core Sets for musculoskeletal conditions among Saudi physical therapists. DESIGN: Cross-sectional study. METHOD: We approached Saudi physical therapists (PTs) involved in managing patients with musculoskeletal conditions. Data were collected through an electronic survey consisting of multiple-choice questions related to the knowledge of the ICF, general ICF Core Sets and ICF Core Sets for musculoskeletal conditions. RESULTS: A total of 203 PTs participated in this study. Seventy percent of PTs knew about the meaning of ICF, but only 33% recognized aspects of the ICF. For the osteoarthritis (OA) ICF Core Set, 71.9% had poor knowledge, and for the low back pain (LBP) ICF Core Set, 61.8% had poor knowledge. CONCLUSIONS: The Saudi PTs surveyed in this study had a good level of knowledge about the meaning of the ICF; however, this knowledge appeared to be limited when they were asked about aspects of the ICF. They had poor knowledge of musculoskeletal ICF Core Sets but seemed to be more familiar with the LBP ICF Core Set compared to the OA ICF Core Set.


Asunto(s)
Dolor de la Región Lumbar , Enfermedades Musculoesqueléticas , Osteoartritis , Fisioterapeutas , Estudios Transversales , Evaluación de la Discapacidad , Humanos , Clasificación Internacional del Funcionamiento, de la Discapacidad y de la Salud , Dolor de la Región Lumbar/diagnóstico , Arabia Saudita
11.
J Allied Health ; 51(2): e45-e51, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35640297

RESUMEN

This study compared the education and background, position characteristics, job responsibilities and satisfaction, and well-being of physical therapists (PTs) and occupational therapists (OTs) in the United States. A mixed-methods, cross-sectional conventional mail survey design was used. The five sections of this survey included personal, education and background, position, and job satisfaction and well-being profiles. One-hundred thirteen PT and 101 OT participated. Between PTs and OTs, significant differences were found for age, years of work experience, salary, and salary adjusted for 40-hr-workweek (p < 0.001), highest level of education (p < 0.001), observation hours (p = 0.004), and the number of programs applied to (p < 0.001). However, between the two professions, no differences existed for job satisfaction, career satisfaction, consideration of pursuing other professions, compromised physical, mental, and non-work relationships (p = 0.396), hours worked per week (p = 0.091), direct admission (p > 0.05), undergraduate or graduate internship hours, undergraduate research studies, or undergraduate GPA (p > 0.05). Differences between career and sex were not significant (p = 0.063). These results facilitate better understanding of the current state of affairs within PT and OT professions.


Asunto(s)
Terapeutas Ocupacionales , Fisioterapeutas , Estudios Transversales , Escolaridad , Humanos , Satisfacción en el Trabajo , Estados Unidos
12.
Stud Health Technol Inform ; 294: 129-130, 2022 May 25.
Artículo en Inglés | MEDLINE | ID: mdl-35612034

RESUMEN

The FutureGlove project aims to further develop the CarbonHand system (a wearable assistive glove) by introducing a new software monitoring application. Within this study, we consulted five physiotherapists during online sessions to gain their views on use of data and patients' empowerment. These first insights suggested that more data needs to be collected than it is doing now to monitor the patients' progress, that therapists would like to personalize the amount of freedom they provide to their patients, and that they would like decision support for algorithms, but they do not fully trust them.


Asunto(s)
Fisioterapeutas , Dispositivos Electrónicos Vestibles , Humanos , Programas Informáticos
14.
Artículo en Inglés | MEDLINE | ID: mdl-35564501

RESUMEN

Orthopedic and sport-related injuries are a major public health concern and a common reason for referral to physical therapy. The use of psychological techniques by physical therapists has been assessed in research studies primarily with retrospective self-report questionnaires that have not been validated against concurrent assessments of the same behaviors. The primary purpose of this study was to examine the extent to which the results obtained from physical therapists' retrospective self-reports of their use of psychological techniques reflect their use of the techniques assessed concurrently. Physical therapists (N = 14) completed the Physiotherapists and Sport Psychology Questionnaire (PSPQ) at the beginning of this study and a checklist based on the PSPQ at the end of the sessions with patients (N = 306). Patients also completed the checklist at the end of the sessions. Across 12 psychological techniques, the physical therapists' retrospective (PSPQ) responses showed relatively weak correspondence (mean r = 0.31) and poor concordance with their concurrent (checklist) responses. Compared to the physical therapists' checklist responses, the patients' checklist responses showed weaker correspondence (mean r = 0.03) and better concordance with the physical therapists' PSPQ responses. The findings suggest that retrospective self-reports may not accurately reflect the use of psychological techniques by physical therapists and, consequently, that physical therapists should consider documenting their use of psychological techniques as close to their implementation as possible. Suggestions for improved assessment are provided.


Asunto(s)
Fisioterapeutas , Deportes , Humanos , Psicología del Deporte , Estudios Retrospectivos , Encuestas y Cuestionarios
15.
Fisioterapia (Madr., Ed. impr.) ; 44(3): 163-172, may.-jun. 2022. tab, graf
Artículo en Español | IBECS | ID: ibc-203760

RESUMEN

Antecedentes y objetivo: El alumnado con necesidades educativas especiales puede necesitar el apoyo específico y especializado de fisioterapia, con el fin de facilitar el desarrollo de su máximo potencial y ayudar en su inclusión educativa. La información acerca de la implementación de la fisioterapia en los centros educativos en el territorio español es muy escasa. El objetivo de este estudio es describir la situación de la fisioterapia en los centros educativos y compararla entre las diferentes comunidades autónomas. Materiales y métodos: Se realizó un estudio descriptivo y transversal a través de la elaboración de una encuesta online, diseñada junto a un panel de expertos a través del método Delphi. Se incluyeron seis bloques temáticos relacionados con la atención de fisioterapia, las condiciones laborales de los fisioterapeutas en los centros educativos y con la cobertura de las necesidades del alumnado. Resultados: Se obtuvieron 178 respuestas. Su distribución geográfica fue homogénea, aunque se detectaron grandes diferencias entre las comunidades autónomas. La mayoría de las personas encuestadas trabajan en centros de educación especial y existen comunidades autónomas en las que no se trabaja en centros ordinarios. Solo el 28,4% contestaron que la figura del fisioterapeuta está integrada en los equipos de orientación educativa de su comunidad autónoma y tienen la función de determinar la necesidad del recurso. Conclusiones: El desarrollo del trabajo de fisioterapia en los centros educativos como apoyo al alumnado con necesidades educativas especiales es desigual entre las comunidades autónomas, y en algunas, se considera insuficiente.


Background and objective: Students with special educational needs may need the specific and specialized support of Physiotherapy in order to facilitate the development of their maximum potential and help in their educational inclusion. The information about school-based Physical Therapy development in Spain is very scarce. The objective of this study is to describe the situation of physiotherapy in educational centers and compare it among the different autonomous communities. Materials and methods: A descriptive and cross-sectional study was carried out through the elaboration of an online survey, designed together with a panel of experts using the Delphi method. Six thematic blocks were included related to the provision of the physiotherapy service, working conditions and the coverage of the students’ needs. Results: 178 responses were obtained. Their geographical distribution was homogeneous, although large differences were detected among the autonomous communities. Most of the participants work in special education centers and there are autonomous communities in which physical therapists do not work in ordinary centers. Only 28.4% answered that the physiotherapist is integrated into the educational orientation teams of their autonomous community and has the function of determining the need for the resource. Conclusions: School-based Physiotherapy services to support students with special educational needs is unequal among the autonomous communities, and in some of them it is considered insufficient.


Asunto(s)
Humanos , Niño , Instituciones Académicas , Fisioterapeutas , Niños con Discapacidad , Especialidad de Fisioterapia , España , Educación , Capacitación Profesional , Personas con Discapacidad , Epidemiología Descriptiva , Estudios Transversales , Encuestas y Cuestionarios
16.
BMJ Open Qual ; 11(2)2022 May.
Artículo en Inglés | MEDLINE | ID: mdl-35589276

RESUMEN

BACKGROUND: For the design of a robust quality system for hospital-based physiotherapy, it is important to know what key stakeholders consider quality to be. OBJECTIVE: To explore key stakeholders' views on quality of hospital-based physiotherapy. METHODS: We conducted 53 semi-structured interviews with 62 representatives of five key stakeholder groups of hospital-based physiotherapy: medical specialists, hospital managers, boards of directors, multidisciplinary colleagues and patients. Audio recordings of these interviews were transcribed verbatim and analysed with thematic analysis. RESULTS: According to the interviewees, quality of hospital-based physiotherapy is characterised by: (1) a human approach, (2) context-specific and up-to-date applicable knowledge and expertise, (3) providing the right care in the right place at the right time, (4) a proactive departmental policy in which added value for the hospital is transparent, (5) professional development and innovation based on a vision on science and developments in healthcare, (6) easy access and awareness of one's own and others' position within the interdisciplinary cooperation and (7) ensuring a continuum of care with the inclusion of preclinical and postclinical care of patients. CONCLUSIONS: Important quality aspects in the perspective of all stakeholders were an expertise that matches the specific pathology of the patient, the hospital-based physiotherapist being a part of the care team, and the support and supervision of all patients concerning physical functioning during the hospitalisation period. Whereas patients mainly mentioned the personal qualities of the physiotherapist, the other stakeholders mainly focused on professional and organisational factors. The results of this study offer opportunities for hospital-based physiotherapy to improve the quality of provided care seen from the perspective of key stakeholders.


Asunto(s)
Fisioterapeutas , Hospitales , Humanos , Modalidades de Fisioterapia , Investigación Cualitativa
17.
BMC Musculoskelet Disord ; 23(1): 453, 2022 May 14.
Artículo en Inglés | MEDLINE | ID: mdl-35568833

RESUMEN

BACKGROUND: Physical therapists (PTs) are at increased risk for development of work-related upper limb disorders (WRULDs) due to the physically intensive, constant hands-on nature of the profession. The objectives of this systematic review were to examine the literature on WRULDs among PTs, specifically the (1) 1-year prevalence, (2) workplace risk factors, (3) consequences, and (4) coping strategies utilized to mitigate WRULDs. METHODS: A comprehensive search of the literature was performed using PubMed, CINHAL, EMBASE, and Google Scholar. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were used for conducting this systematic review. Studies that reported the 1-year prevalence of WRULDs among PTs, workplace risk factors for WRULDs, consequences of WRULDs, and coping strategies utilized by PTs were included. RESULTS: Twelve studies met the inclusion criteria. The 1-year WRULDs prevalence rates varied widely, with thumb disorders having the highest prevalence (7.6-52.5%), followed by wrist and hand disorders (5-66.2%), shoulder disorders (3.2-45.2%), and elbow disorders (4-16%). Reported risk factors included treating a high volume of patients and frequent performance of manual therapy techniques. Consequences included interference with PTs' personal and professional activities while coping strategies involved alterations to the work environment, techniques used, and workload. CONCLUSIONS: WRULDs remain a persistent threat to the PT workforce, likely due to the hands-on, physically intensive nature of professional activities. An essential strategy to reduce WRULDs is to improve clinicians' awareness of WRULDs, workplace risk factors, and subsequent consequences of WRULDs. Effective coping strategies are critical to preserve, protect, and prolong PTs' use of the upper limbs.


Asunto(s)
Enfermedades Musculoesqueléticas , Enfermedades Profesionales , Fisioterapeutas , Humanos , Enfermedades Musculoesqueléticas/diagnóstico , Enfermedades Musculoesqueléticas/epidemiología , Enfermedades Musculoesqueléticas/prevención & control , Enfermedades Profesionales/epidemiología , Enfermedades Profesionales/prevención & control , Prevalencia , Extremidad Superior
18.
PLoS One ; 17(5): e0266765, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35536853

RESUMEN

BACKGROUND: Nigeria has the highest rates of physical inactivity in Africa. As physical inactivity is a leading global risk factor for non-communicable diseases (NCD), physical activity promotion is a strategy for their mitigation. Physiotherapists are already ideally situated to undertake this role and can assist in the reversal of NCD. Gaining insight into how physiotherapists in Nigeria perceive their role in relation to physical activity promotion is needed to ensure this undertaking will be effective. This national survey aimed to investigate Nigerian physiotherapists' knowledge and current practice for promoting physical activity across Nigeria and perceptions of their role related to this. METHODS: Following ethical approval, a cross-sectional, online questionnaire survey design was employed to investigate the aim. 330 qualified physiotherapists, working across Nigeria were recruited. Internal consistency of the survey was examined using Cronbach's alpha. Descriptive statistics were used to analyse closed questions. Thematic content analysis was used to analyse open-ended questions. Chi-square inferential statistic was used to investigate the association between variables with alpha interpreted at a level of 0.05. RESULTS: The internal consistency of the questionnaire survey was good overall (Cronbach Alpha α = 0.71). 330 physiotherapists participated. 99.4% agreed that discussing the benefits of a physically active lifestyle with patients is part of their role. However, over 60% did not feel confident in suggesting specific physical activity programs for their patients. 59.7% were aware of one or more physical activity guideline. However, only 49.1% were incorporating it into their practice. 85.5% felt that developing a physical activity guideline specifically for Nigeria would promote physical activity. 63.3% of respondents did not use any resource in promoting physical activity. An association was found between the physiotherapist's awareness of physical activity guidelines and male sex (χ2 = 8.95, df = 2, p = 0.01). CONCLUSION: Whilst most physiotherapists had a positive perception of their role in promoting physical activity, translating this into practice would seem to be challenging. A systems approach to physical activity health promotion is recommended with the need for a commitment by the Nigerian Government to the development and implementation of national guidelines. Incorporating more training in physiotherapy education could foster more confidence in the delivery of these guidelines. Greater use of resources and working with community organisations could help to optimise physical activity uptake in Nigeria.


Asunto(s)
Enfermedades no Transmisibles , Fisioterapeutas , Estudios Transversales , Ejercicio Físico , Conocimientos, Actitudes y Práctica en Salud , Humanos , Masculino , Nigeria , Fisioterapeutas/educación , Encuestas y Cuestionarios
19.
Front Public Health ; 10: 891276, 2022.
Artículo en Inglés | MEDLINE | ID: mdl-35548079

RESUMEN

Purpose: The purpose of the study was to examine the level of generalized anxiety disorder among occupational and physical therapists during treatment sessions and its association with somatic symptoms during the COVID-19 pandemic. Methods: A descriptive cross-sectional design was used in this study. Data were collected during the month of April 2021, and the study included occupational and physical therapists who practiced during COVID-19 from March 2020 to March 2021. The generalized anxiety disorder scale (GAD-7) and a modified patient health questionnaire (mPHQ-15) were used to examine self-reported anxiety and somatic symptoms among the study participants. The independent t-test was used to determine differences between groups based on GAD-7 and mPHQ-15 results. Spearman's correlation test and chi-squared test were used to find the relationships between different variables such as anxiety and somatic symptoms. Results: The study (n = 98 participants) included 56 occupational and 42 physical therapists. An 84% response rate was achieved. GAD-7 final score was µ = 9.21 ± 5.63 with 27% reporting no anxiety, 14% mild, 38% moderate, and 21% severe. Independent t-tests on GAD-7 scores showed significant differences between therapist specializations [t (96) = -2.256; p = 0.026] and between therapists residing with or without their parents [t (96) = -2.536; p = 0.013]. The mPHQ-15 final score was µ = 9.52 ± 5.54 with 13% reporting no symptoms (n = 13), 20% mild (n = 20), 38% moderate (n = 37), and 29% severe (n = 28). GAD-7 and mPHQ-15 scores were moderately positively correlated [r (96) = 0.569; p <0.000]. The chi-squared test showed a significant association between GAD-7 levels of anxiety and mPHQ-15 levels of somatic symptoms [x 2 (9, N = 98) = 70.62 p <0.000]. Therapists reported that the quality (76%) and effectiveness (20%) of their rehabilitation services were negatively impacted by the COVID-19 pandemic. Conclusion: The majority of study participants experienced moderate to severe anxiety and associated somatic symptoms. During COVID-19, ongoing psychological counseling of healthcare professionals such as occupational and physical therapists is required to maintain positive mental health. Implications for practice are presented.


Asunto(s)
COVID-19 , Síntomas sin Explicación Médica , Fisioterapeutas , Trastornos de Ansiedad/epidemiología , COVID-19/epidemiología , Estudios Transversales , Humanos , Pandemias , SARS-CoV-2
20.
BMJ Open ; 12(5): e061283, 2022 05 24.
Artículo en Inglés | MEDLINE | ID: mdl-35613820

RESUMEN

INTRODUCTION: Low back pain is a common problem and a substantial source of morbidity and disability worldwide. Patients frequently visit the emergency department (ED) for low back pain, but many experience persistent symptoms at 3 months despite frequent receipt of opioids. Although physical therapy interventions have been demonstrated to improve patient functioning in the outpatient setting, no randomised trial has yet to evaluate physical therapy in the ED setting. METHODS AND ANALYSIS: This is a single-centre cluster-randomised trial of an embedded ED physical therapy intervention for acute low back pain. We used a covariate-constrained approach to randomise individual physicians (clusters) at an urban academic ED in Chicago, Illinois, USA, to receive, or not receive, an embedded physical therapist on their primary treatment team to evaluate all patients with low back pain. We will then enrol individual ED patients with acute low back pain and allocate them to the embedded physical therapy or usual care study arms, depending on the randomisation assignment of their treating physician. We will follow patients to a primary endpoint of 3 months and compare a primary outcome of change in PROMIS-Pain Interference score and secondary outcomes of change in modified Oswestry Disability Index score and patient-reported opioid use. Our primary approach will be a modified intention-to-treat analysis, whereby all participants who complete at least one follow-up data time point will be included in analyses, regardless of their or their physicians' adherence to their assigned study arm. ETHICS AND DISSEMINATION: This trial is funded by the US Agency for Healthcare Research and Quality (R01HS027426) and was approved by the Northwestern University Institutional Review Board. All physician and patient participants will give written informed consent to study participation. Trial results will be submitted for presentation at scientific meetings and for publication in peer-reviewed journals. TRIAL REGISTRATION NUMBER: ClinicalTrials.gov (NCT04921449).


Asunto(s)
Dolor Agudo , Dolor de la Región Lumbar , Fisioterapeutas , Dolor Agudo/etiología , Dolor Agudo/terapia , Servicio de Urgencia en Hospital , Humanos , Dolor de la Región Lumbar/diagnóstico , Modalidades de Fisioterapia , Ensayos Clínicos Controlados Aleatorios como Asunto , Resultado del Tratamiento
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