A systematic review of work related musculoskeletal disorders among physical therapists and physiotherapists.

Physical therapists and physiotherapists (PPTs) perform and repeat physical tasks that can lead to work-related musculoskeletal disorders (WMSD). The aim was to study the main research concerning this problem, i.e. the risk factors, activities that exacerbate WMSD symptoms, alterations in work habits and the proposed responses, and to estimate mean value (±standard deviation, STD) for the most studied parameters. This review was conducted according to the PRISMA guideline. Five databases (Pubmed, ScienceDirect, Google Scholar, Medeley and Science.gov) were scanned to identify works investigating the different aspects of WMSD among PPTs. Two reviewers independently selected relevant studies using inclusion/exclusion criteria, critically appraised, and extracted data. To homogenize the data, prevalence were reported to the total sample studied when necessary. Among the 9846 articles identified, 19 articles were included. The WMSD prevalence was over 50 %. The areas most affected were the lower back, neck and thumb. An exhaustive list of parameters were constructed for job risk factors (n = 19), activities that exacerbating symptoms (n = 13), altered work habits (n = 15), responses and treatments (n = 26). The mean prevalence (±STD) was calculated for the major parameters. Nine main job risk factors were extracted with an average prevalence of about 30 % and a relatively high variability. Seven activities exacerbating WMSD symptoms and five altered work habits were identified with a homogeneous rate (5-20 %). Three main responses and treatments were found with heterogeneous prevalence. This review provides useful results for the development of future protocols to prevent the occurrence of WMSD among PPTs and meta-analyses.

Work-related interventions are not commonly included in physiotherapy management of lower limb osteoarthritis: A cross-sectional survey of Australian Physiotherapists.

BACKGROUND: Lower limb osteoarthritis (OA) is a leading cause of disability and can affect an individual's ability to work. OBJECTIVES: To explore Australian physiotherapists' use of work-related interventions in managing patients with lower limb OA, and identify current management practices. METHODS: Physiotherapists with at least two years of experience treating patients with lower limb OA were invited to complete an online survey to understand how physiotherapists manage patients with lower limb OA, specifically regarding interventions related to work. RESULTS: A total of 132 physiotherapists completed the survey. In free text responses, only 1.5% and 2.3% of physiotherapists nominated work-related items in their key components of treatment or educational topics discussed with patients with lower limb OA, respectively. From a range of work-related activities presented, over half of physiotherapists indicated they regularly/always provided education about the benefits of remaining in work (63.5%) and advice on managing symptoms at work (57.4%). Less than 10% of physiotherapists regularly/always used a validated scale to identify barriers for work (9.6%), discussed absences from work (9.6%), conducted a workplace assessment (4.4%), and discussed submitting workers' compensation claims (2.6%). Exercise and patient education were the most frequently nominated physiotherapy treatments in free text (96.2% and 86.3%, respectively) and fixed response (99.2% and 93.9%, respectively) questions. CONCLUSION: Many physiotherapists do not address work-related activities in their management of patients with lower limb OA. In light of work-related challenges commonly experienced by individuals with lower limb OA, this is an important aspect of management of this condition.

Nível de atividade física de fisioterapeutas de um hospital público / Level of physical activity of physical therapists at a public hospital

Objetivo: avaliar o nível de atividade física dos fisioterapeutas e identificar o perfil socioeconômico desses profissionais de um hospital público de grande porte em Goiânia. Métodos: Trata-se de um estudo observacional, transversal e quantitativo realizado de abril a agosto de 2020. Foram incluídos fisioterapeutas de ambos os sexos, contratados há no mínimo seis meses, e que assinaram o termo de consentimento livre e esclarecido. Excluídos da pesquisa aqueles em férias ou licença médica no período da coleta de dados. Para avaliar o nível de atividade física utilizou-se o Questionário Internacional de Atividade Física (IPAQ), e um questionário para conhecer o perfil socioeconômico desses profissionais. As variáveis contínuas foram apresentadas como média e desvio padrão, enquanto as categóricas, em frequência absoluta e relativa. Resultados: Grande parte dos indivíduos é do sexo feminino (73,5%) com maior prevalência de inativos (76%), sendo que (49,9%) cumprem carga horária maior que 30 horas semanais. Do total da amostra (61,8%) tem pelo menos especialização na sua formação profissional. Conclusão: Os fisioterapeutas do serviço público apresentam o nível de atividade física reduzido, com maior proporção classificados como inativos, segundo a OMS.

Purpose: evaluate the level of physical activity of physical therapists and identify the socioeconomic profile of these professionals in a large public hospital in Goiânia. Methods: This is an observational, cross-sectional and quantitative study carried out from April to August 2020. Physical therapists of both sexes, hired for at least six months, and who signed a free and informed consent form, were included. The research excluded those on vacation or sick leave during the data collection period. In order to assess the level of physical activity, the International Physical Activity Questionnaire (IPAQ) was used, as well as a questionnaire to learn about the socioeconomic profile of these professionals. Continuous variables were presented as mean and standard deviation, while categorical variables were in absolute and relative frequency. Results: Most of the individuals are female (73.5%) with a higher prevalence of inactive people (76%), and (49.9%) working more than 30 hours per week. From the total sample, 61.8% were at least specialists in their areas. Conclusion: Public service physical therapists have a reduced level of physical activity, with a greater proportion being classified as inactive, according to WHO.

Description of physical rehabilitation in intensive care units in Argentina: usual practice and during the COVID-19 pandemic. Online survey. / Descripción de la rehabilitación física en terapias intensivas de Argentina, práctica habitual y durante la pandemia COVID-19. Encuesta tipo online.

OBJECTIVE: To describe the usual practice of mobility therapy in the adult intensive care unit for patients with and without COVID-19. METHODS: Online survey in which physical therapists working in an adult intensive care unit in Argentina participated. Sixteen multiple-choice or single-response questions grouped into three sections were asked. The first section addressed personal, professional and work environment data. The second section presented questions regarding usual care, and the third focused on practices under COVID-19 pandemic conditions. RESULTS: Of 351 physical therapists, 76.1% answer that they were exclusively responsible for patient mobility. The highest motor-based goal varied according to four patient scenarios: Mechanically ventilated patients, patients weaned from mechanical ventilation, patients who had never required mechanical ventilation, and patients with COVID-19 under mechanical ventilation. In the first and last scenarios, the highest goal was to optimize muscle strength, while for the other two, it was to perform activities of daily living. Finally, the greatest limitation in working with patients with COVID-19 was respiratory and/or contact isolation. CONCLUSION: Physical therapists in Argentina reported being responsible for the mobility of patients in the intensive care unit. The highest motor-based therapeutic goals for four classic scenarios in the closed area were limited by the need for mechanical ventilation. The greatest limitation when mobilizing patients with COVID-19 was respiratory and contact isolation.

OBJETIVO: Describir la práctica habitual de asistencia kinésica motora en la unidad de cuidados intensivos de adultos, tanto en pacientes con y sin COVID-19. MÉTODOS: Estudio observacional transversal de tipo encuesta online. Se incluyeron kinesiólogos que trabajan en unidades de cuidados intensivos de adultos en Argentina. Se realizaron 16 preguntas de respuesta múltiple o simple agrupadas en 3 apartados. El primero caracterizado por datos personales, profesionales o del ámbito laboral. El segundo, destinado a conocer el accionar habitual y un tercero enfocado en las prácticas bajo la pandemia COVID-19. RESULTADOS: Sobre 351 kinesiólogos, el 76.1% reportó que la movilización de los pacientes estaba a cargo exclusivamente de ellos. El objetivo máximo a alcanzar desde el aspecto motor fue variable según cuatro escenarios: Pacientes en ventilación mecánica, desvinculados de la ventilación mecánica, los que nunca estuvieron asociados a la ventilación mecánica y con COVID-19 en ventilación mecánica. En el primer y último escenario el objetivo máximo fue optimizar valores de fuerza muscular. En los restantes fue realizar actividades de la vida diaria. Por último, la mayor limitante en el abordaje de pacientes con COVID-19 fue el aislamiento respiratorio y/o de contacto. CONCLUSIÓN: Los kinesiólogos en Argentina reportaron encargarse de la movilización de los pacientes en la unidad de cuidados intensivos. Los objetivos máximos desde el aspecto motor para cuatro escenarios clásicos en el área cerrada podrían estar determinado por la asociación con la ventilación mecánica. La mayor limitación a la hora de movilizar a pacientes con COVID-19 fue el aislamiento respiratorio y de contacto.

Physical activity in health care professionals as a means of primary prevention of cardiovascular disease: A STROBE compliant cross-sectional study.

ABSTRACT: The aim of this study was to assess the physical activity level of health care professionals, as well as the differences by sex, age, academic background, and among different health care professions.This is an cross-sectional study.Health care settings in the Valencian Community, Spain.A total of 647 health care professionals.Physical activity was assessed with the European Health Interview Survey-Physical Activity Questionnaire (EHIS-PAQ) that includes the assessment of work-related physical activity, transport-related physical activity, health-enhancing physical activity, muscle-strengthening physical activity, and total physical activity.93.51% of all health care professionals were physically active at work. Transport-related physical activity and health-enhancing physical activity were significantly lower in women (21.62% vs 41.86%, P < .001; and 50.19% vs 68.99%, P < .001, respectively). In addition, compliance with health-enhancing and muscle-strengthening physical activity guidelines were lower in older professionals (42.7% vs 61.84%, P < .001; and 47.57% vs 61.84%, P < .001, respectively). Those with higher education were more compliant with health-enhancing and muscle-strengthening physical activity guidelines (58.55% vs 45.69%, P = .002; and 60.24% vs 48.28%, P = .003, respectively). Moreover, 67.98% of physiotherapists performed health-enhancing physical activity and 67.54% muscle-strengthening physical activity regularly, and significant differences in all outcomes were observed compared to the rest of health care professionals (P < .05). Technicians showed lower work-related and total physical activity than nurses and nursing assistants (74.55% vs 90.37%, P = .002; and 83.64% vs 95.72%, P < .001, respectively). Additionally, nursing assistants showed higher work-related physical activity compared to nurses (97.18% vs 90.37%, P = .008).Most health care professionals showed an appropriate level of physical activity. Men performed more transport-related and health-enhancing physical activity than women. Younger professionals and those with higher education were more compliant with health-enhancing and muscle-strengthening physical activity guidelines. Physiotherapists were more physically active when compared to the rest of health care professionals.

Physiotherapists' perspectives on barriers to implementation of direct access of physiotherapy services in the United Arab Emirates: A cross-sectional study.

BACKGROUND: There are two primary ways of accessing physiotherapy for service users around the world. The direct access, as opposed to the indirect access which requires a referral from a general physician, has several merits including better quality, timeliness, cost effectiveness of treatment and better probability of preventing acute conditions from turning into chronic ailments. Despite these benefits, several countries including the UAE, do not allow direct access to physiotherapists. This study aims to understand the level of awareness among practicing physiotherapists in the United Arab Emirates (UAE) about direct access and to determine whether any of their demographic variables influence the way they perceive the concept. Further, the study sought to explore the perceived barriers and benefits of direct access according to the participating physiotherapists. SUBJECTS AND METHODS: An observational cross-sectional study was employed. The questionnaire survey developed by Bury and Stokes in 2013 was adapted and employed in this study. The instrument had six sections with close-ended items using a Likert five-point scale to rate them. Two hundred and sixty-four physiotherapists answered the questionnaire shared with them through a web link. Finally, MANOVA was employed to explore any influence of demographic variables on the opinions of the respondents. RESULTS: The findings showed that 70% of participants were aware about direct access while nearly 30% were completely unaware. Younger physiotherapists were more willing to endorse the practice whereas older ones were more apprehensive of the barriers. The main barriers reported were the limited support from the physicians and policy makers, professional autonomy, and the limited scope of practice for the physiotherapists, as well as evidence-based practice. The impact of demographic variables on direct access indicated that physiotherapists under the age of 23 endorsed direct access more strongly than other age groups. CONCLUSION: More efforts are needed to implement direct access in the UAE, considering the benefits of improved professional status, cost savings, patient satisfaction, and higher efficiency. This study recommends leadership support, professional autonomy, and mentorship as possible ways to achieve this goal.

Videoconferencing psychotherapy for couples and families: A systematic review.

The delivery of videoconferencing psychotherapy (VCP) has been found to be an efficacious, acceptable and feasible treatment modality for individual therapy. However, less is known about the use of VCP for couple and family therapy (CFT). The focus of this systematic review was to examine the efficacy, feasibility and acceptability of using VCP as a treatment delivery modality for CFT. A systematic search was conducted, data relating to efficacy, feasibility and acceptability were extracted from included studies. The search returned 7,112 abstracts, with 37 papers (0.005%) included. The methods of the review were pre-registered (PROSPERO; CRD42018106137). VCP for CFT was demonstrated to be feasible and acceptable. A meta-analysis was not conducted; however, results from the included studies indicate that VCP is an efficacious delivery method for CFT. Recommendations for future research and implications regarding clinical practice are made, which may be of interest to practitioners given the COVID-19 pandemic.

Descripción de la rehabilitación física en terapias intensivas de Argentina, práctica habitual y durante la pandemia COVID-19. Encuesta tipo online / Description of physical rehabilitation in intensive care units in Argentina: usual practice and during the COVID-19 pandemic. Online survey

RESUMEN Objetivo: Describir la práctica habitual de asistencia kinésica motora en la unidad de cuidados intensivos de adultos, tanto en pacientes con y sin COVID-19. Métodos: Estudio observacional transversal de tipo encuesta online. Se incluyeron kinesiólogos que trabajan en unidades de cuidados intensivos de adultos en Argentina. Se realizaron 16 preguntas de respuesta múltiple o simple agrupadas en 3 apartados. El primero caracterizado por datos personales, profesionales o del ámbito laboral. El segundo, destinado a conocer el accionar habitual y un tercero enfocado en las prácticas bajo la pandemia COVID-19. Resultados: Sobre 351 kinesiólogos, el 76.1% reportó que la movilización de los pacientes estaba a cargo exclusivamente de ellos. El objetivo máximo a alcanzar desde el aspecto motor fue variable según cuatro escenarios: Pacientes en ventilación mecánica, desvinculados de la ventilación mecánica, los que nunca estuvieron asociados a la ventilación mecánica y con COVID-19 en ventilación mecánica. En el primer y último escenario el objetivo máximo fue optimizar valores de fuerza muscular. En los restantes fue realizar actividades de la vida diaria. Por último, la mayor limitante en el abordaje de pacientes con COVID-19 fue el aislamiento respiratorio y/o de contacto. Conclusión: Los kinesiólogos en Argentina reportaron encargarse de la movilización de los pacientes en la unidad de cuidados intensivos. Los objetivos máximos desde el aspecto motor para cuatro escenarios clásicos en el área cerrada podrían estar determinado por la asociación con la ventilación mecánica. La mayor limitación a la hora de movilizar a pacientes con COVID-19 fue el aislamiento respiratorio y de contacto.

Abstract Objective: To describe the usual practice of mobility therapy in the adult intensive care unit for patients with and without COVID-19. Methods: Online survey in which physical therapists working in an adult intensive care unit in Argentina participated. Sixteen multiple-choice or single-response questions grouped into three sections were asked. The first section addressed personal, professional and work environment data. The second section presented questions regarding usual care, and the third focused on practices under COVID-19 pandemic conditions. Results: Of 351 physical therapists, 76.1% answer that they were exclusively responsible for patient mobility. The highest motor-based goal varied according to four patient scenarios: Mechanically ventilated patients, patients weaned from mechanical ventilation, patients who had never required mechanical ventilation, and patients with COVID-19 under mechanical ventilation. In the first and last scenarios, the highest goal was to optimize muscle strength, while for the other two, it was to perform activities of daily living. Finally, the greatest limitation in working with patients with COVID-19 was respiratory and/or contact isolation. Conclusion: Physical therapists in Argentina reported being responsible for the mobility of patients in the intensive care unit. The highest motor-based therapeutic goals for four classic scenarios in the closed area were limited by the need for mechanical ventilation. The greatest limitation when mobilizing patients with COVID-19 was respiratory and contact isolation.

Moral distress of medical family therapists and their physician colleagues during the transition to COVID-19.

The COVID-19 pandemic has transformed healthcare for both clinicians and patients. This conceptual article uses ideas from the moral distress literature to understand the challenges MedFTs and physicians face during the COVID-19 pandemic. The authors highlight earlier themes from the moral distress literature and share current reflections to illustrate similar challenges. Some clinicians who were already experiencing a rise in burnout due to the mass digitization of healthcare are now facing increased moral distress due to ethical dilemmas, pervasive uncertainty, boundary ambiguity, isolation, and burnout brought about by emerging COVID-19 policies. Fears about personal safety, exposing loved ones, financial concerns, self-doubt, and frustrations with telehealth have contributed to increased moral distress during the COVID-19 pandemic. Building resilience by setting one's personal moral compass can help clinicians avoid the pitfalls of moral distress. Five steps for developing resilience and implications for guiding trainees in developing resilience are discussed.

Couple teletherapy in the era of COVID-19: Experiences and recommendations.

The unprecedented times of the novel Coronavirus quarantine and subsequent stay-at-home orders have changed the way many couple therapists provide clinical services. Understanding couple therapists' experiences with teletherapy is important for optimizing future telehealth delivery with couples. Thus, the purpose of this mixed methods survey study was to explore couple therapists' experiences of transitioning from in-person/traditional therapy to online/telehealth delivery. A total of 58 couple therapists completed an online survey for this study. Reported are both quantitative and qualitative findings. Overall, this study found that couple therapists experienced a positive shift from traditional/in-person therapy to online/telehealth therapy, with a majority of couple therapists (74%) reporting they would continue providing teletherapy after the novel Coronavirus pandemic and social distancing regulations had ended. Thematic analysis was used to identify themes from couple therapists' experiences related to advantages, challenges, and recommendations for practice. Implications for clinical training and future research are discussed.

"It's splendid once you grow into it:" Client experiences of relational teletherapy in the era of COVID-19.

The novel Coronavirus pandemic (COVID-19) and subsequent social distancing practices have altered the way we move through the world and access physical and mental healthcare. While researchers and clinicians have begun to explore the impact of telehealth delivery on psychotherapy and treatment outcomes, the purpose of this study was to explore the lived experiences of individuals in teletherapy, specifically those engaging in teletherapy with a romantic partner or family member. Using a thematic analysis of open-ended online survey questions, we explored the experiences of 25 individuals who engaged in couple or family teletherapy after social distancing began. The resulting themes included "making do," safe therapeutic space, convenience, logistical challenges, and therapist accommodation. We discuss the clinical implications of these themes to support effective couple and family teletherapy and offer suggestions and considerations for remote clinical interventions and practices. [Correction added on 22 March 2021, after first online publication: The term '19' has been changed to '(COVID-19)' in the first line of the Abstract section, in this version.].

Systemic teletherapists' meaningful experiences during the first months of the coronavirus pandemic.

Fifty-five clinicians who provided teletherapy to couples, partnerships, families, and kin networks during the first two months of the coronavirus pandemic responded to a survey about their most and least meaningful experiences. Reflexive thematic analysis indicated that the participants experienced adjustments to their schedule or routines, they used technology glitches to promote client growth, and they altered how they engaged clients. Participants noted shifts in their personal and relational dynamics. They reported feeling fatigued and resilient. Participants described their adaptability, gratitude, digital and relational connectivity, and an ability to reframe negative experiences into opportunities for growth.

A Delphi study to explore and gain consensus regarding the most important barriers and facilitators affecting physiotherapist and pharmacist non-medical prescribing.

Non-medical prescribing was introduced into the United Kingdom to improve patient care, but early research indicated a third of Allied Health Professionals may not use their prescribing qualification. A previous literature review, highlighting factors influencing prescribing, identified only papers with nursing and pharmacy participants. This investigation explored consensus on factors affecting physiotherapist and pharmacist non-medical prescribers. A three round Delphi study was conducted with pharmacist and physiotherapist prescribers. Round One comprised information gathering on facilitators and barriers to prescribing participants had experienced, and underwent content analysis. This was followed by two sequential consensus seeking rounds with participants asked to rate the importance of statements to themselves. Consensus criteria were determined a priori, including median, interquartile range, percentage agreement and Kendall's Coefficient of Concordance (W). Statements reaching consensus were ranked for importance in Round Three and analysed to produce top ten ranks for all participants and for each professional group. Participants, recruited October 2018, comprised 24 pharmacists and 18 physiotherapists. In Round One, content analysis of 172 statements regarding prescribing influences revealed 24 themes. 127 statements were included in Round Two for importance rating (barriers = 68, facilitators = 59). After Round Two, 29 statements reached consensus (barriers = 1, facilitators = 28), with no further statements reaching consensus following Round Three. The highest ranked statement in Round Three overall was: "Being able to prescribe to patients is more effective and really useful working [in my area]". Medical support and improved patient care factors appeared the most important. Differences were noted between physiotherapist and pharmacist prescribers regarding the top ten ranked statements, for example team working which pharmacists ranked higher than physiotherapists. Differences may be explained by the variety of practice areas and relative newness of physiotherapy prescribing. Barriers appear to be post or person specific, whereas facilitators appear universal.

Toward proficiency in telebehavioral health: applying interprofessional competencies in couple and family therapy.

During the coronavirus pandemic, many behavioral health professionals providing psychotherapeutic services, including couple/marriage and family therapists (C/MFTs), quickly changed from providing in-person services to telebehavioral health (TBH) services, with specific reliance on teleconferencing. Many therapists were thrust into telehealth with minimal or no prior telebehavioral health experience, education, or training. Although TBH services have been shown to be effective and efficient with mental health and substance abuse problems, the teaching and learning of telebehavioral competencies have generally not been included in the formal education and training received by C/MFTs. This article presents an existing interprofessional telebehavioral health competencies framework not before published in C/MFT journals. This article will also demonstrate how those competencies are applicable to the education, training, and practice of telebehavioral health by C/MFTs. Implications for educational, service, and regulatory organizations are presented.

Burnout and distress among allied health care professionals in a cardiovascular centre of a quaternary hospital network: a cross-sectional survey.

BACKGROUND: Burnout and distress negatively affect the well-being of health care professionals and the treatment they provide. Our aim was to measure the prevalence of burnout and distress among allied health care staff at a cardiovascular centre of a quaternary hospital network in Canada, and compare outcomes to those for nonphysician employees in the United States. METHODS: We conducted a survey of allied health care staff, including physical, respiratory and occupational therapists, pharmacists, social workers, dietitians and speech-language pathologists, in a cardiovascular centre at 2 quaternary referral hospitals in Toronto, Ontario, between Nov. 27, 2018, and Jan. 31, 2019. The survey tool included the Well-Being Index (WBI), which measures fatigue, depression, burnout, anxiety or stress, quality of life, work-life integration, meaning in work and overall distress; a score of 2 or higher indicated high distress. We carried out standard univariate statistical comparisons using the χ2, Fisher exact or Kruskal-Wallis test as appropriate to perform univariate comparisons in the sample of respondents. We assessed the relation between a WBI score of 2 or higher and demographic characteristics. We compared univariate associations among WBI data for nonphysician employees in the US who completed the WBI to responses from our participants. RESULTS: The response rate to the survey was 86% (45/52). Thirty-three respondents (73%) reported experiencing burnout in the previous month, and 31 (69%) reported emotional problems. Compared to respondents who perceived fair treatment in the workplace, those who perceived unfair treatment (20 [44%]) were more likely to report emotional problems (17 [85%] v. 13 [54%], p = 0.05), to worry that work was hardening them emotionally (15 [75%] v. 8 [33%], p = 0.008), and to feel down, depressed or hopeless (12 [60%] v. 4 [17%], p = 0.005). Twenty-five respondents (56%) and 13 respondents (29%) reported WBI scores consistent with high (≥ 2) or severe (≥ 5) distress, respectively. Respondents were more likely to have a high WBI score if they perceived unfair treatment or inadequate staffing levels. Our respondents had a higher prevalence of burnout (73.3% v. 53.6%, p = 0.008) and a higher average WBI score (2.6 [SD 2.8] v. 1.7 [SD 2.6], p = 0.05) than 9096 nonphysician employees in the US. INTERPRETATION: The prevalence of burnout, emotional problems and distress was high among allied health care staff. Fair treatment in the workplace and adequate staffing may lower distress levels and improve the work experience of these health care professionals.

Current Physical Therapy Practice in Norway for Children With Cerebral Palsy.

PURPOSE: To investigate to what degree functional physical therapy approaches are implemented in Norway when promoting gross motor skill acquisition in children with cerebral palsy. METHODS: It was a national survey about current practice among Norwegian pediatric physical therapists. The physical therapists chose between 5 predefined approaches developed through practice descriptions by a convenience sample of 55 physical therapists. RESULTS: The distribution of the main approaches were: functional training based on principles of motor learning, training of body functions and structures, manual stimulation of position and movements, addressing environmental factors, and conceptual methods. Working in the North and having more experience predicted less chance of using functional approaches. Most physical therapists frequently used other approaches as a supplement to the main approach, but not conceptual methods. CONCLUSIONS: Functional training based on principles of motor learning has become the method of choice in Norway.

Evaluation of Pragmatic Telehealth Physical Therapy Implementation During the COVID-19 Pandemic.

OBJECTIVE: The objective was to evaluate implementation of telehealth physical therapy in response to COVID-19 and identify implementation strategies to maintain and scale up telehealth physical therapy within a large urban academic medical center. METHODS: The Reach Effectiveness Adoption Implementation Maintenance (RE-AIM) framework was used to evaluate telehealth physical therapy implementation. Patient-level data were extracted from electronic medical records between March 16, 2020, and May 16, 2020 (implementation phase). Reach was defined as the proportion of physical therapy sessions completed via telehealth. Effectiveness was assessed using a patient-reported satisfaction survey with a 5-point Likert scale. Adoption was defined as the proportion of physical therapists who used telehealth. Implementation was assessed through qualitative analysis of patient and clinician perspectives to identify emergent themes, retrospectively classify strategies used during the implementation phase, and prospectively identify evidence-based strategies to increase telehealth maintenance and scale-up. Maintenance of telehealth was defined as the proportion of patients who indicated they would attend another telehealth session. RESULTS: There were 4548 physical therapy sessions provided by 40 therapists from March 22, 2020, to May 16, 2020, of which 3883 (85%) were telehealth. Ninety-four percent of patients were satisfied. All physical therapists (100%) used telehealth technology at least once. Retrospectively classified and prospectively identified evidence-based strategies were organized into 5 qualitative themes that supported implementation: organizational factors (policies, preexisting partnerships), engaging external stakeholders (satisfaction survey), champions (clinician leaders), clinician education (dynamic, ongoing training), and process (promote adaptability, small tests of change). Ninety-two percent of patients reported they would attend another telehealth session. CONCLUSION: Findings from this study suggest that implementation of telehealth physical therapy during the COVID-19 pandemic was feasible and acceptable in this setting. IMPACT: These results can be used to guide future health policy, quality improvement, and implementation science initiatives to expand the use and study of telehealth for physical therapy.

Pressure injury related to the use of personal protective equipment in COVID-19 pandemic.

OBJECTIVE: To describe the prevalence and factors associated with pressure injuries related to the use of personal protective equipment during the COVID-19 pandemic. METHODS: Cross-sectional study conducted using an instrument made available in social networks with 1,106 health professionals. The data were analyzed using descriptive statistics and compared, considering pvalue < 0.05. RESULTS: There was a prevalence of 69.4% for pressure injuries related to the use of personal protective equipment, with an average of 2.4 injuries per professional. The significant factors were: under 35 years of age, working and wearing personal protective equipment for more than six hours a day, in hospital units, and without the use of inputs for protection. CONCLUSION: Pressure injuries related to the use of medical devices showed a high prevalence in this population. The recognition of the damage in these professionals makes it possible to advance in prevention strategies.

Team Members' Roles in Home Healthcare: Evidence From the "AKEΣΩ-1" Project in Greece.

Home healthcare has just recently won the interest of policy decision makers in Greece and there is a lack of knowledge regarding the contributions provided by each team member. The aim of this study was to describe the home care interventions carried out by nurses, physicians, and physiotherapists during the AKEΣΩ-1 project. We examined the data from 1,094 patients who received home healthcare (HHC) from an interdisciplinary team from the Hellenic Red Cross HHC services in three major cities in Greece during a 20-month period. The visits and interventions by nurses, physicians, and physiotherapists were grouped and measured. Patients were mostly older adults (80.73%), women (68.37%) with medical problems (46.8%). Nurses conducted 70.76% of the visits, and provided 21,017 interventions. Physiotherapists conducted 22.83% of the visits and 4,627 interventions, and physicians conducted 6.4% of the visits and 2,117 interventions. Nurses provided a wide range of complex skilled nursing interventions that required knowledge of the community and ability to network. Physiotherapy and educating patients and caregivers were the most frequent interventions of physiotherapists. The main role of physicians was to conduct clinical exams. The Greek healthcare system is hospital- and physician-oriented. We documented that in HHC, nurses take a lead role in providing care, organizing services, and collaborating with other community services. From a health and social policy perspective, proper planning and staffing of HHC services are required. From an academic and licensing perspective, it is important to ensure that nurses working in the community have appropriate preparation.