Wheelchair satisfaction among elderly Arab and Jewish patients - a cross-sectional survey.

PURPOSE: To evaluate patient satisfaction with their wheelchairs among Jewish and Arab older adults. MATERIALS AND METHOD: A cross-sectional study based on personal interviews. Participants were confined to a wheelchair (WC) Level 3. The Quebec User Evaluation of Satisfaction (scales 1-5) evaluated patient satisfaction. T test evaluated differences between continuous variables and χ2 or a Fisher's exact test between categorical variables. The contribution of background variables to the overall satisfaction with the wheelchair and related service was evaluated by multivariate regression. RESULTS: A total of 74 Jewish and 24 Arab (mean age 78.4 ± 14.1), participated in the study. The overall satisfaction score was moderate/high (3.97 ± 0.8) with no difference between the groups. The most important items for all participants were WC safety, comfort and weight. Participants from the Arab sector were less educated, had higher BMI and were less satisfied with the chair dimensions. CONCLUSIONS: A WC Level 3 may be effective and meets most of the basic needs of both Jewish and Arab patients at older ages. Higher BMI may result in difficulty to adopt to WC dimensions and can explain the less satisfaction of Arab patients with this component. A routine initial phone call follow-up is recommended to all patients after receiving a wheelchair. Those with problems will be scheduled for home visit. It is recommended to perform a study that will include more types of assistive devices and other groups of patients. Implication For RehabilitationApparently, despite lack of home visit follow-up, overall satisfaction with wheelchaires is relatively high. Therefore, initial phone calls may be monitored to all patients and home visits may be scheduled only for those unsatisfied with their chair.Converting a home visit to phone call can reduce the costs associated with routine home visits for all patients as is currently the case in some counties. This counts for both Jewish and Arab patients.

Identification of Signs and Symptoms of Axillary Web Syndrome and Breast Seroma During a Course of Physical Therapy 7 Months After Lumpectomy: A Case Report.

Background and Purpose: Axillary web syndrome (AWS) and seroma are common and function-limiting side effects following treatments for breast cancer. Studies of AWS and seroma are rare, and there are no guidelines for physical therapy in these cases. Case Description: After left breast lumpectomy due to invasive ductal carcinoma, a 65-year-old female patient underwent intraoperative radiation therapy and whole breast radiation. Seven months later, during treatment for breast swelling, AWS and breast seroma were identified by a physical therapist certified in lymphedema treatment. Treatment goals were to reduce breast swelling and pain and to improve shoulder movements. Interventions included manual lymph drainage, left arm stretching, and instruction about self-lymphatic-drainage and stretching exercise. Also, a compression bra was ordered, and continued daily activities and physical activity were recommended. Outcomes: Improvement in shoulder movement, breast swelling, and pain. Discussion: Because evidence for treatment guidelines following treatments for breast cancer is lacking, close follow-up for treatment-related complications is recommended. Management should be chosen according to signs and symptoms. Realistic expectations can reduce patient frustration and improve coping strategies and compliance with self-treatment demands. Clinical studies to support these conclusions are required.

Academic Achievement, Perceived Stress, Admission Data, and Sociodemographic Background Among Therapy Students in Israel.

BACKGROUND: Academic achievement (AA) is of great importance in the academic world. The aims of this study were to: 1) identify contributors to AA of physical therapy (PT) students; 2) evaluate students' perceived stress (PS); and 3) identify contributors to PS. METHODS: A cross-sectional study involving three undergraduate PT classes in a single academic year was performed 1 week prior to final examinations. Current grade point average (GPA) and admission data were collected from administrative records. Additional data, collected using an online questionnaire, included the Perceived Stress Scale 10 (PSS), Scale for Assessing Academic Stress (SAAS), and selected sociodemographic variables. Regression analysis identified contributors to AA and to PS. RESULTS: Records of 153 students and questionnaires of 118 students were included in the study. Combined grades from psychometric tests and matriculation exams at admission, low PS, absence due to military reserve service during the academic year, and participation in the second and third years of the PT program accounted for a modest variance (31.1% ) in students' GPA. CONCLUSIONS: The low contribution of admission criteria to GPA suggests that there is no justification for raising the level of the present criteria.

Equality, accessibility, and availability of physical therapy services in Israel-Perception of national directors.

To date no research has described Israeli physical therapy (PT) services to determine whether they are provided in the spirit intended by the National Health Insurance Law (NHIL). This study aimed to assess the equality, accessibility, and availability of PT services in Israel. Qualitative research was based on semi-structured, personal interviews with all national directors of PT services in Israel, followed by content analysis of the data obtained. According to the findings, PT services are provided by all Health Maintenance Organisations (HMOs) throughout Israel. In peripheral areas, access to services is limited; availability of services at most clinics is poor, a problem which is solved mainly by referring patients to PT outsourcing. The number of treatment sessions is determined by the NHIL; however, all directors agreed that the number of treatments provided should be based on a professional decision following patient evaluation and progress, rather than on administrative considerations. Inequality of service to peripheral areas could be reduced by creating cooperation between HMOs, thereby establishing clinics capable of providing services that are both accessible and equitable. In addition, the number of sessions provided to patients in the health-care basket should be reassessed, and a set of uniform criteria should be created for determining the optimal number of PT sessions. This could lead to greater uniformity in distribution of PT services provided by the HMOs.

The implementation of the ICF among Israeli rehabilitation centers--the case of physical therapy.

The extent of the implementation of the International Classification of Functioning, Disability and Health (ICF), developed by the WHO, in rehabilitation units and in physical therapy (PT) departments is unknown. The study aims to describe the extent to which the ICF has been implemented in PT services within rehabilitation units in Israel. To update data on ICF implementation since its inception. An online semi-structured survey was administered to 25 physiotherapists in charge of PT departments in all rehabilitation units throughout Israel. Rehabilitation units were grouped into three categories: general, geriatric and pediatric. The questionnaire included items regarding the ICF implementation, its strengths, and weaknesses. Twenty two physiotherapists (88%) completed the questionnaire. The majority was familiar with the ICF and nearly two thirds reported partial implementation in their units. Implementation focused mostly on adopting the biopsychosocial concepts and using ICF terms. The ICF was not used either for evaluating patients, or for reporting or encoding patient information. Physiotherapists, directors of most Israeli PT departments in rehabilitation units are familiar with the ICF; however, its clinical implementation is very limited. There is need for further research into the processes of knowledge transfer and implementation of the ICF, in order to better understand the factors that facilitate and those that impede ICF implementation.

Stress among healthcare students--a cross disciplinary perspective.

BACKGROUND AND PURPOSES: Perceived stress (PS) among healthcare students worldwide is a recognized problem. To address the paucity of data about the actual degree of PS, this study aimed to: 1) evaluate and compare PS across three healthcare programs (Physical Therapy [PT], Communication Disorders [CD], and Nutrition Sciences [NS]) in one university; 2) evaluate changes in PS across study years; 3) identify the contribution of academic- and socio-demographic-related variables to PS; and 4) determine whether the Israeli students' PS levels differ from those of their peers in other countries. METHODS: A cross-sectional survey was performed among all undergraduate PT, CD, and NS students from one university. Data were collected using anonymous questionnaires. Instruments included the Perceived Stress Scale 10 (PSS) and the Undergraduate Sources of Stress (USOS). ANOVA was used to evaluate the differences between the three programs, and regression analysis to evaluate the contribution of socio-demographic factors to PS and USOS. RESULTS: A total of 312 students (PT--154; CD--92; NS--66) participated in the study. Mean PSS (range: 13.5-13.6) was similar in the three programs. The USOS academic factor was the most reported source of stress in all programs. Most socio-demographic variables were not related to either PS or USOS. CONCLUSIONS: Students from PT, CD, and NS programs perceived similar levels of stress. The academic factor was perceived as the most important source of stress by students from the three departments, despite differences in the academic educational programs. Further studies are needed to generalize these results and enable a comparison between healthcare students and other students' stress perceptions.

Quality of life and health conditions reported from two post-polio clinics in Israel.

OBJECTIVE: To evaluate the perceptions of health and quality of life among a group of polio survivors in Israel and to identify potential activities for improving their quality of life. DESIGN: An observational study. SUBJECTS: The sample consisted of 101 polio survivors who sought treatment at 2 post-polio clinics in Israel. The majority of participants were between the ages of 45 and 65 years, and approximately 25% were wheelchair-bound. METHODS: Participants were invited to attend a seminar, where they were invited to complete a questionnaire on demographic variables, mobility, perceptions of and satisfaction with health status and quality of life, and the potential contribution of 16 activities to improve their quality of life. RESULTS: Participants had low physical scores and normative mental scores. Mean scores on the Short-Form-12 questionnaire for physical and mental components were 32.9 and 50.3, respectively. Approximately 70% expressed the belief that exposure to up-to-date information about post-polio, as well as participation in social activities, might improve their quality of life. CONCLUSION: Information about the physical and mental components of polio survivors, as well as the desire to partake in specific activities for polio survivors, may serve as a basis for the operations and prioritization of service providers.

Low back pain incident episodes: a community-based study.

BACKGROUND CONTEXT: The available evidence regarding low back pain (LBP) incident episodes is not consistent. Such knowledge can add information for the potential contribution of preventive programs. PURPOSE: a) To evaluate annual incident episodes of LBP among the general population. b) To evaluate the contribution of demographic, lifestyle, and back pain history to LBP incident episodes. STUDY DESIGN: A community-based longitudinal study. PATIENT SAMPLE: A randomized sample of individuals, free of LBP at a previous cross-sectional survey. OUTCOME MEASURES: Low back pain during the past year. METHODS: Subjects were followed up after 1 year. Baseline data included back pain history, perception of general health, physical activity, smoking, work satisfaction, and demographic characteristics. RESULTS: Annual incident episodes of LBP were 18.4%. Those who experienced LBP during the past year had a lower baseline perception of general health and were less involved in sporting activities than those free of pain. Those without history of LBP were more likely to be free of back pain after 1 year. CONCLUSIONS: The annual incident episodes of LBP are relatively high and relate indirectly to baseline perception of general health and to level of sporting activities. Those without history of LBP are more likely to be free of back pain after 1 year. These results raise the potential of LBP preventive programs for adult populations.

Are localized low back pain and generalized back pain similar entities? Results of a longitudinal community based study.

PURPOSE: To compare subjects with localized low back pain (LBP) and with generalized back pain (BP) with regard to baseline characteristics and long-term outcomes. METHODS: A community-based longitudinal study. All inhabitants aged 22 - 70 of a single town were asked to complete self-administered questionnaires regarding back and neck pain and lifestyle characteristics. Those reporting LBP during the previous month were followed up after one year. Data were stratified by sites of pain with respect to 'localized LBP' and to 'LBP with additional sites of BP'. Among LBP measures were the Roland and Morris Disability scale and Pain symptoms indices. RESULTS: Nearly 30% of the total population (602) experienced LBP during the previous month, of whom more than half (336) reported 'localized LBP' and the rest LBP + neck and or upper back pain (Generalized BP). Both subgroups differed from those free of BP, however, those reported 'Generalized BP' comprised more females, were less educated, smoked more, were less engaged in sporting activities and reported higher level of LBP measures than those reported 'localized LBP'. After one year, both subgroups were similar with regard to lifestyle but remained different with regard to some of the LBP measures. CONCLUSIONS: Subjects with 'localized LBP' presented healthier lifestyle than subjects with 'Generalized BP'. The latter experienced higher degree of pain measures. It seems that 'Generalized BP' is not a different entity than 'localized LBP' but rather a more severe one.

A longitudinal, community-based study of low back pain outcomes.

OBJECTIVES: To assess the report of low back pain (LBP) over 1 year and its predictors in individuals reporting symptoms during an initial cross-sectional survey. STUDY DESIGN: A longitudinal community-based study. SUMMARY OF BACKGROUND DATA: The natural history of LBP is poorly understood. Different studies report various rates of persistent and recurrent symptoms as well as different predictors of outcomes. METHODS: Subjects from a single town in Israel reporting low back pain during the previous month were followed up after 2 and 12 months. The primary outcome was experiencing LBP and the secondary outcomes were pain and functional status as measured by the Roland & Morris Disability questionnaire and Pain Symptoms Frequency and Bothersomeness Indexes. RESULTS: More than three fourths reported LBP (different levels of severity) after 2 and 12 months. This group did not show an improvement in pain measures. Baseline pain characteristics and perception of general health were predictors of both primary and secondary outcomes. Work satisfaction and experiencing a negative event during the past months were also predictors of the secondary outcomes. CONCLUSIONS: In this community-based study, LBP symptoms after 1 year are common and symptoms of those experiencing LBP at follow up do not improve over time. Predictors of experiencing LBP and of LBP symptoms after 1 year included baseline pain characteristics and psychosocial factors.

Physical activities and low back pain: a community-based study.

PURPOSE: Very little is known about the relationship between physical activity and low back pain (LBP) in general populations. This study aimed to evaluate the relationship between different dimensions of physical activity and LBP among all adults of a defined community. METHODS: A cross-sectional survey addressed all adults aged 22-70 of a single town. Inhabitants were asked to complete a self-administered questionnaire regarding physical activities, LBP, and related characteristics. The Beacke Physical Activity Questionnaire evaluated physical activity, and the Modified Roland and Morris Disability Questionnaire, a pain severity scale, and the Pain Symptoms Frequency and Bothersomeness Indices evaluated LBP. RESULTS: High occupational activity demands contributed to increased LBP prevalence, and, conversely, high sporting activity participation contributed to a decline in all LBP measures. Subjects free of LBP and subjects who participate in sporting activities are more likely not to smoke and not to participate in high occupational activity demands. Type of sporting activity was not associated with LBP prevalence or severity. CONCLUSIONS: Different dimensions of physical activity yield different relationships to LBP. There are several shared characteristics of those participating in sport on a regular basis and those free of LBP. Both groups present a healthier lifestyle. Although LBP was less frequent among those who participate in sporting activities, participating in sporting activities did not contribute independently to a lower prevalence of LBP. However, once LBP was established, participating in sporting activities contributed indirectly to its severity.