RESUMEN
Problem: Like most low- and middle-income countries, Viet Nam has a scarcity of rehabilitation professionals and lacks training programmes that meet international standards. Approach: In 2018, four Vietnamese medical universities, the Université Catholique de Louvain, the Université Libre de Bruxelles, the Humanity & Inclusion charity and World Physiotherapy agreed to collaborate on strengthening pre-service education for physiotherapists in the country. Local setting: Viet Nam has a favourable environment for nurturing rehabilitation services and education: development funds have been available; government investment is increasing; and rehabilitation education has existed for many decades. Relevant changes: The collaboration resulted in the establishment of: (i) a 4-year, competency-based, entry-level curriculum for physiotherapists (bachelor's degree); (ii) opportunities for continuing professional development; (iii) a 2-year master's programme for physiotherapy lecturers and clinical supervisors; and (iv) a national physiotherapy association. In addition, four students were supported in studying for PhD degrees. Strong collaboration and comprehensive and complementary interventions have laid the foundations for sustainable, high-quality, educational programmes for physiotherapists, which will improve access to, and the standard of, rehabilitation services in Viet Nam, thereby leading to better patient outcomes. Lessons learnt: Curricula for entry-level physiotherapy programmes should be competency-based, be actively managed by national educators and meet international standards while being responsive to local priorities. To strengthen the rehabilitation workforce, educators involved in teaching and supervising training programmes should have the skills and knowledge required. A national professional physiotherapy association should be established to provide continuing professional development for physiotherapists and to take part in international collaborations.
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Fisioterapeutas , Humanos , Vietnam , Curriculum , Recursos Humanos , EstudiantesRESUMEN
OBJECTIVE: The purpose of this study was to measure effects of connective tissue massage (CTM) on the autonomic nervous system using thermography and physiological measurements. METHODS: A repeated-measures design was used. The setting was a university laboratory. Skin temperature at the site of massage, blood pressure, heart rate, and dorsal foot temperature were measured in 8 healthy participants before CTM, immediately after, and at 15-minute intervals for 1 hour. RESULTS: The effect of CTM on skin temperature was statistically significant, P = .011. Post hoc pairwise comparisons revealed that the 15-, 30-, 45-, and 60-minute data all differed significantly from the pre-CTM data (all P < .05) and also from the immediately post-CTM data (all P < .05). For diastolic blood pressure, the main analysis of variance showed a statistical significance at P = .062. For other variables, there was no evidence for an effect. CONCLUSIONS: Evidence was seen of some effects of CTM on autonomic function. This is information that will increase our knowledge of how CTM affects the autonomic nervous system.
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Sistema Nervioso Autónomo/fisiología , Tejido Conectivo , Masaje , Adulto , Dorso , Presión Sanguínea/fisiología , Femenino , Pie , Frecuencia Cardíaca/fisiología , Humanos , Persona de Mediana Edad , Temperatura Cutánea/fisiología , Termografía , Adulto JovenRESUMEN
Connective tissue manipulation or connective tissue massage (bindegewebsmassage) is a manual reflex therapy in that it is applied with the therapist's hands which are in contact with the patient's skin. The assessment of the patient and the clinical decision-making that directs treatment is based on a theoretical model that assumes a reflex effect on the autonomic nervous system which is induced by manipulating the fascial layers within and beneath the skin to stimulate cutaneo-visceral reflexes. This paper reviews the literature and current research findings to establish the theoretical framework for CTM and the evidence for its clinical effects. The rationale for the principles of treatment are discussed and the evidence for the clinical effectiveness assessed through an analytical review of the clinical research.