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2.
Artigo em Inglês | MEDLINE | ID: mdl-34639583

RESUMO

This study primarily aimed to develop a shorter version of the self-reported adherence to patient-centered physical therapy (s-SAPCPTS) by using Rasch analysis and secondarily aimed to preliminarily investigate the relationship between the s-SAPCPTS scores and demographics (i.e., age, sex, final academic degree (non-postgraduate degrees or postgraduate degrees), and practice environment). In an online anonymous survey, 110 Japanese physical therapists completed the self-reported adherence to patient-centered physical therapy and provided data on their demographics. Through the Rasch analysis, items were excluded in a stepwise manner, until certain pre-established criteria of the unidimensionality were satisfied. Subsequently, a conversion table for the Rasch score was developed. Furthermore, multiple regression analysis was conducted by using the independent variables age, sex, and final academic degree. Using the Kruskal-Wallis test, we compared the Rasch s-SAPCPTS scores among four practice environments. Consequently, the seven-item s-SAPCPTS was developed by excluding seven items through the Rasch analysis. Postgraduate degree was a statistically significant contributing factor for Rasch s-SAPCPTS scores (p = 0.038, ß = 0.20). The Kruskal-Wallis test demonstrated statistically significant differences in the Rasch s-SAPCPTS scores among the four practice environments (p = 0.006). In conclusion, the seven-item s-SAPCPTS was developed with the preliminary evidence of construct validity. It was also found that the final academic degree and practice environment could be the contributing factors of s-SAPCPTS scores.


Assuntos
Fisioterapeutas , Estudos Transversais , Humanos , Japão , Assistência Centrada no Paciente , Modalidades de Fisioterapia , Psicometria , Reprodutibilidade dos Testes , Autorrelato
3.
Medicine (Baltimore) ; 100(38): e27245, 2021 Sep 24.
Artigo em Inglês | MEDLINE | ID: mdl-34559126

RESUMO

ABSTRACT: When developing a new medical device, it is essential to assess the usability of such a device through various stakeholders.This study assessed the usability of pain medical devices through a Delphi survey administered to physiatrists and physiotherapists.A Delphi survey was conducted on the problems and improvements in hardware and software for a panel consisting of 10 physiatrists and 10 physiotherapists. A total of 3 rounds of surveys were conducted, and the third round of survey was confirmed through a Likert scale (1 = strongly agree to 5 = strongly disagree).The 2 groups generally had a common perception of the problems and improvements in pain medical devices. However, the physiatrist group mostly identified problems such as linking patient information, whereas the physiotherapist group deemed hardware problems such as device weight or connection cables as being more important (mean [standard deviation]; physiatrist, hardware 2.90 [0.93], software 2.28 [0.91] / physiotherapist, hardware 3.04 [0.84], software 3.03 [1.13]).To date, analysis has not been conducted by dividing the focus of various stakeholders using pain medical devices. The difference in view of the usability of these 2 stakeholder groups should be considered when improving the hardware or software of pain medical devices in the future. Further research is warranted to investigate other stakeholders such as patients and device developers to improve the devices.


Assuntos
Desenho de Equipamento/normas , Manejo da Dor/instrumentação , Design Centrado no Usuário , Adulto , Técnica Delfos , Desenho de Equipamento/estatística & dados numéricos , Feminino , Humanos , Masculino , Manejo da Dor/normas , Manejo da Dor/tendências , Fisiatras/tendências , Fisioterapeutas/tendências , República da Coreia , Estatísticas não Paramétricas , Inquéritos e Questionários
4.
Pediatr Endocrinol Diabetes Metab ; 27(2): 109-116, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34514767

RESUMO

INTRODUCTION: Physiotherapists may play an important part in raising the awareness of patients and society as regards type 1 diabetes (T1D) and the prevention of concomitant diseases. The objective of the paper is to assess the level of T1D education among physiotherapists versus selected factors. MATERIAL AND METHODS: The diagnostic poll used an original questionnaire with personal questions and a test (17 single-select questions). The respondents included 103 physiotherapists from Poland, aged between 20 and 50, with 64.1% women and 35.9% men. RESULTS: When asked about the sources of T1D education, 72 respondents (36.5%) selected websites, 71 (36%) medical literature, 36 (18.3%) university classes and 18 (9.1%) a physician. As far as the test results for the total knowledge of T1D was concerned, the knowledge level was medium for the majority (69 (67%)) of the respondents, high for 28 respondents (27.2%) and low for six respondents (5,8%). A statistically significant correlation was observed between the years of working as a physiotherapist, and the level of T1D knowledge (r = 0.196, p = 0.047). The respondents that had been on the job longer had more answers that were correct. The level of knowledge was not correlated with age (r = 0.113, p = 0.258) or sex (r = 0.142, p = 0.344) or the subjective self-assessment of knowledge of the respondents (r = -0.04, p = 0.685). CONCLUSIONS: The majority of the respondents had a moderate level of diabetes education. The level of the T1D knowledge of physiotherapists was primarily determined by their number of years on the job. Age and sex of the respondents had no impact on the level of their knowledge of diabetes (T1D).


Assuntos
Diabetes Mellitus Tipo 1 , Fisioterapeutas , Adulto , Diabetes Mellitus Tipo 1/terapia , Feminino , Educação em Saúde , Conhecimentos, Atitudes e Prática em Saúde , Humanos , Masculino , Pessoa de Meia-Idade , Polônia , Inquéritos e Questionários , Adulto Jovem
5.
Prim Health Care Res Dev ; 22: e41, 2021 09 13.
Artigo em Inglês | MEDLINE | ID: mdl-34515023

RESUMO

AIM: The aim of this study was to explore the perspectives of physiotherapists in four selected regions of sub-Saharan Africa regarding health system challenges impacting the integration of physiotherapy-led falls prevention services in the primary care of persons living with HIV (PLWH). BACKGROUND: Falls may pose a significant problem among younger PLWH in low- and middle-income countries. Physiotherapists' role in optimising function and quality of life can do much in the prevention of falls in PLWH and reducing the harm that results. However, falls prevention strategies have not been implemented effectively especially in primary health care settings in sub-Saharan Africa. Physiotherapists' account of the health system challenges they encounter may provide insights into potential strategies that may be considered in optimising fall prevention for PLWH in poorly resourced settings. METHODS: A descriptive qualitative study was conducted in selected urban districts in the capital cities of four sub-Saharan African countries. In-depth interviews were conducted with 21 purposively selected physiotherapists involved in the primary care of PLWH. Audio recordings of interviews were transcribed verbatim and analysed using deductive thematic content analysis. FINDINGS: The main results are presented in the theme 'Health care system challenges' and in nine categories informed by the WHO health system framework: lack of policies and clinical practice guidelines, shortage/Inaccessible falls prevention services, inadequate human resource, physiotherapists not adequately equipped in falls prevention, inaccessible/No facilities for BMD measurement, inefficient data capturing systems, lack of evidence regarding falls among PLWH, unclear physiotherapy role descriptions, inefficient referral system. Physiotherapists highlighted the need for more information and research regarding fall prevention for PLWH, promote their role in the primary care of PLWH and adopt a patient-centred approach to fall prevention.


Assuntos
Infecções por HIV , Fisioterapeutas , África ao Sul do Saara , Infecções por HIV/prevenção & controle , Humanos , Pesquisa Qualitativa , Qualidade de Vida
6.
J Physiother ; 67(4): 291-297, 2021 10.
Artigo em Inglês | MEDLINE | ID: mdl-34521586

RESUMO

QUESTION: What are the core capabilities that physiotherapists need in order to deliver quality care via videoconferencing? DESIGN: A three-round modified e-Delphi survey. PARTICIPANTS: An international Delphi panel comprising a Steering Group and experts in the field, including physiotherapy researchers, physiotherapy clinicians, representatives of physiotherapy organisations, and consumers. METHODS: The draft framework was developed by the research team and Steering Group, based on relevant documents identified within the literature. The panel considered a draft framework of 73 specific capabilities mapped across eight domains. Over three rounds, panellists rated their agreement (Likert or numerical rating scales) on whether each capability was essential (core) for physiotherapists to deliver quality care via videoconferencing. Those capabilities achieving consensus, defined as 75% of the panel ratings being ≥ 7 out of 10 in Round 3, were retained. RESULTS: A total of 130 panellists from 32 countries participated in Round 1, with retention rates of 65% and 60% in Rounds 2 and 3, respectively. The final framework comprised 60 capabilities across seven domains: compliance (n = 7 capabilities); patient privacy and confidentiality (n = 4); patient safety (n = 7); technology skills (n = 7); telehealth delivery (n = 16); assessment and diagnosis (n = 7); and care planning and management (n = 12). CONCLUSION: This framework outlines the specific core capabilities required of physiotherapists to provide quality care via videoconferencing. The core capability framework provides guidance for physiotherapists to deliver care via videoconferencing and will help inform future development of physiotherapy curricula and professional development initiatives in the delivery of telehealth.


Assuntos
Fisioterapeutas , Técnica Delfos , Humanos , Modalidades de Fisioterapia , Qualidade da Assistência à Saúde , Comunicação por Videoconferência
7.
BMJ Open ; 11(9): e053004, 2021 09 07.
Artigo em Inglês | MEDLINE | ID: mdl-34493525

RESUMO

OBJECTIVES: To assess the effectiveness and cost-effectiveness of a single session compared with multiple sessions of education and exercise for older adults with spinal pain treated conservatively in an advanced practice physiotherapy model of care. METHODS AND ANALYSIS: In this pragmatic randomised controlled trial, 152 older adults (≥65 years old) with neck or back pain initially referred for a consultation in neurosurgery, but treated conservatively, will be recruited through the advanced practice physiotherapy neurosurgery CareAxis programme in the Montreal region (Quebec, Canada). In the CareAxis programme, older patients with spinal pain are triaged by an advance practice physiotherapist and are offered conservative care and only potential surgical candidates are referred to a neurosurgeon. Participants will be randomised into one of two arms: 1-a single session or 2-multiple sessions (6 sessions over 12 weeks) of education and exercise with the advance practice physiotherapist (1:1 ratio). The primary outcome measure will be the Brief Pain Inventory (pain severity and interference subscales). Secondary measures will include self-reported disability (the Neck Disability Index or Oswestry Disability Index), the Pain Catastrophizing Scale, satisfaction with care questionnaires (9-item Visit-specific Satisfaction Questionnaire and MedRisk), and the EQ-5D-5L. Participants' healthcare resources use and related costs will be measured. Outcomes will be collected at baseline and at 6, 12 and 26 weeks after enrolment. Intention-to-treat analyses will be performed, and repeated mixed-model analysis of variance will assess differences between treatment arms. Cost-utility analyses will be conducted from the perspective of the healthcare system. ETHICS AND DISSEMINATION: Ethics approval has been obtained from the Comité d'éthique de la recherche du CIUSS de l'Est-de-l'Île-de-Montréal (FWA00001935 and IRB00002087). Results of this study will be presented to different stakeholders, published in peer-reviewed journals and presented at international conferences. PROTOCOL VERSION: V.4 August 2021. TRIAL REGISTRATION NUMBER: NCT04868591; Pre-results.


Assuntos
Fisioterapeutas , Modalidades de Fisioterapia , Idoso , Análise Custo-Benefício , Exercício Físico , Humanos , Dor , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Inquéritos e Questionários
8.
Artigo em Inglês | MEDLINE | ID: mdl-34574600

RESUMO

The psychosocial impact of the work environment during the COVID-19 pandemic on health professionals is a growing issue. The present study examined specific psychosocial work environment indicators during the COVID-19 pandemic, through a multiple regression model of a self-administered cross-sectional online survey in a cohort of physical therapists from a region of Southern Italy from March 2020 to May 2021. The questionnaire contained items on work and healthcare issues related to COVID-19. Eighty physical therapists (29 male and 51 female), mean age 32.5 ± 10.1 years, were involved in this survey. The multiple regression analysis showed that "management activity" was significantly correlated to "therapist frustration" during the COVID-19 pandemic (ΔR2 = 0.16; p < 0.03). Findings of this study underline the importance of a healthy psychosocial work environment to enhance job satisfaction of all health professionals and to avoid role conflict and burnout syndrome during the COVID-19 pandemic.


Assuntos
Esgotamento Profissional , COVID-19 , Fisioterapeutas , Angústia Psicológica , Adulto , Esgotamento Profissional/epidemiologia , Estudos Transversais , Feminino , Humanos , Itália/epidemiologia , Masculino , Pandemias , Percepção , SARS-CoV-2 , Inquéritos e Questionários , Adulto Jovem
9.
Int J Qual Health Care ; 33(3)2021 Sep 04.
Artigo em Inglês | MEDLINE | ID: mdl-34428299

RESUMO

OBJECTIVE: The objective of this study was to evaluate an extended role for the physiotherapist in primary care in referring patients to plain X-ray. METHODS: This prospective cohort study was set in a single region in Sweden. It included 20 physiotherapists who were educated in a 1-day training in performing referral to X-ray, along with 107 patients with musculoskeletal disorders who were referred to X-ray. We evaluated referral quality and patient and physiotherapist satisfaction and calculated healthcare and patient costs. RESULTS: All referrals fulfilled the basic requirements of quality, and 78% were classified as good, fulfilling all criteria. Both patients and physiotherapists were satisfied with the extended role for the physiotherapist that decreased the waiting time to diagnosis and to adequate treatment. Costs were reduced for patients (by €53/patient) and healthcare (by €6286.2/107 patients). The cost to visit a physician was twice that of a physiotherapist visit. CONCLUSIONS: An extended role for physiotherapists in primary care in referring patients to X-ray was effective and safe for patients and reduced costs for patients and for healthcare. Physiotherapists in primary care were able to refer patients to X-ray after a 1 day of training, and the extended role freed up 45 min of physician time for each patient with a musculoskeletal disorder in need of an X-ray.


Assuntos
Fisioterapeutas , Humanos , Atenção Primária à Saúde , Estudos Prospectivos , Encaminhamento e Consulta , Raios X
10.
Artigo em Inglês | MEDLINE | ID: mdl-34444118

RESUMO

This qualitative exploratory study addressed the perspectives of Spanish physical therapists (PTs) regarding (a) the organization of their work during the first wave of the pandemic; (b) their role within the intensive care units (ICUs); (c) management of COVID-19 survivors; (d) potential future challenges identified for the physical therapy profession. Thirty PTs who had worked at a National Public Hospital in Madrid during the first COVID-19 outbreak were recruited by purposeful sampling and snowball techniques. In-depth interviews and researcher field notes were used to collect data. Interviews were transcribed verbatim. An inductive thematic analysis was used to identify emerging themes. After identifying 1110 codes, four themes emerged. Throughout the first wave of the pandemic, the role and work of PTs in hospitals experienced a change. These changes took place at their organizational level, affecting the distribution of PTs in the hospital, and the role of PTs in front-line COVID units such as ICUs, as well as direct management of outpatients at the onset of the pandemic, and after discharge from the ICUs. This situation has led to PTs foreseeing challenges and developing new expectations concerning their role and the physical therapy profession in the future.


Assuntos
COVID-19 , Fisioterapeutas , Humanos , Pandemias , Modalidades de Fisioterapia , Pesquisa Qualitativa , SARS-CoV-2 , Espanha/epidemiologia
11.
Artigo em Inglês | MEDLINE | ID: mdl-34444477

RESUMO

The rehabilitation needs of COVID-19 survivors are increasingly recognized, with a focus on combating respiratory and neuromuscular dysfunctions. The aim here was to explore the perception of Austrian physiotherapists and physiotherapy students on post-COVID-19 rehabilitation care and to identify barriers for the application of sufficient rehabilitation. We analysed current knowledge and practical skills in respiratory physiotherapy, performing a cross-sectional national survey among physiotherapists working in outpatient settings and physiotherapy students in their last academic year of bachelor-level education in Austria. Out of 255 survey participants, one-third already had inquiries to treat post-COVID-19 patients, and the majority of respondents expected a further increased inflow of patients with rehabilitation needs (64.2%). Only 11.2% of respondents reported feeling sufficiently informed about post-COVID-19 rehabilitation. A total of 68.2% of students and up to 48.1% of physiotherapists favoured a COVID-19-specific adaptation already in the basic academic education, and 74.1% of survey participants indicated interest in attending specific training. Concerning respiratory physiotherapy, our data showed discrepancies between the estimation of the importance of specific examination and treatment techniques and the level of current experience. There is a clear lack of experience in implementing effective device-based respiratory therapy. Our data indicate an urgent need to develop new education and training programs with a focus on the interdisciplinary rehabilitation of patients with post-COVID-19 syndrome.


Assuntos
COVID-19 , Fisioterapeutas , Áustria , COVID-19/complicações , Estudos Transversais , Humanos , Percepção , Modalidades de Fisioterapia , SARS-CoV-2 , Estudantes
12.
Pediatr Phys Ther ; 33(4): 251-258, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34417425

RESUMO

PURPOSE: To describe the scope of practice of physical therapists (PTs) working with children worldwide. METHODS: PTs working with children in any context and country were invited via social media and email campaigns to complete an online survey containing 42 questions about work context and service delivery. Descriptive statistics were computed. RESULTS: Of the 1133 participants from 77 countries, most worked with children full-time (51.8%), and in government-funded work settings (57.5%). Modalities of access to services varied across countries, work settings, and children's conditions, yet 46.7% of PTs reported that most children had direct access to services. PTs provided services to children with a variety of conditions, with cerebral palsy being most reported (83.3%). Interventions focused primarily on improving body function (42.0%) and on providing face-to-face individual treatment (96.6%). CONCLUSIONS: This study provides an international portrait of pediatric PT practice and illustrates the diversity of services in pediatric PT.


Assuntos
Paralisia Cerebral , Fisioterapeutas , Criança , Humanos , Inquéritos e Questionários
14.
BMC Musculoskelet Disord ; 22(1): 697, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34399702

RESUMO

BACKGROUND: Arthroscopic surgery for femoroacetabular impingement syndrome (FAI) is known to lead to self-reported symptom improvement. In the context of surgical interventions with known contextual effects and no true sham comparator trials, it is important to ascertain outcomes that are less susceptible to placebo effects. The primary aim of this trial was to determine if study participants with FAI who have hip arthroscopy demonstrate greater improvements in delayed gadolinium-enhanced magnetic resonance imaging (MRI) of cartilage (dGEMRIC) index between baseline and 12 months, compared to participants who undergo physiotherapist-led management. METHODS: Multi-centre, pragmatic, two-arm superiority randomised controlled trial comparing physiotherapist-led management to hip arthroscopy for FAI. FAI participants were recruited from participating orthopaedic surgeons clinics, and randomly allocated to receive either physiotherapist-led conservative care or surgery. The surgical intervention was arthroscopic FAI surgery. The physiotherapist-led conservative management was an individualised physiotherapy program, named Personalised Hip Therapy (PHT). The primary outcome measure was change in dGEMRIC score between baseline and 12 months. Secondary outcomes included a range of patient-reported outcomes and structural measures relevant to FAI pathoanatomy and hip osteoarthritis development. Interventions were compared by intention-to-treat analysis. RESULTS: Ninety-nine participants were recruited, of mean age 33 years and 58% male. Primary outcome data were available for 53 participants (27 in surgical group, 26 in PHT). The adjusted group difference in change at 12 months in dGEMRIC was -59 ms (95%CI - 137.9 to - 19.6) (p = 0.14) favouring PHT. Hip-related quality of life (iHOT-33) showed improvements in both groups with the adjusted between-group difference at 12 months showing a statistically and clinically important improvement in arthroscopy of 14 units (95% CI 5.6 to 23.9) (p = 0.003). CONCLUSION: The primary outcome of dGEMRIC showed no statistically significant difference between PHT and arthroscopic hip surgery at 12 months of follow-up. Patients treated with surgery reported greater benefits in symptoms at 12 months compared to PHT, but these benefits are not explained by better hip cartilage metabolism. TRIAL REGISTRATION DETAILS: Australia New Zealand Clinical Trials Registry reference: ACTRN12615001177549 . Trial registered 2/11/2015.


Assuntos
Impacto Femoroacetabular , Fisioterapeutas , Adulto , Artroscopia , Austrália , Feminino , Impacto Femoroacetabular/diagnóstico por imagem , Impacto Femoroacetabular/cirurgia , Articulação do Quadril/diagnóstico por imagem , Articulação do Quadril/cirurgia , Humanos , Masculino , Qualidade de Vida , Resultado do Tratamento
15.
BMC Health Serv Res ; 21(1): 877, 2021 Aug 26.
Artigo em Inglês | MEDLINE | ID: mdl-34445993

RESUMO

BACKGROUND: Reablement is a municipal service given to patients at home. The purpose of the service is to assist recovery after hospital discharges or other sudden changes in a patient's functional level. The service is often provided by a team of nurses, physiotherapists, and occupational therapists. The purpose of this paper is to compare users of this service to users who receive traditional home care services. Outcomes to be measured are risk of long-term care and mortality. METHODS: All users of health and care services in a Norwegian municipality were eligible for inclusion. Data was extracted from the local user administrative database. Users were divided in two groups: those who received reablement and those home care users who did not receive reablement service. Propensity score matching was used to match users based on age, sex, and level of functioning in activities of daily living (ADL). Survival analysis was deployed to test if the reablement users had different risk of becoming long-term care users, and whether the mortality rate differed for this group. RESULTS: 153 reablement users were included in the study. These were matched to 153 non-reablement home care users. The groups had similar distributions of age, sex, and level of functioning when starting their service trajectories. Regressions showed that reablement users had lower risk of using long-term care services in the study period (time at risk up to 4 years), and lower mortality. However, none of these estimates were statistically significant. CONCLUSIONS: The study indicates that the reablement users in one municipality had lower use of long -term care and lower mortality when properly estimated, but numbers were too small for statistical significance to be found.


Assuntos
Serviços de Assistência Domiciliar , Fisioterapeutas , Atividades Cotidianas , Humanos , Noruega/epidemiologia , Análise de Sobrevida
16.
Am J Case Rep ; 22: e932212, 2021 Aug 16.
Artigo em Inglês | MEDLINE | ID: mdl-34398869

RESUMO

BACKGROUND Persistent pain is one of the most common reasons individuals seek healthcare in the United States, costing $635 billion annually. At present, the medical literature outlines many treatments for persistent pain. Pain neuroscience education (PNE) is described in the literature as an educational intervention for patients with persistent pain that can be applied by a physical therapist. There is limited research on the application of PNE by a student physical therapist; however, this case report offers a unique opportunity to examine outcomes for this intervention when applied by a student physical therapist in conjunction with manual therapy and therapeutic exercise. CASE REPORT This case report examined the outcomes of PNE for a 65-year-old patient with a long-standing history of low back, cervical, shoulder, knee, and foot pain. Interventions included 7 sessions of PNE over 4 weeks delivered by a student physical therapist, in combination with manual therapy and exercise prescribed by a licensed physical therapist. Outcomes measured were fear avoidance belief questionnaire, visual analog scale, Tampa scale of kinesiophobia, neurophysiology of pain questionnaire, neck disability index, and Oswestry disability index. CONCLUSIONS Outcomes included clinically significant decreases in subjective pain level, and kinesiophobia; however, there was only a minimal decrease in fear avoidance and no decrease in perceived disability. This case report provides preliminary evidence that positive outcomes can be achieved when PNE is delivered by a student physical therapist combined with manual therapy and therapeutic exercise from an expert clinician for patients with persistent musculoskeletal pain.


Assuntos
Dor Musculoesquelética , Fisioterapeutas , Idoso , Humanos , Dor Musculoesquelética/terapia , Medição da Dor , Estudantes , Resultado do Tratamento
17.
Artigo em Inglês | MEDLINE | ID: mdl-34444233

RESUMO

(1) Background: It is important to explore the ethical situations that physiotherapy students encountered in their clinical practices. (2) Methods: Qualitative, explorative, descriptive study. The participants included third-year physiotherapy students. They had to write five narratives about ethical situations encountered in their clinical practices. Krippendorff's method for qualitative content analysis was used to cluster units within the data to identify emergent themes. The study protocol was approved by the authors' University Ethic Committee of Human Research (H1515588244257). (3) Result: 280 narratives were reported by 64 students (23.34 ± 4.20 years, 59% women). Eight categories were identified from the qualitative analysis of the data: (a) professional responsibility, (b) professional competence, (c), beneficence, (d) equality and justice, (e) autonomy, (f) confidentiality, (g) respect for privacy, and (h) sincerity. All participants were informed and provided written informed consent. (4) Conclusions: Ethical principles were frequently violated in physiotherapy. Experiences of physiotherapy students must be examined to tailor educational interventions prior to their initiation into practice. Ethics education is needed in workplaces and should be increased in basic education. Facilitating the ethical awareness of future physiotherapists is a challenge for university teachers who provide ethical competence training.


Assuntos
Fisioterapeutas , Estudantes de Enfermagem , Feminino , Humanos , Masculino , Modalidades de Fisioterapia , Competência Profissional , Pesquisa Qualitativa
18.
Trials ; 22(1): 575, 2021 Aug 28.
Artigo em Inglês | MEDLINE | ID: mdl-34454573

RESUMO

BACKGROUND: Stroke results in varying physical, cognitive, emotional and/or social disabilities in the short and long term alike. Motor impairments are important, persistent consequences of stroke and include, among others, decreased respiratory muscle function, decreased ability to expand the thorax and postural dysfunction. These deficits affect the patient's ability to perform daily activities, produce fatigue and reduce endurance and quality of life. Inspiratory muscle training (IMT) aims to improve the strength and endurance of the diaphragm and the external intercostal muscles. The objectives of this study are to investigate the effect of 3 weeks of IMT on (i) maximal inspiratory pressure (MIP) in adults having suffered a stroke, as well as (ii) functional activities and expiratory measurements. METHODS/DESIGN: This is a randomised controlled trial (RCT) comparing IMT with conventional neurorehabilitation (usual practice). The trial will include 80 patients with reduced MIP hospitalised at a specialised neurorehabilitation hospital in Denmark. The intervention group will receive IMT sessions, exercising at 30% of MIP. Patients in the intervention group will perform two daily sessions (one session of IMT with Threshold IMT consisting of two times 15 inspirations at normal breathing rhythm (5-10 min)), 7 days a week for 3 weeks. Training can be with or without physiotherapist supervision. STUDY OUTCOMES: MIP assessed by the Power Breath, Functional Independence Measurement, The 6-min walk test, the Fatigue Severity Scale and average voice volume. Expiratory function will be assessed using spirometry. All assessments will be conducted at baseline and 3 weeks (at termination of the intervention) and 3 months after the intervention has concluded. DISCUSSION: IMT is a promising and partly self-managed tool for rehabilitation to improve respiratory function. The introduction of IMT in combination with traditional physical therapy may enhance faster recovery after stroke and may at the same time demand little personnel resources to increase training intensity. This trial will provide further evidence of IMT to clinicians, patients and health managers. Hereby, this study accepts the call for further research. TRIAL REGISTRATION: ClinicalTrials.gov NCT04686019 . Registered on 28 December 2020.


Assuntos
Fisioterapeutas , Acidente Vascular Cerebral , Adulto , Exercício Físico , Humanos , Modalidades de Fisioterapia , Ensaios Clínicos Controlados Aleatórios como Assunto , Músculos Respiratórios , Acidente Vascular Cerebral/diagnóstico
19.
Pediatr Phys Ther ; 33(4): 237-244, 2021 10 01.
Artigo em Inglês | MEDLINE | ID: mdl-34323864

RESUMO

PURPOSE: To describe the characteristics of pediatric physical therapy telehealth practice during COVID-19. METHODS: An anonymous, online survey was distributed to pediatric physical therapists (PTs) in the United States who transitioned to telehealth during COVID-19. RESULTS: Two hundred five respondents completed all quantitative questions. Ninety-six percent reported never providing telehealth previously and only 14.6% had formal training. More than 35% reported 76% to 100% of their caseload transitioned to telehealth. Most respondents perceived that telehealth was somewhat or very effective for caregivers (90.3%) and children (77.1%) and felt somewhat or very confident providing telehealth (73.2%). However, those practicing in school-based settings rated perceived effectiveness and confidence lower than PTs in other settings. Ultimately, 76.1% of respondents would consider providing telehealth in the future. CONCLUSION: The forced transition of pediatric PTs to the telehealth model during the COVID-19 pandemic resulted in positive experiences for many, supporting wider adoption in the future.


Assuntos
COVID-19 , Fisioterapeutas , Telemedicina , Criança , Humanos , Pandemias , SARS-CoV-2 , Inquéritos e Questionários , Estados Unidos
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