[Physiotherapy for juvenile idiopathic arthritis].

Science.gov (United States)

Spamer, M; Georgi, M; Häfner, R; Händel, H; König, M; Haas, J-P

2012-07-01

Control of disease activity and recovery of function are major issues in the treatment of children and adolescents suffering from juvenile idiopathic arthritis (JIA). Functional therapies including physiotherapy are important components in the multidisciplinary teamwork and each phase of the disease requires different strategies. While in the active phase of the disease pain alleviation is the main focus, the inactive phase requires strategies for improving motility and function. During remission the aim is to regain general fitness by sports activities. These phase adapted strategies must be individually designed and usually require a combination of different measures including physiotherapy, occupational therapy, massage as well as other physical procedures and sport therapy. There are only few controlled studies investigating the effectiveness of physical therapies in JIA and many strategies are derived from long-standing experience. New results from physiology and sport sciences have contributed to the development in recent years. This report summarizes the basics and main strategies of physical therapy in JIA.

Hope and self-regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior.

NARCIS (Netherlands)

Poels, K.; Dewitte, S.

2008-01-01

This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

Hope and self regulatory goals applied to an advertising context : promoting prevention stimulates goal-directed behavior

NARCIS (Netherlands)

Poels, K.; Dewitte, S.; Astregaard, S.; Dwight, M.

2007-01-01

This article proposes the existence of two types of hope which differ in terms of self-regulatory goals: prevention hope and promotion hope. Consistent with the functional emotion approach and regulatory focus theory, we show that prevention hope generates more goal-directed behavior compared to

Physical function in hospice patients and physiotherapy interventions: a profile of hospice physiotherapy.

Science.gov (United States)

Cobbe, Sinead; Kennedy, Norelee

2012-07-01

There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally. The study design consisted of a retrospective chart audit over 6 months. The study took place at a specialist palliative care inpatient unit (hospice) in Limerick, Ireland. All patients were discharged (through death or discharge onwards) from January to June 2010. The Edmonton Functional Assessment Tool (EFAT-2) was used as an outcome measure. Sixty-five percent were referred for physiotherapy; 58% (n=144) were assessed and treated. A wide range of patients was referred (mean functional score 11, range 1-23, SD 5). Rehabilitation activities were widespread: 48% with more than one functional score recorded made improvements; 53% of physiotherapy patients were eventually discharged home; 47% of physiotherapy patients died, of whom 52% received physiotherapy in the last week of life. The median physiotherapy program lasted 11 days (range 1-186, SD 22) whereas the median number of treatments was four (range 1-99, SD 10). The most common interventions were gait re-education (67%), transfer training (58%), and exercises (53%). One third of treatment attempts were unsuccessful because of the unavailability/unsuitability of patients. Challenges for physiotherapists included frequent suspension of treatment and large functional fluctuations in patients. There was a high referral rate to physiotherapy in this hospice. Functional changes in hospice patients were mapped, showing that physiotherapy involved both rehabilitative and quality of life/supportive measures. The most common treatments were physical activity interventions.

Physiotherapy in a whiplash injury: a case report

Directory of Open Access Journals (Sweden)

C. Van Eck

2008-01-01

Full Text Available Study Design: Case ReportObjectives: To describe physiotherapy intervention in an individual with asuspected whiplash injury.Background: The patient was a 29-year old male with complaints of neckpain and tightness following a motor vehicle accident. Methods and Measures: The focus of the case study is physiotherapyassessment and intervention in a stage II whiplash injury. Results: Following intervention, positive changes occurred in outcome measures such as pain, work status and activities of daily living. Conclusion: Physiotherapy intervention is successful in addressing whiplash associated disorders.

Moving forth: Imagining physiotherapy education differently.

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Barradell, Sarah

2017-06-01

Contemporary and future physiotherapists are, and will be, presented with challenges different to their forebears. Yet, physiotherapy tends to remain tied to historical ways of seeing the world: these are passed down to generations of physiotherapy graduates. These historical perspectives privilege particular knowledge and skills so that students gain competency for graduation. However, contemporary practice is inherently more complex than the focus on knowledge and skills would have us believe. Professional life requires students to develop the capability to deal with uncertain and diverse futures. This paper argues that physiotherapy needs to think differently about entry-level education; the focus on knowledge and competencies that has been the mainstay in physiotherapy education must now be understood in the context of an education that embraces knowing, doing, being. Two educational frameworks are offered in support of this argument - threshold concepts and ways of thinking and practicing (WTP). Taken together, these ideas can assist physiotherapy to think in fresh ways about disciplinary learning. Threshold concepts and WTP help to understand the nature of a discipline: its behaviors, culture, discourses, and methods. By interrogating the discursive aspects of the discipline, physiotherapy educators will be better placed to provide more relevant preparation for practice.

Physical function in hospice patients and physiotherapy interventions: a profile of hospice physiotherapy.

LENUS (Irish Health Repository)

Cobbe, Sinead

2012-07-01

Abstract Objective: There is a dearth of international research on hospice physiotherapy. This study aims to profile hospice physiotherapy in an Irish setting in order to inform practice internationally. Design: The study design consisted of a retrospective chart audit over 6 months. Setting: The study took place at a specialist palliative care inpatient unit (hospice) in Limerick, Ireland. Participants: All patients were discharged (through death or discharge onwards) from January to June 2010. Outcome measure: The Edmonton Functional Assessment Tool (EFAT-2) was used as an outcome measure. Results: Sixty-five percent were referred for physiotherapy; 58% (n=144) were assessed and treated. A wide range of patients was referred (mean functional score 11, range 1-23, SD 5). Rehabilitation activities were widespread: 48% with more than one functional score recorded made improvements; 53% of physiotherapy patients were eventually discharged home; 47% of physiotherapy patients died, of whom 52% received physiotherapy in the last week of life. The median physiotherapy program lasted 11 days (range 1-186, SD 22) whereas the median number of treatments was four (range 1-99, SD 10). The most common interventions were gait re-education (67%), transfer training (58%), and exercises (53%). One third of treatment attempts were unsuccessful because of the unavailability\\/unsuitability of patients. Challenges for physiotherapists included frequent suspension of treatment and large functional fluctuations in patients. Conclusion: There was a high referral rate to physiotherapy in this hospice. Functional changes in hospice patients were mapped, showing that physiotherapy involved both rehabilitative and quality of life\\/supportive measures. The most common treatments were physical activity interventions.

Get a taste of your goals: promoting motive-goal congruence through affect-focus goal fantasy.

Science.gov (United States)

Job, Veronika; Brandstätter, Veronika

2009-10-01

Studies show that motive-goal congruence is an important predictor of well-being (Baumann, Kaschel, & Kuhl, 2005; Brunstein, Schultheiss, & Grässmann, 1998). However, little is known about the factors that promote congruence between implicit motives and goals. Relying on McClelland's (1985) concept of implicit motives and the theory of fantasy realization (Oettingen, 1999), we postulated that goal fantasies focusing on motive-specific affective incentives promote motive-congruent goal setting. This hypothesis was tested in 3 experimental studies. In Study 1 (n=46) and Study 2 (n=48), participants were asked to select goals in a hypothetical scenario. In Study 3 (n=179), they rated their commitment to personal goals for their actual life situation. The results of all 3 studies supported our hypothesis that participants who focus on motive-specific affective incentives in their goal fantasies set their goals in line with their corresponding implicit motive dispositions.

Physiotherapy and Mental Health

OpenAIRE

Probst, Michel

2017-01-01

Physiotherapy in mental health care and psychiatry is a recognized specialty within physiotherapy. It offers a rich variety of observational and evaluation tools as well as a range of interventions that are related to the patient’s physical and mental health problems based on evidence-based literature and a 50-year history. Physiotherapy in mental health care addresses human movement, function, physical activity and exercise in individual and group therapeutic settings. Additionally, it conne...

Teaching physiotherapy skills in culturally-diverse classes

Directory of Open Access Journals (Sweden)

Grimmer-Somers Karen

2011-06-01

Full Text Available Abstract Background Cultural competence, the ability to work in cross-cultural situations, has been acknowledged as a core skill for physiotherapists and other health professionals. Literature in this area has focused on the rationale for physiotherapists to provide culturally-competent care and the effectiveness of various educational strategies to facilitate the acquisition of knowledge about cultural competence by physiotherapists and physiotherapy students. However, there is a paucity of research on how students with different cultural needs, who are attending one university class, can be accommodated within a framework of learning core physiotherapy skills to achieve professional standards. Results This paper reports on steps which were taken to resolve the specific needs of a culturally-diverse body of first year physiotherapy students, and the impact this had on teaching in a new physiotherapy program located in Greater Western Sydney, Australia. Physiotherapy legislative, accreditation and registration requirements were considered in addition to anti-discrimination legislation and the four ethical principles of decision making. Conclusions Reflection on this issue and the steps taken to resolve it has resulted in the development of a generic framework which focuses on providing quality and equitable physiotherapy education opportunities to all students. This framework is generalizable to other health professions worldwide.

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: an exploratory prospective study.

Science.gov (United States)

Presseau, Justin; Francis, Jill J; Campbell, Neil C; Sniehotta, Falko F

2011-07-15

The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland) to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate). Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively) in behaviour over and above intention and perceived behavioural control. Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better understand health professional behaviour.

Physiotherapy in the care of the dying.

Science.gov (United States)

Davies, B

1980-01-01

This paper examines the role of the physiotherapist in the care of patients whose conditions have reached the point at which intensive active treatment is no longer appropriate and is, therefore, replaced by palliative care directed toward the comfort and support of the patients and their families. The principles of physiotherapy in the delivery of palliative care (modified treatment aims, team approach, and acceptance of death), the possible contexts--both physical and psychological--of effective palliative care, and the attitudinal characteristics of physiotherapists best suited to the implementation of effective palliative care are discussed. The results of a survey of Canadian undergraduate training in physiotherapeutic palliative care, and the present level and method of instruction in this area, are included. The article demonstrates how the physiotherapist can play a central role in the multidisciplinary approach to terminal patient care by assisting patients to make the most of their decreasing potentials, by encouraging them to set short-term goals, and by relieving them of their discomfort.

[The effect of goal framing on the activation of affective representations].

Science.gov (United States)

Takehashi, Hiroki; Karasawa, Kaori

2007-10-01

Guided by regulatory focus theory, this study examined the effects of goal framing on the subjective experience of affect and the accessibility of affective representations. Study I examined lay persons' beliefs concerning the relationship between goal framing and certain kinds of affective experiences. The results indicated that a promotion focus was associated with happiness and disappointment, whereas a prevention focus was associated with relaxation and tension. Study 2 examined the effect of goal framing on the activation of affective representations, and found that a promotion focus activated both gain-related representations (happy and disappointment) and loss-related representations (relaxation and tension), whereas a prevention focus activated only loss-related representations. These results suggest that goal framing activates particular affective representations, and the activated affective representations may influence the interpretation of positive or negative experiences. The discussion considered the function of the activation of affective representations as a mediator between goal framing and its cognitive and behavioral consequences.

Rethinking physical activity communication: using focus groups to understand women's goals, values, and beliefs to improve public health.

Science.gov (United States)

Segar, Michelle; Taber, Jennifer M; Patrick, Heather; Thai, Chan L; Oh, April

2017-05-18

Communication about physical activity (PA) frames PA and influences what it means to people, including the role it plays in their lives. To the extent that PA messages can be designed to reflect outcomes that are relevant to what people most value experiencing and achieving in their daily lives, the more compelling and effective they will be. Aligned with self-determination theory, this study investigated proximal goals and values that are salient in everyday life and how they could be leveraged through new messaging to better support PA participation among women. The present study was designed to examine the nature of women's daily goals and priorities and investigate women's PA beliefs, feelings, and experiences, in order to identify how PA may compete with or facilitate women's daily goals and priorities. Preliminary recommendations are proposed for designing new PA messages that align PA with women's daily goals and desired experiences to better motivate participation. Eight focus groups were conducted with White, Black, and Hispanic/Latina women aged 22-49, stratified by amount of self-reported PA (29 low active participants, 11 high active participants). Respondents discussed their goals, values, and daily priorities along with beliefs, feelings about and experiences being physically active. Data were collected, coded, and analyzed using a thematic analysis strategy to identify emergent themes. Many of the goals and values that both low and high active participants discussed as desiring and valuing map on to key principles of self-determination theory. However, the discussions among low active participants suggested that their beliefs, feelings, experiences, and definitions of PA were in conflict with their proximal goals, values, and priorities, also undermining their psychological needs for autonomy, competence, and relatedness. Findings from this study can be used to inform and evaluate new physical activity communication strategies that leverage more

Goal conflict, goal facilitation, and health professionals' provision of physical activity advice in primary care: An exploratory prospective study

Directory of Open Access Journals (Sweden)

Campbell Neil C

2011-07-01

Full Text Available Abstract Background The theory of planned behaviour has well-evidenced utility in predicting health professional behaviour, but focuses on a single behaviour isolated from the numerous potentially conflicting and facilitating goal-directed behaviours performed alongside. Goal conflict and goal facilitation may influence whether health professionals engage in guideline-recommended behaviours, and may supplement the predictive power of the theory of planned behaviour. We hypothesised that goal facilitation and goal conflict contribute to predicting primary care health professionals' provision of physical activity advice to patients with hypertension, over and above predictors of behaviour from the theory of planned behaviour. Methods Using a prospective predictive design, at baseline we invited a random sample of 606 primary care health professionals from all primary care practices in NHS Grampian and NHS Tayside (Scotland to complete postal questionnaires. Goal facilitation and goal conflict were measured alongside theory of planned behaviour constructs at baseline. At follow-up six months later, participants self-reported the number of patients, out of those seen in the preceding two weeks, to whom they provided physical activity advice. Results Forty-four primary care physicians and nurses completed measures at both time points (7.3% response rate. Goal facilitation and goal conflict improved the prediction of behaviour, accounting for substantial additional variance (5.8% and 8.4%, respectively in behaviour over and above intention and perceived behavioural control. Conclusions Health professionals' provision of physical activity advice in primary care can be predicted by perceptions about how their conflicting and facilitating goal-directed behaviours help and hinder giving advice, over and above theory of planned behaviour constructs. Incorporating features of multiple goal pursuit into the theory of planned behaviour may help to better

Habit strength is predicted by activity dynamics in goal-directed brain systems during training.

Science.gov (United States)

Zwosta, Katharina; Ruge, Hannes; Goschke, Thomas; Wolfensteller, Uta

2018-01-15

Previous neuroscientific research revealed insights into the brain networks supporting goal-directed and habitual behavior, respectively. However, it remains unclear how these contribute to inter-individual differences in habit strength which is relevant for understanding not only normal behavior but also more severe dysregulations between these types of action control, such as in addiction. In the present fMRI study, we trained subjects on approach and avoidance behavior for an extended period of time before testing the habit strength of the acquired stimulus-response associations. We found that stronger habits were associated with a stronger decrease in inferior parietal lobule activity for approach and avoidance behavior and weaker vmPFC activity at the end of training for avoidance behavior, areas associated with the anticipation of outcome identity and value. VmPFC in particular showed markedly different activity dynamics during the training of approach and avoidance behavior. Furthermore, while ongoing training was accompanied by increasing functional connectivity between posterior putamen and premotor cortex, consistent with previous assumptions about the neural basis of increasing habitualization, this was not predictive of later habit strength. Together, our findings suggest that inter-individual differences in habitual behavior are driven by differences in the persistent involvement of brain areas supporting goal-directed behavior during training. Copyright © 2017. Published by Elsevier Inc.

Goal-Directed Decision Making with Spiking Neurons.

Science.gov (United States)

Friedrich, Johannes; Lengyel, Máté

2016-02-03

Behavioral and neuroscientific data on reward-based decision making point to a fundamental distinction between habitual and goal-directed action selection. The formation of habits, which requires simple updating of cached values, has been studied in great detail, and the reward prediction error theory of dopamine function has enjoyed prominent success in accounting for its neural bases. In contrast, the neural circuit mechanisms of goal-directed decision making, requiring extended iterative computations to estimate values online, are still unknown. Here we present a spiking neural network that provably solves the difficult online value estimation problem underlying goal-directed decision making in a near-optimal way and reproduces behavioral as well as neurophysiological experimental data on tasks ranging from simple binary choice to sequential decision making. Our model uses local plasticity rules to learn the synaptic weights of a simple neural network to achieve optimal performance and solves one-step decision-making tasks, commonly considered in neuroeconomics, as well as more challenging sequential decision-making tasks within 1 s. These decision times, and their parametric dependence on task parameters, as well as the final choice probabilities match behavioral data, whereas the evolution of neural activities in the network closely mimics neural responses recorded in frontal cortices during the execution of such tasks. Our theory provides a principled framework to understand the neural underpinning of goal-directed decision making and makes novel predictions for sequential decision-making tasks with multiple rewards. Goal-directed actions requiring prospective planning pervade decision making, but their circuit-level mechanisms remain elusive. We show how a model circuit of biologically realistic spiking neurons can solve this computationally challenging problem in a novel way. The synaptic weights of our network can be learned using local plasticity rules

Physiotherapy in frozen shoulder syndrome - literature review

Directory of Open Access Journals (Sweden)

Katarzyna Korabiusz

2017-08-01

Full Text Available Introduction: The frozen shoulder syndrome is seen as civilization illness. A significant amount of people suffer from it. The frozen shoulder syndrome is one of the most frequent dysfunctions of pectoral girdle. It is seen as a second frequent reason for visits at General Practicioner. There are three stages of this illness, there are a lot of symptoms, but one that occurs most commonly is pain. This illness can be completely curable. Research goal: Goal of this dissertation is a review of literature about available physiotherapy methods used in frozen shoulder syndrome. Conclusion: Kinesiotherapy, kinesiotaping, criotherapy, LASER, Traebert’s currents, iontophoresis, magnetic fields, ultrasounds, massage, manual therapy and combined therapy   are effective physiotherapy methods used in treating frozen shoulder syndrome. Those methods reduce pain indispositions and increase range of movement in shoulder joint.

Social support contributes to resilience among physiotherapy students: a cross sectional survey and focus group study.

Science.gov (United States)

Bíró, Éva; Veres-Balajti, Ilona; Kósa, Karolina

2016-06-01

The present study, taking a resource-oriented approach to mental health, aimed at investigating mental resilience and its determinants among undergraduate physiotherapy students using quantitative and qualitative tools. A questionnaire-based cross-sectional survey supplemented by 2 focus groups. One university in Hungary. 130 physiotherapy students at years 1, 2, and 3. Sense of coherence, a measure of dynamic self-esteem, as well as social support from family and peers were used to assess mental well-being. A screening instrument for psychological morbidity and perceived stress were used as deficiency-oriented approaches. Student opinions were gathered on positive and negative determinants of mental health. Resilience was lower [mean difference 4.8 (95% CI -3.4; 13.1)], and the occurrence of psychological morbidity (32.5% vs. 0%) was higher among female compared to male students. However, the proportion of students fully supported by their peers was higher among females (63% vs. 37.5%). Female students, unlike their male counterparts, experienced higher stress compared to their peers in the general population. Social support declined as students progressed in their studies though this proved to be the most important protective factor for their mental well-being. Results were fed back to the course organizers recommending the implementation of an evidence-based method to improve social support as delineated by the Guide to Community Preventive Services of the US the outcomes of which are to be seen in the future. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Using Student Centred Evaluation for Curriculum Enhancement: An Examination of Undergraduate Physiotherapy Education in Relation to Physical Activity and Exercise Prescription

Science.gov (United States)

O'Donoghue, Grainne; Doody, Catherine; Cusack, Tara

2011-01-01

The purpose of this study was to examine physiotherapy students' perceptions of current education content of entry-level physiotherapy programmes in terms of physical activity (PA) and exercise promotion and prescription (EPP). Sixty-two physiotherapy students from three Irish Universities participated. Three Structured Group Feedback Sessions…

Acute Whiplash Injury Study (AWIS): a protocol for a cluster randomised pilot and feasibility trial of an Active Behavioural Physiotherapy Intervention in an insurance private setting

Science.gov (United States)

Wiangkham, Taweewat; Duda, Joan; Haque, M Sayeed; Price, Jonathan; Rushton, Alison

2016-01-01

Introduction Whiplash-associated disorder (WAD) causes substantial social and economic burden internationally. Up to 60% of patients with WAD progress to chronicity. Research therefore needs to focus on effective management in the acute stage to prevent the development of chronicity. Approximately 93% of patients are classified as WADII (neck complaint and musculoskeletal sign(s)), and in the UK, most are managed in the private sector. In our recent systematic review, a combination of active and behavioural physiotherapy was identified as potentially effective in the acute stage. An Active Behavioural Physiotherapy Intervention (ABPI) was developed through combining empirical (modified Delphi study) and theoretical (social cognitive theory focusing on self-efficacy) evidence. This pilot and feasibility trial has been designed to inform the design of an adequately powered definitive randomised controlled trial. Methods and analysis Two parallel phases. (1) An external pilot and feasibility cluster randomised double-blind (assessor and participants), parallel two-arm (ABPI vs standard physiotherapy) clinical trial to evaluate procedures and feasibility. Six UK private physiotherapy clinics will be recruited and cluster randomised by a computer-generated randomisation sequence. Sixty participants (30 each arm) will be assessed at recruitment (baseline) and at 3 months postbaseline. The planned primary outcome measure is the neck disability index. (2) An embedded exploratory qualitative study using semistructured indepth interviews (n=3–4 physiotherapists) and a focus group (n=6–8 patients) and entailing the recruitment of purposive samples will explore perceptions of the ABPI. Quantitative data will be analysed descriptively. Qualitative data will be coded and analysed deductively (identify themes) and inductively (identify additional themes). Ethics and dissemination This trial is approved by the University of Birmingham Ethics Committee (ERN_15-0542). Trial

The downside of goal-focused leadership: the role of personality in subordinate exhaustion.

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Perry, Sara Jansen; Witt, L A; Penney, Lisa M; Atwater, Leanne

2010-11-01

Exhaustion has a significant impact on employees and organizations, and leader behavior may affect it. We applied conservation of resources theory to test propositions regarding the joint effects of goal-focused leadership (GFL) and personality on employee exhaustion. We proposed that the relationship between GFL and exhaustion depends on employees' standing on both conscientiousness and emotional stability. Specifically, we expected that high-conscientiousness subordinates experience greater compatibility with a goal-focused leader because of their predisposition to direct resources toward achievement and goal setting, resulting in lower exhaustion under such a leader than among low-conscientiousness employees. Furthermore, high emotional stability may compensate for GFL incompatibility among low-conscientiousness employees by providing additional resources to manage GFL. In contrast, employees low on both traits likely experience greater exhaustion under a goal-focused leader compared with other employees. Results revealed a 3-way interaction in 2 independent samples and were generally supportive of our predictions. GFL was associated with heightened exhaustion among individuals in the low-emotional-stability, low-conscientiousness group but not among workers having any other trait combination. (c) 2010 APA, all rights reserved.

Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

Science.gov (United States)

Ghaderi, Fariba; Oskouei, Ali E.

2014-01-01

[Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to identify articles that address physiotherapy for SUI, including the Cochrane Library, Medline, and CINAHL. [Results] According to the articles identified in our databases research, greater improvements in SUI occur when women receive a supervised exercise program of at least three months. The effectiveness of physiotherapy treatment is increased if the exercise program is based on some principles, such as intensity, duration, resembling functional task, and the position in which the exercise for pelvic floor muscles is performed. Biofeedback and electrical stimulation may also be clinically useful and acceptable modalities for some women with SUI. [Conclusion] We concluded that the plan for physiotherapy care should be individualized for each patient and include standard physiotherapy interventions. PMID:25276044

Goal-Directed and Goal-Less Imitation in Autism Spectrum Disorder

Science.gov (United States)

Wild, Kelly S.; Poliakoff, Ellen; Jerrison, Andrew; Gowen, Emma

2012-01-01

To investigate how people with Autism are affected by the presence of goals during imitation, we conducted a study to measure movement kinematics and eye movements during the imitation of goal-directed and goal-less hand movements. Our results showed that a control group imitated changes in movement kinematics and increased the level that they…

Physiotherapy for Women with Stress Urinary Incontinence: A Review Article

OpenAIRE

Ghaderi, Fariba; Oskouei, Ali E.

2014-01-01

[Purpose] This review article is designed to expose physiotherapists to a physiotherapy assessment of stress urinary incontinence (SUI) and the treatment and possibly preventive roles that they might play for women with SUI. Specifically, the goal of this article is to provide an understanding of pelvic floor muscle function and the implications that this function has for physiotherapy treatment by reviewing articles published in this area. [Methods] A range of databases was searched to ident...

Infants Show Stability of Goal-Directed Imitation

Science.gov (United States)

Sakkalou, Elena; Ellis-Davies, Kate; Fowler, Nia C.; Hilbrink, Elma E.; Gattis, Merideth

2013-01-01

Previous studies have reported that infants selectively reproduce observed actions and have argued that this selectivity reflects understanding of intentions and goals, or goal-directed imitation. We reasoned that if selective imitation of goal-directed actions reflects understanding of intentions, infants should demonstrate stability across…

Emotion, Intent and Voluntary Movement in Children with Autism. an Example: The Goal Directed Locomotion

Science.gov (United States)

Longuet, Sophie; Ferrel-Chapus, Carole; Oreve, Marie-Joelle; Chamot, Jean-Marc; Vernazza-Martin, Sylvie

2012-01-01

This article focuses on the impact of intentionality on goal directed locomotion in healthy and autistic children. Closely linked with emotions and motivation, it is directly connected with movement planning. Is planning only preserved when the goal of the action appears motivating for healthy and autistic children? Is movement programming similar…

What areas of functioning are influenced by aquatic physiotherapy? Experiences of parents of children with cerebral palsy.

Science.gov (United States)

Güeita-Rodríguez, Javier; García-Muro, Francisco; Rodríguez-Fernández, Ángel L; Lambeck, Johan; Fernández-de-Las-Peñas, Cesar; Palacios-Ceña, Domingo

2017-09-21

To explore the experiences regarding aquatic physiotherapy among parents of children with cerebral palsy and to identify a list of relevant intervention categories for aquatic physiotherapy treatments. We conducted semi-structured interviews and focus groups using the components of the International Classification of Functioning, Disability and Health (ICF) as a frame of reference to explore and code experiences regarding aquatic physiotherapy. A non-probabilistic purposive sampling strategy was used. Content analysis methods and ICF linking processes were used to analyze data. From the parents' perspective (n = 34), both the Body Functions and Activities and Participation components were mainly influenced by aquatic physiotherapy. Also, parents described Environmental Factors acting as barriers affecting progress during therapy. Parents identified a wide range of categories influenced by aquatic physiotherapy. Social and contextual aspects were highlighted, as well as a series of changes related to the illness as a result of treatment.

Circuit class therapy and 7-day-week therapy increase physiotherapy time, but not patient activity: early results from the CIRCIT trial.

Science.gov (United States)

English, Coralie; Bernhardt, Julie; Hillier, Susan

2014-10-01

The optimum model of physiotherapy service delivery for maximizing active task practice during rehabilitation after stroke is unknown. The purpose of the study was to examine the relative effectiveness of 2 alternative models of physiotherapy service delivery against a usual care control with regard to increasing patient activity. Substudy within a large 3-armed randomized controlled trial, which compared 3 different models of physiotherapy service delivery, was provided for 4 weeks during subacute, inpatient rehabilitation (n=283). The duration of all physiotherapy sessions was recorded. In addition, 32 participants were observed at 10-minute intervals for 1 weekday and 1 weekend day between 8:00 am and 4:30 pm. At each observation, we recorded physical activity, location, and people present. Participants receiving 7-day-week and circuit class therapy received an additional 3 hours and 22 hours of physiotherapy time, respectively, when compared with usual care. Participants were standing or walking for a median of 8.2% of observations. On weekdays, circuit class therapy participants spent more time in therapy-related activity (10.2% of observations) when compared with usual care participants (6.1% of observations). On weekends, 7-day therapy participants spent more time in therapy-related activity (4.2% of observations) when compared with both usual care and circuit class therapy participants (0% of observations for both groups). Activity levels outside of therapy sessions did not differ between groups. A greater dosage of physiotherapy time did not translate into meaningful increases in physical activity across the day. http://www.anzctr.org.au/. Unique identifier: ACTRN12610000096055. © 2014 American Heart Association, Inc.

Does the addition of deep breathing exercises to physiotherapy-directed early mobilisation alter patient outcomes following high-risk open upper abdominal surgery? Cluster randomised controlled trial.

Science.gov (United States)

Silva, Y R; Li, S K; Rickard, M J F X

2013-09-01

To investigate whether the inclusion of deep breathing exercises in physiotherapy-directed early mobilisation confers any additional benefit in reducing postoperative pulmonary complications (PPCs) when patients are treated once daily after elective open upper abdominal surgery. This study also compared postoperative outcomes following early and delayed mobilisation. Cluster randomised controlled trial. Single-centre study in a teaching hospital. Eighty-six high-risk patients undergoing elective open upper abdominal surgery. Three groups: early mobilisation (Group A), early mobilisation plus breathing exercises (Group B), and delayed mobilisation (mobilised from third postoperative day) plus breathing exercises (Group C). PPCs and postoperative outcomes [number of days until discharge from physiotherapy, physiotherapy input and length of stay (LOS)]. There was no significant difference in PPCs between Groups A and B. The LOS for Group A {mean 10.7 [standard deviation (SD) 5.0] days} was significantly shorter than the LOS for Groups B [mean 16.7 (SD 9.7) days] and C [mean 15.2 (SD 9.8) days; P=0.036]. The greatest difference was between Groups A and B (mean difference -5.93, 95% confidence interval -10.22 to -1.65; P=0.008). Group C had fewer smokers (26%) and patients with chronic obstructive pulmonary disease (0%) compared with Group B (53% and 14%, respectively). This may have led to fewer PPCs in Group C, but the difference was not significant. Despite Group C having fewer PPCs and less physiotherapy input, the number of days until discharge from physiotherapy and LOS were similar to Group B. The addition of deep breathing exercises to physiotherapy-directed early mobilisation did not further reduce PPCs compared with mobility alone. PPCs can be reduced with once-daily physiotherapy if the patients are mobilised to a moderate level of exertion. Delayed mobilisation tended to increase physiotherapy input and the number of days until discharge from physiotherapy

People-, Process- and Goal-Focused Leadership Behaviour: An Empirical Study in a Global Company

Directory of Open Access Journals (Sweden)

Thanh Ha-Vikstrom

2017-03-01

Full Text Available This study explores the focus of leadership behaviours that perceived and experienced by leaders in a multinational company. By using triangulation method including questionnaires, in-depth interviews and observations, we analyse the data collected from twenty managers across organisational levels. The results reveal the patterns of managerial behaviour in three key focus areas for success: people, process and goal. Directors and general managers are more people-focused than line managers, who in turn tend to be more process-focused. The research findings bridge the gap in the field and initiate a new normative leadership behaviour model (people-, process and goal-focused, which can be used to directly support leaders in enhancing their leadership skills as well as for recruitment or promotion purposes. The model can be utilized as an aid to organisations when developing training programs to support leaders in different types of organisations (for-profit or non-profit to focus their development efforts on organizational success.

Physiotherapy clinical education at a South African university

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V Chetty

2018-04-01

Full Text Available Background. Clinical education for physiotherapists forms a vital part of undergraduate programmes and equips students with competencies to practise autonomously as qualified health practitioners. However, disparities are evident in approaches to clinical education.Objective. To explore the perceptions of physiotherapy students, community-service physiotherapists and physiotherapy clinical supervisors regarding the clinical education framework at a tertiary institution in South Africa in order to understand preparedness of students for practice.Methods. A case study approach with two focus group discussions with students and interviews with community physiotherapists and clinical supervisors was employed. Data were analysed and categorised into key themes and sub-themes.Results. Five themes emerged from triangulation of data from the three groups: preparedness for professional practice, institutional barriers, curriculum disputes, personal factors and recommendations for physiotherapy clinical education. Students felt inadequately prepared owing to a perceived lack of exposure to certain aspects of physiotherapy, while community therapists believed that reflection on the undergraduate programme after qualifying contributed to their adequate preparation. Clinical supervisors supposed that students would benefit from actively engaging with teaching and learning opportunities, and clinical personnel collaboration was seen as key to facilitate a continuum in clinical education from classroom to healthcare setting.Conclusion. Participants reported that the existing curriculum structure may need to be revisited to address various issues, while holistic collaboration between students, supervisors and clinical personnel is imperative to create a cohesive learning environment.

[Physiotherapy strategies in osteoporosis--recommendations for daily practice].

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Uhlemann, C; Lange, U

2006-09-01

Physiotherapy in osteoporosis essentially takes the form of stimulatory therapy tailored to the findings and the pathomechanism. The choice of therapy and its dosage depend on the desired result (prevention, cure, rehabilitation). Physical therapy applied in osteoporosis includes electrical, thermic (hydrothermic, high frequency thermic, light thermic) and mechanical (massage, physiotherapy) stimuli, which can be applied regionally, locally or hoistically. To be efficient, a pain therapy requires that the various painful states be differentiated between: whereas, for example, in the case of acute pain physiotherapy fulfils the function of immediate therapy (normally rest and "mild" cold applications), in chronic pain it has to fulfil the function of an adaptive performance therapy of neuronal structures (formative-adaptive physiotherapy, thermic therapy improving trophism, direct current, transcutaneous electric nerve stimulation/TENS). It is necessary and extremely important forday-to-day clinical practice that physiotherapy strategies that are tailored to each patient's needs and also economically justifiable be implemented. The article isintended to contribute to this.

Medicine and Physiotherapy students: are they physically active? Comparative research on Spanish and German population.

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Zeńczak-Praga, Krystyna; Pluto-Prondzinska, Joanna; Zgorzalewicz-Stachowiak, Małgorzata

2017-05-23

Despite the fact that regular physical activity is beneficial to human life, there are still more and more overweight and obese people throughout the world today. Healthy habits taken from home or socioeconomic situation are factors which might influence on regular physical activity. People who lead a healthy lifestyle in childhood are also active during adulthood. On the other hand academic life might promote less healthy lifestyle. The aim of the study was to assess and compare the level of physical activity of both German and Spanish students of Medicine and Physiotherapy. The study involved 100 Spanish and 100 German students aged from 19 to 24 years. Based on Eurobarometer 72.3, the respondents were asked a set of questions regarding physical activity. The chi-squared test (χ2) and Mann-Whitney U test were used for the statistical analysis. The vast majority of students presented a normal BMI value, but it was not related to high physical activity. More than one-third of all students seldom practised any sports. The Spanish students usually did some form of physical activity outdoors, whereas the German students exercised in a fitness centre. Lack of time was to the Medicine and Physiotherapy students the most significant factor that did not allow them to be more physically active. Medicine and Physiotherapy students should be more physically active in order to promote a good, healthy lifestyle model to society and there should be more physical activity education to encourage more students to practise sports.

Physiotherapy Exercise After Fast-Track Total Hip and Knee Arthroplasty: Time for Reconsideration?

DEFF Research Database (Denmark)

Bandholm, Thomas; Kehlet, Henrik

2012-01-01

Bandholm T, Kehlet H. Physiotherapy exercise after fast-track total hip and knee arthroplasty: time for reconsideration? Major surgery, including total hip arthroplasty (THA) and total knee arthroplasty (TKA), is followed by a convalescence period, during which the loss of muscle strength......-track methodology or enhanced recovery programs. It is the nature of this methodology to systematically and scientifically optimize all perioperative care components, with the overall goal of enhancing recovery. This is also the case for the care component "physiotherapy exercise" after THA and TKA. The 2 latest...... meta-analyses on the effectiveness of physiotherapy exercise after THA and TKA generally conclude that physiotherapy exercise after THA and TKA either does not work or is not very effective. The reason for this may be that the "pill" of physiotherapy exercise typically offered after THA and TKA does...

Chartered Society of Physiotherapy's identification of national research priorities for physiotherapy using a modified Delphi technique.

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Rankin, Gabrielle; Rushton, Alison; Olver, Pat; Moore, Ann

2012-09-01

To define research priorities to strategically inform the evidence base for physiotherapy practice. A modified Delphi method using SurveyMonkey software identified priorities for physiotherapy research through national consensus. An iterative process of three rounds provided feedback. Round 1 requested five priorities using pre-defined prioritisation criteria. Content analysis identified research themes and topics. Round 2 requested rating of the importance of the research topics using a 1-5 Likert scale. Round 3 requested a further process of rating. Quantitative and qualitative data informed decision-making. Level of consensus was established as mean rating ≥ 3.5, coefficient of variation ≤ 30%, and ≥ 55% agreement. Consensus across participants was evaluated using Kendall's W. Four expert panels (n=40-61) encompassing a range of stakeholders and reflecting four core areas of physiotherapy practice were established by steering groups (n=204 participants overall). Response rates of 53-78% across three rounds were good. The identification of 24/185 topics for musculoskeletal, 43/174 for neurology, 30/120 for cardiorespiratory and medical rehabilitation, and 30/113 for mental and physical health and wellbeing as priorities demonstrated discrimination of the process. Consensus between participants was good for most topics. Measurement validity of the research topics was good. The involvement of multiple stakeholders as participants ensured the current context of the intended use of the priorities. From a process of national consensus involving key stakeholders, including service users, physiotherapy research topics have been identified and prioritised. Setting priorities provides a vision of how research can contribute to the developing research base in physiotherapy to maximise focus. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy: a focused review

DEFF Research Database (Denmark)

Anttila, Heidi; Suoranta, Jutta; Malmivaara, Antti

2008-01-01

We conducted a criteria-based appraisal of systematic reviews on the effectiveness of physiotherapy and conductive education interventions in children with cerebral palsy (CP). Computerized bibliographic databases were searched without language restriction up to August 2007. Reviews on trials...... physiotherapy and occupational therapy interventions. Conclusions in the other reviews should be interpreted cautiously, although, because of the poor quality of the primary studies, most reviews drew no conclusions on the effectiveness of the reviewed interventions. Reviews on complex interventions...

Maintained physical activity and physiotherapy in the management of distal upper limb pain - a protocol for a randomised controlled trial (the arm pain trial).

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Jones, Gareth T; Mertens, Kathrin; Macfarlane, Gary J; Palmer, Keith T; Coggon, David; Walker-Bone, Karen; Burton, Kim; Heine, Peter J; McCabe, Candy; McNamee, Paul; McConnachie, Alex

2014-03-10

Distal upper limb pain (pain affecting the elbow, forearm, wrist, or hand) can be non-specific, or can arise from specific musculoskeletal disorders. It is clinically important and costly, the best approach to clinical management is unclear. Physiotherapy is the standard treatment and, while awaiting treatment, advice is often given to rest and avoid strenuous activities, but there is no evidence base to support these strategies. This paper describes the protocol of a randomised controlled trial to determine, among patients awaiting physiotherapy for distal arm pain, (a) whether advice to remain active and maintain usual activities results in a long-term reduction in arm pain and disability, compared with advice to rest; and (b) whether immediate physiotherapy results in a long-term reduction in arm pain and disability, compared with physiotherapy delivered after a seven week waiting list period. Between January 2012 and January 2014, new referrals to 14 out-patient physiotherapy departments were screened for potential eligibility. Eligible and consenting patients were randomly allocated to one of the following three groups in equal numbers: 1) advice to remain active, 2) advice to rest, 3) immediate physiotherapy. Patients were and followed up at 6, 13, and 26 weeks post-randomisation by self-complete postal questionnaire and, at six weeks, patients who had not received physiotherapy were offered it at this time. The primary outcome is the proportion of patients free of disability at 26 weeks, as determined by the modified DASH (Disabilities of the Arm, Shoulder and Hand) questionnaire.We hypothesise (a) that advice to maintain usual activities while awaiting physiotherapy will be superior than advice to rest the arm; and (b) that fast-track physiotherapy will be superior to normal (waiting list) physiotherapy. These hypotheses will be examined using an intention-to-treat analysis. Results from this trial will contribute to the evidence base underpinning the

Physiotherapy after subacromial decompression surgery

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Falla, Deborah; Frost, Poul

2015-01-01

This paper describes the development and details of a standardised physiotherapy exercise intervention designed to address pain and disability in patients with difficulty returning to usual activities after arthroscopic decompression surgery for subacromial impingement syndrome. To develop...... the intervention, the literature was reviewed with respect to the effectiveness of postoperative exercises, components of previous exercise programmes were extracted, and input from clinical physiotherapists in the field was obtained through a series of workshops. The physiotherapy exercise intervention...

Identification of a common language describing paediatric physiotherapy practice for children with additional support needs, to support communication with those outside the physiotherapy profession.

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Hunter, Cathleen; Maciver, Donald; Howden, Stella; Forsyth, Kirsty; Adamson, Amanda; Bremner, Lynne

2013-03-01

Children with additional support needs (ASNs) often require physiotherapy intervention to help maximise their participation within the primary school setting. The aim of this research was to investigate paediatric physiotherapy practice in supporting primary school aged children with ASNs, in order to identify a language to describe this, which could be used to support communication with teachers, parents and others outside the profession. Using a qualitative research multiple methods design, 2 focus groups and 5 structured interviews were held to investigate physiotherapy practice for this group. Senior paediatric physiotherapists (n=13) from a range of specialities, with experience of supporting primary school aged children with ASNs. Focus groups and interviews were digitally recorded, transcribed verbatim and analysed to establish links and patterns: followed by a cyclical process of respondent validation, and expert review. Eight targets for physiotherapy intervention and twelve technique headings were synthesised from the data. The language used for labelling and description of these was aimed to be easily understood by colleagues outside the profession. The findings clearly identified the role of the paediatric physiotherapist as being to support primary school aged children with ASNs to acquire aspects of postural control, mobility and cardio-respiratory function. By grouping the data into eight areas of challenge as the focus of intervention, and twelve commonly used techniques, the researchers generated a language which can be used by paediatric physiotherapists to support communication with teachers, parents and others outside the profession, when describing their intent and interactions regarding these children. Copyright © 2012 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Sleep Deprivation Promotes Habitual Control over Goal-Directed Control: Behavioral and Neuroimaging Evidence.

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Chen, Jie; Liang, Jie; Lin, Xiao; Zhang, Yang; Zhang, Yan; Lu, Lin; Shi, Jie

2017-12-06

Sleep is one of the most fundamental processes of life, playing an important role in the regulation of brain function. The long-term lack of sleep can cause memory impairments, declines in learning ability, and executive dysfunction. In the present study, we evaluated the effects of sleep deprivation on instrumental learning behavior, particularly goal-directed and habitual actions in humans, and investigated the underlying neural mechanisms. Healthy college students of either gender were enrolled and randomly divided into sleep deprivation group and sleep control group. fMRI data were collected. We found that one night of sleep deprivation led to greater responsiveness to stimuli that were associated with devalued outcomes in the slips-of-action test, indicating a deficit in the formation of goal-directed control and an overreliance on habits. Furthermore, sleep deprivation had no effect on the expression of acquired goal-directed action. The level of goal-directed action after sleep deprivation was positively correlated with baseline working memory capacity. The neuroimaging data indicated that goal-directed learning mainly recruited the ventromedial PFC (vmPFC), the activation of which was less pronounced during goal-directed learning after sleep deprivation. Activation of the vmPFC during goal-directed learning during training was positively correlated with the level of goal-directed action performance. The present study suggests that people rely predominantly on habits at the expense of goal-directed control after sleep deprivation, and this process involves the vmPFC. These results contribute to a better understanding of the effects of sleep loss on decision-making. SIGNIFICANCE STATEMENT Understanding the cognitive consequences of sleep deprivation has become extremely important over the past half century, given the continued decline in sleep duration in industrialized societies. Our results provide novel evidence that goal-directed action may be

A Student Experience of Peer Assisted Study Sessions in Physiotherapy

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Sole, Gisela; Rose, Andrew; Bennet, Tracey; Jaques, Katrina; Rippon, Zoe; van der Meer, Jacques

2012-01-01

Peer Assisted Study Sessions (PASS) were introduced as an optional learning experience in a Bachelor of Physiotherapy programme. The aim of this study was to evaluate the use of PASS from the student perspective. Eight third year physiotherapy students who had participated in PASS during their second year of training attended a focus group, at…

Attitudes of Flemish physiotherapy students towards mental health and psychiatry.

Science.gov (United States)

Probst, Michel; Peuskens, Jos

2010-03-01

In general, psychiatry is not very popular among healthcare providers, although no information is available concerning the attitudes of physiotherapy students towards mental heath. This study examined the attitudes of physiotherapy students towards psychiatry considering the subject's gender, previous experience with psychiatry and the impact of a specific course. This experimental study compared the attitudes of physiotherapy students (n=219) with those of students without a biomedical background (n=112) towards psychiatry. All students were between 17 and 28 years of age, and completed an established international questionnaire entitled 'Attitudes Towards Psychiatry'. Within the group of physiotherapy students, the effect of a 65-hour course on psychiatric rehabilitation on their attitudes was evaluated. Attitudes towards psychiatry were moderately positive [mean (SD) 103.3 (9.9)]. There was a small but significant difference between physiotherapy students and non-medical students (Cohen's d=0.31). Female students had a more positive attitude towards psychiatry than their male peers (Cohen's d=0.44). Prior experience with mental illness was associated with more positive attitudes (Cohen's d=0.68). Attitudes increased in positivity after completion of a psychiatry course (Cohen's d=0.72). To ensure basic physiotherapeutic treatment for the mentally ill, physiotherapy education should aim to promote positive attitudes towards mental illness as well as psychiatry. High-quality courses and personal interaction with patients are the best strategies to achieve this goal.

Physiotherapy and patients with osteogenesis imperfecta: an experience report

Directory of Open Access Journals (Sweden)

Carmem Lia Martins Moreira

Full Text Available Introduction Individuals with osteogenesis imperfecta (OI have bone fragility and osteopenia which cause fractures, mobility restriction and pain. Objective This article examines a physiotherapy experience with people diagnosed with OI in an OI reference center of Rio de Janeiro. Materials and methods This was an exploratory qualitative study, based on field notes related to physiotherapy care to 92 patients of both genders with clinical diagnoses of OI, aged between 30 days and 37 years old, during the period 2004–2008. The analysis comprised a reading of the field notes as a corpus, considering them as a means of understanding the subjects’ perspectives. Two different forms of codification were applied — open and focused — followed by semiotic analysis techniques. Results Early encouragement to perform active movements within a safe environment, or even after fractures, reduced articular contractures and enhanced muscular tonus; physiotherapy manipulation facilitated the integration of body perception in relation to movements and responses to tactile-kinesthetic-vestibular stimuli; promoting family involvement, by adopting practical solutions adapted to each patient’s reality, contributed to reduce fear of fractures and allowed the construction of a new functional image. Conclusion Physiotherapy assessment and treatment should be based not only on clinical and neurofunctional elements and technical strategies, but also on a dialogue that includes the multiple dimensions of the patients and their family members, in order to engage them in a learning process to stimulate potentials, abilities and competences.

Physiotherapy treatment of the diabetic shoulder: a longitudinal study following patients with diabetes and shoulder pain using a pre-post treatment design.

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Kyhlbäck, Maria; Schröder Winter, Helena; Thierfelder, Tomas; Söderlund, Anne

2014-01-01

The aim of this study was to describe and evaluate a physiotherapy program targeted to reduce pain intensity and improve the daily functioning of diabetics with shoulder problems. It was hypothesized that patients receiving specific physiotherapy treatment improved more frequently and rapidly than diabetic patients followed up without specific physiotherapeutic intervention. A pre-post treatment design was completed for a group of 10 subjects. The treatment protocol, also applied during the daily activities of the subjects, was aiming at reducing pain intensity and shoulder stiffness and improving impaired functioning in daily activities by muscle relaxation, light-load exercise and enhancing proper shoulder co-ordination. The group analysis showed significant decrease of pain intensity level as well as improved shoulder functioning and sustained level of subject self-efficacy beliefs throughout the study period. The results suggest that it is possible to relieve shoulder pain intensity and improve daily activities of patients with diabetes-related shoulder problems by employing a physiotherapy program focusing on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities. A physiotherapy program can be effective in reducing pain and improving shoulder function in diabetics with shoulder problems. The treatment should focus on muscle relaxation, light-load exercise and on the enhancement of proper shoulder co-ordination in daily activities.

Sportiness and masculinities among female and male physiotherapy students.

Science.gov (United States)

Dahl-Michelsen, Tone

2014-07-01

This article explores the gendered importance of sportiness in terms of students' judgments of themselves and their classmates as suitable physiotherapy students. The article is based on observations and qualitative interviews with students attending clinical skills training classes in the first year of a bachelor's degree program in physiotherapy in Norway. The analysis focuses on sportiness as a display of masculinity and is inspired by Connell's concept of multiple masculinities. The findings demonstrate sportiness as a shared common value among students. However, it was also found that there are two main typologies: (1) hyper-sportiness; and (2) ordinary sportiness. Male students judged as possessing hyper-sportiness are acknowledged as particularly suitable physiotherapy students and assume a hegemonic position in the student milieu. Female students who adapt hyper-sportiness have the potential to assume a hegemonic position, but tend not to do so. Female students with an ordinary level of sportiness have no particular problems in being identified as suitable physiotherapy students, whereas male students do encounter such problems. The article demonstrates how physiotherapy students' sportiness is more complex than previously known, particularly concerning differences in how female and male students are acknowledged in terms of perceived suitability as physiotherapy students. Additionally, this work shows a continuity of historical lines with respect to how sportiness is embedded in gender within the physiotherapy profession.

The effect of different physiotherapy interventions in post-BTX-A treatment of children with cerebral palsy.

Science.gov (United States)

Desloovere, K; De Cat, J; Molenaers, G; Franki, I; Himpens, E; Van Waelvelde, H; Fagard, K; Van den Broeck, C

2012-01-01

To distinguish the effects of different physiotherapeutic programs in a post BTX-A regime for children with Cerebral Palsy (CP). Retrospective, controlled intervention study. A group of 38 children (X¯ = 7y7m, GMFCS I-III, 27 bilateral, 11 unilateral CP) receiving an individually defined Neurodevelopment Treatment (NDT) program, was matched and compared to a group of children with the same age, GMFCS and diagnosis, receiving more conventional physiotherapy treatment. All patients received selective tone-reduction by means of multilevel BTX-A injections and adequate follow-up treatment, including physiotherapy. Three-dimensional gait analyses and clinical examination was performed pre and two months post-injection. Treatment success was defined using the Goal Attainment Scale (GAS). Both groups' mean converted GAS scores were above 50. The average converted GAS score was higher in the group of children receiving NDT than in the group receiving conventional physiotherapy (p physiotherapy group. Especially for the goals based on gait analyses (p children with bilateral CP (p physiotherapy approach. Copyright © 2011 European Paediatric Neurology Society. Published by Elsevier Ltd. All rights reserved.

Physiotherapy to improve physical activity in community-dwelling older adults with mobility problems (Coach2Move): study protocol for a randomized controlled trial.

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de Vries, Nienke M; Staal, J Bart; Teerenstra, Steven; Adang, Eddy M M; Rikkert, Marcel G M Olde; Nijhuis-van der Sanden, Maria W G

2013-12-17

Older adults can benefit from physical activity in numerous ways. Physical activity is considered to be one of the few ways to influence the level of frailty. Standardized exercise programs do not necessarily lead to more physical activity in daily life, however, and a more personalized approach seems appropriate. The main objective of this study is to investigate whether a focused, problem-oriented coaching intervention ('Coach2Move') delivered by a physiotherapist specializing in geriatrics is more effective for improving physical activity, mobility and health status in community-dwelling older adults than usual physiotherapy care. In addition, cost-effectiveness will be determined. The design of this study is a single-blind randomized controlled trial in thirteen physiotherapy practices. Randomization will take place at the individual patient level. The study population consists of older adults, ≥70 years of age, with decreased physical functioning and mobility and/or a physically inactive lifestyle. The intervention group will receive geriatric physiotherapy according to the Coach2Move strategy. The control group will receive the usual physiotherapy care. Measurements will be performed by research assistants not aware of group assignment. The results will be evaluated on the amount of physical activity (LASA Physical Activity Questionnaire), mobility (modified 'get up and go' test, walking speed and six-minute walking test), quality of life (SF-36), degree of frailty (Evaluative Frailty Index for Physical Activity), fatigue (NRS-fatigue), perceived effect (Global Perceived Effect and Patient Specific Complaints questionnaire) and health care costs. Most studies on the effect of exercise or physical activity consist of standardized programs. In this study, a personalized approach is evaluated within a group of frail older adults, many of whom suffer from multiple and complex diseases and problems. A complicating factor in evaluating a new approach is that it

Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

Science.gov (United States)

Liu, Shuyan; Schad, Daniel J; Kuschpel, Maxim S; Rapp, Michael A; Heinz, Andreas

2016-01-01

Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

Neuronal activity in primate prefrontal cortex related to goal-directed behavior during auditory working memory tasks.

Science.gov (United States)

Huang, Ying; Brosch, Michael

2016-06-01

Prefrontal cortex (PFC) has been documented to play critical roles in goal-directed behaviors, like representing goal-relevant events and working memory (WM). However, neurophysiological evidence for such roles of PFC has been obtained mainly with visual tasks but rarely with auditory tasks. In the present study, we tested roles of PFC in auditory goal-directed behaviors by recording local field potentials in the auditory region of left ventrolateral PFC while a monkey performed auditory WM tasks. The tasks consisted of multiple events and required the monkey to change its mental states to achieve the reward. The events were auditory and visual stimuli, as well as specific actions. Mental states were engaging in the tasks and holding task-relevant information in auditory WM. We found that, although based on recordings from one hemisphere in one monkey only, PFC represented multiple events that were important for achieving reward, including auditory and visual stimuli like turning on and off an LED, as well as bar touch. The responses to auditory events depended on the tasks and on the context of the tasks. This provides support for the idea that neuronal representations in PFC are flexible and can be related to the behavioral meaning of stimuli. We also found that engaging in the tasks and holding information in auditory WM were associated with persistent changes of slow potentials, both of which are essential for auditory goal-directed behaviors. Our study, on a single hemisphere in a single monkey, reveals roles of PFC in auditory goal-directed behaviors similar to those in visual goal-directed behaviors, suggesting that functions of PFC in goal-directed behaviors are probably common across the auditory and visual modality. This article is part of a Special Issue entitled SI: Auditory working memory. Copyright © 2016 Elsevier B.V. All rights reserved.

The role of physiotherapy in patients undergoing pulmonary surgery for lung cancer. A literature review.

Science.gov (United States)

Kendall, F; Abreu, P; Pinho, P; Oliveira, J; Bastos, P

This review aims to appraise the role of physiotherapy care in patients submitted to pulmonary surgery, in preoperative, perioperative, and postoperative phases. Pulmonary surgery is the gold standard treatment for patients with lung cancer if it is completely resectable. However, the major impairments and complications induced by surgery are well known. Physiotherapy has been regularly used both in the preparation of the surgical candidates; in their functional recovery in the immediate postoperative period, and in the medium/long term but there is a lack of concise evidence-based recommendations. Therefore, the aim of this review is to appraise the literature about the role of physiotherapy interventions in patients undergoing lung surgery for lung cancer, in preoperative, perioperative, postoperative and maintenance stages, to the recovery and well-being, regardless of the extent of surgical approach. In conclusion, physiotherapy programs should be individually designed, and the goals established according to surgery timings, and according to each subject's needs. It can also be concluded that in the preoperative phase, the main goals are to avoid postoperative pulmonary complications and reduce the length of hospital stay, and the therapeutic targets are respiratory muscle training, bronchial hygiene and exercise training. For the perioperative period, breathing exercises for pulmonary expansion and bronchial hygiene, as well as early mobilization and deambulation, postural correction and shoulder range of motion activities, should be added. Finally, it can be concluded that in the postoperative phase exercise training should be maintained, and adoption of healthy life-style behaviours must be encouraged. Copyright © 2017 Sociedade Portuguesa de Pneumologia. Published by Elsevier España, S.L.U. All rights reserved.

Development of an active behavioural physiotherapy intervention (ABPI) for acute whiplash-associated disorder (WAD) II management: a modified Delphi study.

Science.gov (United States)

Wiangkham, Taweewat; Duda, Joan; Haque, M Sayeed; Rushton, Alison

2016-09-14

To develop an active behavioural physiotherapy intervention (ABPI) for managing acute whiplash-associated disorder (WAD) II using a modified Delphi method to develop consensus for the basic features of the ABPI. Modified Delphi study. Our systematic review and meta-analysis evaluating conservative management for acute WADII found that a combined ABPI may be a useful intervention to prevent patients progressing to chronicity. No previous research has considered a combined behavioural approach and active physiotherapy in the management of acute WADII patients. The ABPI was therefore developed using a rigorous consensus method using international research and local clinical whiplash experts. Descriptive statistics were used to assess consensus in each round. Online international survey. A purposive sample of 97 potential participants (aiming to recruit n=30) consisting of international research whiplash experts, UK private physiotherapists and UK postgraduate musculoskeletal physiotherapy students were invited to participate via electronic mail with an attached participant information sheet and consent form. 36 individuals signed and returned the consent form. In round 1, 32/36 participants (response rate=89%, mean age±SD=36.03±13.22 years) across 8 countries (Australia, Finland, Greece, India, Netherlands, Norway, Sweden and UK) contributed to round 1 questionnaire. Response rates were 78% and 75% for rounds 2 and 3, respectively. Following round 3, 12 underlying principles (eg, return to normal function as soon as possible, pain management, encouragement of self-management, reduce fear avoidance and anxiety) achieved consensus. The treatment components reaching consensus included behavioural (eg, education, reassurance, self-management) and physiotherapy components (eg, exercises for stability and mobility). No passive intervention achieved consensus. Experts suggested and agreed the underlying principles and treatment components of the ABPI for the management

The meaning of physiotherapy:experiences of parents of young adults with impairment

OpenAIRE

Ekenberg, Lilly

2000-01-01

The overall aim of this thesis is to increase the understanding of the meaning of physiotherapy when fathering and mothering a child with impairment. The research has been focused on parents’ experiences of their participation in physiotherapy training of their child. The research focus and research methods have gradually changed from a more quantitative approach to a more qualitative approach as the understanding and knowledge progressed. The first two studies were questionnaires sent to par...

Sportiness and masculinities among female and male physiotherapy students

OpenAIRE

Dahl-Michelsen, Tone

2014-01-01

This article explores the gendered importance of sportiness in terms of students’ judgments of themselves and their classmates as suitable physiotherapy students. The article is based on observations and qualitative interviews with students attending clinical skills training classes in the first year of a bachelor’s degree program in physiotherapy in Norway. The analysis focuses on sportiness as a display of masculinity and is inspired by Connell’s concept of multiple masculinities. The findi...

[Analysis of the activity of mobile rehabilitation-physiotherapy units in primary care].

Science.gov (United States)

López-Liria, Remedios; Padilla Góngora, David; Catalán Matamoros, Daniel; Arrebola López, Clara; Garrido Fernández, Pablo; Martínez Cortés, María Del Carmen; Zurita Ortega, Félix

2010-05-01

To describe the home care provided by mobile rehabilitation-physiotherapy teams as a response to the needs of the dependent population, the characteristics of their application, and the results they have on patients and their functional independence. A descriptive, cross-sectional study from 2004 to June 2007. Community setting. Mobile rehabilitation-physiotherapy teams from Primary Care in Almeria. A total of 1093 patients were included in the programme. Data were collected on, the state of the patients' health (primary disabling process, reasons for inclusion in the treatment, initial and final functional assessment and Barthel Index); details of physiotherapy treatment, and number of sessions. Of the total sample, the mean age was 78 years and 64.2% were female. The mean waiting time for their assessment was 4 days and there was a wide variety of primary disabling processes described. There was a high percentage of symptoms of severe motor deterioration, pain and muscle weakness. Physiotherapy treatment was given in 88.6%, physiotherapy and occupational therapy in 11.1%, and orthopaedic treatment in 0.3%, of the patients. The mean number of sessions was 12.85. The variation in the Barthel Index after the final therapy was given was, 61.9% for kinesiotherapy, 10.2% combined with electrotherapy, and 14.5% for kinesiotherapy and carer education. Valuable information is provided as regards the characteristics of the geriatric and dependent population, as well as the physiotherapy help they are receiving, and also how the procedure is carried out. Copyright 2009 Elsevier España, S.L. All rights reserved.

Approaches toward learning in physiotherapy

Directory of Open Access Journals (Sweden)

L. Keiller

2013-11-01

Full Text Available The aim of this study was to investigate the approaches toward learning of undergraduate Physiotherapy students in a PBl module to enhance facilitation of learning at the Stellenbosch University, Division of Physiotherapy in South Africa. This quantitative, descriptive study utilized the revised Two-factor Study Process Questionnaire (r-SPQ-2f to evaluate the study cohorts’ approaches toward learning in the module. results of the data instruments were analysed statistically and discussed in a descriptive manner. There were a statistically significant greater number of students who adopted a deep approach toward learning at the commencement of the academic year. Students showed a trend toward an increase in their intrinsic interest in the learning material as the module progressed. Students in the Applied Physiotherapy module (ATP started to shift their focus from a surface learning approach to a deep learning approach. further research is needed to determine the long-term changes in approach toward learning and the possible determinants of these changes. This can be done in conjunction with the implementation of quality assurance mechanisms for learning material and earlier preparation of students for the change in the learning environment.

EFFICACY OF PHYSIOTHERAPY INTERVENTIONS LATE AFTER STROKE: A META-ANALYSIS

OpenAIRE

Ferrarello , Francesco; Baccini , Marco; Rinaldi , Lucio Antonio; Cavallini , Maria Chiara; Mossello , Enrico; Masotti , Giulio; Marchionni , Niccolò; Di Bari , Mauro

2010-01-01

Abstract Objective. Physiotherapy is usually provided only in the first few months after stroke, while its effectiveness and appropriateness in the chronic phase are uncertain. We conducted a systematic review and meta-analysis of randomized clinical trials (RCT) to evaluate the efficacy of physiotherapy interventions on motor and functional outcomes late after stroke. Methods. We searched published studies where participants were randomized to an active physiotherapy intervention,...

Concepts of body and health in physiotherapy:

DEFF Research Database (Denmark)

Jørgensen, Pia

2000-01-01

The concept of the body which highlights the social and the cultural aspects of life and open concepts of health, served as the theory for this study as well as the inspiration from two models of clinical practice. The data consists of observations of the practice of physiotherapy of seven hip...... to comply with the physiotherapy regimen. The physiotherapists gave a much higher priority to the physical capability of the patients than to social/cultural aspects. As experts, the physiotherapists legitimised the dialogue with the patients. The physiotherapists were not able to conform clinical practice...... according to the above mentioned concepts of body and health since they had not have enough information about cultural/social aspects. The patients had little or no direct influence upon the contents of the physiotherapy regimen. Finally, the author discusses this rather paternalistic clinical practice....

Evidence of Physiotherapy Interventions for Patients with Chronic Neck Pain: A Systematic Review of Randomised Controlled Trials

Science.gov (United States)

Damgaard, Pia; Bartels, Else Marie; Ris, Inge; Christensen, Robin; Juul-Kristensen, Birgit

2013-01-01

Chronic neck pain (CNP) is common and costly, and the effect of physiotherapeutic interventions on the condition is unclear. We reviewed the literature for evidence of effect of physiotherapy interventions on patients with CNP. Five bibliographic databases (MEDLINE, EMBASE, CINAHL, Cochrane Library, and PEDro) were systematically searched. Randomised, placebo and active-treatment-controlled trials including physiotherapy interventions for adults with CNP were selected. Data were extracted primary outcome was pain. Risk of bias was appraised. Effect of an intervention was assessed, weighted to risk of bias. 42 trials reporting on randomised comparisons of various physiotherapy interventions and control conditions were eligible for inclusion involving 3919 patients with CNP. Out of these, 23 were unclear or at high risk of bias, and their results were considered moderate- or low-quality evidence. Nineteen were at low risk of bias, and here eight trials found effect on pain of a physiotherapy intervention. Only exercise therapy, focusing on strength and endurance training, and multimodal physiotherapy, cognitive-behavioural interventions, massage, manipulations, laser therapy, and to some extent also TNS appear to have an effect on CNP. However, sufficient evidence for application of a specific physiotherapy modality or aiming at a specific patient subgroup is not available. PMID:27335877

[Physiotherapy of cancer patients].

Science.gov (United States)

Gomez, Izabella; Szekanecz, Éva; Szekanecz, Zoltán; Bender, Tamás

2016-07-01

Physiotherapy of cancer patients is one of the most controversial issues in our country. Malignant diseases are firstly mentioned as a contraindication of physiotherapy. Until now, physiotherapy was not suggested (or only in limited accessibility) for those patients who had malignant disease in medical history. International medical practice was less restrictive in managing this topic. The development of imaging techniques put this question in a new light. On the basis of evidence, the majority of articles have reported beneficial effects of physiotherapy in cancer patients, and only few articles mentioned it as harmful. Of course, each patient requires an individual assessment, however, if we exclude the possibility of tumor recurrence and metastasis, most of physiotherapy procedures can be used safely. One of the aims of this review is to support the physicians' decisions when to prescribe treatments, in such a way, that more patients could receive physiotherapy. Orv. Hetil., 2016, 157(31), 1224-1231.

Managers' Goal-Setting Strategies : Focus on Small Businesses

OpenAIRE

Stark, Fredrik; Purohit, Nisha

2007-01-01

Abstract Background: Goals and goal-setting are two aspects that occur everyday in business life however little is known about the effect of strategic goal-setting. To a cer-tain extent, this affects all of us either directly or indirectly, everyday through strategic decisions that are made by business managers all around the world. A company’s performance of a company can be measured in many ways. A firm’s performance can be financially successful if the com-pany’s strategy is well planned. ...

Effect on the process of care of an active strategy to implement clinical guidelines on physiotherapy for low back pain: a cluster randomised controlled trial

NARCIS (Netherlands)

Bekkering, G.E.; Hendriks, H.J.M.; Tulder, van M.; Knol, D.L.; Hoeijenbos, M.; Oostendorp, R.A.B.; Bouter, L.M.

2005-01-01

OBJECTIVES: To evaluate the effect on the process of care of an active strategy to implement clinical guidelines on physiotherapy for low back pain. DESIGN: A cluster randomised controlled trial comparing an active strategy with standard dissemination. SETTING: Primary care physiotherapy practices.

Music and Video Gaming during Breaks: Influence on Habitual versus Goal-Directed Decision Making.

Directory of Open Access Journals (Sweden)

Shuyan Liu

Full Text Available Different systems for habitual versus goal-directed control are thought to underlie human decision-making. Working memory is known to shape these decision-making systems and their interplay, and is known to support goal-directed decision making even under stress. Here, we investigated if and how decision systems are differentially influenced by breaks filled with diverse everyday life activities known to modulate working memory performance. We used a within-subject design where young adults listened to music and played a video game during breaks interleaved with trials of a sequential two-step Markov decision task, designed to assess habitual as well as goal-directed decision making. Based on a neurocomputational model of task performance, we observed that for individuals with a rather limited working memory capacity video gaming as compared to music reduced reliance on the goal-directed decision-making system, while a rather large working memory capacity prevented such a decline. Our findings suggest differential effects of everyday activities on key decision-making processes.

Leadership capabilities of physiotherapy leaders in Ireland: Part 1 physiotherapy managers.

Science.gov (United States)

McGowan, Emer; Elliott, Naomi; Stokes, Emma

2018-05-07

Investigation of the leadership capabilities of physiotherapists is needed to allow understanding of current leadership practice and to enable appropriate training programs to be developed. To explore physiotherapy managers´ perceptions of their leadership capabilities. Semi-structured interviews were conducted with a purposive sample of 18 physiotherapy managers from a range of public services and private practices in Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework which details four leadership frames: structural, human resource, political, and symbolic. The physiotherapy managers described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the physiotherapy managers suggested that they work predominantly through the structural and human resource frames. The employment of capabilities associated with the political frame varied between participants; some participants described working through this frame while others reported difficulties. The symbolic frame was underused; there were fewer examples given of capabilities such as communicating their vision, demonstrating passion and facilitating a positive workplace culture. Physiotherapy managers work predominantly through the structural and human resource frames. To successfully meet the leadership requirements of their roles physiotherapy managers may benefit from specific leadership development training to develop leadership capabilities in the political and symbolic frames.

Application physiotherapy in rehabilitation rheumatoid arthritis

Directory of Open Access Journals (Sweden)

Angela Nogas

2017-02-01

National University of Water and Environmental Engineering   Abstract Background: Rheumatoid arthritis is one of the most common forms of inflammatory diseases of the joints. The disease leads to deformation, then to destruction of the diseased joint and to disability. Physiotherapy is used for the treatment and rehabilitation of rheumatoid arthritis. It is assumed that physiotherapy treatments that promote remission of the disease, improve the quality of patients’ life, create the necessary conditions for comprehensive rehabilitation programs. Objective: Systematic’s review conducting of studies that assess the effect of physiotherapy in the rehabilitation of patients with rheumatoid arthritis. Methods: Theoretical analysis of scientific and methodical literature, methods of analysis, synthesis, generalization. Results: To reduce inflammation in the joints is performed UV of affected joints weak or medium erythermal or middle erythermal doses used UHF therapy. UHF-therapy prescribed to the area of joint in I or II dose, duration 10 min., the course – 5-8 treatments. For patients with minimal activity is added electrophoresis NSAIDs. Electrophoresis aspirin is applied on the affected joints (every day, the course – 10-12 procedures, which favorably affect the course of rheumatoid arthritis. Conclusions: Physical therapy can reduce pain and stiffness in the joints, prevent deformity and restore function, improve independence and quality of life. State of the art is a major incentive to develop new activities in the treatment and rehabilitation of patients with rheumatoid arthritis to improve joint functional activity and their physical health.   Keywords: rheumatoid arthritis, physiotherapy, rehabilitation, hydrotherapy.

Routine physiotherapy does not induce a cardiorespiratory training effect post-stroke, regardless of walking ability.

Science.gov (United States)

Kuys, Suzanne; Brauer, Sandra; Ada, Louise

2006-12-01

Cardiorespiratory fitness is increasingly being recognized as an impairment requiring physiotherapy intervention after stroke. The present study seeks to investigate if routine physiotherapy treatment is capable of inducing a cardiorespiratory training effect and if stroke patients attending physiotherapy who are unable to walk experience less cardiorespiratory stress during physiotherapy when compared to those who are able to walk. A descriptive, observational study, with heart rate monitoring and video-recording of physiotherapy rehabilitation, was conducted. Thirty consecutive stroke patients from a geriatric and rehabilitation unit of a tertiary metropolitan hospital, admitted for rehabilitation, and requiring physiotherapy were included in the study. The main measures of the study were duration (time) and intensity (percentage of heart rate reserve) of standing and walking activities during physiotherapy rehabilitation for non-walking and walking stroke patients. Stroke patients spent an average of 21 minutes participating in standing and walking activities that were capable of inducing a cardiorespiratory training effect. Stroke patients who were able to walk spent longer in these activities during physiotherapy rehabilitation than non-walking stroke patients (p physiotherapy rehabilitation had insufficient duration and intensity to result in a cardiorespiratory training effect in our group of stroke patients.

Introducing Acceptance and Commitment Therapy to a physiotherapy-led pain rehabilitation programme: an Action Research study.

Science.gov (United States)

Barker, Karen L; Heelas, Leila; Toye, Francine

2016-02-01

Recent developments in pain rehabilitation emphasise the importance of promoting psychological flexibility. Acceptance and Commitment Therapy (ACT) is one approach that has been shown to be effective for the treatment of chronic musculoskeletal pain. However, studies have shown that introducing innovative approaches such as ACT into established health care can cause some anxiety for professional groups. We used Action Research to evaluate the implementation of ACT to a physiotherapy-led pain rehabilitation programme. All staff in the pain service were invited to participate. Participants took part in focus groups, engaged in reflective sessions/meetings and completed reflective diaries. The analysis was undertaken by an experienced qualitative researcher using constant comparison. Participants reviewed emerging themes and validated the findings. Four key themes emerged from the study: (a) the need to see pain as an embodied, rather than dualistic, experience; (b) the need for a more therapeutic construction of 'acceptance'; (c) value-based goals as profound motivation for positive change; and (d) it's quite a long way from physiotherapy. Integral to a therapeutic definition of acceptance was the challenge of moving away from 'fixing' towards 'sitting with'. Participants described this as uncomfortable because it did not fit their biomedical training. This article describes how Action Research methodology was used in the introduction of ACT to a physiotherapy-led pain rehabilitation programme. The innovation of this study is that it helps us to understand the potential barriers and facilitators to embedding an ACT philosophy within a physiotherapy setting.

Physiotherapy and Occupational Therapy vs No Therapy in Mild to Moderate Parkinson Disease: A Randomized Clinical Trial.

Science.gov (United States)

Clarke, Carl E; Patel, Smitaa; Ives, Natalie; Rick, Caroline E; Dowling, Francis; Woolley, Rebecca; Wheatley, Keith; Walker, Marion F; Sackley, Catherine M

2016-03-01

adverse events. Physiotherapy and occupational therapy were not associated with immediate or medium-term clinically meaningful improvements in ADL or quality of life in mild to moderate PD. This evidence does not support the use of low-dose, patient-centered, goal-directed physiotherapy and occupational therapy in patients in the early stages of PD. Future research should explore the development and testing of more structured and intensive physical and occupational therapy programs in patients with all stages of PD. isrctn.org Identifier: ISRCTN17452402.

Factors influencing Zimbabwean physiotherapy students in choosing physiotherapy as a career

OpenAIRE

T. Mkondo; W. Mudzi; N. P. Mbambo

2007-01-01

People join professions for different reasons and the same applies to physiotherapists. The aim of the study was to identify the reasons for choosing physiotherapy as a career by Zimbabwean physiotherapy students. The study used a descriptive cross-sectional design where a questionnaire was administered to 60 students. Data were collected on the demographics of the students and also on their rating on the importance of 12 factors for their influence in them choosing physiotherapy as a career....

Physiotherapy - a feminine profession.

Science.gov (United States)

Short, S D

1986-01-01

The female-dominated professions in health care are not as powerful as the male-dominated medical profession. This paper suggests that the key factor in shaping the discrepancies in pay, status and power between medicine and the female-dominated professions is gender. It is argued that physiotherapy developed as a profession for middle-class women and that family responsibilities continue to take priority over professional responsibilities for the majority of physiotherapists. Physiotherapy enjoys higher occupational prestige than social work, speech therapy, occupational therapy and nursing and it is suggested that physiotherapy has achieved this status through recruitment of women from middle and upper middle class backgrounds. The history of physiotherapy is the history of a middle class feminine profession. Copyright © 1986 Australian Physiotherapy Association. Published by . All rights reserved.

Robot-Mediated Upper Limb Physiotherapy: Review and Recommendations for Future Clinical Trials

Science.gov (United States)

Peter, Orsolya; Fazekas, Gabor; Zsiga, Katalin; Denes, Zoltan

2011-01-01

Robot-mediated physiotherapy provides a new possibility for improving the outcome of rehabilitation of patients who are recovering from stroke. This study is a review of robot-supported upper limb physiotherapy focusing on the shoulder, elbow, and wrist. A literature search was carried out in PubMed, OVID, and EBSCO for clinical trials with robots…

Habitual versus goal-directed action control in Parkinson disease.

Science.gov (United States)

de Wit, Sanne; Barker, Roger A; Dickinson, Anthony D; Cools, Roshan

2011-05-01

This study presents the first direct investigation of the hypothesis that dopamine depletion of the dorsal striatum in mild Parkinson disease leads to impaired stimulus-response habit formation, thereby rendering behavior slow and effortful. However, using an instrumental conflict task, we show that patients are able to rely on direct stimulus-response associations when a goal-directed strategy causes response conflict, suggesting that habit formation is not impaired. If anything our results suggest a disease severity-dependent deficit in goal-directed behavior. These results are discussed in the context of Parkinson disease and the neurobiology of habitual and goal-directed behavior.

Pain and cardiorespiratory responses of children during physiotherapy after heart surgery.

Science.gov (United States)

Araujo, Adriana Sanches Garcia; Klamt, Jyrson Guilherme; Vicente, Walter Villela de Andrade; Garcia, Luis Vicente

2014-01-01

The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

Physiotherapy for pain

DEFF Research Database (Denmark)

Ginnerup-Nielsen, Elisabeth; Christensen, Robin; Thorborg, Kristian

2016-01-01

OBJECTIVES: To empirically assess the clinical effects of physiotherapy on pain in adults. DESIGN: Using meta-epidemiology, we report on the effects of a 'physiotherapy' intervention on self-reported pain in adults. For each trial, the group difference in the outcome 'pain intensity' was assessed...... as standardised mean differences (SMD) with 95% CIs. Stratified analyses were conducted according to patient population (International Classification of Diseases-10 classes), type of physiotherapy intervention, their interaction, as well as type of comparator group and risks of bias. The quality of the body...... 'no intervention' or of a sham-controlled design were selected. Only articles written in English were eligible. RESULTS: An overall moderate effect of physiotherapy on pain corresponding to 0.65 SD-units (95% CI 0.57 to 0.73) was found based on a moderate inconsistency (I(2)=51%). Stratified...

Pain and cardiorespiratory responses of children during physiotherapy after heart surgery

Directory of Open Access Journals (Sweden)

Adriana Sanches Garcia Araujo

2014-04-01

Full Text Available Objective: The aim of the present study was to determine the occurrence of pain and changes in blood pressure, heart rate, respiratory rate, and arterial oxygen saturation associated with physiotherapy in children undergoing cardiac surgery. Methods: Eighteen extubated children were assessed for the presence of pain using the face, legs, activity, cry, consolability scale, and blood pressure, heart rate, respiratory rate and arterial oxygen saturation were simultaneously recorded. The physiological parameters were measured at the following time periods: immediately before physiotherapy, five and 10 minutes after the beginning of physiotherapy, and five minutes after its end. Pain was assessed immediately before physiotherapy, ten minutes after the beginning of physiotherapy and five minutes after its end. Pain and physiological changes were assessed by the Friedman test and the correlation between the physiological parameters and the pain scores was assessed by the Spearman test. Results: Pain increased during physiotherapy and decreased significantly after it compared to pre-physiotherapy scores. Systolic blood pressure and heart rate increased significantly after 10 minutes of the beginning of physiotherapy. Arterial oxygen saturation tended to decrease during physiotherapy and to increase after it, although without significance. The correlation between pain scores and the physiological variables was significant only for systolic blood pressure and heart rate ten minutes after the beginning of physiotherapy. Conclusion: Manipulation after the beginning of physiotherapy seems to be accompanied by significant pain and by important associated cardiovascular changes. Apparent analgesia and improved respiratory function were observed after respiratory physiotherapy.

Case of physiotherapy care for patient diagnosed with rheumatoid arthritis

OpenAIRE

Šedková, Štěpánka

2013-01-01

Title of bachelor's thesis: Case of physiotherapy care for patient diagnosed with rheumatoid arthritis Objectives: The aim is to emphasize the use of physiotherapy as a part of comprehensive treatment of a patient with rheumatoid arthritis. The thesis includes a detailed casuistry of a patient with rheumatoid arthritis. Methods: The thesis is divided into a general part and a special part. The general part is focused on description of rheumatoid arthritis. It discusses characteristics of the ...

External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study.

Science.gov (United States)

Hammarlund, Catharina Sjödahl; Nilsson, Maria H; Gummesson, Christina

2015-01-01

Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students' learning processes and their adaptation to self-directed learning online. Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years) participated. Qualitative content analysis and triangulation was used when investigating the students' self-reflections, written during a five week self-directed, problem-oriented online course. Two categories emerged: 'the influence of the structured framework' and 'communication and interaction with teachers and peers.' The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to over-come were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment. The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy.

Lessons to be learned: a retrospective analysis of physiotherapy injury claims.

Science.gov (United States)

Johnson, Gillian M; Skinner, Margot A; Stephen, Rachel E

2012-08-01

Retrospective, descriptive analysis. To describe the prevalence and nature of insurance claims for injuries attributed to physiotherapy care. In New Zealand, a national insurance scheme, the Accident Compensation Corporation, provides comprehensive, no-fault personal injury coverage. The patterns of injury sustained during physiotherapy care have not previously been described. De-identified data for all injuries registered with the Accident Compensation Corporation from 2005 to 2010 and attributed to physiotherapy were accessed. Prevalence patterns (percentages) of new-claim data were determined for physiotherapy intervention category, injury site, nature of injury, age, and sex. A subcategory, exercise-related injuries, was analyzed according to injury site and whether the injury was related (primary) or unrelated (secondary) to the intended therapeutic goal. There were 279 claims related to physiotherapy care filed with the Accident Compensation Corporation during the studied reporting period. Injury was attributed predominantly to exercise (n = 88, 31.5% of cases) and manual therapy (n = 74, 26.5% of cases). The prevalence of events categorized as exercise related was greatest in those who were 55 to 59 years of age (n = 14, 16.3%) and greater in females (n = 47, 54.7%). Of the exercise-related injuries, 39.8% were in the lower-limb region and 35.2% were categorized as sprains/strains. Injuries attributed to exercise exceeded those linked to other therapies provided by physiotherapists, yet exercise therapy rarely features as a cause of adverse events reported to the physiotherapy profession. The proportion of exercise-related injury events underlines the need for ensuring safe and careful consideration of exercise prescription. Harm, level 4.

Physical function outcome in cervical radiculopathy patients after physiotherapy alone compared with anterior surgery followed by physiotherapy: a prospective randomized study with a 2-year follow-up.

Science.gov (United States)

Peolsson, Anneli; Söderlund, Anne; Engquist, Markus; Lind, Bengt; Löfgren, Håkan; Vavruch, Ludek; Holtz, Anders; Winström-Christersson, Annelie; Isaksson, Ingrid; Öberg, Birgitta

2013-02-15

Prospective randomized study. To investigate differences in physical functional outcome in patients with radiculopathy due to cervical disc disease, after structured physiotherapy alone (consisting of neck-specific exercises with a cognitive-behavioral approach) versus after anterior cervical decompression and fusion (ACDF) followed by the same structured physiotherapy program. No earlier studies have evaluated the effectiveness of a structured physiotherapy program or postoperative physical rehabilitation after ACDF for patients with magnetic resonance imaging-verified nerve compression due to cervical disc disease. Our prospective randomized study included 63 patients with radiculopathy and magnetic resonance imaging-verified nerve root compression, who were randomized to receive either ACDF in combination with physiotherapy or physiotherapy alone. For 49 of these patients, an independent examiner measured functional outcomes, including active range of neck motion, neck muscle endurance, and hand-related functioning before treatment and at 3-, 6-, 12-, and 24-month follow-ups. There were no significant differences between the 2 treatment alternatives in any of the measurements performed (P = 0.17-0.91). Both groups showed improvements over time in neck muscle endurance (P ≤ 0.01), manual dexterity (P ≤ 0.03), and right-handgrip strength (P = 0.01). Compared with a structured physiotherapy program alone, ACDF followed by physiotherapy did not result in additional improvements in neck active range of motion, neck muscle endurance, or hand-related function in patients with radiculopathy. We suggest that a structured physiotherapy program should precede a decision for ACDF intervention in patients with radiculopathy, to reduce the need for surgery. 2.

Physiotherapy students’ mental health assessment

OpenAIRE

Gesouli-Voltyraki –E.; Charisi E.; Papastergiou D.; Κostopoulou S.; Borou A.; Alverti V.; Avlakiotis K.; Spanos S.

2012-01-01

Introduction: Educational environment has a serious impact on students’ mental health. Few data are available on mental health of Physiotherapy students. Aim: The purpose of this study was to assess the mental heath of students in a tertiary Physiotherapy Department during the 3rd years of studies. Material and methods: 80 males and females physiotherapy students of the 5th and 6th semester of a tertiary Physiotherapy Department filled in the GHQ-28 questionnaire. Comparisons between groups w...

[Evaluation of the lifestyle of students of physiotherapy and technical & computer science basing on their diet and physical activity].

Science.gov (United States)

Medrela-Kuder, Ewa

2011-01-01

The aim of the study was the evaluation of a dietary habits profile and physical activity of Physiotherapy and Technical & Computer Science students. The research involved a group of 174 non-full-time students of higher education institutions in Krakow aged between 22 and 27. 81 students of the surveyed studied Physiotherapy at the University of Physical Education, whereas 93 followed a course in Technical & Computer Science at the Pedagogical University. In this project a diagnostic survey method was used. The study revealed that the lifestyle of university youth left much to be desired. Dietary errors were exemplified by irregular meals intake, low consumption of fish, milk and dairy, snacking between meals on high calorie products with a poor nutrient content. With regard to physical activity, Physiotherapy students were characterised by more positive attitudes than those from Technical & Computer Science. Such physical activity forms as swimming, team sports, cycling and strolling were declared by the surveyed the most frequently. Health-oriented education should be introduced in such a way as to improve the knowledge pertaining to a health-promoting lifestyle as a means of prevention of numerous diseases.

When Preferences Are in the Way: Children's Predictions of Goal-Directed Behaviors.

Science.gov (United States)

Yang, Fan; Frye, Douglas

2017-12-18

Across three studies, we examined 4- to 7-year-olds' predictions of goal-directed behaviors when goals conflict with preferences. In Study 1, when presented with stories in which a character had to act against basic preferences to achieve an interpersonal goal (e.g., playing with a partner), 6- and 7-year-olds were more likely than 4- and 5-year-olds to predict the actor would act in accordance with the goal to play with the partner, instead of fulfilling the basic preference of playing a favored activity. Similar results were obtained in Study 2 with scenarios that each involved a single individual pursuing intrapersonal goals that conflicted with his or her basic preferences. In Study 3, younger children's predictions of goal-directed behaviors did not increase for novel goals and preferences, when the influences of their own preferences, future thinking, or a lack of impulse control were minimized. The results suggest that between ages 4 and 7, children increasingly integrate and give more weight to other sources of motivational information (e.g., goals) in addition to preferences when predicting people's behaviors. This increasing awareness may have implications for children's self-regulatory and goal pursuit behaviors. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Predicting response to physiotherapy treatment for musculoskeletal shoulder pain: protocol for a longitudinal cohort study

Science.gov (United States)

2013-01-01

Background Shoulder pain affects all ages, with a lifetime prevalence of one in three. The most effective treatment is not known. Physiotherapy is often recommended as the first choice of treatment. At present, it is not possible to identify, from the initial physiotherapy assessment, which factors predict the outcome of physiotherapy for patients with shoulder pain. The primary objective of this study is to identify which patient characteristics and baseline measures, typically assessed at the first physiotherapy appointment, are related to the functional outcome of shoulder pain 6 weeks and 6 months after starting physiotherapy treatment. Methods/Design Participants with musculoskeletal shoulder pain of any duration will be recruited from participating physiotherapy departments. For this longitudinal cohort study, the participants care pathway, including physiotherapy treatment will be therapist determined. Potential prognostic variables will be collected from participants during their first physiotherapy appointment and will include demographic details, lifestyle, psychosocial factors, shoulder symptoms, general health, clinical examination, activity limitations and participation restrictions. Outcome measures (Shoulder Pain and Disability Index, Quick Disability of the Arm, Shoulder and Hand, and Global Impression of Change) will be collected by postal self-report questionnaires 6 weeks and 6 months after commencing physiotherapy. Details of attendance and treatment will be collected by the treating physiotherapist. Participants will be asked to complete an exercise dairy. An initial exploratory analysis will assess the relationship between potential prognostic factors at baseline and outcome using univariate statistical tests. Those factors significant at the 5% level will be further considered as prognostic factors using a general linear model. It is estimated that 780 subjects will provide more than 90% power to detect an effect size of less than 0

Physiotherapy in asthma--seeking consensus.

Science.gov (United States)

Nowobilski, Roman; Plaszewski, Maciej; Wloch, Tomasz; Mika, Piotr; Gajewski, Piotr; Brożek, Jan L

2013-08-01

The evidence base for or against physiotherapy interventions in asthmatic adults remains ambiguous, and there are discrepancies between different clinical practice guidelines. We evaluated the level of agreement between the recommendations about physiotherapy for adults with asthma in two major clinical practice guidelines: the Global Initiative for Asthma (GINA 2011) and the British Thoracic Society and the Association of Chartered Physiotherapists in Respiratory Care (BTS/ACPRC 2009). We used the Appraisal of Guidelines for Research & Evaluation (AGREE II) instrument to assess the methodological rigor of the guideline development, the Assessment of Multiple Systematic Reviews (AMSTAR) tool and the Physiotherapy Evidence Database (PEDro) scale to assess the methodological quality of systematic reviews and clinical trials included in the analyzed documents. Additionally, we compared the reference lists of the analyzed sections to establish the overlap in included primary and secondary studies. We observed no agreement between the two guidelines in the choice of source research articles. Only two studies out of 18 used in BTS guidelines were used in the GINA. The reason why GINA developers did not use the body of evidence included in BTS is that it is not clear. Three independent investigators indicated higher scores in all domains of the AGREE II in the BTS/ACPRC document in comparison with the GINA guidelines. The significant differences in the content and in the development processes of the examined sections of the two guidelines suggest the need for more frequent and careful updating or directing the readers of the GINA to the BTS/ACPRC, a guideline addressing specifically and more comprehensively physiotherapy interventions in asthma.

Physiotherapy in pauciarticular juvenile idiopathic arthritis. Case study.

Science.gov (United States)

Zuk, Beata; Kaczor, Zofia; Zuk-Drążyk, Berenika; Księżopolska-Orłowska, Krystyna

2014-01-01

Juvenile idiopathic arthritis (JIA) is the most common arthropathy of childhood and adolescence. This term encompasses a group of chronic systemic inflammatory diseases of the connective tissue which cause arthritis in patients under 16 years of age lasting at least 6 weeks. The authors presented the characteristic features of physiotherapy based on functional examination results on the basis of two cases of girls with pauciarticular JIA treated according to an established pharmacological regimen. Physiotherapy should be introduced at an early stage of the disease. Kinesiotherapy preceded by history-taking and a functional examination of the patient, has to focus on both primary and secondary joint lesions.

Evidence-based practice in physiotherapy: a systematic review of barriers, enablers and interventions.

Science.gov (United States)

Scurlock-Evans, Laura; Upton, Penney; Upton, Dominic

2014-09-01

Despite clear benefits of the Evidence-Based Practice (EBP) approach to ensuring quality and consistency of care, its uptake within physiotherapy has been inconsistent. Synthesise the findings of research into EBP barriers, facilitators and interventions in physiotherapy and identify methods of enhancing adoption and implementation. Literature concerning physiotherapists' practice between 2000 and 2012 was systematically searched using: Academic Search Complete, Cumulative Index of Nursing and Allied Health Literature Plus, American Psychological Association databases, Medline, Journal Storage, and Science Direct. Reference lists were searched to identify additional studies. Thirty-two studies, focusing either on physiotherapists' EBP knowledge, attitudes or implementation, or EBP interventions in physiotherapy were included. One author undertook all data extraction and a second author reviewed to ensure consistency and rigour. Synthesis was organised around the themes of EBP barriers/enablers, attitudes, knowledge/skills, use and interventions. Many physiotherapists hold positive attitudes towards EBP. However, this does not necessarily translate into consistent, high-quality EBP. Many barriers to EBP implementation are apparent, including: lack of time and skills, and misperceptions of EBP. Only studies published in the English language, in peer-reviewed journals were included, thereby introducing possible publication bias. Furthermore, narrative synthesis may be subject to greater confirmation bias. There is no "one-size fits all" approach to enhancing EBP implementation; assessing organisational culture prior to designing interventions is crucial. Although some interventions appear promising, further research is required to explore the most effective methods of supporting physiotherapists' adoption of EBP. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

'Finding a balance' in involving patients in goal setting early after stroke: a physiotherapy perspective.

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Lloyd, A; Roberts, A R; Freeman, J A

2014-09-01

Collaborative goal setting (between patient and professional) confers benefits within stroke and neurological rehabilitation, and is recommended in clinical guidelines. However, evidence suggests that patient participation in rehabilitation goal setting is not maximized, particularly within the hospital setting. The purpose of this study was to investigate physiotherapists' perceptions about their experiences of collaborative goal setting with patients in the sub-acute stages after stroke, in the hospital setting. This qualitative study employed constructivist grounded theory methodology. Nine physiotherapists, of varying experience, were selected using purposive then theoretical sampling from three National Health Service hospital stroke units in England. Semi-structured interviews were conducted, audio-recorded and transcribed. Transcripts were coded and analysed using the constant comparative method of grounded theory to find common themes. Three themes emerged from the data: 1) 'coming to terms with stroke' - the individual patient journey; 2) the evolution of goal setting skill - the individual physiotherapist journey; and 3) 'finding a balance' - managing expectations and negotiating interactions. A provisional grounded theory was constructed, which highlighted that, from the physiotherapists' perspective, collaboration with patients within goal setting early after stroke involved finding a balance between numerous different drivers, which have the potential to compete. Patient-directed and therapist-directed goal setting approaches could be viewed as opposite ends of a continuum, along which patient-centred goal setting is possible. Physiotherapists perceived that collaborating with patients in goal setting was important but challenging. Goal setting interactions with other professionals, patients and families were perceived as complex, difficult and requiring significant effort. The importance of individuality and temporality were recognized suggesting that

Physiotherapy as bricolage: theorizing expert practice.

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Shaw, James A; DeForge, Ryan T

2012-08-01

Theories about how knowledge is sought and applied in clinical practice are often referred to as practice epistemologies, and have not been extensively explored in the physiotherapy profession. Tacit assumptions about what counts as physiotherapy knowledge thus form the basis for many approaches to gaining and using information in practice. The purpose of this paper is to propose a physiotherapy practice epistemology, through the notion of the bricoleur, which takes an alternative approach to understanding how knowledge might best be viewed in relation to physiotherapy. The term bricoleur refers to a handyman or handywoman who uses all tools and types of knowledge available. The notion of physiotherapists as bricoleurs recognizes that all practice knowledge is situated within social, cultural, and historical contexts that shape our beliefs about what counts as physiotherapy knowledge. This recognition leads physiotherapists who act as bricoleurs to embrace multiple epistemologies, discovering new ways of knowing and clinical reasoning strategies to provide a more holistic approach to physiotherapy practice. The relationships between expertise in clinical reasoning and the epistemology of the bricoleur are then addressed, explicating the utility of multiple epistemologies in achieving excellent physiotherapy care. A bricoleur's epistemology is then applied to the concept of expertise in physiotherapy, de-stabilizing the notion that a single authoritative approach to the practice of physiotherapy ought to be idealized.

Evaluation of a course designed to teach physics to students of physiotherapy

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Simpson, Ian A.; Singer, Kevin P.; Treagust, David; Zadnik, Marjan G.

1990-01-01

This paper describes the development and evaluation of a course in physiotherapy whereby the physics fundamental to the modalities of cold, heat and ultrasound therapies was integrated in lectures and actual physiotherapy activities. The design of the course is described together with the perceptions of physiotherapy students regarding the organisation of the course, safety aspects and how well the integration contributed to their understanding of the physics involved in electrotherapy.

A SWOT analysis of the physiotherapy profession in Kuwait.

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MacPherson, Meghan M; MacArthur, Lauren; Jadan, Patrick; Glassman, Leah; Bouzubar, Fawzi F; Hamdan, Elham; Landry, Michel D

2013-03-01

Since the end of the Gulf War in 1991, Kuwait has become one of the wealthiest countries in the world and one that has a highly socialized health-care system. This rapid growth and socio-economic development appears to have had a negative impact on the health of its people. As such, the profession of physiotherapy may be in a unique position to address this issue by providing health behaviour interventions and promoting healthy lifestyles. The purpose of this study was to explore the current state of physiotherapy in Kuwait and provide recommendations for future development and growth. Using a qualitative research approach, we conducted 17 key informant interviews (clinicians, administrators and other key stakeholders) in Kuwait. The strengths, weaknesses, opportunities and threats framework was then used to categorize the emerging themes and provide a basis for a strategic direction for the profession. Informants reported that strengths included funding for services and motivation of professionals. Weaknesses included education and professional resources, marketing/advocacy, standardization and regulation of practice. Opportunities discussed were untapped demand for physiotherapy services, internal development and evolution of the physiotherapy association, along with professional collaboration. Threats addressed included low public awareness of physiotherapy, challenges with inter-professional practice/communication, and cultural perspectives of healthy lifestyles. Our research indicates that many unique opportunities exist for physiotherapists in Kuwait. Further development and evolution of Kuwait's physiotherapy professional association could facilitate efforts to advocate for the profession, initiate standards of practice and provide enhanced opportunities for professional collaboration. Copyright © 2012 John Wiley & Sons, Ltd.

Perspectives of Canadian Final-Year Physiotherapy Students on Cardiorespiratory Physiotherapy as a Career Choice

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Araujo, Tamara; Romano, Julia Marie; Camp, Pat G.; Hall, Mark; Mathur, Sunita; Brooks, Dina

2016-01-01

Purpose: To investigate the opinions of final-year Canadian physiotherapy students of cardiorespiratory physiotherapy (CRP) and the factors influencing their decision about whether to pursue a career in CRP. Methods: A cross-sectional online survey was completed by final-year Master of Science of Physical Therapy students from three of the largest English-speaking physiotherapy schools in Canada. Results: A total of 120 students responded to the survey (overall response rate was 44%). Fifteen students (12.5%) responded that they were extremely or quite interested in specializing in CRP. The most common factors that positively influenced students' decision to consider specializing in CRP were job accessibility, potential salary, and experiences in the area, and the most common factors that negatively influenced their decision were the clinical aspects of the area, their experiences in the area, job accessibility, and the influence of others. The most common factors that positively influenced students' opinion of CRP were their clinical supervisor, educator, or lecturer; their own clinical experience; and evidence in the literature, and the most common factors that negatively influenced their opinion were their own clinical experience and their peers. Conclusion: Strategies focusing on increasing awareness of the role of physiotherapists in the care of patients with cardiorespiratory conditions, exposing students to the positive impact that physiotherapists have in this practice area, and good mentorship experiences may promote the attractiveness of this specialty. PMID:27909378

Chest physiotherapy during anesthesia for children with cystic fibrosis: effects on respiratory function.

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Tannenbaum, E; Prasad, S A; Dinwiddie, R; Main, Eleanor

2007-12-01

Physiotherapists sometimes use elective surgical procedures for children with cystic fibrosis as an opportunity to perform physiotherapy treatments during anesthesia. These treatments theoretically facilitate direct endotracheal airway clearance and compensate for any post-operative respiratory deterioration related to the anaesthetic and surgery. MATERIALS, PATIENTS, AND METHODS: Children were randomized either to receive physiotherapy or not following anesthesia and intubation. Respiratory mechanics (C(rs) and R(rs)), tidal volume, and peak inspiratory pressure (PIP) were measured immediately before and after physiotherapy. FEV(1) was measured before and after surgery and post-operative physiotherapy requirements were recorded. Eighteen patients, mean age 12 years (range 2.8-15 years) were recruited, with nine in each group. Both groups showed a non-significant decline in FEV(1) the day after surgery compared with pre-operative values (-5.8%: physiotherapy and -7.1%: control). Both PIP and R(rs) increased significantly following physiotherapy (within- and between-groups, P physiotherapy which approached significance between-groups (P = 0.07). There were no significant within- or between-group differences in tidal volume following treatment in either group. The unanticipated decline in respiratory function immediately following physiotherapy was short-lived and not discernible in longer term outcomes measured by FEV(1) or physiotherapy requirements post-operatively. If respiratory physiotherapy under anesthesia is considered necessary and the benefits of removing secretions are deemed to outweigh the short-term risks, it may be necessary for the anaesthetist to consider modifying ventilatory support to counteract any short-term negative effects of the treatment.

The role of physiotherapy in patients undergoing pulmonary surgery for lung cancer. A literature review

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F. Kendall

2017-11-01

In conclusion, physiotherapy programs should be individually designed, and the goals established according to surgery timings, and according to each subject's needs. It can also be concluded that in the preoperative phase, the main goals are to avoid postoperative pulmonary complications and reduce the length of hospital stay, and the therapeutic targets are respiratory muscle training, bronchial hygiene and exercise training. For the perioperative period, breathing exercises for pulmonary expansion and bronchial hygiene, as well as early mobilization and deambulation, postural correction and shoulder range of motion activities, should be added. Finally, it can be concluded that in the postoperative phase exercise training should be maintained, and adoption of healthy life-style behaviours must be encouraged.

Point of View: Physiotherapy in Malawi – a step in the right direction

African Journals Online (AJOL)

trained to the level of a physiotherapist, they harbour generic therapy skills, which can make a .... allows them to provide basic physiotherapy, occupational therapy and speech and language .... Neurol, Neurosurg Psychiatry. 2011;82:136-143.

External and internal factors influencing self-directed online learning of physiotherapy undergraduate students in Sweden: a qualitative study

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Catharina Sjödahl Hammarlund

2015-06-01

Full Text Available Purpose: Online courses have become common in health sciences education. This learning environment can be designed using different approaches to support student learning. To further develop online environment, it is important to understand how students perceive working and learning online. The aim of this study is to identify aspects influencing students’ learning processes and their adaptation to self-directed learning online. Methods: Thirty-four physiotherapy students with a mean age of 25 years (range, 21 to 34 years participated. Qualitative content analysis and triangulation was used when investigating the students’ self-reflections, written during a five week self-directed, problem-oriented online course. Results: Two categories emerged: ‘the influence of the structured framework’ and ‘communication and interaction with teachers and peers.’ The learning processes were influenced by external factors, e.g., a clear structure including a transparent alignment of assignments and assessment. Important challenges to over-come were primarily internal factors, e.g., low self-efficacy, difficulties to plan the work effectively and adapting to a new environment. Conclusion: The analyses reflected important perspectives targeting areas which enable further course development. The influences of external and internal factors on learning strategies and self-efficacy are important aspects to consider when designing online courses. Factors such as pedagogical design, clarity of purpose, goals, and guidelines were important as well as continuous opportunities for communication and collaboration. Further studies are needed to understand and scaffold the motivational factors among students with low self-efficacy.

Which learning activities enhance physiotherapy practice? A systematic review protocol of quantitative and qualitative studies.

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Leahy, Edmund; Chipchase, Lucy; Blackstock, Felicity

2017-04-17

Learning activities are fundamental for the development of expertise in physiotherapy practice. Continuing professional development (CPD) encompasses formal and informal learning activities undertaken by physiotherapists. Identifying the most efficient and effective learning activities is essential to enable the profession to assimilate research findings and improve clinical skills to ensure the most efficacious care for clients. To date, systematic reviews on the effectiveness of CPD provide limited guidance on the most efficacious models of professional development for physiotherapists. The aim of this systematic review is to evaluate which learning activities enhance physiotherapy practice. A search of Ovid MEDLINE, EMBASE, Cumulative Index to Nursing and Allied Health Literature (CINAHL), PsycINFO (Psychological Abstracts), PEDro, Cochrane Library, AMED and Educational Resources and Information Center (ERIC) will be completed. Citation searching and reference list searching will be undertaken to locate additional studies. Quantitative and qualitative studies will be included if they examine the impact of learning activities on clinician's behaviour, attitude, knowledge, beliefs, skills, self-efficacy, work satisfaction and patient outcomes. Risk of bias will be assessed by two independent researchers. Grading of Recommendations Assessment, Development, and Evaluation (GRADE) and Confidence in the Evidence from Reviews of Qualitative research (CERQual) will be used to synthesise results where a meta-analysis is possible. Where a meta-analysis is not possible, a narrative synthesis will be conducted. PROSPERO CRD42016050157.

The allocation of attention to learning of goal-directed actions: A cognitive neuroscience framework focusing on the basal ganglia

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Liz eFranz

2012-12-01

Full Text Available The present paper builds on the idea that attention is largely in service of our actions. A framework and model which captures the allocation of attention for learning of goal-directed actions is proposed and developed. This framework highlights an evolutionary model based on the notion that rudimentary brain functions have become embedded into increasingly higher levels of networks which all contribute to adaptive learning. Background literature is presented alongside key evidence based on experimental studies in the so-called ‘split-brain’ (surgically divided cerebral hemispheres with a key focus on bimanual actions. The proposed multilevel cognitive-neural system of attention is built upon key processes of a highly-adaptive basal-ganglia-thalamic-cortical system. Although overlap with other existing findings and models is acknowledged where appropriate, the proposed framework is an original synthesis of cognitive experimental findings with supporting evidence of a neural system and a carefully formulated model of attention. It is the hope that this new synthesis will be informative in fields of cognition and other fields of brain sciences and will lead to new avenues for experimentation across domains.

Fronto-parietal coding of goal-directed actions performed by artificial agents.

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Kupferberg, Aleksandra; Iacoboni, Marco; Flanagin, Virginia; Huber, Markus; Kasparbauer, Anna; Baumgartner, Thomas; Hasler, Gregor; Schmidt, Florian; Borst, Christoph; Glasauer, Stefan

2018-03-01

With advances in technology, artificial agents such as humanoid robots will soon become a part of our daily lives. For safe and intuitive collaboration, it is important to understand the goals behind their motor actions. In humans, this process is mediated by changes in activity in fronto-parietal brain areas. The extent to which these areas are activated when observing artificial agents indicates the naturalness and easiness of interaction. Previous studies indicated that fronto-parietal activity does not depend on whether the agent is human or artificial. However, it is unknown whether this activity is modulated by observing grasping (self-related action) and pointing actions (other-related action) performed by an artificial agent depending on the action goal. Therefore, we designed an experiment in which subjects observed human and artificial agents perform pointing and grasping actions aimed at two different object categories suggesting different goals. We found a signal increase in the bilateral inferior parietal lobule and the premotor cortex when tool versus food items were pointed to or grasped by both agents, probably reflecting the association of hand actions with the functional use of tools. Our results show that goal attribution engages the fronto-parietal network not only for observing a human but also a robotic agent for both self-related and social actions. The debriefing after the experiment has shown that actions of human-like artificial agents can be perceived as being goal-directed. Therefore, humans will be able to interact with service robots intuitively in various domains such as education, healthcare, public service, and entertainment. © 2017 Wiley Periodicals, Inc.

Physiotherapy for pelvic pain and female sexual dysfunction: an untapped resource.

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Berghmans, Bary

2018-05-01

Chronic pelvic pain (CPP) in women is a complex syndrome. Pain sensation and intensity often do not correspond with the identified lesion location but are felt elsewhere, leading to muskuloskeletal and myofascial disorders and sexual dysfunction (SD). Although physical aspects are prevalent, they are often underdiagnosed and undertreated due to lack of understanding regarding its origin and distribution. Frequently, patients experience pelvic pain as psychological distress resulting in physical complaints, leading clinicians to prescribe medication or surgical intervention to correct or alleviate these symptoms, often with insufficient results. Because pelvic floor muscle disorders contribute significantly to CPP and SD, there is rationale for physiotherapy. However, physiotherapy is a widely underused and untapped resource, which has its place in the multidisciplinary approach to these health problems. Computer-aided and manual searches and methodological quality assessment were carried out for meta-analyses, systematic reviews, and randomized controlled trials (RCTs) published between 1990 and 2017 investigating classification, assessment, and (physiotherapeutic) treatment of pelvic pain and/or female SD defined by the keywords below. Expert opinions were sought via interviews. Due to a lack of sufficient relevant medical information, referral data, and test results, focused physiotherapy is difficult to administer adequately. However, recent quality studies indicate significant clinical effects of physiotherapy for CPP and female SD, and experts advocate a multidisciplinary approach that includes physiotherapy. Because of its holistic approach, physiotherapy can contribute significantly to the multidisciplinary assessment and treatment of CPP and female SD.

Goal-directed learning and obsessive–compulsive disorder

Science.gov (United States)

Gillan, Claire M.; Robbins, Trevor W.

2014-01-01

Obsessive–compulsive disorder (OCD) has become a paradigmatic case of goal-directed dysfunction in psychiatry. In this article, we review the neurobiological evidence, historical and recent, that originally led to this supposition and continues to support a habit hypothesis of OCD. We will then discuss a number of recent studies that have directly tested this hypothesis, using behavioural experiments in patient populations. Based on this research evidence, which suggests that rather than goal-directed avoidance behaviours, compulsions in OCD may derive from manifestations of excessive habit formation, we present the details of a novel account of the functional relationship between these habits and the full symptom profile of the disorder. Borrowing from a cognitive dissonance framework, we propose that the irrational threat beliefs (obsessions) characteristic of OCD may be a consequence, rather than an instigator, of compulsive behaviour in these patients. This lays the foundation for a potential shift in both clinical and neuropsychological conceptualization of OCD and related disorders. This model may also prove relevant to other putative disorders of compulsivity, such as substance dependence, where the experience of ‘wanting’ drugs may be better understood as post hoc rationalizations of otherwise goal-insensitive, stimulus-driven behaviour. PMID:25267818

Physiotherapy in Bangladesh: Inequality Begets Inequality

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Firoz Ahmed Mamin

2018-03-01

Full Text Available BackgroundThe demand for health services in developing countries often outweighs provision. This article describes the present condition of physiotherapy in Bangladesh. Physiotherapy is not recognized as a profession by the government. There is no single registration and regulation body. The health-related and economic benefits of physiotherapy are not felt by the majority of Bangladeshi citizens.Areas coveredThe burden of disease is changing, and Bangladesh needs a profession that specializes in physical rehabilitation to face these challenges. This article outlines the benefits to patients and the wider economy from a broad physiotherapy regime for all Bangladeshi citizens. It describes the many barriers the profession faces.ConclusionPhysiotherapy is efficacious in many post-trauma situations and long-term conditions. Economic evidence supports the provision physiotherapy as a cost-effective treatment which should be considered as part of the provision of a universal health-care service. Official recognition of the protected “physiotherapist” title and a single registration and regulation agency are recommended.

Physiotherapy in Bangladesh: Inequality Begets Inequality.

Science.gov (United States)

Mamin, Firoz Ahmed; Hayes, Rieke

2018-01-01

The demand for health services in developing countries often outweighs provision. This article describes the present condition of physiotherapy in Bangladesh. Physiotherapy is not recognized as a profession by the government. There is no single registration and regulation body. The health-related and economic benefits of physiotherapy are not felt by the majority of Bangladeshi citizens. The burden of disease is changing, and Bangladesh needs a profession that specializes in physical rehabilitation to face these challenges. This article outlines the benefits to patients and the wider economy from a broad physiotherapy regime for all Bangladeshi citizens. It describes the many barriers the profession faces. Physiotherapy is efficacious in many post-trauma situations and long-term conditions. Economic evidence supports the provision physiotherapy as a cost-effective treatment which should be considered as part of the provision of a universal health-care service. Official recognition of the protected "physiotherapist" title and a single registration and regulation agency are recommended.

Comrades marathon for short-term experiential learning as perceived by physiotherapy students: A short report

OpenAIRE

U. Useh; A. Human

2011-01-01

This  study  described  the  learning  experiences  of physiotherapy students during the 2009 comrades marathon. A quali-tative  approach  using  focus  group  discussions  was  employed  for  this study.The population for this study was all the 43 B.Sc. physiotherapy final year students of the university of limpopo, who provided physio-therapy services at the 2009 comrades Marathon. forty (93%) students participated in this study. All the participants were black with majo-rity 23 (58%) of th...

Exploring the decision-making process in the delivery of physiotherapy in a stroke unit.

Science.gov (United States)

McGlinchey, Mark P; Davenport, Sally

2015-01-01

The aim of this study was to explore the decision-making process in the delivery of physiotherapy in a stroke unit. A focused ethnographical approach involving semi-structured interviews and observations of clinical practice was used. A purposive sample of seven neurophysiotherapists and four patients participated in semi-structured interviews. From this group, three neurophysiotherapists and four patients were involved in observation of practice. Data from interviews and observations were analysed to generate themes. Three themes were identified: planning the ideal physiotherapy delivery, the reality of physiotherapy delivery and involvement in the decision-making process. Physiotherapists used a variety of clinical reasoning strategies and considered many factors to influence their decision-making in the planning and delivery of physiotherapy post-stroke. These factors included the therapist's clinical experience, patient's presentation and response to therapy, prioritisation, organisational constraints and compliance with organisational practice. All physiotherapists highlighted the importance to involve patients in planning and delivering their physiotherapy. However, there were varying levels of patient involvement observed in this process. The study has generated insight into the reality of decision-making in the planning and delivery of physiotherapy post-stroke. Further research involving other stroke units is required to gain a greater understanding of this aspect of physiotherapy. Implications for Rehabilitation Physiotherapists need to consider multiple patient, therapist and organisational factors when planning and delivering physiotherapy in a stroke unit. Physiotherapists should continually reflect upon how they provide physiotherapy, with respect to the duration, frequency and time of day sessions are delivered, in order to guide current and future physiotherapy delivery. As patients may demonstrate varying levels of participation in deciding and

Implementing a 6-day physiotherapy service in rehabilitation: exploring staff perceptions.

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Caruana, Erin L; Kuys, Suzanne S; Clarke, Jane; Brauer, Sandra G

2017-11-20

Objective Australian weekend rehabilitation therapy provision is increasing. Staff engagement optimises service delivery. The present mixed-methods process evaluation explored staff perceptions regarding implementation of a 6-day physiotherapy service in a private rehabilitation unit. Methods All multidisciplinary staff working in the rehabilitation unit were surveyed regarding barriers, facilitators and perceptions of the effect of a 6-day physiotherapy service on length of stay (LOS) and patient goal attainment at three time points: before and after implementation, as well as after modification of a 6-day physiotherapy service. Descriptive statistics and thematic analysis was used to analyse the data. Results Fifty-one staff (50%) responded. Before implementation, all staff identified barriers, the most common being staffing (62%) and patient selection (29%). After implementation, only 30% of staff identified barriers, which differed to those identified before implementation, and included staff rostering and experience (20%), timing of therapy (10%) and increasing the allocation of patients (5%). Over time, staff perceptions changed from being unsure to being positive about the effect of the 6-day service on LOS and patient goal attainment. Conclusion Staff perceived a large number of barriers before implementation of a 6-day rehabilitation service, but these did not eventuate following implementation. Staff perceived improved LOS and patient goal attainment after implementation of a 6-day rehabilitation service incorporating staff feedback. What is known about this topic? Rehabilitation weekend services improve patient quality of life and functional independence while reducing LOS. What does this study add? Staff feedback during implementation and modification of new services is important to address potential barriers and ensure staff satisfaction and support. What are the implications for practitioners? Staff engagement and open communication are important to

Description of physiotherapy services in a mental health institution in Nigeria

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C.A. Gbiri

2011-01-01

Full Text Available Physiotherapy  has  long  been  recognised  as  adjunct  to  drug therapy in the management of individuals with mental illness. however, little evidence existed on the utilization of physiotherapy in mental health especially in developing worlds.This study reviewed the utilization of physiotherapy in a Mental health  Institution in lagos, nigeria and determined its contribution to quality of  patient-care in the hospital.This study involved review of clients’ activity profile and patients’ record in a federal neuro-psychiatric hospital in lagos, nigeria between 2002 and 2006. The hospital records were used as source of information for socio- demographic details. Information on the physical diagnosis was extracted from the patients’ records in the departmental records. Data were summarized using descriptive statistics.Six thousand, four hundred and seventy-three (3.3% out of the 195,686  patients of the hospital within the study period enjoyed physiotherapy ser vices. only 766 (14% of the hospital in-patients enjoyed physiotherapy services. In addition, 808 clients enjoyed the health promotion services. low back pain (85; 21.7%, osteo-arthritis (82; 20.9%, stroke (64; 16.3% and shoulder pain  (29; 7.4% were the most common co-existing health problems referred for physiotherapy.The importance of physiotherapy in mental health is evidenced in the number of patients/clients who benefited from its services. Therefore, physiotherapy is an integral and indispensible member of the mental health team. however, physiotherapy  is  still  under-utilized  in  the  hospital.  This  points  to  the  need  for  proper  integration  of  physiotherapy  into mental health team in the hospital and other similar health institutions.

Physical inactivity among physiotherapy undergraduates: exploring the knowledge-practice gap.

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Ranasinghe, Chathuranga; Sigera, Chathurani; Ranasinghe, Priyanga; Jayawardena, Ranil; Ranasinghe, Ayodya C R; Hills, Andrew P; King, Neil

2016-01-01

Physical inactivity is a common risk factor for several non-communicable diseases (NCDs). Increasing physical activity could reduce the burden of disease due to major NCDs and increase life expectancy. Undergraduate physiotherapy students represent a group of young-adults expected to have a good knowledge of physical activity. We evaluated physical activity levels of undergraduate physiotherapy students of University of Colombo, Sri Lanka and determined their motives and barriers for participation in physical activity. All physiotherapy undergraduates studying at the University of Colombo, Sri Lanka in 2013 were invited for the study. Phase one was a quantitative study to evaluate the physical activity levels and phase two was a qualitative study to identify motives and barriers for physical activity and sports in the same cohort. Physical activity levels (phase 1) were assessed using the interviewer administered International Physical Activity Questionnaire (long-version). The qualitative study (phase 2) was conducted in the same population using Focus Group Discussions ( n  = 3) and individual In-depth Interviews ( n  = 5). Sample size in phase 1 and phase 2 were 113 (response rate = 98%; [N-115]) and 87 (response rat = 97%; [N-90]) respectively. Mean age (±SD) of participants was 23.4 ± 1 years. The mean weekly total MET minutes (±SD) of the study population was 1791.25 ± 3097. According to the IPAQ categorical score a higher percentage of participants were 'inactive' (48.7%), while only 15.9% were in the 'Highly active' group. Lack of support and encouragement received during childhood to engage in sports activity seem to have played an important role in continuing their exercise behavior through to the adult life. Academic activities were given priority by both parents and teachers. The environment and support from teachers, family and friends were important to initiate and adhere to sports and physical activity. A higher

fMRI activities in the emotional cerebellum: a preference for negative stimuli and goal-directed behavior.

Science.gov (United States)

Schraa-Tam, Caroline K L; Rietdijk, Willem J R; Verbeke, Willem J M I; Dietvorst, Roeland C; van den Berg, Wouter E; Bagozzi, Richard P; De Zeeuw, Chris I

2012-03-01

Several studies indicate that the cerebellum might play a role in experiencing and/or controlling emphatic emotions, but it remains to be determined whether there is a distinction between positive and negative emotions, and, if so, which specific parts of the cerebellum are involved in these types of emotions. Here, we visualized activations of the cerebellum and extracerebellar regions using high-field fMRI, while we asked participants to observe and imitate images with pictures of human faces expressing different emotional states or with moving geometric shapes as control. The state of the emotions could be positive (happiness and surprise), negative (anger and disgust), or neutral. The positive emotional faces only evoked mild activations of crus 2 in the cerebellum, whereas the negative emotional faces evoked prominent activations in lobules VI and VIIa in its hemispheres and lobules VIII and IX in the vermis. The cerebellar activations associated with negative emotions occurred concomitantly with activations of mirror neuron domains such as the insula and amygdala. These data suggest that the potential role of the cerebellum in control of emotions may be particularly relevant for goal-directed behavior that is required for observing and reacting to another person's (negative) expressions.

The possibility of physiotherapy treatment after injury of anterior cruciate ligament

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Katarzyna Korabiusz

2017-09-01

Full Text Available Introduction: Damage of ACL represents approximately 50% of all internal damages of knee joint after its injury. According to statistics, 1 person out of 1000 residents suffers from ACL injury. Approximately 3 thousand reconstructions of ACL are performed yearly therefore it is very important to work out an optimal post-operative rehabilitation. Through this, it is possible to reduce pain indispositions and restore a good joint stabilization and improved quality of life. Goal of dissertation: Goal of this dissertation is a review of literature about available physiotherapy methods used after injury of anterior cruciate ligament. Conclusion: There are many physiotherapy methods used after injury of ACL. Methods proposed in literature increase range of movement in knee joint,  reduce pain  and restore a good joint stabilization The most often used methods are: transdermal nerves stimulation TENS, criotherapy,  magnetic field, ultrasounds, LASER, electrostimulation, interferention, kinesitherapy and kinesiotaping, Rehabilitation significantly reduces pain indispositions and has a positive influence on quality of life of patients after ACL injuring.

Empowering the Physiotherapy Profession in Ethiopia through Leadership Development within the Doctoring Process.

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Footer, Cheryl Burditt; Tsegaye, Hailu Seifu; Yitnagashaw, Tesfaye Asnake; Mekonnen, Wintana; Shiferaw, Tizita Destaw; Abera, Endashaw; Davis, Alice

2017-01-01

Ethiopia recently introduced the Doctor of Physiotherapy (DPT) degree at Addis Ababa University as a mechanism to increase the work force capacity of primary care providers in the health sector. The DPT program was supported by an international academic partnership and was designed to empower physiotherapists as leaders to move the profession forward. The curriculum was framed by core pedagogical principles and strategies and was phased into two programs. First, the 4-year Advanced Standing DPT program focused on developing registered Ethiopian physiotherapists with Bachelor of Science degrees as academic faculty. Second, these new faculty would then sustain a 6-year Generic DPT program that would matriculate students upon graduation from high school. The curriculum represented depth and breadth of foundation and clinical sciences, evidence-based practice, clinical reasoning skills, and interprofessional education opportunities. A leadership thread provided opportunities to develop skills necessary to effectively navigate and manage the challenges faced by the profession. The main outcomes included (1) an 8-year international partnership, (2) the academic performance of students, and (3) and leadership capabilities as demonstrated through activities and assignments. While the program has been criticized as an unnecessary extravagance for Ethiopia, the advantages of the DPT degree were revealed in a direct comparison to other academic physiotherapy programs in Ethiopia. In the end, because the DPT is new to the country, it will take time to fully understand the true impact within the Ethiopian health system.

What factors influence physiotherapy service provision in rural communities? A pilot study.

Science.gov (United States)

Adams, Robyn; Sheppard, Lorraine; Jones, Anne; Lefmann, Sophie

2014-06-01

To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive sampling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery. © 2014 National Rural Health Alliance Inc.

ANALYSIS OF AUDITORS IN HEALTH AS TO PUBLIC THE PHYSIOTHERAPY SERVICES OF THE BAHIA STATE

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Ítalo Ricardo Santos Aleluia

2013-01-01

Full Text Available The audit in the SUS searchers the effectiveness and quality in the actions and healt services given to the population. Although the multiprofessionalism in such activity is recognized nationally, there are categories such as Physiotherapists that not work in the teams, this service being audited by professionals non-technical. Soon, gives credit that this can cause fragilities in the control of the resources and quality of the Physiotherapy services givento the users. This study it had as objective to identify the main difficulties encountered by auditors of the SUS in the services of Physiotherapy in the Bahia State. It is a study of transversal with a convenience sample of 40 auditors of the SUS, trough a semi-structured questionnaire. There are difficulties found had demonstrated a direct relation between the technician knowledge auditor and better or worse performance in the process of auditing of the Physiotherapy, translates the relevance the physiotherapist on audit of team the SUS, since this is the professional who dominates the knowledge technician of the area .

Perceived Focus of Professional Mentoring for Goal Setting and ...

African Journals Online (AJOL)

This paper therefore, perceives professional mentoring as one of the essential coaching services required by business education graduate employees to excel in this responsibility. The paper centred on the perceived focus of professional mentoring for goal setting and improved performance of business education graduate ...

Moving the boundaries : peer learning between nursing and physiotherapy students

OpenAIRE

Fogstad, Lise; Christiansen, Bjørg

2011-01-01

Aim: The objective of this study was to explore nursing and physiotherapy students’ views on peer learning as an innovative learning strategy. Background: Departments of nursing and physiotherapy at Oslo University College, Norway, initiated a cooperative project based on interdisciplinary and cross-level learning in patient transfer activities. Patient transfer is based on natural human body movement patterns, ergonomics, and communication skills. The project involved partnering sec...

A case report of physiotherapy treatment of a patient with peripheral facial palsy

OpenAIRE

Příhonská, Jana

2016-01-01

Thesis title: A case report of physiotherapy treatment of a patient with peripheral facial palsy Thesis summary: The thesis focuses on physiotherapy treatment techniques for peripheral facial palsy. It consists of a theoretical part and a practical part. The theoretical part covers basic anatomy and neurology, the characteristics, clinical picture, diagnosis, and treatment. The practical part is a case report of a patient with peripheral facial palsy. The case report includes the clinical exa...

Clinical reasoning-embodied meaning-making in physiotherapy.

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Chowdhury, Anoop; Bjorbækmo, Wenche Schrøder

2017-07-01

This article examines physiotherapists' lived experience of practicing physiotherapy in primary care, focusing on clinical reasoning and decision-making in the case of a patient we call Eva. The material presented derives from a larger study involving two women participants, both with a protracted history of neck and shoulder pain. A total of eight sessions, all of them conducted by the first author, a professional physiotherapist, in his own practice room, were videotaped, after which the first author transcribed the sessions and added reflective notes. One session emerged as particularly stressful for both parties and is explored in detail in this article. In our analysis, we seek to be attentive to the experiences of physiotherapy displayed and to explore their meaning, significance and uniqueness from a phenomenological perspective. Our research reveals the complexity of integrating multiple theoretical perspectives of practice in clinical decision-making and suggests that a phenomenological perspective can provide insights into clinical encounters through its recognition of embodied knowledge. We argue that good physiotherapy practice demands tactfulness, sensitivity, and the desire to build a cooperative patient-therapist relationship. Informed by theoretical and practical knowledge from multiple disciplines, patient management can evolve and unfold beyond rehearsed routines and theoretical principles.

Biofeedback and physiotherapy versus physiotherapy alone in the treatment of genuine stress urinary incontinence

DEFF Research Database (Denmark)

Glavind, K; Nøhr, S B; Walter, S

1996-01-01

Biofeedback is a method of pelvic floor rehabilitation using a surface electrode inserted into the vagina and a catheter in the rectum. Forty women with genuine urinary stress incontinence were randomized to compare the efficacy of physiotherapy and physiotherapy in combination with biofeedback...

Effectiveness of graded activity versus physiotherapy in patients with chronic nonspecific low back pain: midterm follow up results of a randomized controlled trial.

Science.gov (United States)

Magalhães, Maurício Oliveira; Comachio, Josielli; Ferreira, Paulo Henrique; Pappas, Evangelos; Marques, Amélia Pasqual

Low back pain (LBP) is a major health and economic problem worldwide. Graded activity and physiotherapy are commonly used interventions for nonspecific low back pain. However, there is currently little evidence to support the use of one intervention over the other in the medium-term. To compare the effectiveness of graded activity exercises to physiotherapy-based exercises at mid-term (three and six months' post intervention) in patients with chronic nonspecific LBP. Sixty-six patients were randomly allocated to two groups: graded activity group (n=33) and physiotherapy group (n=33). These patients received individual sessions twice a week for six weeks. Follow-up measurements were taken at three and six months. The main outcome measurements were intensity pain (Pain Numerical Rating Scale) and disability (Rolland Morris Disability Questionnaire). No significant differences between groups after three and six month-follow ups were observed. Both groups showed similar outcomes for pain intensity at three months [between group differences: -0.1 (95% confidence interval [CI]=-1.5 to 1.2)] and six months [0.1 (95% CI=-1.1 to 1.5)], disability at three months was [-0.6 (95% CI=-3.4 to 2.2)] and six months [0.0 (95% CI=-2.9 to 3.0)]. The results of this study suggest that graded activity and physiotherapy have similar effects in the medium-term for patients with chronic nonspecific low back pain. Copyright © 2017 Associação Brasileira de Pesquisa e Pós-Graduação em Fisioterapia. Publicado por Elsevier Editora Ltda. All rights reserved.

Motorized CPM/CAM physiotherapy device with sliding-mode Fuzzy Neural Network control loop.

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Ho, Hung-Jung; Chen, Tien-Chi

2009-11-01

Continuous passive motion (CPM) and controllable active motion (CAM) physiotherapy devices promote rehabilitation of damaged joints. This paper presents a computerized CPM/CAM system that obviates the need for mechanical resistance devices such as springs. The system is controlled by a computer which performs sliding-mode Fuzzy Neural Network (FNN) calculations online. CAM-type resistance force is generated by the active performance of an electric motor which is controlled so as to oppose the motion of the patient's leg. A force sensor under the patient's foot on the device pedal provides data for feedback in a sliding-mode FNN control loop built around the motor. Via an active impedance control feedback system, the controller drives the motor to behave similarly to a damped spring by generating and controlling the amplitude and direction of the pedal force in relation to the patient's leg. Experiments demonstrate the high sensitivity and speed of the device. The PC-based feedback nature of the control loop means that sophisticated auto-adaptable CPM/CAM custom-designed physiotherapy becomes possible. The computer base also allows extensive data recording, data analysis and network-connected remote patient monitoring.

Physiotherapists and General Practitioners attitudes towards 'Physio Direct' phone based musculoskeletal Physiotherapy services: a national survey.

Science.gov (United States)

Harland, Nicholas; Blacklidge, Brian

2017-06-01

Physiotherapy phone based, "Physio Direct" (PD) musculoskeletal triage and treat services are a relatively new phenomena. This study explored Physiotherapist and GP attitudes towards PD services. Online national survey via cascade e-mail initiated by study leads. 488 Physiotherapists and 68 GPs completed the survey. The survey asked three negatively worded and three positively worded Likert scale questions regarding PD services. It also collected demographic data and more global attitudes including a version of the friends and family test. Overall both Physiotherapists and GP's have positive attitudes towards PD services. There was global agreement that PD triage was a good idea but in both groups the majority of respondents who expressed a definite opinion thought that patients would still eventually need to be seen face to face. The vast majority of all respondents also thought patients should be given a choice about first accessing PD services. Physiotherapists with experience of PD services had more positive and less negative attitudes than those without experience. More detailed results are discussed. Relevant clinical stakeholders have generally positive attitudes towards PD services, but more so when they have experience of them. Counter to research findings significant proportions of respondents believe patients accessing PD services will still need to be seen face to face. The significant majority of respondents believe patients should be given a choice whether they access PD services in the first instance or not. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Dynamical Intention: Integrated Intelligence Modeling for Goal-directed Embodied Agents

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Eric Aaron

2016-11-01

Full Text Available Intelligent embodied robots are integrated systems: As they move continuously through their environments, executing behaviors and carrying out tasks, components for low-level and high-level intelligence are integrated in the robot's cognitive system, and cognitive and physical processes combine to create their behavior. For a modeling framework to enable the design and analysis of such integrated intelligence, the underlying representations in the design of the robot should be dynamically sensitive, capable of reflecting both continuous motion and micro-cognitive influences, while also directly representing the necessary beliefs and intentions for goal-directed behavior. In this paper, a dynamical intention-based modeling framework is presented that satisfies these criteria, along with a hybrid dynamical cognitive agent (HDCA framework for employing dynamical intentions in embodied agents. This dynamical intention-HDCA (DI-HDCA modeling framework is a fusion of concepts from spreading activation networks, hybrid dynamical system models, and the BDI (belief-desire-intention theory of goal-directed reasoning, adapted and employed unconventionally to meet entailments of environment and embodiment. The paper presents two kinds of autonomous agent learning results that demonstrate dynamical intentions and the multi-faceted integration they enable in embodied robots: with a simulated service robot in a grid-world office environment, reactive-level learning minimizes reliance on deliberative-level intelligence, enabling task sequencing and action selection to be distributed over both deliberative and reactive levels; and with a simulated game of Tag, the cognitive-physical integration of an autonomous agent enables the straightforward learning of a user-specified strategy during gameplay, without interruption to the game. In addition, the paper argues that dynamical intentions are consistent with cognitive theory underlying goal-directed behavior, and

Predictors for half-year outcome of impairment in daily life for back pain patients referred for physiotherapy: a prospective observational study.

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Sven Karstens

Full Text Available BACKGROUND AND OBJECTIVE: From observational studies, there is only sparse information available on the predictors of development of impairment in daily life for patients receiving physiotherapy. Therefore, our aim was to identify factors which predict impairment in daily life for patients with back pain 6 months after receiving physiotherapy. METHODS: We conducted a prospective cohort study with 6-month follow-up. Patients were enrolled for treatment in private physiotherapy practices. Patients with a first physiotherapy referral because of thoracic or low back pain, aged 18 to 65 years were included. Primary outcome impairment was measured utilising the 16-item version of the Musculoskeletal Function Assessment Questionnaire. Therapy was documented on a standardized form. Baseline scores for impairment in daily life, symptom characteristics, sociodemographic and psychosocial factors, physical activity, nicotine consumption, intake of analgesics, comorbidity and delivered primary therapy approach were investigated as possible predictors. Univariate and multiple linear regression analyses were performed. RESULTS: A total of 792 patients participated in the study (59% female, mean age 44.4 (SD 11.4, with 6-month follow-up results available from 391 patients. In univariate analysis 17 variables reached significance. In multiple linear regression identified predictors were: impairment in daily life before therapy, mental disorders, duration of the complaints, self-prognosis on work ability, rheumatoid arthritis, age, form of stress at work and physical activity. The variables explain 34% of variance (adjusted R(2, p<0.001. CONCLUSIONS: With minimal information available from observational studies on the predictors of development of back problems for physiotherapy patients, this study adds new knowledge for forming appropriate referral guidelines. Impairment in daily life before therapy, mental disorder as comorbidity and the duration of the

Factors affecting osteoarthritis patients' self-reported goal-directed drug information-seeking behaviors after exposure to direct-to-consumer advertising from physicians and the internet.

Science.gov (United States)

Liu, Yifei; Farris, Karen B; Doucette, William R

2011-10-01

The objective of this study was to investigate appraisal of means (ie, self-efficacy, outcome expectancy, and affect) in predicting patients' goal-directed behaviors of direct-to-consumer advertising (DTCA)-prompted drug-information search from physicians and the internet. One thousand patients were randomly selected from a nationwide sample frame of 3000 osteoarthritis patients. A self-administered survey assessed exposure to DTCA, drug-information search as goal, self-efficacy, outcome expectancy, affect, and osteoarthritis pain. After 6 weeks, another survey measured the behavior of drug-information search for respondents to the first survey. Study subjects were those who were exposed to DTCA in the previous month, and who set drug-information search as their goal. For each information source, a multiple regression analysis was conducted in which drug-information search was the dependent variable, and self-efficacy, outcome expectancy, affect, and osteoarthritis pain were the independent variables. Among 454 patients who were exposed to DTCA, 174 patients set drug-information search as their goal and were the study subjects. The regression for physicians was not statistically significant. The regression for the internet was significant, accounting for 15% of behavior variance. Self-efficacy was a strong predictor of goal-directed drug-information search from the internet. Appraisal of means was useful to predict the goal-directed behavior of DTCA-prompted drug-information search from the internet. For patients who set drug-information search as a goal, actions to promote drug-information search from the internet need to focus on self-efficacy.

"In the physio we trust": A qualitative study on patients' preferences for physiotherapy.

Science.gov (United States)

Bernhardsson, Susanne; Larsson, Maria E H; Johansson, Kajsa; Öberg, Birgitta

2017-07-01

Patients' preferences should be integrated in evidence-based practice. This study aimed to explore patients' preferences for physiotherapy treatment and participation in decision making. A qualitative study set in an urban physiotherapy clinic in Gothenburg, Sweden. Individual, semi-structured interviews were conducted with 20 individuals who sought physiotherapy for musculoskeletal disorders. The interviews were recorded, transcribed, and analyzed with qualitative content analysis. An overarching theme, embracing six categories, was conceptualized: Trust in the physiotherapist fosters active engagement in therapy. The participants preferred active treatment strategies such as exercise and advice for self-management, allowing them to actively engage in their therapy. Some preferred passive treatments. Key influencers on treatment preferences were previous experiences and media. All participants wanted to be involved in the clinical decision making, but to varying extents. Some expressed a preference for an active role and wanting to share decisions while others were content with a passive role. Expectations for a professional management were reflected in trust and confidence in physiotherapists' skills and competence, expectations for good outcomes, and believing that treatment methods should be evidence-based. Trust in the physiotherapist's competence, as well as a desire to participate in clinical decision making, fosters active engagement in physiotherapy.

Leadership capabilities of physiotherapy leaders in Ireland: Part 2. Clinical specialists and advanced physiotherapy practitioners.

Science.gov (United States)

McGowan, E; Elliott, N; Stokes, E

2018-05-07

Investigation of the leadership capabilities of physiotherapy managers found that they report predominantly demonstrating capabilities associated with the human resource and structural frames. However, little is known about the leadership capabilities of clinical specialists and advanced physiotherapy practitioners (APPs) who also are identified as having responsibility for leadership. To explore clinical specialists´ and APPs' perceptions of their leadership capabilities and compare them with the reported leadership capabilities of physiotherapy managers. Semi-structured interviews were conducted with a purposive sample of 17 physiotherapy clinical specialists and APPs from a range of practice settings across Ireland. The interviews were analyzed using template analysis and the coding template was based on the Bolman and Deal Leadership framework. The participants described demonstrating leadership capabilities associated with each of the four leadership frames. However, the language used by the clinical specialists/APPs suggested that they work predominantly through the human resource frame. Structural frame capabilities were reported by the clinical specialists/APPs and there were some differences to those reported by the managers. In keeping with the reported leadership capabilities of the physiotherapy managers, the employment of capabilities associated with the political frame varied between participants and symbolic frame capabilities were underused. There are many similarities in the self-reported leadership capabilities of managers and clinical specialists/APPs. However, differences were also noted. Both cohorts of physiotherapy leaders may benefit from specific development programs to develop leadership capabilities associated with the political and symbolic frames.

Learning outcomes of occupational therapy and physiotherapy students during their communitybased education attachment

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T Ndlovu

2017-12-01

Full Text Available Background. Community-based education (CBE is a learning approach that enables students to acquire skills by means of applied learning in the community. The goals of CBE include creating adequate knowledge, skills and attitudes that facilitate service delivery in communities. These goals ensure the provision of efficient health services to marginalised communities with significant resource constraints. The Department of Rehabilitation at the University of Zimbabwe, Harare, has adopted CBE as one of the learning approaches that enables students to acquire comprehensive skills for future service provision in the community.Objectives. To determine the learning outcomes of rehabilitation students at the University of Zimbabwe and to identify factors affecting learning during the CBE attachments.Methods. A descriptive cross-sectional survey was conducted at the University of Zimbabwe. Thirty-five final-year occupational therapy and physiotherapy students responded to a self-administered questionnaire. Data were analysed using Microsoft Excel 2013 (USA and SPSS version 21 (IBM Corp., USA.Results. All the students reported that the CBE attachment improved their community-engagement skills, professional skills and personal growth. Barriers to effective learning included inadequate transport (100%, poor internet connectivity (82%, lack of research-related objectives (74% and inadequate resources for CBE activities (60%.Conclusion. The CBE attachment enabled students to gain skills in community engagement, professionalism and personal growth. However, more funding directed towards CBE activities and introducing objectives related to research, are some of the strategies that might improve the students’ learning outcomes during the attachments.

Limited interface between physiotherapy primary care and people with severe mental illness: a qualitative study.

Science.gov (United States)

Lee, Samantha; Waters, Flavie; Briffa, Kathy; Fary, Robyn E

2017-07-01

How do mental health professionals perceive the role of physiotherapists in the care of people with severe and persistent mental illness, and what factors do they perceive as influencing access to physiotherapy services? How do people with severe and persistent mental illness understand the potential role of physiotherapy in their healthcare, and what factors do they perceive as influencing access to physiotherapy services? Qualitative study. Twenty-four mental health professionals and 35 people with severe and persistent mental illness. Interview schedules were developed to explore participants' understanding of physiotherapy, as well as barriers and enablers to service access. Focus groups and interviews were conducted for each group of participants. Transcripts were analysed using an inductive approach to derive key themes. Both the mental health professionals and the people with severe and persistent mental illness expressed a limited understanding of the role and relevance of physiotherapy for physical health in mental healthcare. Common barriers to service access were cost, transport and lack of motivation. Likewise, enablers of reduced cost, provision of transport and education about physiotherapy to improve their understanding were identified. The health system structure and perceived lack of mental health knowledge by physiotherapists influenced referrals from mental health professionals. Consequently, education in mental health for physiotherapists and integration of the service within mental health were identified as potential enablers to physiotherapy access. Limited understanding about physiotherapy and its relevance to physical health in mental healthcare among mental health professionals and people with severe and persistent mental illness was found to be a key factor influencing service access. Limited physiotherapy presence and advocacy within mental health were also highlighted. There is a need for greater understanding about physiotherapy among

[Stroke rehabilitation in nursing homes: intensity of and motivation for physiotherapy].

Science.gov (United States)

Wissink, K S; Spruit-van Eijk, M; Buijck, B I; Koopmans, R T C M; Zuidema, S U

2014-06-01

Stroke is a frequent and potential invalidating disease, of which recovery can be improved by rehabilitation. In The Netherlands old and frail stroke patients are rehabilitated in nursing homes. Probably, the intensity of and motivation for physiotherapy are important for successful discharge. The aim was to determine (1) therapy intensity of and motivation for physical therapy of geriatric stroke patients (2) its correlates and (3) the effect on discharge destination. Data were obtained from the 'GRAMPS'-study, a longitudinal observational study of stroke rehabilitation in 15 Dutch nursing homes. Direct time spent on physiotherapy was registered during admission. Motivation was measured by the Pittsburgh Rehabilitation Participation Scale (PRPS). Data of 84 patients were analysed using uni- and multivariate regression analysis. Patients received an average 109 min of physiotherapy per week. 69 patients (82%) were good motivated for physiotherapy (had all PRPS scores 4 or higher). Therapy intensity was positively associated with the presence of a partner and good motivation. No significant independent variables of motivation were found. Therapy-intensity was positively related to discharge to prior living situation. Intensity of physiotherapy of stroke rehabilitation is an independent variable of successful discharge and is higher when the patient has a partner or is better motivated. These findings stress the importance of high motivation and therapy intensity in geriatric stroke rehabilitation.

5 YEAR PHYSIOTHERAPY AND REHABILITATION RESULTS OF THE PATIENT WITH MILLER FISHER SYNDROME

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Bihter AKINOĞLU

2016-08-01

Full Text Available Background: Miller-Fisher syndrome (MFS is characterized by gait ataxia, external ophtalmoplegia and areflexia and thought as an uncommon variant of Guillain Barre syndrome. Miller-Fisher syndrome is observed in about 5-8% of all Guillain Barre syndrome (GBS cases. In MFS patients, spontaneous improvement was observed in the first 3 months and these improvements were started by the 2nd week. Methods: This case was referred to physiotherapy and rehabilitation program at the 4th week since the appropriate medical treatments were unsuccessful after the attack. The patient was evaluated generally before physiotherapy program, and muscle length, strength loss, deep tendon reflexes, postural impairments and daily difficult activities and positions were assessed. Besides, the desired daily activities were identified by The Canadian Occupational Performance Measure (COPM. Treatment program was adjusted according to the patient and changes during treatment period were observed. Physiotherapy program included classical physiotherapy methods: posture correction, correction of short muscles, muscle strengthening, flexibility increase, balance/coordination, sitting and standing functions and walking improvement and climbing up stairs. Results: After the treatment, lower extremity muscle shortness decreased and muscle strength, standing on one foot duration, independent walk speed increased in time. Before treatment, he could not climbing upstairs, but it was achieved 1 year after the treatment. Berg balance score increased in time and his most desired activities by COPM (10/10 were could be performed after the treatment. Conclusion: The case improved with physiotherapy and rehabilitation program gradually with years.In the treatment of MFS patients, physiotherapy and rehabilitation being part of the treatment will be useful.

Physiotherapy and bronchial mucus transport

NARCIS (Netherlands)

van der Schans, CP; Postma, DS; Koeter, GH; Rubin, BK

Cough and expectoration of mucus are the best-known symptoms in patients with pulmonary disease, The most applied intervention for these symptoms is the use of chest physiotherapy to increase bronchial mucus transport and reduce retention of mucus in the airways, Chest physiotherapy interventions

PHYSIOTHERAPY OF BLIND AND LOW VISION INDIVIDUALS

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Alenka Tatjana Sterle

2002-12-01

Full Text Available Background. The authors present a preventive physiotherapy programme intended to improve the well-being of persons who have been blind or visually impaired since birth or experience partial or complete loss of vision later in life as a result of injury or disease.Methods. Different methods and techniques of physiotherapy, kinesitherapy and relaxation used in the rehabilitation of visually impaired persons are described.Results. The goals of timely physical treatment are to avoid unnecessary problems, such as improper posture, tension of the entire body, face and eyes, and deterioration of facial expression, that often accompany partial or complete loss of vision. Regular training improves functional skills, restores the skills that have been lost, and prevents the development of defects and consequent disorders of the locomotor apparatus.Conclusions. It is very difficult to change the life style and habits of blind and visually imapired persons. Especially elderly people who experience complete or partial loss of vision later in their lives are often left to their fate. Therefore blind and visually impaired persons of all age groups should be enrolled in a suitable rehabilitation programme that will improve the quality of their life.

The co-constructive processes in physiotherapy

OpenAIRE

Areskoug Josefsson, Kristina; Andersson, Ann-Christine

2017-01-01

To employ a person-centred approach, it is essential to work with the patient in deciding the important issues that the physiotherapy intervention should target, and to develop and adjust the individual treatment accordingly. Those co-constructive processes of physiotherapy consist of several parts, aiming to improve patient involvement and to optimize intervention outcomes. This paper aims to discuss and bring forward the role of the co-constructive processes in physiotherapy, by using persp...

Decreasing Striatopallidal Pathway Function Enhances Motivation by Energizing the Initiation of Goal-Directed Action

Science.gov (United States)

Carvalho Poyraz, Fernanda; Holzner, Eva; Bailey, Matthew R.; Meszaros, Jozsef; Kenney, Lindsay; Kheirbek, Mazen A.

2016-01-01

Altered dopamine D2 receptor (D2R) binding in the striatum has been associated with abnormal motivation in neuropsychiatric disorders, including schizophrenia. Here, we tested whether motivational deficits observed in mice with upregulated D2Rs (D2R-OEdev mice) are reversed by decreasing function of the striatopallidal “no-go” pathway. To this end, we expressed the Gαi-coupled designer receptor hM4D in adult striatopallidal neurons and activated the receptor with clozapine-N-oxide (CNO). Using a head-mounted miniature microscope we confirmed with calcium imaging in awake mice that hM4D activation by CNO inhibits striatopallidal function measured as disinhibited downstream activity in the globus pallidus. Mice were then tested in three operant tasks that address motivated behavior, the progressive ratio task, the progressive hold-down task, and outcome devaluation. Decreasing striatopallidal function in the dorsomedial striatum or nucleus accumbens core enhanced motivation in D2R-OEdev mice and control littermates. This effect was due to increased response initiation but came at the cost of goal-directed efficiency. Moreover, response vigor and the sensitivity to changes in reward value were not altered. Chronic activation of hM4D by administering CNO for 2 weeks in drinking water did not affect motivation due to a tolerance effect. However, the acute effect of CNO on motivation was reinstated after discontinuing chronic treatment for 48 h. Used as a therapeutic approach, striatopallidal inhibition should consider the risk of impairing goal-directed efficiency and behavioral desensitization. SIGNIFICANCE STATEMENT Motivation involves a directional component that allows subjects to efficiently select the behavior that will lead to an optimal outcome and an activational component that initiates and maintains the vigor and persistence of actions. Striatal output pathways modulate motivated behavior, but it remains unknown how these pathways regulate specific

Decreasing Striatopallidal Pathway Function Enhances Motivation by Energizing the Initiation of Goal-Directed Action.

Science.gov (United States)

Carvalho Poyraz, Fernanda; Holzner, Eva; Bailey, Matthew R; Meszaros, Jozsef; Kenney, Lindsay; Kheirbek, Mazen A; Balsam, Peter D; Kellendonk, Christoph

2016-06-01

Altered dopamine D2 receptor (D2R) binding in the striatum has been associated with abnormal motivation in neuropsychiatric disorders, including schizophrenia. Here, we tested whether motivational deficits observed in mice with upregulated D2Rs (D2R-OEdev mice) are reversed by decreasing function of the striatopallidal "no-go" pathway. To this end, we expressed the Gαi-coupled designer receptor hM4D in adult striatopallidal neurons and activated the receptor with clozapine-N-oxide (CNO). Using a head-mounted miniature microscope we confirmed with calcium imaging in awake mice that hM4D activation by CNO inhibits striatopallidal function measured as disinhibited downstream activity in the globus pallidus. Mice were then tested in three operant tasks that address motivated behavior, the progressive ratio task, the progressive hold-down task, and outcome devaluation. Decreasing striatopallidal function in the dorsomedial striatum or nucleus accumbens core enhanced motivation in D2R-OEdev mice and control littermates. This effect was due to increased response initiation but came at the cost of goal-directed efficiency. Moreover, response vigor and the sensitivity to changes in reward value were not altered. Chronic activation of hM4D by administering CNO for 2 weeks in drinking water did not affect motivation due to a tolerance effect. However, the acute effect of CNO on motivation was reinstated after discontinuing chronic treatment for 48 h. Used as a therapeutic approach, striatopallidal inhibition should consider the risk of impairing goal-directed efficiency and behavioral desensitization. Motivation involves a directional component that allows subjects to efficiently select the behavior that will lead to an optimal outcome and an activational component that initiates and maintains the vigor and persistence of actions. Striatal output pathways modulate motivated behavior, but it remains unknown how these pathways regulate specific components of motivation. Here

Physiotherapy and cardiac rhythm devices: a review of the current scope of practice.

Science.gov (United States)

Digby, Geneviève C; Daubney, Marguerite E; Baggs, Jim; Campbell, Debra; Simpson, Christopher S; Redfearn, Damian P; Brennan, F James; Abdollah, Hoshiar; Baranchuk, Adrian

2009-07-01

are best avoided in patients with CRDs. However, there is no consensus and it may be possible to safely deliver these modalities in a proper setting with device and patient monitoring. Although further research is required in this regard, active collaboration between physiotherapists and CRD clinic physicians should allow for the safe application of most physiotherapy modalities.

Gross anatomy education for South African undergraduate physiotherapy students.

Science.gov (United States)

Shead, Dorothy A; Roos, Ronel; Olivier, Benita; Ihunwo, Amadi O

2018-01-16

Eight faculties in South Africa offer undergraduate physiotherapy training with gross anatomy included as a basis for clinical practice. Little information exists about anatomy education for this student body. A 42-question peer-reviewed survey was distributed to physiotherapy gross anatomy course coordinators in all the eight faculties. Seven coordinators from six (75%) of the universities responded. Two respondents' data from the same university were pooled. Collected data show that staff qualifications and experience varied widely and high to average staff to student ratios exist between faculties. Direct anatomy teaching duration was 12.3 (SD ±5.2) weeks per semester. Total number of weeks in courses per faculty was 27.6 (SD ±5.7) varying widely between institutions. Calculable direct contact anatomy hours ranged between 100 and 308 with a mean of 207.6 (SD ±78.1). Direct contact hours in lectures averaged 3.9 (SD ±1.6) per week and the average direct contact hours in practical sessions were 3.5 (SD ±1.8) per week. Dissection, prosection, plastinated models, surface anatomy, and e-learning were available across faculties. Ancillary modalities such as vertical integration and inter-professional learning were in use. All faculties had multiple-choice questions, spot tests, and short examination questions. Half had viva-voce examinations and one had additional long questions assessment. Students evaluated teaching performance in five faculties. Four faculties were reviewing anatomy programs to consider implementing changes to anatomy curriculum or pedagogy. The findings highlighted disparity between programs and also identified the need for specific guidelines to develop a unified South African gross anatomy course for physiotherapy students. Anat Sci Educ. © 2018 American Association of Anatomists. © 2018 American Association of Anatomists.

Physiotherapy intervention in Parkinson's disease: systematic review and meta-analysis.

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Tomlinson, Claire L; Patel, Smitaa; Meek, Charmaine; Herd, Clare P; Clarke, Carl E; Stowe, Rebecca; Shah, Laila; Sackley, Catherine; Deane, Katherine H O; Wheatley, Keith; Ives, Natalie

2012-08-06

To assess the effectiveness of physiotherapy compared with no intervention in patients with Parkinson's disease. Systematic review and meta-analysis of randomised controlled trials. Literature databases, trial registries, journals, abstract books, and conference proceedings, and reference lists, searched up to the end of January 2012. Randomised controlled trials comparing physiotherapy with no intervention in patients with Parkinson's disease were eligible. Two authors independently abstracted data from each trial. Standard meta-analysis methods were used to assess the effectiveness of physiotherapy compared with no intervention. Tests for heterogeneity were used to assess for differences in treatment effect across different physiotherapy interventions used. Outcome measures were gait, functional mobility and balance, falls, clinician rated impairment and disability measures, patient rated quality of life, adverse events, compliance, and economic analysis outcomes. 39 trials of 1827 participants met the inclusion criteria, of which 29 trials provided data for the meta-analyses. Significant benefit from physiotherapy was reported for nine of 18 outcomes assessed. Outcomes which may be clinically significant were speed (0.04 m/s, 95% confidence interval 0.02 to 0.06, P<0.001), Berg balance scale (3.71 points, 2.30 to 5.11, P<0.001), and scores on the unified Parkinson's disease rating scale (total score -6.15 points, -8.57 to -3.73, P<0.001; activities of daily living subscore -1.36, -2.41 to -0.30, P=0.01; motor subscore -5.01, -6.30 to -3.72, P<0.001). Indirect comparisons of the different physiotherapy interventions found no evidence that the treatment effect differed across the interventions for any outcomes assessed, apart from motor subscores on the unified Parkinson's disease rating scale (in which one trial was found to be the cause of the heterogeneity). Physiotherapy has short term benefits in Parkinson's disease. A wide range of physiotherapy techniques

[Physiotherapy in outpatients with osteoporosis. Insufficient evidence for therapy success].

Science.gov (United States)

Lange, U; Müller-Ladner, U; Teichmann, J

2012-06-01

This prospective study analyzed the quality and number of physiotherapeutic reports, the cooperation between physiotherapists and rheumatologists/osteologists as well as the correctness of the physiotherapy in relation to the respective prescription within the German medical healthcare system. Furthermore, it was evaluated whether reported information is sufficient to evaluate outpatient physiotherapy. In 475 physiotherapeutic prescriptions for conservative treatment of patients with osteoporosis, the report quality was evaluated prospectively. The types of prescription and actually performed physiotherapy were compared. The ability of the patients to demonstrate the exercises, as had to be learned during therapy, was analyzed and also the number of mandatory documented questioned follow-up forms. Furthermore, the efficiency of different types of physiotherapy was evaluated. Only 46 reports from 475 prescriptions were received, i.e., the obligation to report was performed only in 9.7% of the cases. Depending on the type of physiotherapy, there was a different range in reporting (classical massage 6.8%, thermotherapy 12.8%, active muscle training with weights and resistant exercises or in water 9.1-20.4% and electrical field treatment 20%). In 141 prescriptions the patients should have learned to do the exercises by themselves as a home program. However, only 38 patients (27%) were able to demonstrate this at the reassessment appointment. In addition in 38 cases of the 46 reports, i.e. in 82.6%, the physiotherapist asked for another prescription. The data illustrate that for outpatient treatment of osteoporosis patients there is insufficient cooperation between physiotherapists and rheumatologists and/or osteologists. Owing to this shortcoming, the efficiency of physiotherapy could not be evaluated due to lack of prescription reports. Therefore, new control mechanisms as well as sufficient education in prescription of physiotherapy should be implemented.

Physiotherapy postgraduate studies in South Africa: Facilitators and barriers

Directory of Open Access Journals (Sweden)

Saul Cobbing

2017-02-01

Full Text Available Aim: To investigate the facilitators and barriers to attaining a postgraduate physiotherapy degree in South Africa. Methods: A quantitative, cross-sectional design using an internet-based survey was employed. The population of the study included all qualified physiotherapists who had completed community service and who were on the South African Society of Physiotherapy e-mailing list at the time of the study. Results: In all, 425 valid responses were received. The study participants were predominantly white women with a mean age of 36.9 and the majority were working in private practice. A total of 20.5% of respondents had completed a master’s or doctoral degree in physiotherapy, while a further 13% of respondents were registered for a postgraduate degree in physiotherapy at the time of the study. Study participants who had obtained a postgraduate degree identified the same main barriers (namely cost/lack of financial support, family commitments and lack of time and the same main facilitators (namely gaining of expertise, fulfilment of a personal goal and improvement of patient care as participants who had not obtained a postgraduate degree. Participants who had not obtained a postgraduate degree were significantly more likely (p < 0.05 to report concerns regarding their own ability and a lack of motivation as barriers to further study. Conclusion: South African physiotherapists with and without a postgraduate degree reported common facilitators and barriers to pursuing postgraduate studies. In order to ensure that a greater number and diversity of physiotherapists see postgraduate studies as a worthwhile career option, stakeholders in health and education in both the South African public and private sectors need to be engaged to limit the barriers to postgraduate study and seek novel methods of making postgraduate study a more attractive option from a personal development and career perspective.

Mirroring "meaningful" actions: sensorimotor learning modulates imitation of goal-directed actions.

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Catmur, Caroline; Heyes, Cecilia

2017-06-19

Imitation is important in the development of social and technological skills throughout the lifespan. Experiments investigating the acquisition and modulation of imitation (and of its proposed neural substrate, the mirror neuron system) have produced evidence that the capacity for imitation depends on associative learning in which connections are formed between sensory and motor representations of actions. However, evidence that the development of imitation depends on associative learning has been found only for non-goal-directed actions. One reason for the lack of research on goal-directed actions is that imitation of such actions is commonly confounded with the tendency to respond in a spatially compatible manner. However, since the most prominent account of mirror neuron function, and hence of imitation, suggests that these cells encode goal-directed actions, it is important to establish whether sensorimotor learning can also modulate imitation of goal-directed actions. Experiment 1 demonstrated that imitation of goal-directed grasping can be measured while controlling for spatial compatibility, and Experiment 2 showed that this imitation effect can be modulated by sensorimotor training. Together these data support the hypothesis that the capacity for behavioural imitation, and the properties of the mirror neuron system, are constructed in the course of development through associative learning.

A Unifying Approach to Goal-Directed Evaluation

DEFF Research Database (Denmark)

Danvy, Olivier; Rhiger, Morten; Grobauer, Bernd

2001-01-01

Goal-directed evaluation, as embodied in Icon and Snobol, is built on the notions of backtracking and of generating successive results, and therefore it has always been something of a challenge to specify and implement. In this article, we address this challenge using computational monads and par...

Analysis of the physiotherapy industry: challenges for marketing.

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Sheppard, L

1996-01-01

The physiotherapy industry can be analysed using Porter's (1979) five forces. Physiotherapy uses medical, geographic and funding segmentation. The power of the buyers in these segments is considerable. Substitutes are posing a threat to physiotherapy with few barriers to entry to operate in the health care environment. The suppliers, particularly doctors, have significant power in referring clients. Competitive rivalry for these clients can exist between individual physiotherapists and multi-disciplinary clinics. The difference in orientation of private and public physiotherapy can also be a basis for rivalry. Repositioning to view the client as both the supplier and recipients enables the physiotherapy industry to gain competitive advantage and ensures long term growth.

INSTALLING AN ERP SYSTEM WITH A METHODOLOGY BASED ON THE PRINCIPLES OF GOAL DIRECTED PROJECT MANAGEMENT

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Ioannis Zafeiropoulos

2010-01-01

Full Text Available This paper describes a generic methodology to support the process of modelling, adaptation and implementation (MAI of Enterprise Resource Planning Systems (ERPS based on the principles of goal directed project management (GDPM. The proposed methodology guides the project manager through specific stages in order to successfully complete the ERPS implementation. The development of the proper MAI methodology is deemed necessary because it will simplify the installation process of ERPS. The goal directed project management method was chosen since it provides a way of focusing all changes towards a predetermined goal. The main stages of the methodology are the promotion and preparation steps, the proposal, the contract, the implementation and the completion. The methodology was applied as a pilot application by a major ERPS development company. Important benefits were the easy and effective guidance for all installation and analysis stages, the faster installation for the ERPS and the control and cost reduction for the installation, in terms of time, manpower, technological equipment and other resources.

Identity Processes and Intrinsic and Extrinsic Goal Pursuits: Directionality of Effects in College Students.

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Luyckx, Koen; Duriez, Bart; Green, Lindsey M; Negru-Subtirica, Oana

2017-08-01

Identity research has mainly focused on the degree to which adolescents and emerging adults engage in exploration and commitment to identity goals and strivings. Somewhat lacking from this research tradition is an explicit focus on the content of the identity goals that individuals deem important and pursue. The present manuscript describes two longitudinal studies sampling college students in which we examine how exploration and commitment processes relate to intrinsic and extrinsic goal pursuits as defined in Self-Determination Theory. Study 1 was a two-wave longitudinal study spanning 6 months (N = 370; 77.4% women; mean age 18.24 years); Study 2 was a three-wave longitudinal study spanning 6 months (N = 458 students; 84.9% women; mean age 18.25 years). Using cross-lagged path analyses, hypotheses were supported to various degrees of convergence between studies, pointing to the extent of which results were replicated across our two independent longitudinal samples. Whereas an intrinsic goal orientation positively predicted commitment making (Study 1) and identification with commitment over time (Studies 1 and 2), an extrinsic goal orientation positively predicted ruminative exploration over time, which led to decreases in intrinsic orientation over time (Study 2). Further, an intrinsic goal orientation negatively predicted ruminative exploration over time (Study 1). The findings in for pro-active exploration processes were inconsistent across both studies, being prospectively related to both intrinsic (Study 2) and extrinsic goal orientations (Study 1). Implications and suggestions for future research are discussed.

Inpatient Physiotherapy Management for Stiff-Person Syndrome: A Case Report

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Kahraman

2016-01-01

Full Text Available Introduction Stiff-person syndrome (SPS is a rare autoimmune neurological disorder presenting with inability to perform daily activities independently. Because SPS is a rare disorder, the efficacy of physiotherapy in the management of SPS is not yet known. Case Presentation The patient was a 65-year-old female with SPS diagnosed 1 year before. Assessments were performed, such as range of motion, muscle strength, pain, balance, and functional mobility. She had shoulder pain, with a score of 5/10 on the numerical pain rating scale for both shoulders. Moreover, her muscle strength was impaired. Although the patient could not maintain an upright position or walk, she had sitting balance. The physiotherapy functional mobility profile (PFMP was scored as 35/63. She received 14 sessions of physiotherapy intervention, which included exercises to improve strength, flexibility, posture, balance, and functional mobility. Walking exercises were performed after the patient gained the ability to maintain an upright stance. Her muscle strength and posture improved, and her pain disappeared. The patient could maintain upright position and began to walk with a walker. At the end of the physiotherapy program, the PFMP was scored as 49/63, and the patient was able to walk 20 m with a walker without need to rest. Conclusions Inpatient physiotherapy management for SPS seems effective in improving balance, gait, and functional mobility.

Current Uses (and Potential Misuses) of Facebook: An Online Survey in Physiotherapy.

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Laliberté, Maude; Beaulieu-Poulin, Camille; Campeau Larrivée, Alexandre; Charbonneau, Maude; Samson, Émilie; Ehrmann Feldman, Debbie

2016-01-01

In recent years, the use of social media such as Facebook has become extremely popular and widespread in our society. Among users are health care professionals, who must develop ways to extend their professionalism online. Before issuing formal guidelines, policies, or recommendations to guide online behaviours, there is a need to know to what extent Facebook influences the professional life of physiotherapy professionals. Our goal was to explore knowledge and behaviour that physiotherapists and physical rehabilitation therapists practicing in Quebec have of Facebook. We used an empirical cross-sectional online survey design (n=322, response rate 4.5%). The results showed that 84.3% of physiotherapy professionals had a Facebook account. Almost all had colleagues or former colleagues as Facebook friends, 21% had patients as friends, and 27% had employers as friends. More than a third of workplaces had clinic pages with information intended for the public. Regarding workplace Facebook policies, 37.3% said that there was no policy and another 41.6% were not aware whether there was one or not. There appears to be a need to establish guidelines regarding the use of social media for physiotherapy professionals to ensure maintenance of professionalism and ethical conduct.

The economic value of an investment in physiotherapy education: a net present value analysis

OpenAIRE

George Rivers; Jonathan Foo; Dragan Ilic; Peter Nicklen; Scott Reeves; Kieran Walsh; Stephen Maloney

2015-01-01

Questions: What is the economic value for an individual to invest in physiotherapy undergraduate education in Australia? How is this affected by increased education costs or decreased wages? Design: A cost-benefit analysis using a net present value (NPV) approach was conducted and reported in Australian dollars. In relation to physiotherapy education, the NPV represents future earnings as a physiotherapist minus the direct and indirect costs in obtaining the degree. Sensitivity analyses were ...

Towards evidence-based physiotherapy for patients with stroke

NARCIS (Netherlands)

van Peppen, R.P.S.

2008-01-01

The first aim of the thesis was to collect and review systematically, and to appraise critically the available evidence stemming from physiotherapy and physiotherapy-related studies in patients with stroke. It can be concluded that the application of physiotherapy improves performance to execute

Physiotherapy contributions to weaning and extubation of patients ...

African Journals Online (AJOL)

MV and (ii) describe current physiotherapy practice related to weaning and extubation. Methods ... and extubation; weaning interventions and physiotherapy modalities; physiotherapy autonomy; .... team in ICU on extubation of patients. .... in intensive care and maintenance of muscle strength have been shown to reduce the ...

Indicators of adherence to physiotherapy attendance among Saudi female patients with mechanical low back pain: a clinical audit

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Al-Eisa Einas

2010-06-01

Full Text Available Abstract Background Among current musculoskeletal interventions used to treat low back pain (LBP, physiotherapy exercise has the highest evidence of effectiveness in avoiding recurrence and chronic disability. However, effectiveness of physiotherapy is thought to be directly related to the patients' adherence to physiotherapy. Since adherence is reported to be directly influenced by socio-cultural factors, this study was conducted to investigate factors related to patients' adherence in a group of Saudi female patients with LBP. Methods A retrospective chart review was conducted on female LBP patients referred to the department of physiotherapy at a local tertiary hospital over a 12 month period. A total of 98 charts were reviewed. Two physiotherapists specialized in musculoskeletal rehabilitation collected information from the medical files. Data were classified in three categories: patients' personal demographics, patients' medical condition and history, and type of physiotherapy administered. Contingency tables and chi-square test were computed to test for differences in proportions. Spearman rank correlation coefficient was calculated to examine relationships among variables. Results Subjects who attended their scheduled appointments were classified as adherent (40%, and those who failed to attend 2 consecutive scheduled appointments and got discharged were classified as non-adherent (60%. Factors that significantly correlated with adherence included: age (r = 0.7, p Conclusion This study reveals an alarming level of non-adherence to physiotherapy among patients with LBP. It remains unclear as to what level of adherence is required to achieve beneficial effect of treatment. It is quite evident however, that early withdrawal from treatment would not allow the therapeutic benefits of the treatment to be realized. Future research should be directed toward developing strategies to improve adherence.

Executive control of stimulus-driven and goal-directed attention in visual working memory.

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Hu, Yanmei; Allen, Richard J; Baddeley, Alan D; Hitch, Graham J

2016-10-01

We examined the role of executive control in stimulus-driven and goal-directed attention in visual working memory using probed recall of a series of objects, a task that allows study of the dynamics of storage through analysis of serial position data. Experiment 1 examined whether executive control underlies goal-directed prioritization of certain items within the sequence. Instructing participants to prioritize either the first or final item resulted in improved recall for these items, and an increase in concurrent task difficulty reduced or abolished these gains, consistent with their dependence on executive control. Experiment 2 examined whether executive control is also involved in the disruption caused by a post-series visual distractor (suffix). A demanding concurrent task disrupted memory for all items except the most recent, whereas a suffix disrupted only the most recent items. There was no interaction when concurrent load and suffix were combined, suggesting that deploying selective attention to ignore the distractor did not draw upon executive resources. A final experiment replicated the independent interfering effects of suffix and concurrent load while ruling out possible artifacts. We discuss the results in terms of a domain-general episodic buffer in which information is retained in a transient, limited capacity privileged state, influenced by both stimulus-driven and goal-directed processes. The privileged state contains the most recent environmental input together with goal-relevant representations being actively maintained using executive resources.

Preoperative physiotherapy and short-term functional outcomes of primary total knee arthroplasty.

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Mat Eil Ismail, Mohd Shukry; Sharifudin, Mohd Ariff; Shokri, Amran Ahmed; Ab Rahman, Shaifuzain

2016-03-01

Physiotherapy is an important part of rehabilitation following arthroplasty, but the impact of preoperative physiotherapy on functional outcomes is still being studied. This randomised controlled trial evaluated the effect of preoperative physiotherapy on the short-term functional outcomes of primary total knee arthroplasty (TKA). 50 patients with primary knee osteoarthritis who underwent unilateral primary TKA were randomised into two groups: the physiotherapy group (n = 24), whose patients performed physical exercises for six weeks immediately prior to surgery, and the nonphysiotherapy group (n = 26). All patients went through a similar physiotherapy regime in the postoperative rehabilitation period. Functional outcome assessment using the algofunctional Knee Injury and Osteoarthritis Outcome Score (KOOS) scale and range of motion (ROM) evaluation was performed preoperatively, and postoperatively at six weeks and three months. Both groups showed a significant difference in all algofunctional KOOS subscales (p 0.05). Significant differences were observed in the time-versus-treatment analysis between groups for the symptoms (p = 0.003) and activities of daily living (p = 0.025) subscales. No significant difference in ROM was found when comparing preoperative measurements and those at three months following surgery, as well as in time-versus-treatment analysis (p = 0.928). Six-week preoperative physiotherapy showed no significant impact on short-term functional outcomes (KOOS subscales) and ROM of the knee following primary TKA. Copyright: © Singapore Medical Association.

A systematic review of grounded theory studies in physiotherapy.

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Ali, Nancy; May, Stephen; Grafton, Kate

2018-05-23

This systematic review aimed at appraising the methodological rigor of grounded theory research published in the field of physiotherapy to assess how the methodology is understood and applied. A secondary aim was to provide research implications drawn from the findings to guide future grounded theory methodology (GTM) research. A systematic search was conducted in MEDLINE, CINHAL, SPORT Discus, Science Direct, PubMed, Scopus, and Web of Science to identify studies in the field of physiotherapy that reported using GTM and/or methods in the study title and/or abstract. The descriptive characteristics and methodological quality of eligible studies were examined using grounded theory methodology assessment guidelines. The review included 68 studies conducted between 1998 and 2017. The findings showed that GTM is becoming increasingly used by physiotherapy researchers. Thirty-six studies (53%) demonstrated a good understanding and appropriate application of GTM. Thirty-two studies (47%) presented descriptive findings and were considered to be of poor methodological quality. There are several key tenets of GTM that are integral to the iterative process of qualitative theorizing and need to be applied throughout all research practices including sampling, data collection, and analysis.

A STUDY EVALUATING THE EFFECTS OF BOMBAY HOSPITAL PHYSIOTHERAPY PROGRAM AND CONVENTIONAL PHYSIOTHERAPY EXERCISE PROGRAM ON GERIATRIC PATIENTS PRESENTING WITH CALF PAIN

OpenAIRE

Rohit Subhedar; Pallavi Dave; Priyanka Mishra; Shailee Jain

2015-01-01

Objective: To investigate the effects of (BHP-Program) on geriatric patients with calf pain. Method: This research was designed by evaluating the progress report of Geriatric Physiotherapy patients at Multi-specialty Department of Physiotherapy- Bombay Hospital-Indore. The subjects were the patients receiving Physiotherapy at Multi specialty Physiotherapy Department - Bombay Hospital, Indore. VAS scale was used for the pain evaluation. Pain Scale parameters of 30 Patients of age group 60...

Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study.

Science.gov (United States)

Sevenhuysen, Samantha; Farlie, Melanie K; Keating, Jennifer L; Haines, Terry P; Molloy, Elizabeth

2015-04-01

What are the experiences of students and clinical educators in a paired student placement model incorporating facilitated peer-assisted learning (PAL) activities, compared to a traditional paired teaching approach? Qualitative study utilising focus groups. Twenty-four physiotherapy students and 12 clinical educators. Participants in this study had experienced two models of physiotherapy clinical undergraduate education: a traditional paired model (usual clinical supervision and learning activities led by clinical educators supervising pairs of students) and a PAL model (a standardised series of learning activities undertaken by student pairs and clinical educators to facilitate peer interaction using guided strategies). Peer-assisted learning appears to reduce the students' anxiety, enhance their sense of safety in the learning environment, reduce educator burden, maximise the use of downtime, and build professional skills including collaboration and feedback. While PAL adds to the clinical learning experience, it is not considered to be a substitute for observation of the clinical educator, expert feedback and guidance, or hands-on immersive learning activities. Cohesion of the student-student relationship was seen as an enabler of successful PAL. Students and educators perceive that PAL can help to position students as active learners through reduced dependence on the clinical educator, heightened roles in observing practice, and making and communicating evaluative judgments about quality of practice. The role of the clinical educator is not diminished with PAL, but rather is central in designing flexible and meaningful peer-based experiences and in balancing PAL with independent learning opportunities. ACTRN12610000859088. [Sevenhuysen S, Farlie MK, Keating JL, Haines TP, Molloy E (2015) Physiotherapy students and clinical educators perceive several ways in which incorporating peer-assisted learning could improve clinical placements: a qualitative study

An investigation into the alignment of a South African physiotherapy curriculum and the expectations of the healthcare system.

Science.gov (United States)

Ramklass, Serela S

2009-09-01

Until 1994, physiotherapy education and training were aligned with the expectations of the South African healthcare system. Subsequent to policy shifts since 1994, the professional role of physiotherapists has expanded. In the absence of guiding strategies to support this change, physiotherapy curricula have remained relatively static. The paper examines the discrepancies between physiotherapy education and training at a South African university post apartheid and the expectations of the healthcare system. Located within critical feminist research framings and employing narrative inquiry as the selected methodology, data were produced through multiple methods to obtain multiple perspectives and orientations. This multisectorial data production approach involving student physiotherapists, physiotherapy academics and practising physiotherapists included in-depth focus group interviews, individual interviews, life-history biographies and open-ended questionnaires. The data were analysed separately for each group of research participants (physiotherapy students, practitioners and academics), followed by a cross-sector analysis. The analysis illustrated current disciplinary trends and shortcomings of the physiotherapy undergraduate curriculum, whilst highlighting that which is considered valuable and progressive in physiotherapy and health care. The dominant themes that emerged included issues relating to physiotherapy theory and practice, and issues that influenced the construction of relationships in the curriculum. The significance of this study lies in the value of student and practitioner feedback to inform curriculum and professional development in the light of sociopolitical changes and healthcare expectations.

Physiotherapy interventions for patients with chronic pelvic pain: A systematic review of the literature.

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Fuentes-Márquez, Pedro; Cabrera-Martos, Irene; Valenza, Marie Carmen

2018-05-14

To summarize the available scientific evidence on physiotherapy interventions in the management of chronic pelvic pain (CPP). A systematic review of randomized controlled trials was performed. An electronic search of MEDLINE, CINAHL, and Web of Science databases was performed to identify relevant randomized trials from 2010-2016. Manuscripts were included if at least one of the comparison groups received a physiotherapy intervention. Studies were assessed in duplicate for data extraction and risk of bias using the Physiotherapy Evidence Database scale PEDro. Eight of the studies screened met the inclusion criteria. Four manuscripts studied the effects of electrotherapy including intravaginal electrical stimulation, short wave diathermy, respiratory-gated auricular vagal afferent nerve stimulation, percutaneous tibial nerve stimulation, and sono-electro-magnetic therapy with positive results. Three studies focused on manual assessing the efficacy of myofascial versus massage therapy in two of them and ischemic compression for trigger points. Although physiotherapy interventions show some beneficial effects, evidence cannot support the results. Heterogeneity in terms of population phenotype, methodological quality, interpretation of results, and operational definition result in little overall evidence to guide treatment.

Foucault and physiotherapy.

Science.gov (United States)

Nicholls, David A

2012-08-01

For nearly 40 years, researchers have been coming to terms with the impact of Michel Foucault's philosophical work. In fields as diverse as medical sociology, health policy, architecture, urban geography, history, and sport, scholars have made use of Foucault's notions of discourse, knowledge, truth, and power. With a few exceptions, however, Foucault's writings have yet to permeate physiotherapy. Foucault's ideas represent powerful, and highly useful analytical strategies for analyzing our past, present, and future, and his writings provide us with a set of conceptual, methodological, and philosophical approaches to help us unpack the cultural, historical, and social context in which we operate as a profession. In this paper, I attempt to introduce the reader to some of Foucault's radical ideas and show how these might be applied to physiotherapy practice. Drawing on Foucault's writings on the functions of discourse to illustrate how something as benign as a physiotherapist's treatment bed can be understood as something more than a piece of necessary medical technology, I show that by approaching seemingly obvious, everyday objects, practices, systems, and structures, we can learn much about physiotherapy's past, present, and future and apply this knowledge to think in new ways about the profession.

Effects of McGill stabilization exercises and conventional physiotherapy on pain, functional disability and active back range of motion in patients with chronic non-specific low back pain.

Science.gov (United States)

Ghorbanpour, Arsalan; Azghani, Mahmoud Reza; Taghipour, Mohammad; Salahzadeh, Zahra; Ghaderi, Fariba; Oskouei, Ali E

2018-04-01

[Purpose] The aim of this study was to compare the effects of "McGill stabilization exercises" and "conventional physiotherapy" on pain, functional disability and active back flexion and extension range of motion in patients with chronic non-specific low back pain. [Subjects and Methods] Thirty four patients with chronic non-specific low back pain were randomly assigned to McGill stabilization exercises group (n=17) and conventional physiotherapy group (n=17). In both groups, patients performed the corresponding exercises for six weeks. The visual analog scale (VAS), Quebec Low Back Pain Disability Scale Questionnaire and inclinometer were used to measure pain, functional disability, and active back flexion and extension range of motion, respectively. [Results] Statistically significant improvements were observed in pain, functional disability, and active back extension range of motion in McGill stabilization exercises group. However, active back flexion range of motion was the only clinical symptom that statistically increased in patients who performed conventional physiotherapy. There was no significant difference between the clinical characteristics while compared these two groups of patients. [Conclusion] The results of this study indicated that McGill stabilization exercises and conventional physiotherapy provided approximately similar improvement in pain, functional disability, and active back range of motion in patients with chronic non-specific low back pain. However, it appears that McGill stabilization exercises provide an additional benefit to patients with chronic non-specific low back, especially in pain and functional disability improvement.

Knowledge, attitudes and tobacco use among nursing and physiotherapy students.

Science.gov (United States)

Fernández, D; Ordás, B; Álvarez, M J; Ordóñez, C

2015-09-01

As future health educators, nursing and physiotherapy students will play an essential role in the prevention of smoking. To determine the prevalence of smoking among students and to analyse their knowledge of and attitudes towards smoking. This was a descriptive cross-sectional study using an anonymous questionnaire and conducted in a Spanish Faculty of Health Sciences in 2013. 247 nursing and physiotherapy students (82.33%) participated in the study. The global prevalence of smoking (18.2%) was lower compare with the general population group of the same age. We have observed statistical significance in relation to previous studies. Nursing and physiotherapy students showed a low nicotine dependence. We found a lack of knowledge about the harmful effects of cigarette consumption on health. Statistically significant results were also found in relation to degree courses (p students' opinions about their knowledge of strategies and methods to help patients stop smoking. Most students started smoking before commencing their university studies; consequently, interventions should focus on cessation programmes. An analysis of university curricula leading to the award of a degree in the health sciences could serve to identify educational deficiencies in order to implement the necessary modifications. This paper presents an update in tobacco use characteristics amongst nursing and physiotherapy students. Those results have showed a need to improve the curricula in order to develop specific programmes to improve knowledge, attitudes and beliefs. Measures to prevent smoking must be taken at school. © 2015 International Council of Nurses.

Physiotherapy as a disciplinary institution in modern society - A Foucauldian perspective on physiotherapy in Danish private practice

DEFF Research Database (Denmark)

Præstegaard, Jeanette

2015-01-01

In many Western countries, physiotherapy in a private context is practiced and managed within a neoliberal ideology. Little is known about how private physiotherapeutic practice functions, which is why this study aims to explore how physiotherapy is practiced from the perspective...

Efficacy of physiotherapy for musculoskeletal disorders : What can we learn from research?

NARCIS (Netherlands)

Beckerman, H.; Bouter, L. M.; Van Der Heljden, G. J M G; De Bie, R. A.; Koes, B. W.

1993-01-01

In order to summarize the available clinical evidence for the efficacy of physiotherapy, 400 randomized clinical trials were identified from the literature. Studies were found by using bibliographic databases, citation tracking, and correspondence with researchers in the field. Focusing on disorders

Physical activity in physiotherapy and physical education high school students

Directory of Open Access Journals (Sweden)

Mihailova A.

2014-01-01

Full Text Available A term of health-related physical fitness became topical with four its components: aerobic and/or cardiovascular fitness, body composition, abdominal muscle strength and endurance, and lower back and hamstring flexibility. Complex evaluation of health-related physical fitness and physical activity (PA may show a wider insight in health promotion and disease prevention. The aim of this study was to evaluate physical activity relation to health-related physical fitness in Physiotherapy (PT and Physical Education (PE students. Final study sample consisted of 67 students (46 women and 21 men (aged 21.61 ± 0.71. All participants filled in International Physical Activity Questionnaire. Health-related physical testing included: 1 body composition evaluation, 2 abdominal muscles strength tests, 3 dynamometry, 4 hamstring muscles and m. quadratus lumborum elasticity evaluation tests, 5 bicycle ergometer test (anaerobic threshold, maximal oxygen consumption. Results showed that most students had normal body composition parameters (BMI, body fat, muscle mass, body water in both genders and study programs. Women were less physically active that men, and PA duration was higher in PE students. PT students had higher body composition values, lower cardiorespiratory fitness parameters and lower handgrip strength in both hands than PE students. Greater PA generally implies a higher level of health-related physical fitness. PA significantly positively affects body composition, upper m. rectus abdominisstrength, grip strength and aerobic capacity.

Physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity: a nested mixed-methods randomised-controlled study.

Science.gov (United States)

Boden, Ianthe; El-Ansary, Doa; Zalucki, Nadia; Robertson, Iain K; Browning, Laura; Skinner, Elizabeth H; Denehy, Linda

2018-06-01

To (1) assess memorability and treatment fidelity of pre-operative physiotherapy education prior to elective upper abdominal surgery and, (2) to explore patient opinions on pre-operative education. Mixed-methods analysis of a convenience sample within a larger parallel-group, double-blinded, randomised controlled trial with concealed allocation and intention-to-treat analysis. Tertiary Australian hospital. Twenty-nine patients having upper abdominal surgery attending pre-admission clinic within six-weeks of surgery. The control group received an information booklet about preventing pulmonary complications with early ambulation and breathing exercises. The experimental group received an additional face-to-face 30-minute physiotherapy education and training session on pulmonary complications, early ambulation, and breathing exercises. Primary outcome was proportion of participants who remembered the taught breathing exercises following surgery. Secondary outcomes were recall of information sub-items and attainment of early ambulation goals. These were measured using standardised scoring of a semi-scripted digitally-recorded interview on the 5th postoperative day, and the attainment of early ambulation goals over the first two postoperative days. Experimental group participants were six-times more likely to remember the breathing exercises (95%CI 1.7 to 22) and 11-times more likely (95%CI 1.6 to 70) to report physiotherapy as the most memorable part of pre-admission clinic. Participants reported physiotherapy education content to be detailed, interesting, and of high value. Some participants reported not reading the booklet and professed a preference for face-to-face information delivery. Face-to-face pre-operative physiotherapy education and training prior to upper abdominal surgery is memorable and has high treatment fidelity. ACTRN-12613000664741. Copyright © 2017 Chartered Society of Physiotherapy. All rights reserved.

Occupational exposure to electromagnetic fields in physiotherapy departments

International Nuclear Information System (INIS)

Macca, I.; Scapellato, M. L.; Carrieri, M.; Di Bisceglie, A. P.; Saia, B.; Bartolucci, G. B.

2008-01-01

To assess occupational exposure to electromagnetic fields, 11 microwave (MW), 4 short-wave diathermy and 15 magneto therapy devices were analysed in eight physiotherapy departments. Measurements taken at consoles and environmental mapping showed values above European Directive 2004/40/EC and ACGIH exposure limits at ∼50 cm from MW applicators (2.45 GHz) and above the Directive magnetic field limit near the diathermy unit (27.12 MHz). Levels in front of MW therapy applicators decreased rapidly with distance and reduction in power; this may not always occur in work environments where nearby metal structures (chairs, couches, etc.) may reflect or perturb electromagnetic fields. Large differences in stray field intensities were found for various MW applicators. Measurements of power density strength around MW electrodes confirmed radiation fields between 30 deg. and 150 deg., with a peak at 90 deg., in front of the cylindrical applicator and maximum values between 30 deg. and 150 deg. over the whole range of 180 deg. for the rectangular parabolic applicator. Our results reveal that although most areas show substantially low levels of occupational exposure to electromagnetic fields in physiotherapy units, certain cases of over-occupational exposure limits do exist. (authors)

Speed/accuracy trade-off between the habitual and the goal-directed processes.

Directory of Open Access Journals (Sweden)

Mehdi Keramati

2011-05-01

Full Text Available Instrumental responses are hypothesized to be of two kinds: habitual and goal-directed, mediated by the sensorimotor and the associative cortico-basal ganglia circuits, respectively. The existence of the two heterogeneous associative learning mechanisms can be hypothesized to arise from the comparative advantages that they have at different stages of learning. In this paper, we assume that the goal-directed system is behaviourally flexible, but slow in choice selection. The habitual system, in contrast, is fast in responding, but inflexible in adapting its behavioural strategy to new conditions. Based on these assumptions and using the computational theory of reinforcement learning, we propose a normative model for arbitration between the two processes that makes an approximately optimal balance between search-time and accuracy in decision making. Behaviourally, the model can explain experimental evidence on behavioural sensitivity to outcome at the early stages of learning, but insensitivity at the later stages. It also explains that when two choices with equal incentive values are available concurrently, the behaviour remains outcome-sensitive, even after extensive training. Moreover, the model can explain choice reaction time variations during the course of learning, as well as the experimental observation that as the number of choices increases, the reaction time also increases. Neurobiologically, by assuming that phasic and tonic activities of midbrain dopamine neurons carry the reward prediction error and the average reward signals used by the model, respectively, the model predicts that whereas phasic dopamine indirectly affects behaviour through reinforcing stimulus-response associations, tonic dopamine can directly affect behaviour through manipulating the competition between the habitual and the goal-directed systems and thus, affect reaction time.

Physiotherapy after arthroscopic partial meniscectomy surgery: an assessment of costs to the National Health Service, patients, and society.

Science.gov (United States)

Goodwin, Peter Charles; Ratcliffe, Julie; Morrissey, Matthew Charles

2005-01-01

The purpose of this study was to determine and inform clinicians, managers, and budget allocators of the costs incurred to the British National Health Service (NHS), patient, and society when attending clinic-based physiotherapy compared with not attending clinic-based physiotherapy after arthroscopic partial meniscectomy surgery. The valuation principle used in this study was the economic concept of opportunity cost. Costs were referred to as direct medical (NHS), direct nonmedical (patient), and indirect (societal) costs. Due to the difficulties of their measurement and valuation, intangible costs, in the form of pain and anxiety related to the effect of receiving or not receiving treatment, have not been considered in this analysis. Providing clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is more costly to the NHS and patient, but no more costly to society than when not providing it and does not result in reduced contact with the NHS. Clinic-based physiotherapy after knee arthroscopic partial meniscectomy surgery is costly and evidence is needed that its effectiveness is high enough to support its use.

Intensity and direction of competitive anxiety as a function of goal attainment expectation and competition goal generation.

Science.gov (United States)

O'Brien, M; Hanton, S; Mellalieu, S D

2005-12-01

Jones's control model was adopted to investigate differences in the labelling of symptoms associated with pre-competition anxiety and self-confidence as a function of goal attainment expectation and competition goal generation. Team sport performers (N = 96) were divided into outcome, performance and process goal groups. Anxiety intensity and direction, and self-confidence were then examined as a function of goal expectancy (positive or negative) and perceived input into goal production (input or no input). MANOVA and follow-up ANOVA supported the study predictions. Specifically, participants who reported positive expectations of goal achievement and indicated some input into the goal generation process experienced the most facilitative interpretations of cognitive symptoms and greater self-confidence. The results highlight the need to consider how goals are generated when attempting to foster a sense of control and help athletes cope with the psychological demands of competition.

Exploring aspects of physiotherapy care valued by breast cancer patients.

Science.gov (United States)

Pidlyskyj, K; Roddam, H; Rawlinson, G; Selfe, J

2014-06-01

To explore the reported value of physiotherapy care received by patients who had accessed a Specialist Breast Care Physiotherapy Service. Exploratory qualitative study using in-depth interviews to explore aspects of physiotherapy care valued by breast cancer patients. Thematic network analysis was used to interpret the data and bring together the different experiences of the participants and identify common themes. Physiotherapy Department at a NHS Foundation Trust Teaching Hospital. Nineteen participants were recruited and three were selected to take part in the in-depth interviews. All participants had received physiotherapy care from a Specialist Breast Care Physiotherapy Service and had been discharged within the last six months. Participants valued a patient-centred holistic approach to care and access to a Specialist Service with an experienced clinician. In particular the importance of the therapeutic alliance and the value of psychological, emotional and educational support emerged, with the participants feeling empowered in their recovery. Participants reported an overall positive experience of their physiotherapy care. This study supports the need for service providers to evaluate their current physiotherapy provision and subsequently develop Specialised Services to meet the physiotherapy needs of breast cancer patients throughout all stages of their treatment pathway from the delivery of pre-operative care through to post-treatment follow-up. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

African Journal of Physiotherapy and Rehabilitation Sciences

African Journals Online (AJOL)

Knowledge of physiotherapy in the prevention and treatment of soccer injuries ... Profile of children with cerebral palsy attending outpatient physiotherapy clinics in ... exercises on selected cardiopulmonary parameters in patients with asthma ...

The Neural Representation of Goal-Directed Actions and Outcomes in the Ventral Striatum's Olfactory Tubercle

Science.gov (United States)

Gadziola, Marie A.

2016-01-01

The ventral striatum is critical for evaluating reward information and the initiation of goal-directed behaviors. The many cellular, afferent, and efferent similarities between the ventral striatum's nucleus accumbens and olfactory tubercle (OT) suggests the distributed involvement of neurons within the ventral striatopallidal complex in motivated behaviors. Although the nucleus accumbens has an established role in representing goal-directed actions and their outcomes, it is not known whether this function is localized within the nucleus accumbens or distributed also within the OT. Answering such a fundamental question will expand our understanding of the neural mechanisms underlying motivated behaviors. Here we address whether the OT encodes natural reinforcers and serves as a substrate for motivational information processing. In recordings from mice engaged in a novel water-motivated instrumental task, we report that OT neurons modulate their firing rate during initiation and progression of the instrumental licking behavior, with some activity being internally generated and preceding the first lick. We further found that as motivational drive decreases throughout a session, the activity of OT neurons is enhanced earlier relative to the behavioral action. Additionally, OT neurons discriminate the types and magnitudes of fluid reinforcers. Together, these data suggest that the processing of reward information and the orchestration of goal-directed behaviors is a global principle of the ventral striatum and have important implications for understanding the neural systems subserving addiction and mood disorders. SIGNIFICANCE STATEMENT Goal-directed behaviors are widespread among animals and underlie complex behaviors ranging from food intake, social behavior, and even pathological conditions, such as gambling and drug addiction. The ventral striatum is a neural system critical for evaluating reward information and the initiation of goal-directed behaviors. Here we

Shoulder Physiotherapy Exercise Recognition: Machine Learning the Inertial Signals from a Smartwatch

OpenAIRE

Burns, David; Leung, Nathan; Hardisty, Michael; Whyne, Cari; Henry, Patrick; McLachlin, Stewart

2018-01-01

Objective: Participation in a physical therapy program is considered one of the greatest predictors of successful conservative management of common shoulder disorders. However, adherence to these protocols is often poor and typically worse for unsupervised home exercise programs. Currently, there are limited tools available for objective measurement of adherence in the home setting. The goal of this study was to develop and evaluate the potential for performing home shoulder physiotherapy mon...

The efficacy of a short education program and a short physiotherapy program for treating low back pain in primary care: a cluster randomized trial.

Science.gov (United States)

Albaladejo, Celia; Kovacs, Francisco M; Royuela, Ana; del Pino, Rafael; Zamora, Javier

2010-03-01

Cluster randomized clinical trial. To assess the efficacy of a short education program and short physiotherapy program for treating low back pain (LBP) in primary care. There is sparse evidence on the effectiveness of education and physiotherapy programs that are short enough to be feasible in primary care. Sixty-nine primary care physicians were randomly assigned to 3 groups and recruited 348 patients consulting for LBP; 265 (79.8%) were chronic. All patients received usual care, were given a booklet and received a consistent 15 minutes group talk on health education, which focused on healthy nutrition habits in the control group, and on active management for LBP in the "education" and "education + physiotherapy" groups. Additionally, in the "education + physiotherapy" group, patients were given a second booklet and a 15-minute group talk on postural hygiene, and 4 one-hour physiotherapy sessions of exercise and stretching which they were encouraged to keep practicing at home. The main outcome measure was improvement of LBP-related disability at 6 months. Patients' assessment and data analyses were blinded. During the 6-month follow-up period, improvement in the "control" group was negligible. Additional improvement in the "education" and "education + physiotherapy" groups was found for disability (2.0 and 2.2 Roland Morris Questionnaire points, respectively), LBP (1.8 and 2.10 Visual Analogue Scale points), referred pain (1.3 and 1.6 Visual Analogue Scale points), catastrophizing (1.6 and 1.8 Coping Strategies Questionnaire points), physical quality of life (2.9 and 2.9 SF-12 points), and mental quality of life (3.7 and 5.1 SF-12 points). The addition of a short education program on active management to usual care in primary care leads to small but consistent improvements in disability, pain, and quality of life. The addition of a short physiotherapy program composed of education on postural hygiene and exercise intended to be continued at home, increases those

Competition and quality in a physiotherapy market with fixed prices.

Science.gov (United States)

Pekola, Piia; Linnosmaa, Ismo; Mikkola, Hennamari

2017-01-01

Our study focuses on competition and quality in physiotherapy organized and regulated by the Social Insurance Institution of Finland (Kela). We first derive a hypothesis with a theoretical model and then perform empirical analyses of the data. Within the physiotherapy market, prices are regulated by Kela, and after registration eligible firms are accepted to join a pool of firms from which patients choose service providers based on their individual preferences. By using 2SLS estimation techniques, we analyzed the relationship among quality, competition and regulated price. According to the results, competition has a statistically significant (yet weak) negative effect (p = 0.019) on quality. The outcome for quality is likely caused by imperfect information. It seems that Kela has provided too little information for patients about the quality of the service.

Management of temporomandibular joint ankylosis with combination of gap arthroplasty surgery and physiotherapy

Directory of Open Access Journals (Sweden)

Nurul Ramadhanty

2017-08-01

Full Text Available Background. Temporomandibular joint (TMJ ankylosis is a union of the articular surface of the temporal bone to the disc-condyle complex that restricts mandibular movements due to either a fibrous or bony union between the head of the condyle and the glenoid fossa. Common etiological factors are trauma, infection, and pathology in the joint or systemic diseases. The diagnosis of TMJ ankylosis is established through physical and clinical evaluation, and imaging examination. Currently, the surgical techniques used to treat TMJ ankylosis are gap arthroplasty, interpositional arthroplasty, joint reconstruction, and distraction osteogenesis. Purpose. To provide overview about management of temporomandibular joint ankylosis with gap arthroplasty combined with physiotherapy post surgery. Case. A 12-year-old female patient came to Department of Oral and Maxillofacial Surgery with complaint of opening mouth restriction, which occured since one year prior to admission. After complete physical and radiographic examination, patient then was diagnosed with TMJ ankylosis due to neglected odontogenic infection. The treatment was performed with gap arthroplasty under general anesthesia. Patient then underwent physiotherapy after the surgery, including application of heat on the affected region and exercises to open and close mouth. Discussion. Ankylosis of TMJ is an uncommon case that results in chronic and severe limited mouth opening. The critical factor of successful treatment of TMJ ankylosis is early detection, correct surgery approach, implementation of an intensive physiotherapy program, and a good post-operative conduct. Therefore on this patient, gap arthroplasty was the chosen surgery approach followed by intensive physiotherapy. Conclusion.Management goal in TMJ ankylosis is  to increase the patient’s mandibular function, correct associated facial deformity, decrease pain, and prevent reankylosis. Careful surgical technique and subsequent atten

Surgery versus physiotherapy for stress urinary incontinence.

Science.gov (United States)

Labrie, Julien; Berghmans, Bary L C M; Fischer, Kathelijn; Milani, Alfredo L; van der Wijk, Ileana; Smalbraak, Dina J C; Vollebregt, Astrid; Schellart, René P; Graziosi, Giuseppe C M; van der Ploeg, J Marinus; Brouns, Joseph F G M; Tiersma, E Stella M; Groenendijk, Annette G; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E; Adriaanse, Albert H; Schram, Aaltje; Roovers, Jan-Paul W R; Lagro-Janssen, Antoine L M; van der Vaart, Carl H

2013-09-19

Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial therapy. We performed a multicenter, randomized trial to compare physiotherapy and midurethral-sling surgery in women with stress urinary incontinence. Crossover between groups was allowed. The primary outcome was subjective improvement, measured by means of the Patient Global Impression of Improvement at 12 months. We randomly assigned 230 women to the surgery group and 230 women to the physiotherapy group. A total of 49.0% of women in the physiotherapy group and 11.2% of women in the surgery group crossed over to the alternative treatment. In an intention-to-treat analysis, subjective improvement was reported by 90.8% of women in the surgery group and 64.4% of women in the physiotherapy group (absolute difference, 26.4 percentage points; 95% confidence interval [CI], 18.1 to 34.5). The rates of subjective cure were 85.2% in the surgery group and 53.4% in the physiotherapy group (absolute difference, 31.8 percentage points; 95% CI, 22.6 to 40.3); rates of objective cure were 76.5% and 58.8%, respectively (absolute difference, 17.8 percentage points; 95% CI, 7.9 to 27.3). A post hoc per-protocol analysis showed that women who crossed over to the surgery group had outcomes similar to those of women initially assigned to surgery and that both these groups had outcomes superior to those of women who did not cross over to surgery. For women with stress urinary incontinence, initial midurethral-sling surgery, as compared with initial physiotherapy, results in higher rates of subjective improvement and subjective and objective cure at 1 year. (Funded by ZonMw, the Netherlands Organization for Health Research and Development; Dutch Trial Register number, NTR1248.).

Predictors for half-year outcome of impairment in daily life for back pain patients referred for physiotherapy: a prospective observational study.

Science.gov (United States)

Karstens, Sven; Hermann, Katja; Froböse, Ingo; Weiler, Stephan W

2013-01-01

From observational studies, there is only sparse information available on the predictors of development of impairment in daily life for patients receiving physiotherapy. Therefore, our aim was to identify factors which predict impairment in daily life for patients with back pain 6 months after receiving physiotherapy. We conducted a prospective cohort study with 6-month follow-up. Patients were enrolled for treatment in private physiotherapy practices. Patients with a first physiotherapy referral because of thoracic or low back pain, aged 18 to 65 years were included. Primary outcome impairment was measured utilising the 16-item version of the Musculoskeletal Function Assessment Questionnaire. Therapy was documented on a standardized form. Baseline scores for impairment in daily life, symptom characteristics, sociodemographic and psychosocial factors, physical activity, nicotine consumption, intake of analgesics, comorbidity and delivered primary therapy approach were investigated as possible predictors. Univariate and multiple linear regression analyses were performed. A total of 792 patients participated in the study (59% female, mean age 44.4 (SD 11.4), with 6-month follow-up results available from 391 patients. In univariate analysis 17 variables reached significance. In multiple linear regression identified predictors were: impairment in daily life before therapy, mental disorders, duration of the complaints, self-prognosis on work ability, rheumatoid arthritis, age, form of stress at work and physical activity. The variables explain 34% of variance (adjusted R(2), pphysiotherapy patients, this study adds new knowledge for forming appropriate referral guidelines. Impairment in daily life before therapy, mental disorder as comorbidity and the duration of the complaints can be named as outstanding factors. The results of this study can be used to facilitate comparison of patient therapy goals with the prognosis in everyday practice.

Physiotherapy Intervention for Joint Hypermobility in Three Cases with Heritable Connective Tissue Disorders

OpenAIRE

Kaux, Jean-François; Foidart-Dessalle, Marguerite; Croisier, Jean-Louis; Toussaint, Geoffrey; Forthomme, Bénédicte; Crielaard, Jean-Michel

2010-01-01

Introduction: In Joint Hypermobility Syndromes, chronic pain is the most disabling symptom. Its origin can be multiple (i.e. subluxations, sprains, pathologies of tendons, ligaments, peripheral nerves, multiple operations). The goal of this article was intended to discuss appropriate physiotherapy in hyperlax patients. Patients and Method: The recovery process was analyzed in three cases (Marfan Syndrome, Ehlers-Danlos Syndrome and Osteogenesis Imperfecta). Hypermobility was assessed using...

Mediodorsal thalamus hypofunction impairs flexible goal-directed behavior.

Science.gov (United States)

Parnaudeau, Sébastien; Taylor, Kathleen; Bolkan, Scott S; Ward, Ryan D; Balsam, Peter D; Kellendonk, Christoph

2015-03-01

Cognitive inflexibility is a core symptom of several mental disorders including schizophrenia. Brain imaging studies in schizophrenia patients performing cognitive tasks have reported decreased activation of the mediodorsal thalamus (MD). Using a pharmacogenetic approach to model MD hypofunction, we recently showed that decreasing MD activity impairs reversal learning in mice. While this demonstrates causality between MD hypofunction and cognitive inflexibility, questions remain about the elementary cognitive processes that account for the deficit. Using the Designer Receptors Exclusively Activated by Designer Drugs system, we reversibly decreased MD activity during behavioral tasks assessing elementary cognitive processes inherent to flexible goal-directed behaviors, including extinction, contingency degradation, outcome devaluation, and Pavlovian-to-instrumental transfer (n = 134 mice). While MD hypofunction impaired reversal learning, it did not affect the ability to learn about nonrewarded cues or the ability to modulate action selection based on the outcome value. In contrast, decreasing MD activity delayed the ability to adapt to changes in the contingency between actions and their outcomes. In addition, while Pavlovian learning was not affected by MD hypofunction, decreasing MD activity during Pavlovian learning impaired the ability of conditioned stimuli to modulate instrumental behavior. Mediodorsal thalamus hypofunction causes cognitive inflexibility reflected by an impaired ability to adapt actions when their consequences change. Furthermore, it alters the encoding of environmental stimuli so that they cannot be properly utilized to guide behavior. Modulating MD activity could be a potential therapeutic strategy for promoting adaptive behavior in human subjects with cognitive inflexibility. Copyright © 2015 Society of Biological Psychiatry. Published by Elsevier Inc. All rights reserved.

Interprofessional education for physiotherapy, medical and dietetics students: a pilot programme.

Science.gov (United States)

Pullon, Sue; McKinlay, Eileen; Beckingsale, Louise; Perry, Meredith; Darlow, Ben; Gray, Ben; Gallagher, Peter; Hoare, Kath; Morgan, Sonya

2013-03-01

Interprofessional education (IPE) has been shown to enhance interprofessional practice among health professionals. Until recently there has been limited opportunity to undertake such initiatives within existing pre-registration degree courses in New Zealand. This study aimed to test the feasibility of delivering an interprofessional component within existing health professional courses for medicine, physiotherapy and dietetics at the University of Otago, Wellington, New Zealand. An interprofessional case-based course component (on chronic condition management) was developed by academic clinical teachers from schools of medicine, physiotherapy and dietetics at the same location. Evaluation was undertaken using a previously validated pre- and post-survey tool, to ascertain changes in attitude among students towards interprofessional practice, IPE and the effectiveness of health care teams. Focus groups were conducted with students and teachers. Survey results indicated pre-existing positive attitudes to interprofessional practice and education among students. There was a statistically significant increase in positive attitude towards such practice and education, and increased confidence in the effectiveness of heath care teams. Focus group findings were consistent with the survey results for students, and highlighted challenges experienced by the teachers. Students and teachers alike enjoyed the interprofessional interaction and benefited from a collaborative approach to chronic condition management. The timing and nature of learning activities and assessment methods created logistical challenges. Such course components have potential to improve collaborative practice and the quality and safety of health care among graduates. Interprofessional course components need to be equitable across disciplines and embedded in the unidisciplinary courses.

Change in goal ratings as a mediating variable between self-efficacy and physical activity in older men.

Science.gov (United States)

Hall, Katherine S; Crowley, Gail M; McConnell, Eleanor S; Bosworth, Hayden B; Sloane, Richard; Ekelund, Carola C; Morey, Miriam C

2010-06-01

Few studies have examined the associations between exercise self-efficacy, goals, and physical activity over time. This study examines whether self-selected goals mediate the changes in exercise self-efficacy on physical activity over 12 months. Data are derived from 313 older men participating in the Veterans LIFE Study. Changes in exercise self-efficacy were significantly associated with changes in physical activity both directly (betas = 0.25 and 0.24, p goal ratings (betas = 0.19 and 0.20, p goal setting continued to partially mediate the relationship between exercise self-efficacy and physical activity when covariates were added to the models. This study extends the application of social cognitive and goal-setting theories to physical activity by showing that goals partially mediate the relationship between exercise self-efficacy and physical activity over time.

Interpersonal goal support in achieving ideals and oughts: The role of dispositional regulatory focus

NARCIS (Netherlands)

Righetti, F.; Kumashiro, M.

2012-01-01

The present work examines the role of each partner's regulatory focus in the phenomenon of interpersonal goal support in close relationships. We examined the impact of regulatory orientation for interpersonal support of both ideal and ought self goals. Consistent with expectations, two studies

Surgery versus physiotherapy for stress urinary incontinence

NARCIS (Netherlands)

Labrie, J.; Berghmans, B.L.; Fischer, K.; Milani, A.L.; Wijk, I. van; Smalbraak, D.J.; Vollebregt, A.; Schellart, R.P.; Graziosi, G.C.; Ploeg, J.M. van der; Brouns, J.F.; Tiersma, E.S.; Groenendijk, A.G.; Scholten, P.; Mol, B.W.; Blokhuis, E.E.; Adriaanse, A.H.; Schram, A.; Roovers, J.P.; Lagro-Janssen, A.L.M.; Vaart, C.H. van der

2013-01-01

BACKGROUND: Physiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

Surgery versus Physiotherapy for Stress Urinary Incontinence

NARCIS (Netherlands)

Labrie, Julien; Berghmans, Bary L. C. M.; Fischer, Kathelijn; Milani, Alfredo L.; van der Wijk, Ileana; Smalbraak, Dina J. C.; Vollebregt, Astrid; Schellart, Rene P.; Graziosi, Giuseppe C. M.; van der Ploeg, J. Marinus; Brouns, Joseph F. G. M.; Tiersma, E. Stella M.; Groenendijk, Annette G.; Scholten, Piet; Mol, Ben Willem; Blokhuis, Elisabeth E.; Adriaanse, Albert H.; Schram, Aaltje; Roovers, Jan-Paul W. R.; Lagro-Janssen, Antoine L. M.; van der Vaart, Carl H.

2013-01-01

BackgroundPhysiotherapy involving pelvic-floor muscle training is advocated as first-line treatment for stress urinary incontinence; midurethral-sling surgery is generally recommended when physiotherapy is unsuccessful. Data are lacking from randomized trials comparing these two options as initial

Formative Observation of Teaching: Focusing Peer Assistance on Teachers' Developmental Goals

Science.gov (United States)

Drew, Steve; Phelan, Liam; Lindsay, Katherine; Carbone, Angela; Ross, Bella; Wood, Kayleen; Stoney, Susan; Cottman, Caroline

2017-01-01

Peer observation of teaching can provide valuable insights into effective educational practices. By adopting a developmental focus, peer observation can also provide insights into how practices might be enhanced and, importantly, how enhancements in practices might be aligned to teachers' development goals. However, a review of peer observation of…

Physiotherapy after amputation of the limb

OpenAIRE

Pospíšil, Daniel

2010-01-01

In this bachelor thesis the author considers physiotherapy after amputation of the lower limb. The theoretical section describes the anatomy of the lower limb, a procedure for amputation of the lower limb, occupational theraoy and prosthesis. The author then goes on to discuss physiotherapy in relation to two case studies of patients who have had their lower limbs removed.

Assessing the Risk of Orthorexia in Dietetic and Physiotherapy Students Using the BOT (Bratman Test for Orthorexia).

Science.gov (United States)

Dittfeld, Anna; Gwizdek, Katarzyna; Koszowska, Aneta; Nowak, Justyna; Brończyk-Puzoń, Anna; Jagielski, Paweł; Oświęcimska, Joanna; Ziora, Katarzyna

2016-01-01

Orthorexia nervosa is an obsessive-compulsive focus on a "healthy" diet, which manifests as extreme concern about food content. This research was carried out in order to identify highly sensitive behaviours associated with eating a healthy diet. Assessment of risk of orthorexia nervosa among dietetics students compared to physiotherapy students. Presented research was conducted among 229 dietetic students and 201 physiotherapy students. It was based on general personal characteristics, the Bratman Test for Orthorexia (BOT) and questions posed by the authors. 26.6% of the dietetics students and only 14.9% of physiotherapy students were recognised as health food fanatics. The students of both dietetics (88.2%) and physiotherapy (52%) declared that they noticed changes in their attitude towards food after they had become students. It has been observed that these highly sensitive behaviours towards healthy eating are very common in both surveyed groups, however with a stronger tendency among the students of dietetics. © Polish Society for Pediatric Endocrinology and Diabetology.

Manual therapy in addition to physiotherapy does not improve clinical or economic outcomes after ankle fracture.

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Lin, Chung-Wei Christine; Moseley, Anne M; Haas, Marion; Refshauge, Kathryn M; Herbert, Robert D

2008-06-01

The primary aim of this study was to determine the effectiveness and cost-effectiveness of adding manual therapy to a physiotherapy programme for ankle fracture. Assessor-blinded randomized controlled trial. Ninety-four adults were recruited within one week of cast removal for isolated ankle fracture. Inclusion criteria were: they were able to weight-bear as tolerated or partial weight-bear, were referred for physiotherapy, and experienced pain. Ninety-one participants completed the study. Participants were randomly allocated to receive manual therapy (anterior-posterior joint mobilization over the talus) plus a standard physiotherapy programme (experimental), or the standard physiotherapy programme only (control). They were assessed by a blinded assessor at baseline, and at 4, 12 and 24 weeks. The main outcomes were activity limitation and quality of life. Information on costs and healthcare utilization was collected every 4 weeks up to 24 weeks. There were no clinically worthwhile differences in activity limitation or quality of life between groups at any time-point. There was also no between-group difference in quality-adjusted life-years, but the experimental group incurred higher out-of-pocket costs (mean between-group difference = AU$200, 95% confidence interval 26-432). When provided in addition to a physiotherapy programme, manual therapy did not enhance outcome in adults after ankle fracture.

Development of physiotherapy inherent requirement statements - an Australian experience.

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Bialocerkowski, Andrea; Johnson, Amanda; Allan, Trevor; Phillips, Kirrilee

2013-04-16

The United Nations Convention on the Rights of People with Disabilities promotes equal rights of people with a disability in all aspects of their life including their education. In Australia, Disability Discrimination legislation underpins this Convention. It mandates that higher education providers must demonstrate that no discrimination has occurred and all reasonable accommodations have been considered and implemented, to facilitate access and inclusion for a student with a disability. The first step to meeting legislative requirements is to provide students with information on the inherent requirements of a course. This paper describes the steps which were taken to develop inherent requirement statements for a 4-year entry-level physiotherapy program at one Australian university. Inherent requirement statements were developed using an existing framework, which was endorsed and mandated by the University. Items which described inherencies were extracted from Australian physiotherapy professional standards and statutory regulatory requirements, and units contained in the physiotherapy program. Data were integrated into the 8 prescribed domains: ethical behaviour, behavioural stability, legal, communication, cognition, sensory abilities, strength and mobility, and sustainable performance. Statements for each domain were developed using a 5-level framework (introductory statement, description of the inherent requirement, justification for inherency, characteristics of reasonable adjustments and exemplars) and reviewed by a University Review Panel. Refinement of statements continued until no further changes were required. Fifteen physiotherapy inherent requirement statements were developed. The eight domains identified in the existing framework, developed for Nursing, were relevant to the study of physiotherapy. The inherent requirement statements developed in this study provide a transparent, defensible position on the current requirements of physiotherapy study at

Positive affect and physical activity: Testing effects on goal setting, activation, prioritisation, and attainment.

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Cameron, David S; Bertenshaw, Emma J; Sheeran, Paschal

2018-02-01

The present research tested whether incidental positive affect promotes pursuit of physical activity goals. Four key features of goal pursuit were examined - setting physical activity goals (Study 1), goal activation (Study 2), and goal prioritization and goal attainment (Study 3). Participants (N s = 80, 81, and 59, in Studies 1-3, respectively) were randomized to positive affect (joy, hope) or neutral affect (control) conditions in each study. Questionnaire measures of goal level, goal commitment, and means selection (Study 1); a lexical decision task indexed goal activation (Study 2), a choice task captured goal prioritization and MET minutes quantified goal attainment (Study 3). Study 1 showed that positive affect led to a greater number of intended physical activities, and that joy engendered greater willingness to try activities. In Study 2, a positive affect induction led to heightened activation of the physical activity goal compared to the control condition. The joy induction in Study 3 led to greater physical activity, and a trend towards greater goal prioritization. These findings suggest that positive affect enhances the pursuit of physical activity goals. Implications for health behavior theories and interventions are outlined.

Development of an optimised 1:1 physiotherapy intervention post first-time lumbar discectomy: a mixed-methods study

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Rushton, A; White, L; Heap, A; Heneghan, N; Goodwin, P

2016-01-01

Objectives To develop an optimised 1:1 physiotherapy intervention that reflects best practice, with flexibility to tailor management to individual patients, thereby ensuring patient-centred practice. Design Mixed-methods combining evidence synthesis, expert review and focus groups. Setting Secondary care involving 5 UK specialist spinal centres. Participants A purposive panel of clinical experts from the 5 spinal centres, comprising spinal surgeons, inpatient and outpatient physiotherapists, provided expert review of the draft intervention. Purposive samples of patients (n=10) and physiotherapists (n=10) (inpatient/outpatient physiotherapists managing patients with lumbar discectomy) were invited to participate in the focus groups at 1 spinal centre. Methods A draft intervention developed from 2 systematic reviews; a survey of current practice and research related to stratified care was circulated to the panel of clinical experts. Lead physiotherapists collaborated with physiotherapy and surgeon colleagues to provide feedback that informed the intervention presented at 2 focus groups investigating acceptability to patients and physiotherapists. The focus groups were facilitated by an experienced facilitator, recorded in written and tape-recorded forms by an observer. Tape recordings were transcribed verbatim. Data analysis, conducted by 2 independent researchers, employed an iterative and constant comparative process of (1) initial descriptive coding to identify categories and subsequent themes, and (2) deeper, interpretive coding and thematic analysis enabling concepts to emerge and overarching pattern codes to be identified. Results The intervention reflected best available evidence and provided flexibility to ensure patient-centred care. The intervention comprised up to 8 sessions of 1:1 physiotherapy over 8 weeks, starting 4 weeks postsurgery. The intervention was acceptable to patients and physiotherapists. Conclusions A rigorous process informed an

Dutch physiotherapy guidelines for low back pain

NARCIS (Netherlands)

Bekkering, Geertruida E; Hendriks, H.J.M.; Koes, Bart W; Oostendorp, R. A B; Ostelo, R. W J G; Thomassen, J. M C; van Tulder, M. W.

2003-01-01

Many guidelines for the management of low back pain in primary care have been published during recent years, but guidelines for physiotherapy do not yet exist. Therefore, physiotherapy guidelines have been developed, reflecting the consequences of the current state of knowledge of effective and

Monitoring of peri-operative fluid administration by individualized goal-directed therapy

DEFF Research Database (Denmark)

Bundgaard-Nielsen, M; Holte, Kathrine; Secher, N H

2007-01-01

(n = 725) found a reduced hospital stay. Post-operative nausea and vomiting (PONV) and ileus were reduced in three studies and complications were reduced in four studies. Of the monitors that may be applied for goal-directed therapy, only oesophageal Doppler has been tested adequately; however......, several other options exist. CONCLUSION: Goal-directed therapy with the maximization of flow-related haemodynamic variables reduces hospital stay, PONV and complications, and facilitates faster gastrointestinal functional recovery. So far, oesophageal Doppler is recommended, but other monitors...

Mapping the timecourse of goal-directed attention to location and colour in human vision.

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Adams, Rachel C; Chambers, Christopher D

2012-03-01

Goal-directed attention prioritises perception of task-relevant stimuli according to location, features, or onset time. In this study we compared the behavioural timecourse of goal-directed selection to locations and colours by varying the stimulus-onset asynchrony (SOA) between cue and target in a strategic cueing paradigm. Participants reported the presence or absence of a target following prior information regarding its location or colour. Results revealed that preparatory selection by colour is more effective at enhancing perceptual sensitivity than selection by location, even though both types of cue provided equivalent overall information. More detailed analysis revealed that this advantage arose due a limitation of spatial attention in maintaining a sufficiently broad focus (>2°) for target detection across multiple stimuli. In contrast, when target stimuli fell within 2° of the spatial attention spotlight, the strategic advantages and speed of spatial and colour attention were equated. Our findings are consistent with the conclusion that, under spatially optimal conditions, prior spatial and colour information are equally proficient at guiding top-down selection. When spatial locations are ambiguous, however, colour-based selection is the more efficient mechanism. Copyright © 2012 Elsevier B.V. All rights reserved.

[Influence of chest physiotherapy on gastro-œsophageal reflux in children].

Science.gov (United States)

Reychler, G; Jacques, L; Arnold, D; Scheers, I; Smets, F; Sokal, E; Stephenne, X

2015-05-01

Chest physiotherapy is regularly prescribed for children, particularly in cystic fibrosis. Gastro-oesophageal reflux is common in this disease and is associated with certain chest physiotherapy manoeuvres. To evaluate the influence of two chest physiotherapy techniques on gastro-oesophageal reflux in children. Twenty-nine children were investigated by routine pHmetry. During the examination, they performed two chest physiotherapy manoeuvres in a seated position for 10 minutes each with a 5 minutes rest between them. The two manoeuvres used were a slow expiration technique (ELPr) and positive expiratory pressure (PEP). It was a prospective study and the order of manoeuvres was randomised. The pH traces were analysed blindly when all the studies had been completed. In the sample, 21% of children had gastro-oesophageal reflux during the physiotherapy session. No relationship was found between reflux during physiotherapy and pathological reflux (P=0.411) nor the physiotherapy technique used (P=0.219). The use of these two chest physiotherapy techniques in children in a seated position can produce gastro-oesophageal reflux. Copyright © 2015 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Responsiveness of Static and Dynamic Postural Balance Measures in Patients with Anterior Cruciate Ligament Reconstruction Following Physiotherapy Intervention

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Neda Mostafaee

2017-05-01

Full Text Available Background:The main goal of physiotherapy for patients with anterior cruciate ligament reconstruction (ACL-R is to improve postural control and retain knee function. Therefore, clinicians need to use evaluative tools that assess postural changes during physiotherapy. To maximize the clinical utility of the results of these tools, the extracted measures should have appropriate psychometric properties of reliability, validity and responsiveness. No study has yet addressed responsiveness of postural measures in these patients. This study was designed to investigate the responsiveness and determine the minimal clinically important changes (MCIC of static and dynamic postural measures in patients with (ACL-R following physiotherapy. Methods: Static and dynamic postural measures were evaluated at first occasion and again after four weeks physiotherapy. The static measures consisted of center of pressure (COP parameters while dynamic measures included the stability indices. Correlation analysis and ROC curve were applied for assessing the responsiveness. Results:The meanand SD velocity of COP had acceptable responsiveness in both conditions of standing on injured leg with open-eyes and on uninjured leg with closed-eyes, both with nocognitive task. For dynamic measures, stability indices in double-leg standing with closed-eyes with cognitive task condition attained acceptable responsiveness. MCICs for mean and SD velocity in anteroposterior and mediolateral directions were 0.28cm/s, 0.008cm/s, 0.02cm/s, respectively in standing on injured leg with open-eyes; and 0.14cm/s, 0.07cm/s, 0.06cm/s, respectively in uninjured leg with closed-eyes condition. Also, MCICs for anteroposterior, mediolateral and total stability indices were 0.51◦, 0.37◦, 0.34◦, respectively in DCT condition. Conclusion:Our findings provide evidence for selection of appropriate static and dynamic postural measures for assessment of changes in these patients. MCICs for these

The Effects of Methylphenidate on Goal-Directed Behavior in a Rat Model of ADHD

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Joman Y. Natsheh

2015-11-01

Full Text Available Although attentional and motor alterations in Attention Deficit Hyperactivity Disorder (ADHD have been well characterized, less is known about how this disorder impacts goal-directed behavior. To investigate whether there is a misbalance between goal-directed and habitual behaviors in an animal model of ADHD, we tested adult [P75-P105] Spontaneously Hypertensive Rats (SHR (ADHD rat model and Wistar-Kyoto rats (WKY, the normotensive control strain, on an instrumental conditioning paradigm with two phases: a free-operant training phase in which rats separately acquired two distinct action-outcome contingencies, and a choice test conducted in extinction prior to which one of the food outcomes was devalued through specific satiety. To assess the effects of Methylphenidate, a commonly used ADHD medication, on goal-directed behavior, we injected rats with either Methylphenidate or saline prior to the choice test. Both rat strains acquired an instrumental response, with SHR responding at greater rates over the course of training. During the choice test WKY demonstrated goal-directed behavior, responding more frequently on the lever that delivered, during training, the still-valued outcome. In contrast, SHR showed no goal-directed behavior, responding equally on both levers. However, methylphenidate administration prior to the choice test restored goal-directed behavior in SHR, and disrupted this behavior in WKY rats. This study provides the first experimental evidence for selective impairment in goal-directed behavior in rat models of ADHD, and how methylphenidate acts differently on SHR and WKY animals to restore or impair this behavior, respectively.

Physiotherapy students' perspectives of online e-learning for interdisciplinary management of chronic health conditions: a qualitative study.

Science.gov (United States)

Gardner, Peter; Slater, Helen; Jordan, Joanne E; Fary, Robyn E; Chua, Jason; Briggs, Andrew M

2016-02-16

To qualitatively explore physiotherapy students' perceptions of online e-learning for chronic disease management using a previously developed, innovative and interactive, evidence-based, e-learning package: Rheumatoid Arthritis for Physiotherapists e-Learning (RAP-eL). Physiotherapy students participated in three focus groups in Perth, Western Australia. Purposive sampling was employed to ensure maximum heterogeneity across age, gender and educational background. To explore students' perspectives on the advantages and disadvantages of online e-learning, ways to enhance e-learning, and information/learning gaps in relation to interdisciplinary management of chronic health conditions, a semi-structured interview schedule was developed. Verbatim transcripts were analysed using inductive methods within a grounded theory approach to derive key themes. Twenty-three students (78 % female; 39 % with previous tertiary qualification) of mean (SD) age 23 (3.6) years participated. Students expressed a preference for a combination of both online e-learning and lecture-style learning formats for chronic disease management, citing flexibility to work at one's own pace and time, and access to comprehensive information as advantages of e-learning learning. Personal interaction and ability to clarify information immediately were considered advantages of lecture-style formats. Perceived knowledge gaps included practical application of interdisciplinary approaches to chronic disease management and developing and implementing physiotherapy management plans for people with chronic health conditions. Physiotherapy students preferred multi-modal and blended formats for learning about chronic disease management. This study highlights the need for further development of practically-oriented knowledge and skills related to interdisciplinary care for people with chronic conditions among physiotherapy students. While RAP-eL focuses on rheumatoid arthritis, the principles of learning apply to

Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden

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Westerdahl Elisabeth

2010-08-01

Full Text Available Abstract Background Limited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following cardiac surgery. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden. Methods A prospective survey was carried out among physiotherapists treating adult cardiac surgery patients. A total population sample was identified and postal questionnaires were sent to the 33 physiotherapists currently working at the departments of thoracic surgery in Sweden. In total, 29 physiotherapists (response rate 88% from eight hospitals completed the survey. Results The majority (90% of the physiotherapists offered preoperative information. The main rationale of physiotherapy treatment after cardiac surgery was to prevent and treat postoperative complications, improve pulmonary function and promote physical activity. In general, one to three treatment sessions were given by a physiotherapist on postoperative day 1 and one to two treatment sessions were given during postoperative days 2 and 3. During weekends, physiotherapy was given to a lesser degree (59% on Saturdays and 31% on Sundays to patients on postoperative day 1. No physiotherapy treatment was given in the evenings. The routine use of early mobilization and shoulder range of motion exercises was common during the first postoperative days, but the choice of exercises and duration of treatment varied. Patients were reminded to adhere to sternal precautions. There were great variations of instructions to the patients concerning weight bearing and exercises involving the sternotomy. All respondents considered physiotherapy necessary after cardiac surgery, but only half of them considered the physiotherapy treatment offered as optimal. Conclusions The results of this survey show that there are small variations in physiotherapy-supervised mobilization and exercise

Physiotherapy-supervised mobilization and exercise following cardiac surgery: a national questionnaire survey in Sweden.

Science.gov (United States)

Westerdahl, Elisabeth; Möller, Margareta

2010-08-25

Limited published data are available on how patients are mobilized and exercised during the postoperative hospital stay following cardiac surgery. The aim of this survey was to determine current practice of physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden. A prospective survey was carried out among physiotherapists treating adult cardiac surgery patients. A total population sample was identified and postal questionnaires were sent to the 33 physiotherapists currently working at the departments of thoracic surgery in Sweden. In total, 29 physiotherapists (response rate 88%) from eight hospitals completed the survey. The majority (90%) of the physiotherapists offered preoperative information. The main rationale of physiotherapy treatment after cardiac surgery was to prevent and treat postoperative complications, improve pulmonary function and promote physical activity. In general, one to three treatment sessions were given by a physiotherapist on postoperative day 1 and one to two treatment sessions were given during postoperative days 2 and 3. During weekends, physiotherapy was given to a lesser degree (59% on Saturdays and 31% on Sundays to patients on postoperative day 1). No physiotherapy treatment was given in the evenings. The routine use of early mobilization and shoulder range of motion exercises was common during the first postoperative days, but the choice of exercises and duration of treatment varied. Patients were reminded to adhere to sternal precautions. There were great variations of instructions to the patients concerning weight bearing and exercises involving the sternotomy. All respondents considered physiotherapy necessary after cardiac surgery, but only half of them considered the physiotherapy treatment offered as optimal. The results of this survey show that there are small variations in physiotherapy-supervised mobilization and exercise following cardiac surgery in Sweden. However, the frequency and

Goal conflict and goal facilitation as predictors of daily accelerometer-assessed physical activity.

Science.gov (United States)

Presseau, Justin; Tait, Richard I; Johnston, Derek W; Francis, Jill J; Sniehotta, Falko F

2013-12-01

To test whether perceptions of conflicting and facilitating personal goals, and actual daily time spent in their pursuit, predict accelerometer-assessed physical activity (PA). A prospective multilevel design with a daily accelerometer-based assessment of PA over 1 week was used (N = 106). Participants' personal goals were elicited using personal projects analysis. Participants then rated their personal goals in terms of how they were perceived to facilitate and conflict with their regular PA. Items assessing PA-specific intention and perceived behavioral control (PBC) were also embedded within the baseline measures. For the subsequent 7 consecutive days, participants completed a daily diary based on the day reconstruction method, indicating the time spent in daily episodes involving each of their personal goals, and wore an RT3 tri-axial accelerometer. The main outcome was accelerometer-assessed daily time spent in moderate to vigorous physical activity (MVPA). Random intercept multilevel models indicated that perceived goal facilitation, but not perceived goal conflict, predicted MVPA over and above intention and PBC. Daily time pursuing conflicting goals negatively predicted MVPA when subsequently added to the model and in so doing, attenuated the association between perceived goal facilitation and MVPA. Perceived goal facilitation predicts objectively measured PA over and above intention and PBC, but daily time spent in pursuit of conflicting personal goals provides a better account of how alternative goals relate to engaging in regular PA.

Motivation and value influences in the relative balance of goal-directed and habitual behaviours in obsessive-compulsive disorder.

Science.gov (United States)

Voon, V; Baek, K; Enander, J; Worbe, Y; Morris, L S; Harrison, N A; Robbins, T W; Rück, C; Daw, N

2015-11-03

Our decisions are based on parallel and competing systems of goal-directed and habitual learning, systems which can be impaired in pathological behaviours. Here we focus on the influence of motivation and compare reward and loss outcomes in subjects with obsessive-compulsive disorder (OCD) on model-based goal-directed and model-free habitual behaviours using the two-step task. We further investigate the relationship with acquisition learning using a one-step probabilistic learning task. Forty-eight OCD subjects and 96 healthy volunteers were tested on a reward and 30 OCD subjects and 53 healthy volunteers on the loss version of the two-step task. Thirty-six OCD subjects and 72 healthy volunteers were also tested on a one-step reversal task. OCD subjects compared with healthy volunteers were less goal oriented (model-based) and more habitual (model-free) to reward outcomes with a shift towards greater model-based and lower habitual choices to loss outcomes. OCD subjects also had enhanced acquisition learning to loss outcomes on the one-step task, which correlated with goal-directed learning in the two-step task. OCD subjects had greater stay behaviours or perseveration in the one-step task irrespective of outcome. Compulsion severity was correlated with habitual learning in the reward condition. Obsession severity was correlated with greater switching after loss outcomes. In healthy volunteers, we further show that greater reward magnitudes are associated with a shift towards greater goal-directed learning further emphasizing the role of outcome salience. Our results highlight an important influence of motivation on learning processes in OCD and suggest that distinct clinical strategies based on valence may be warranted.

Is patient responsibility for managing musculoskeletal disorders related to self-reported better outcome of physiotherapy treatment?

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Larsson, Maria E H; Kreuter, Margareta; Nordholm, Lena

2010-07-01

Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.

"Disciplining witnesses" in the teaching of physiotherapy: some insights into the practical accomplishment of a science-based healthcare profession.

Science.gov (United States)

Kell, Clare; Horlick-Jones, Tom

2012-01-01

Physiotherapy in the UK defines itself as a "science-based healthcare profession". Physiotherapy students must undertake at least one thousand hours of learning in live practice settings. Adopting an analytic stance shaped by interaction analysis and workplace studies, and drawing on observational data of placement settings, this paper examines some features of the means by which physiotherapy education is practically accomplished. The paper introduces and utilises a novel notational system for capturing movement and touch in ethnographic fieldwork notes. Our analysis draws upon ideas from Lynch and Macbeth's (1998) study of elementary school science classes. We focus in particular on their notion of "disciplining witnesses" to illustrate how science is enacted -- and plays a privileged role -- within the everyday accomplishment of practice-based physiotherapy education. We show how patients are disciplined to provide information on cue and to act as props for therapeutic demonstrations, while students are disciplined to co-produce standard interpretations of the science of physiotherapy. We conclude the paper with a brief discussion of the ways in which these insights offer a new perspective for physiotherapy practitioners and educators in understanding the nature of interactions entailed in their professional practice, and the role of patients within those interactions.

Toxic epidermal necrolysis and its impact on physiotherapy management: a case report

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J. Schneiderman

2010-01-01

Full Text Available The purpose of this paper is to report on the modified physiotherapy intervention  for  toxic  epidermal  necrolysis  (TEN  in  a 31 year old pregnant human immunodeficiency virus (HIV seropositive woman  on antiretroviral  therapy.  Physiotherapy  intervention  consisted  of  nebulisation  and  the  active  cycle  of  breathing  technique  in  order to  clear  secretions.  To restore  lung  volumes,  the  active  cycle  of  breath-ing  technique  was  utilized  in  addition  to  positive  expiratory  pressure,  incentive  spirometry  and  positioning. Passive  and  active  exercises and  stretches  were  employed  to  maintain  and  regain  range  of  motion in  affected  limbs.  Following  intervention, positive  changes  were  noted  in  outcome  measures  such  as  secretion clearance, breath sounds and general function. It is concluded that physiotherapy intervention has a role to play in the rehabilitation of patients with TEN.

Homebased rehabilitation: Physiotherapy student and client perspectives

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Dianne Parris

2016-05-01

Full Text Available Background. Home-based rehabilitation (HBR in under-resourced areas in a primary healthcare (PHC context exposes students to the real-life situations of their clients. There is a scarcity of literature on student and client experiences of HBR in the physiotherapy context. Increased knowledge of HBR could result in an enhanced experience for both student and client. This study sought to discover the perceptions of final-year physiotherapy students and their clients relating to their experiences of HBR during a PHC placement in a resource-constrained setting. Objectives. To explore the experiences and perceptions of physiotherapy students and their clients regarding HBR as part of clinical training in resource-constrained settings. To discover the barriers to and facilitators of effective HBR. Methods. An exploratory case study was performed. A qualitative phenomenological research design in the interpretivist paradigm was used. Semistructured interviews were conducted with clients (n=7 living in an under-resourced setting, who had received HBR from physiotherapy students. Paired interviews were conducted with final-year physiotherapy students (n=6 after their HBR placement. Results. Clients appreciated the students’ services; however, data revealed communication barriers and unmet expectations. Students reported struggling to adapt to the context, resulting in interventions not being sufficiently client-centred. They voiced a need for language competency and earlier exposure to such contexts. Conclusion. Exposure to real-life situations in under-resourced settings in HBR provides valuable situated and authentic learning opportunities for physiotherapy students. The experience can be useful in preparing graduates to address the needs of the populations they serve during community service.

How much exercise does the enhanced gait-oriented physiotherapy provide for chronic stroke patients?

Science.gov (United States)

Peurala, Sinikka H; Pitkänen, Kauko; Sivenius, Juhani; Tarkka, Ina M

2004-04-01

Physical exercise therapy in sensorimotor rehabilitation of stroke patients includes active and repetitive exercise and task-specific training. The time spent in active practice is fundamental. The purpose of this study was to analyse what was the actual amount of exercise and content of the performed exercise of the three-week gait-oriented physiotherapy program for chronic stroke patients in an in-patient setting. Twenty ambulatory post-stroke patients participated in an in-patient rehabilitation period during which a special effort was made to enhance gait training and the amount of therapy and its contents were recorded in structured form. Baseline and postintervention gait ability assessments were made, but the analysis concentrated on participation records in different forms of therapy. Patients received 19 hours of instructed physiotherapy in three weeks and together with self-initiated training they practised for 28 hours. The practice time in the upright position was 62% of the total duration of the instructed physiotherapy and 35% was performed while sitting. This amount of exercise resulted in improvement of the gait tests. In order to improve gait in the chronic state of disease, a sufficient amount of gait rehabilitation practice can be obtained with a combination of electromechanical gait trainer exercises, physiotherapy, instructed exercise groups and self-initiated training.

A Unifying Approach to Goal-Directed Evaluation

DEFF Research Database (Denmark)

Danvy, Olivier; Grobauer, Bernd; Rhiger, Morten

2001-01-01

semantics coincides with Gudeman’s continuation semantics of Icon. We then compile Icon programs by specializing their interpreter (i.e., by using the first Futamura projection), using type-directed partial evaluation. Through various back ends, including a run-time code generator, we generate ML code, C......Goal-directed evaluation, as embodied in Icon and Snobol, is built on the notions of backtracking and of generating successive results, and therefore it has always been something of a challenge to specify and implement. In this article, we address this challenge using computational monads...... code, and OCaml byte code. Binding-time analysis and partial evaluation of the continuation-based interpreter automatically give rise to C programs that coincide with the result of Proebsting’s optimized compiler....

Physiotherapy students' conceptions of skill at the beginning of their Bachelor studies.

Science.gov (United States)

Kurunsaari, Merja; Piirainen, Arja; Tynjälä, Päivi

2015-05-01

Skills have recently received widespread attention in education policy documents and discussions. This article reports the results of research on Bachelor's degree physiotherapy students' conceptions of skill at the beginning of their studies. The aim of the present study was to examine how beginning students understand skill, and the focus was on conceptions of skill in general rather than on any particular skills. The participants of the study were 35 physiotherapy students. The data were gathered within the first two weeks of their university studies. Specifically, requested essays written by the students were analyzed using the phenomenographic approach. The data-driven analysis yielded four descriptive categories which reflect the students' conceptions of skill: (1) Talents; (2) Skills requiring individual practice; (3) Skills requiring social practice; and (4) Competence requiring collaboration. The categories form a hierarchy. The differences between the categories are described along seven themes of variation. The themes were named: (1) Acquisition; (2) Emotions; (3) Motivation; (4) Reflection; (5) Evaluation; (6) Agency; and (7) Social Environment. This hierarchical system of categories sheds new light on students' understanding of the skill. The findings can be used as a basis for planning physiotherapy curricula, especially for designing skills education and training, and for supporting students along their educational path, especially in offering opportunities for students to reflect on their skill conceptions. Ultimately, physiotherapy students' awareness of different skill conceptions and developing their skills to advise and treat will benefit patients.

Patient-focused goal planning process and outcome after spinal cord injury rehabilitation: quantitative and qualitative audit.

Science.gov (United States)

Byrnes, Michelle; Beilby, Janet; Ray, Patricia; McLennan, Renee; Ker, John; Schug, Stephan

2012-12-01

To evaluate the process and outcome of a multidisciplinary inpatient goal planning rehabilitation programme on physical, social and psychological functioning for patients with spinal cord injury. Clinical audit: quantitative and qualitative analyses. Specialist spinal injury unit, Perth, Australia. Consecutive series of 100 newly injured spinal cord injury inpatients. MAIN MEASURE(S): The Needs Assessment Checklist (NAC), patient-focused goal planning questionnaire and goal planning progress form. The clinical audit of 100 spinal cord injured patients revealed that 547 goal planning meetings were held with 8531 goals stipulated in total. Seventy-five per cent of the goals set at the first goal planning meeting were achieved by the second meeting and the rate of goal achievements at subsequent goal planning meetings dropped to 56%. Based on quantitative analysis of physical, social and psychological functioning, the 100 spinal cord injury patients improved significantly from baseline to discharge. Furthermore, qualitative analysis revealed benefits consistently reported by spinal cord injury patients of the goal planning rehabilitation programme in improvements to their physical, social and psychological adjustment to injury. The findings of this clinical audit underpin the need for patient-focused goal planning rehabilitation programmes which are tailored to the individual's needs and involve a comprehensive multidisciplinary team.

Arts, literature and reflective writing as educational strategies to promote narrative reasoning capabilities among physiotherapy students.

Science.gov (United States)

Caeiro, Carmen; Cruz, Eduardo Brazete; Pereira, Carla Mendes

2014-11-01

The use of arts, literature and reflective writing has becoming increasingly popular in health professionals education. However, research examining its contribution as an educational strategy to promote narrative reasoning capabilities is limited, particularly from the students' perspective. This study aimed to explore the final year physiotherapy students' perspectives about the contribution of arts, literature and reflective writing in facilitating narrative reasoning capabilities. Three focus group meetings using a semi-structured interview schedule were carried out to collect data. Focus group sessions were audiotaped and transcribed verbatim. Interpretative phenomenological analysis was used to conduct the study and analyze the transcripts. Three themes emerged: (1) developmental understanding of the patients' experiences; (2) developmental understanding about the self; and (3) embedding reflection in clinical practice. Students emphasized an increasing capability to be sensitive and vicariously experience the patient's experience. Through reflective writing, students reported they became more capable of thinking critically about their practice and learning needs for continuous professional development. Finally, students highlighted the contribution of these strategies in making reflection part of their practice. Final year physiotherapy students reported enhanced skills of narrative reasoning. The findings support the inclusion of these strategies within the undergraduate physiotherapy curricula.

The efficacy of physiotherapy for musculoskeletal disorders - Overview of the current state of knowledge

NARCIS (Netherlands)

Beckerman, H.; Bouter, L. M.; Van Der Heijden, G. J M G; De Bie, R. A.; Koes, B. W.

1993-01-01

The clinical evidence for the efficacy of physiotherapy found in 180 randomized clinical trials (RCTs) in the literature was summarized. Bibliographic data bases, citation tracking, and correspondence with research in the field provided the material for our study. Focusing on disorders of the

Impaired acquisition of goal-directed action in healthy aging

NARCIS (Netherlands)

de Wit, S.; van de Vijver, I.; Ridderinkhof, K.R.

2014-01-01

According to dual-system theories, instrumental learning is supported by dissociable goal-directed and habitual systems. Previous investigations of the dual-system balance in healthy aging have yielded mixed results. To further investigate this issue, we compared performance of young (17-24 years)

Goal-congruent default network activity facilitates cognitive control.

Science.gov (United States)

Spreng, R Nathan; DuPre, Elizabeth; Selarka, Dhawal; Garcia, Juliana; Gojkovic, Stefan; Mildner, Judith; Luh, Wen-Ming; Turner, Gary R

2014-10-15

Substantial neuroimaging evidence suggests that spontaneous engagement of the default network impairs performance on tasks requiring executive control. We investigated whether this impairment depends on the congruence between executive control demands and internal mentation. We hypothesized that activation of the default network might enhance performance on an executive control task if control processes engage long-term memory representations that are supported by the default network. Using fMRI, we scanned 36 healthy young adult humans on a novel two-back task requiring working memory for famous and anonymous faces. In this task, participants (1) matched anonymous faces interleaved with anonymous face, (2) matched anonymous faces interleaved with a famous face, or (3) matched a famous faces interleaved with an anonymous face. As predicted, we observed a facilitation effect when matching famous faces, compared with anonymous faces. We also observed greater activation of the default network during these famous face-matching trials. The results suggest that activation of the default network can contribute to task performance during an externally directed executive control task. Our findings provide evidence that successful activation of the default network in a contextually relevant manner facilitates goal-directed cognition. Copyright © 2014 the authors 0270-6474/14/3414108-07$15.00/0.

Interaction of Instrumental and Goal-Directed Learning Modulates Prediction Error Representations in the Ventral Striatum.

Science.gov (United States)

Guo, Rong; Böhmer, Wendelin; Hebart, Martin; Chien, Samson; Sommer, Tobias; Obermayer, Klaus; Gläscher, Jan

2016-12-14

Goal-directed and instrumental learning are both important controllers of human behavior. Learning about which stimulus event occurs in the environment and the reward associated with them allows humans to seek out the most valuable stimulus and move through the environment in a goal-directed manner. Stimulus-response associations are characteristic of instrumental learning, whereas response-outcome associations are the hallmark of goal-directed learning. Here we provide behavioral, computational, and neuroimaging results from a novel task in which stimulus-response and response-outcome associations are learned simultaneously but dominate behavior at different stages of the experiment. We found that prediction error representations in the ventral striatum depend on which type of learning dominates. Furthermore, the amygdala tracks the time-dependent weighting of stimulus-response versus response-outcome learning. Our findings suggest that the goal-directed and instrumental controllers dynamically engage the ventral striatum in representing prediction errors whenever one of them is dominating choice behavior. Converging evidence in human neuroimaging studies has shown that the reward prediction errors are correlated with activity in the ventral striatum. Our results demonstrate that this region is simultaneously correlated with a stimulus prediction error. Furthermore, the learning system that is currently dominating behavioral choice dynamically engages the ventral striatum for computing its prediction errors. This demonstrates that the prediction error representations are highly dynamic and influenced by various experimental context. This finding points to a general role of the ventral striatum in detecting expectancy violations and encoding error signals regardless of the specific nature of the reinforcer itself. Copyright © 2016 the authors 0270-6474/16/3612650-11$15.00/0.

An Analysis of Training Focused on Improving SMART Goal Setting for Specific Employee Groups

Science.gov (United States)

Worden, Jeannie M.

2014-01-01

This quantitative study examined the proficiency of employee SMART goal setting following the intervention of employee SMART goal setting training. Current challenges in higher education substantiate the need for employees to align their performance with the mission, vision, and strategic directions of the organization. A performance management…

The acceptability to patients of PhysioDirect telephone assessment and advice services; a qualitative interview study.

Science.gov (United States)

Pearson, Jennifer; Richardson, Jane; Calnan, Michael; Salisbury, Chris; Foster, Nadine E

2016-03-28

In response to long waiting lists and problems with access to primary care physiotherapy, several Primary Care Trusts (PCTs) (now Clinical Commissioning Groups CCGs) developed physiotherapy-led telephone assessment and treatment services. The Medical Research Council (MRC) funded PhysioDirect trial was a randomised control trial (RCT) in four PCTs, with a total of 2252 patients that compared this approach with usual physiotherapy care. This nested qualitative study aimed to explore the acceptability of the PhysioDirect telephone assessment and advice service to patients with musculoskeletal conditions. We conducted 57 semi-structured interviews with adults from 4 PCTs who were referred from general practice to physiotherapy with musculoskeletal conditions and were participating in the PhysioDirect trial. The Framework method was used to analyse the qualitative data. The PhysioDirect service was largely viewed as acceptable although some saw it as a first step to subsequent face-to-face physiotherapy. Most participants found accessing the PhysioDirect service straightforward and smooth, and they valued the faster access to physiotherapy advice offered by the telephone service. Participants generally viewed both the PhysioDirect service and the physiotherapists providing the service as helpful. Participants' preferences and priorities for treatment defined the acceptable features of PhysioDirect but the acceptable features were traded off against less acceptable features. Some participants felt that the PhysioDirect service was impersonal and impaired the development of a good relationship with their physiotherapist, which made the service feel remote and less valuable. The PhysioDirect service was broadly acceptable to participants since it provided faster access to physiotherapy advice for their musculoskeletal conditions. Participants felt that it is best placed as one method of accessing physiotherapy services, in addition to, rather than as a replacement for

Effectiveness of chest physiotherapy in the management of bronchiectasis

International Nuclear Information System (INIS)

Arif, M.; Bashir, M.S.

2014-01-01

Bronchiectasis is a chronic disease in which clearance of sputum is disturbed because bronchi dilated permanently. So for the clearance of sputum we have to use physiotherapy techniques such as postural drainage percussion and vibration (PDPY), active cycle of breathing technique (ACBT), autogenic drainage, positive expiratory pressure, high frequency chest wall oscillation. Objective: To determine the role of Chest Physical therapy intervention in the management of Bronchi ectasis. To compare the prognosis of bronchiectasis with and without chest physiotherapy. Methodology: Data was collected from Gulab Devi Chest Hospital, Lahore. A Randomized Control Trial (RCT) study method was used and 60 patients are studied. In this study, they were divided into 03 groups 1- Antibiotics Therapy 2-Chest Physical therapy 3-Antibiotics and Chest Physical therapy. Each group consistant. (author)

Physiotherapy and Rehabilitation in a Child with Joubert Syndrome

Directory of Open Access Journals (Sweden)

Özge İpek

2017-01-01

Full Text Available Objective. Joubert syndrome (JS is a rare autosomal recessive genetic disorder characterized by brain malformation, hypotonia, breathing abnormalities, ataxia, oculomotor apraxia, and developmental delay. The purpose of this study was to report the efficiency of the physiotherapy and rehabilitation program in a child with JS. Materials and Methods. Our case is a 19-month-old female child with mild clinical signs of JS. The pretreatment and posttreatment motor functioning level of the case was evaluated through the Gross Motor Function Measure (GMFM, whereas the independence level was evaluated through the Pediatric Functional Independence Measure (WeeFIM. The case was included in the rehabilitation program by the physiotherapist for one hour for five days a week throughout the period of 13 months in accordance with the neurodevelopmental treatment principles. Results. The case was able to turn around from the supine position to the reverse direction by oneself, and she was able to rise on her forearms facedown and was able to sit, crawl, and walk independently. The GMFM score was 210, whereas WeeFIM score was 65. Discussion. In the direction of those findings, in Joubert Syndrome, physiotherapy and rehabilitation can be effective in coping with the symptoms causing developmental delay.

Knowledge about idiopathic scoliosis among students of physiotherapy.

Science.gov (United States)

Ciazynski, D; Czernicki, K; Durmala, J

2008-01-01

The aim of the study was to determine the level of basic knowledge about idiopathic scoliosis (IS) among students of physiotherapy. The study included 37 students of Medical University of Silesia (17F and 20M aged 22-25, mean 22.6), attending the 3(rd) year of a 1(st) degree of physiotherapy. All students had credits in kinesiotherapy, including methods of conservative treatment of IS. Students were examined using a questionnaire, comprising general knowledge of IS, questions related to sagittal plane correction, influence of various physical activities on IS and known methods of conservative treatment. 81 students considered IS as 3-D deformity. 62.2% of those questioned would diagnose IS when the Cobb angle reaches 10 degrees . All students agreed that the aetiology of IS remains unknown. 54.1% considered forcible extensory exercises of back as favourable in IS. Questioned students mostly preferred swimming (94.6%), yoga (73.0%) and martial arts (32.4%) as beneficial to IS. The methods of conservative treatment which were known best were: Lehnert-Schroth-Weiss (94.6%), Klapp (91.9%), Majoch (89.2%) and Dobosiewicz (78.4%). The conclusions indicate that the average level of knowledge of idiopathic scoliosis among students of physiotherapy is unsatisfactory, despite the education programme including the SOSORT guidelines. Education in the field of scoliosis should be comprehensive and meet contemporary guidelines and standards.

Monetary reward magnitude effects on behavior and brain function during goal-directed behavior.

Science.gov (United States)

Rosell-Negre, P; Bustamante, J C; Fuentes-Claramonte, P; Costumero, V; Benabarre, S; Barrós-Loscertales, A

2017-08-01

Reward may modulate the cognitive processes required for goal achievement, while individual differences in personality may affect reward modulation. Our aim was to test how different monetary reward magnitudes modulate brain activation and performance during goal-directed behavior, and whether individual differences in reward sensitivity affect this modulation. For this purpose, we scanned 37 subjects with a parametric design in which we varied the magnitude of monetary rewards (€0, €0.01, €0.5, €1 or €1.5) in a blocked fashion while participants performed an interference counting-Stroop condition. The results showed that the brain activity of left dorsolateral prefrontal cortex (DLPFC) and the striatum were modulated by increasing and decreasing reward magnitudes, respectively. Behavioral performance improved as the magnitude of monetary reward increased while comparing the non reward (€0) condition to any other reward condition, or the lower €0.01 to any other reward condition, and this improvement was related with individual differences in reward sensitivity. In conclusion, the locus of influence of monetary incentives overlaps the activity of the regions commonly involved in cognitive control.

Pattern and Pain Assessment of Musculoskeletal Disorders Attending to Physiotherapy Services in Selected Physiotherapy Centres of Dhaka City

Directory of Open Access Journals (Sweden)

Md Ruhul Amin

2015-07-01

Full Text Available Background: Musculoskeletal disorders are the most common causes of severe long-term pain and physical disability, affecting hundreds of millions of people around the world. Among different modalities of treatment and management for musculoskeletal pain, physiotherapy might be cost-effective. Objective: The aim of the study was to determine the pattern and pain assessment of musculoskeletal disorders attending to physiotherapy services in selected physiotherapy centers of Dhaka city. Materials and method: It was a cross sectional study. Sample size was 400 and a pre-tested, modified, semi-structured questionnaire was used to collect the data. Data were analyzed using SPSS software version 16.0. Results: Majority of the respondents (69.2% belonged to 46-65 year age group with least in extreme age groups. Mean±SD of age was 33.58±12.33 years. Most of the respondents were male (69.2%. Study revealed that neck pain (75.2% was the major complaint followed by back pain (48.00%. Regarding pattern of pain, intermittent (73.2% type was predominant. Muscle spasm (29.2% was the main cause for musculoskeletal pain followed by degenerative diseases (27.5%. Of the respondents 55.00% received traction, 91.25% exercise, 21.25% manipulation, 97.95% short wave diathermy, 85.00% ultrasound therapy, 33.75% infra red ray, and 12.75% electrical stimulation as physiotherapy treatment. There were statistically significant difference between sex and severity of pain (p=0.019, educational status and pain persisting time in years (p=0.000. There was also statistically highly significant difference between severity of pain responses before and after physiotherapy treatment (p=0.000. Conclusion: Study concluded that common areas of musculoskeletal pain were neck followed by back and shoulder and pain characteristics were intermittent, radiating, numbness, burning in nature. Respondents had taken medication and different type of physiotherapy services, including traction

Practicing physiotherapy in Danish private practice: an ethical perspective

DEFF Research Database (Denmark)

Præstegaard, Jeanette; Gard, Gunvor; Glasdam, Stinne

2013-01-01

Despite an increasingly growth of professional guidelines, textbooks and research about ethics in Health care, awareness about ethics in Danish physiotherapy private practice seen vague. This article explores how physiotherapists in Danish private practice, from an ethical perspective, perceive...... to practice physiotherapy. The empirical data consists of interviews with twenty-one physiotherapists. The interviews are analysed from a hermeneutic approach, inspired by Ricoeur’s textual interpretation of distanciation. The analysis follows three phases: naı¨ve reading, structural analysis...... and comprehensive analysis. Four main themes are constructed: Beneficence as the driving force; Disciplining the patient through the course of physiotherapy; Balancing between being a trustworthy professional and a businessperson; The dream of a code of practice. Private practice physiotherapy is embedded...

Object-based processes in the planning of goal-directed hand movements

NARCIS (Netherlands)

Bekkering, H.; Pratt, J.

2004-01-01

Theories in motor control suggest that the parameters specified during the planning of goal-directed hand movements to a visual target are defined in spatial parameters like direction and amplitude. Recent findings in the visual attention literature, however, argue widely for early object-based

Prediction of Reach Goals in Depth and Direction from the Parietal Cortex

Directory of Open Access Journals (Sweden)

Matteo Filippini

2018-04-01

Full Text Available Summary: The posterior parietal cortex is well known to mediate sensorimotor transformations during the generation of movement plans, but its ability to control prosthetic limbs in 3D environments has not yet been fully demonstrated. With this aim, we trained monkeys to perform reaches to targets located at various depths and directions and tested whether the reach goal position can be extracted from parietal signals. The reach goal location was reliably decoded with accuracy close to optimal (>90%, and this occurred also well before movement onset. These results, together with recent work showing a reliable decoding of hand grip in the same area, suggest that this is a suitable site to decode the entire prehension action, to be considered in the development of brain-computer interfaces. : Filippini et al. show that it is possible to use parietal cortex activity to predict in which direction the arm will move and how far it will reach. This opens up the possibility of neural prostheses that can accurately guide reach and grasp using signals from this part of the brain. Keywords: neuroprosthetics, offline neural decoding, reaching in depth, monkey, V6A, machine learning, visuomotor transformations, hand guidance, prehension, robotics

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome

DEFF Research Database (Denmark)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik

2016-01-01

BACKGROUND: Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). OBJECTIVE: We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment...... and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. METHODS: Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1-75.9, 1 July 2007...... to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. RESULTS: Within...

Service Level Decision-making in Rural Physiotherapy: Development of Conceptual Models.

Science.gov (United States)

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2016-06-01

Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability; contextual influences; layered decision-making; access issues; value and beliefs; and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with

A therapist-focused knowledge translation intervention for improving patient adherence in musculoskeletal physiotherapy practice.

Science.gov (United States)

Babatunde, Folarin Omoniyi; MacDermid, Joy Christine; MacIntyre, Norma

2017-01-01

Nonadherence to treatment remains high among patients with musculoskeletal conditions with negative impact on the treatment outcomes, use of personal and cost of care. An active knowledge translation (KT) strategy may be an effective strategy to support practice change. The purpose of this study was to deliver a brief, interactive, multifaceted and targeted KT program to improve physiotherapist knowledge and confidence in performing adherence enhancing activities related to risk, barriers, assessment and interventions. We utilised a 2-phase approach in this KT project. Phase 1 involved the development of an adherence tool kit following a synthesis of the literature and an iterative process involving 47 end-users. Clinicians treating patients with musculoskeletal conditions were recruited from two Physiotherapy and Occupational therapy national conferences in Canada. The intervention, based on the acronym SIMPLE TIPS was tested on 51 physiotherapists in phase 2. A pre- and post-repeated measures design was used in Phase 2. Graham's knowledge-to-action cycle was used as the conceptual framework. Participants completed a pre-intervention assessment, took part in a 1-h educational session and completed a post-intervention assessment. A questionnaire was used to measure knowledge of evidence-based treatment adherence barriers, interventions and measures and confidence to perform evidence-based adherence practice activities. Data was analysed using descriptive statistics (frequency and percentage), Fisher's exact test and Wilcoxon Sign-Ranked tests. Barriers and facilitators of adherence were identified under three domains (therapist, patient, health system) in phase 1. Seventy percent of the participants completed the questionnaire. Results indicated that 46.8% of respondents explored barriers including the use of behaviour change strategies and 45.7% reported that they measured adherence but none reported the use of validated outcomes. A significant improvement in

Physiotherapy programme reduces fatigue in patients with advanced cancer receiving palliative care: randomized controlled trial.

Science.gov (United States)

Pyszora, Anna; Budzyński, Jacek; Wójcik, Agnieszka; Prokop, Anna; Krajnik, Małgorzata

2017-09-01

Cancer-related fatigue (CRF) is a common and relevant symptom in patients with advanced cancer that significantly decreases their quality of life. The aim of this study was to evaluate the effect of a physiotherapy programme on CRF and other symptoms in patients diagnosed with advanced cancer. The study was designed as a randomized controlled trial. Sixty patients diagnosed with advanced cancer receiving palliative care were randomized into two groups: the treatment group (n = 30) and the control group (n = 30). The therapy took place three times a week for 2 weeks. The 30-min physiotherapy session included active exercises, myofascial release and proprioceptive neuromuscular facilitation (PNF) techniques. The control group did not exercise. The outcomes included Brief Fatigue Inventory (BFI), Edmonton Symptom Assessment Scale (ESAS) and satisfaction scores. The exercise programme caused a significant reduction in fatigue scores (BFI) in terms of severity of fatigue and its impact on daily functioning. In the control group, no significant changes in the BFI were observed. Moreover, the physiotherapy programme improved patients' general well-being and reduced the intensity of coexisting symptoms such as pain, drowsiness, lack of appetite and depression. The analysis of satisfaction scores showed that it was also positively evaluated by patients. The physiotherapy programme, which included active exercises, myofascial release and PNF techniques, had beneficial effects on CRF and other symptoms in patients with advanced cancer who received palliative care. The results of the study suggest that physiotherapy is a safe and effective method of CRF management.

Physiotherapy Rehabilitation for Osteoporotic Vertebral Fracture (PROVE): study protocol for a randomised controlled trial

Science.gov (United States)

2014-01-01

Background Osteoporosis and vertebral fracture can have a considerable impact on an individual’s quality of life. There is increasing evidence that physiotherapy including manual techniques and exercise interventions may have an important treatment role. This pragmatic randomised controlled trial will investigate the clinical and cost-effectiveness of two different physiotherapy approaches for people with osteoporosis and vertebral fracture, in comparison to usual care. Methods/Design Six hundred people with osteoporosis and a clinically diagnosed vertebral fracture will be recruited and randomly allocated to one of three management strategies, usual care (control - A), an exercise-based physiotherapy intervention (B) or a manual therapy-based physiotherapy intervention (C). Those in the usual care arm will receive a single session of education and advice, those in the active treatment arms (B + C) will be offered seven individual physiotherapy sessions over 12 weeks. The trial is designed as a prospective, adaptive single-blinded randomised controlled trial. An interim analysis will be completed and if one intervention is clearly superior the trial will be adapted at this point to continue with just one intervention and the control. The primary outcomes are quality of life measured by the disease specific QUALLEFO 41 and the Timed Loaded Standing test measured at 1 year. Discussion There are a variety of different physiotherapy packages used to treat patients with osteoporotic vertebral fracture. At present, the indication for each different therapy is not well defined, and the effectiveness of different modalities is unknown. Trial registration Reference number ISRCTN49117867. PMID:24422876

Quality assessment in competency based physiotherapy education

DEFF Research Database (Denmark)

Brandt, Jørgen

Purpose: To ensure a transparent and competency related assessment of physiotherapy education, in order to accomplish a close relationship between competencies at entry level to the profession and challenges in current and future health practice. Relevance: Perspectives and metods regarding...... rehabilitation and health promotion change with demografic evolvement, health politics and patterns of diseases. This calls for an ever ongoing improvement and adjustment of professional competencies being achieved during physiotherapy education. At the same time the education itself is an entity, comitted...... the relationship between learning outcome and demands for professional competencies in practice. This connection is evaluated through the behavior level. It covers newly graduated students perceptions of the degree to which they comply with expectations in physiotherapy practice.Further more the effect level...

Case of physiotherapy care for patient with rheumatoid arthritis diagnosed

OpenAIRE

Koukalová, Martina

2014-01-01

Title of bachelor's thesis: Case of physiotherapy care for patient with rheumatoid arthritis diagnosed Objectives: The aim of this thesis is to show using of physiotherapeutistic methods on patient with rheumatoid arthritis. One part of this thesis is casuistry of patient with rheumatoid arthritis. The summary: The thesis is divided into two parts, the theoretical part and the special part. The theoretical part is focused on issue of rheumatoid arthritis, its characteristic, division, diagnos...

Does evidence support physiotherapy management of adult female chronic pelvic pain? A systematic review

DEFF Research Database (Denmark)

Loving, Sys; Nordling, Jørgen; Jaszczak, Poul

2012-01-01

dysfunction is frequently cited as a possible aetiology. Physiotherapy is therefore recommended as one treatment modality. The aim of this systematic review was to source and critically evaluate the evidence for an effect of physiotherapy on pain, physical activity and quality of life in the treatment...... (RevMan) version 5.0 was used for data analysis. Effect estimates (relative risk, mean difference and mean change) with 95% confidence intervals were calculated for the above outcomes. For significant outcomes the numbers needed to treat were calculated. Results The search strategy identified 3469...... is a new approach that appears to be promising and randomised clinical trials are underway in order to establish its evidence base. Implications Based on the findings of this review, recommendations for physiotherapy in chronic pelvic pain clinical guidelines, textbooks and narrative reviews should...

Exploring perceptions of the educational environment among undergraduate physiotherapy students.

Science.gov (United States)

Palmgren, Per J; Lindquist, Ingrid; Sundberg, Tobias; Nilsson, Gunnar H; Laksov, Klara B

2014-07-19

The aim of this study was to explore areas of strength and weakness in the educational environment as perceived by undergraduate physiotherapy students and to investigate these areas in relation to the respondents' demographic characteristics. This study utilized a cross-sectional study design and employed the Dundee Ready Education Environment Measure, a 50-item, self-administered inventory relating to a variety of topics directly pertinent to educational environments. Convenience sampling was used, and the scores were compared across demographic variables. All undergraduate physiotherapy students in their first five terms of the programme in a major Swedish university were invited to participate in the study. A total of 222 students (80%) completed the inventory. With an overall score of 150/200 (75%), the students rated the educational environment in this institution as "more positive than negative". Two items consistently received deprived scores - authoritarian teachers and teaching with an overemphasis on factual learning. Students in term 4 differed significantly from others, and students with earlier university education experience perceived the atmosphere more negatively than their counterparts. There were no significant differences with regards to other demographic variables. This study provides valuable insight into how undergraduate physiotherapy students perceive their educational environment. In general, students perceived that their educational programme fostered a sound educational environment. However, some areas require remedial measures in order to enhance the educational experience.

Resolution of conflict between goal-directed actions: outcome encoding and neural control processes.

Science.gov (United States)

de Wit, Sanne; Ostlund, Sean B; Balleine, Bernard W; Dickinson, Anthony

2009-07-01

According to O-R theory of instrumental learning, incongruent biconditional discriminations should be impossible to solve in a goal-directed manner because the event acting as the outcome of one response also acts as a discriminative stimulus for an opposite response. Each event should therefore be associated with two competing responses. However, Dickinson and de Wit (2003) have presented evidence that rats can learn incongruent discriminations. The present study investigated whether rats were able to engage additional processes to solve incongruent discriminations in a goal-directed manner. Experiment 1 provides evidence that rats resolve the response conflict that arises in the incongruent discrimination by differentially encoding events in their roles as discriminative stimulus and as outcome. Furthermore, Experiment 2 shows that once goal-directed control has been established the dorsomedial prefrontal cortex is not directly involved in its maintenance but rather plays a central role in conflict resolution processes.

Developing Mobile Clinical Decision Support for Nursing Home Staff Assessment of Urinary Tract Infection using Goal-Directed Design.

Science.gov (United States)

Jones, Wallace; Drake, Cynthia; Mack, David; Reeder, Blaine; Trautner, Barbara; Wald, Heidi

2017-06-20

Unique characteristics of nursing homes (NHs) contribute to high rates of inappropriate antibiotic use for asymptomatic bacteriuria (ASB), a benign condition. A mobile clinical decision support system (CDSS) may support NH staff in differentiating urinary tract infections (UTI) from ASB and reducing antibiotic days. We used Goal-Directed Design to: 1) Characterize information needs for UTI identification and management in NHs; 2) Develop UTI Decide, a mobile CDSS prototype informed by personas and scenarios of use constructed from Aim 1 findings; 3) Evaluate the UTI Decide prototype with NH staff. Focus groups were conducted with providers and nurses in NHs in Denver, Colorado (n= 24). Qualitative descriptive analysis was applied to focus group transcripts to identify information needs and themes related to mobile clinical decision support for UTI identification and management. Personas representing typical end users were developed; typical clinical context scenarios were constructed using information needs as goals. Usability testing was performed using cognitive walk-throughs and a think-aloud protocol. Four information needs were identified including guidance regarding resident assessment; communication with providers; care planning; and urine culture interpretation. Design of a web-based application incorporating a published decision support algorithm for evidence-based UTI diagnoses proceeded with a focus on nursing information needs during resident assessment and communication with providers. Certified nursing assistant (CNA) and registered nurse (RN) personas were constructed in 4 context scenarios with associated key path scenarios. After field testing, a high fidelity prototype of UTI Decide was completed and evaluated by potential end users. Design recommendations and content recommendations were elicited. Goal-Directed Design informed the development of a mobile CDSS supporting participant-identified information needs for UTI assessment and communication

Is physiotherapy effective for children with complex regional pain syndrome type 1?

Science.gov (United States)

Bialocerkowski, Andrea E; Daly, Anne

2012-01-01

This study synthesized current research evidence on the effectiveness of physiotherapy for the management of children diagnosed with complex regional pain syndrome type 1 (CRPS-1), to provide up-to-date physiotherapy treatment recommendations, and to identify areas that require further investigation. Nine electronic databases were searched for quantitative studies that evaluated the effect of physiotherapy on children with CRPS-1. The methodological quality of the studies was evaluated using the Critical Review Form. Data were extracted regarding the study design, participant characteristics, types of outcome measures used, and physiotherapy technique used and its effectiveness. The search strategy identified 303 potential studies, of which 12 met the inclusion criteria (1 randomized controlled trial, 1 comparative study, 10 case series). The methodological quality of all studies was rated as poor to fair. The "stand-alone" value of physiotherapy could not be determined as physiotherapy was prescribed in conjunction with psychological and medical interventions. There is low volume and poor-to-fair quality evidence which suggests that physiotherapy prescribed with other interventions may lead to short-term improvement in the signs and symptoms of CRPS-1 or functional ability in children with CRPS-1, and the relapse rate may be moderately high. High-quality studies are required in this area. These studies should evaluate a package of care (which includes physiotherapy); they should investigate the effects of physiotherapy treatments that have proven effectiveness in adults with CRPS-1; they should use psychometrically sound measures to evaluate outcome; and the nature of physiotherapy should be detailed in future publications to enable replication in the clinical setting.

Physiotherapy management of an infant with Bilateral Congenital ...

African Journals Online (AJOL)

Results: Follow up after one year showed that the child could walk with apparently normal gait and there was no residual deformity Conclusion: There is need for more enlightenment on the importance of early referral of CTEV cases for Physiotherapy care. Keywords: Physiotherapy, talipes equinovarus, passive stretching, ...

The perceptions of Danish physiotherapists on the ethical issues related to the physiotherapist-patient relationship during the first physiotherapy session: A phenomenological approach

DEFF Research Database (Denmark)

Præstegaard, Jeanette; Gard, Gunvor

2011-01-01

Background: In the course of the last four decades, the profession of physiotherapy has progressively expanded its scope of responsibility and its focus on professional autonomy and evidence-based clinical practice. To preserve professional autonomy, it is crucial for the physiotherapy profession...... to meet society’s expectations and demands of professional competence as well as ethical competence. Since it is becoming increasingly popular to choose a carrier in private practice in Denmark this context constitutes the frame of this study. Physiotherapy in private practice involves mainly a meeting...... between two partners: the physiotherapist and the patient. In the meeting, power asymmetry between the two partners is a condition that the physiotherapist has to handle. The aim of this study was to explore whether ethical issues rise during the first physiotherapy session discussed from the perspective...

[Publications in respiratory nursing and physiotherapy].

Science.gov (United States)

Macián Gisbert, Vicente; Sánchez Gómez, Esperanza

2011-01-01

The Respiratory Nursing and Physiotherapy Section of the Spanish Society of Pneumology and Thoracic Surgery, established as a working group more than 19 years ago, has been characterized by a high degree of involvement and collaboration with all the research studies requiring nursing and physiotherapy techniques. However, publication of articles by this collective is scarce compared with that of the rest of the Society and the characteristics, attitudes and limitations of this section pose an obstacle to increasing the number of its publications. This article aims to explain some of the possible reasons that could have given rise to this situation. The new tendencies and the attitude of this collective and the rest of the Society are encouraging and suggest that the work of the Respiratory Nursing and Physiotherapy Section will be better reflected in the future. Copyright © 2011 Sociedad Española de Neumología y Cirugía Torácica. Published by Elsevier Espana. All rights reserved.

Development of physiotherapy inherent requirement statements – an Australian experience

Science.gov (United States)

2013-01-01

Background The United Nations Convention on the Rights of People with Disabilities promotes equal rights of people with a disability in all aspects of their life including their education. In Australia, Disability Discrimination legislation underpins this Convention. It mandates that higher education providers must demonstrate that no discrimination has occurred and all reasonable accommodations have been considered and implemented, to facilitate access and inclusion for a student with a disability. The first step to meeting legislative requirements is to provide students with information on the inherent requirements of a course. This paper describes the steps which were taken to develop inherent requirement statements for a 4-year entry-level physiotherapy program at one Australian university. Case presentation Inherent requirement statements were developed using an existing framework, which was endorsed and mandated by the University. Items which described inherencies were extracted from Australian physiotherapy professional standards and statutory regulatory requirements, and units contained in the physiotherapy program. Data were integrated into the 8 prescribed domains: ethical behaviour, behavioural stability, legal, communication, cognition, sensory abilities, strength and mobility, and sustainable performance. Statements for each domain were developed using a 5-level framework (introductory statement, description of the inherent requirement, justification for inherency, characteristics of reasonable adjustments and exemplars) and reviewed by a University Review Panel. Refinement of statements continued until no further changes were required. Fifteen physiotherapy inherent requirement statements were developed. The eight domains identified in the existing framework, developed for Nursing, were relevant to the study of physiotherapy. Conclusions The inherent requirement statements developed in this study provide a transparent, defensible position on the

Is goal-directed attentional guidance just intertrial priming? A review.

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Lamy, Dominique F; Kristjánsson, Arni

2013-07-01

According to most models of selective visual attention, our goals at any given moment and saliency in the visual field determine attentional priority. But selection is not carried out in isolation--we typically track objects through space and time. This is not well captured within the distinction between goal-directed and saliency-based attentional guidance. Recent studies have shown that selection is strongly facilitated when the characteristics of the objects to be attended and of those to be ignored remain constant between consecutive selections. These studies have generated the proposal that goal-directed or top-down effects are best understood as intertrial priming effects. Here, we provide a detailed overview and critical appraisal of the arguments, experimental strategies, and findings that have been used to promote this idea, along with a review of studies providing potential counterarguments. We divide this review according to different types of attentional control settings that observers are thought to adopt during visual search: feature-based settings, dimension-based settings, and singleton detection mode. We conclude that priming accounts for considerable portions of effects attributed to top-down guidance, but that top-down guidance can be independent of intertrial priming.

Color vision predicts processing modes of goal activation during action cascading.

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Jongkees, Bryant J; Steenbergen, Laura; Colzato, Lorenza S

2017-09-01

One of the most important functions of cognitive control is action cascading: the ability to cope with multiple response options when confronted with various task goals. A recent study implicates a key role for dopamine (DA) in this process, suggesting higher D1 efficiency shifts the action cascading strategy toward a more serial processing mode, whereas higher D2 efficiency promotes a shift in the opposite direction by inducing a more parallel processing mode (Stock, Arning, Epplen, & Beste, 2014). Given that DA is found in high concentration in the retina and modulation of retinal DA release displays characteristics of D2-receptors (Peters, Schweibold, Przuntek, & Müller, 2000), color vision discrimination might serve as an index of D2 efficiency. We used color discrimination, assessed with the Lanthony Desaturated Panel D-15 test, to predict individual differences (N = 85) in a stop-change paradigm that provides a well-established measure of action cascading. In this task it is possible to calculate an individual slope value for each participant that estimates the degree of overlap in task goal activation. When the stopping process of a previous task goal has not finished at the time the change process toward a new task goal is initiated (parallel processing), the slope value becomes steeper. In case of less overlap (more serial processing), the slope value becomes flatter. As expected, participants showing better color vision were more prone to activate goals in a parallel manner as indicated by a steeper slope. Our findings suggest that color vision might represent a predictor of D2 efficiency and the predisposed processing mode of goal activation during action cascading. Copyright © 2017 Elsevier Ltd. All rights reserved.

Increased prevalence of low back pain among physiotherapy students compared to medical students.

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Falavigna, Asdrubal; Teles, Alisson Roberto; Mazzocchin, Thaís; de Braga, Gustavo Lisbôa; Kleber, Fabrício Diniz; Barreto, Felipe; Santin, Juliana Tosetto; Barazzetti, Daniel; Lazzaretti, Lucas; Steiner, Bruna; Beckenkamp, Natália Laste

2011-03-01

Some studies have demonstrated that physiotherapists have a high prevalence of low back pain (LBP). The association between physiotherapy students, who are potentially exposed to the same LBP occupational risks as graduates, and LBP has never been demonstrated. The objective of the study is to evaluate the association between undergraduate physiotherapy study and LBP. The study design includes a cross-sectional study. A questionnaire-based study was carried out with physiotherapy and medical students. LBP was measured as lifetime, 1-year and point prevalence. Bivariate and multivariate analyses were performed to find the factors associated with LBP. Bivariate analyses were also performed to assess differences between LBP characteristics in the two courses. 77.9% of the students had LBP at some point in their lives, 66.8% in the last year and 14.4% of them reported they were suffering from LBP at the moment of answering the questionnaire. Physiotherapy students reported a higher prevalence of LBP when compared with the medical students in all measures. In the logistic regression model, physiotherapy students (A-OR 2.51; 95% CI 1.35-4.67; p = 0.003), and being exposed to the undergraduate study for more than four semesters (A-OR 2.55; 95% CI 1.43-4.55; p = 0.001) were independently associated with LBP. There were no differences between the courses concerning pain intensity and disability. As it was a cross-sectional study, we were not able to observe accurately if there is an increasing incidence of LBP during the course. Also, we did not intend to identify which activities in the course were associated with the development of LBP. This study clearly demonstrated an association between undergraduate physiotherapy study and LBP. The length of course exposure is also associated with LBP.

Effects of aquatic physiotherapy on the improvement of balance and corporal symmetry in stroke survivors

OpenAIRE

Montagna, Jéssica Cristine; Santos, Bárbara C; Battistuzzo, Camila R; Loureiro, Ana Paula C

2014-01-01

Introduction: One of the main problems associate with hemiparesis after stroke is the decrease in balance during static and dynamic postures which can highly affect daily life activities. Objective: To assess the effects of aquatic physiotherapy on the balance and quality of life (SS-QoL) of people with pos stroke. Methods: Chronic stroke participants received at total 18 individual sessions of aquatic physiotherapy using the principle of Halliwick (2x of 40 minutes per week). The outcomes me...

Goal setting: Eating, Physical activity & Weight loss

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No matter what your weight loss goal is, the key to reaching your goals is to make changes to your lifestyle behaviors like eating and physical activity. This involves setting realistic expectations and making a plan.

Feature Interactions Enable Decoding of Sensorimotor Transformations for Goal-Directed Movement

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Barany, Deborah A.; Della-Maggiore, Valeria; Viswanathan, Shivakumar; Cieslak, Matthew

2014-01-01

Neurophysiology and neuroimaging evidence shows that the brain represents multiple environmental and body-related features to compute transformations from sensory input to motor output. However, it is unclear how these features interact during goal-directed movement. To investigate this issue, we examined the representations of sensory and motor features of human hand movements within the left-hemisphere motor network. In a rapid event-related fMRI design, we measured cortical activity as participants performed right-handed movements at the wrist, with either of two postures and two amplitudes, to move a cursor to targets at different locations. Using a multivoxel analysis technique with rigorous generalization tests, we reliably distinguished representations of task-related features (primarily target location, movement direction, and posture) in multiple regions. In particular, we identified an interaction between target location and movement direction in the superior parietal lobule, which may underlie a transformation from the location of the target in space to a movement vector. In addition, we found an influence of posture on primary motor, premotor, and parietal regions. Together, these results reveal the complex interactions between different sensory and motor features that drive the computation of sensorimotor transformations. PMID:24828640

Factors affecting the extent of utilization of physiotherapy services by physicians in Saudi Arabia

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Alshehri, Mansour Abdullah; Alhasan, Hammad; Alayat, Mohamed; Al-subahi, Moayad; Yaseen, Khalid; Ismail, Ayah; Tobaigy, Abdullah; Almalki, Obaid; Alqahtani, Abdulfattah; Fallata, Basmah

2018-01-01

[Purpose] To investigate physicians’ attitudes, opinions and experiences towards physiotherapy services as well as to identify the potential factors that may affect the extent of utilization of physiotherapy services (based on physicians’ beliefs) in Saudi Arabia (SA). [Subjects and Methods] A cross-sectional study was conducted. [Results] A total of 108 respondents met the inclusion criteria. The respondents’ attitude towards physiotherapy was slightly low (53.5%), while their opinions and experiences of physiotherapy indicated some important issues. For example, 50% of them believed that physiotherapists did not create a good awareness about physiotherapy services and 55.5% admitted that they did not have enough information about physiotherapy services. The most potential factor reported by physicians that may affect the extent of utilization of physiotherapy services was the lack of physiotherapist’s skills and knowledge to assess and treat patients (55.3%), followed by the limited knowledge of physicians regarding the types of physiotherapy services (44.5%) and the lack of cooperation between physicians and physiotherapists (40.7%). [Conclusion] There were some factors that limited the extent of utilization of physiotherapy services in SA. Physiotherapy academics and clinicians should attempt to change physicians’ negative attitudes, promoting awareness to provide them with a better understanding of physiotherapy services. PMID:29545681

A Systematic Review of Common Physiotherapy Interventions in School-Aged Children with Cerebral Palsy

Science.gov (United States)

Martin, Liz; Baker, Richard; Harvey, Adrienne

2010-01-01

This systematic review focused on the common conventional physiotherapy interventions used with children with cerebral palsy (CP), aged 4 to 18 years, and critically appraised the recent evidence of each of these interventions using the Oxford Centre for Evidence-Based Medicine Levels of Evidence. The search strategy yielded 34 articles after…

Physiotherapy after Stroke in Ireland: A Qualitative Insight into the Patients' and Physiotherapists' Experience

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Galvin, Rose; Cusack, Tara; Stokes, Emma

2009-01-01

The study aimed to examine the experience of inpatient physiotherapy intervention delivered after stroke in Ireland from two different perspectives: that of the person with stroke and that of the physiotherapist. A qualitative study was conducted involving semistructured interviews with 10 people with stroke and two focus groups with 10 senior…

The economic value of an investment in physiotherapy education: a net present value analysis.

Science.gov (United States)

Rivers, George; Foo, Jonathan; Ilic, Dragan; Nicklen, Peter; Reeves, Scott; Walsh, Kieran; Maloney, Stephen

2015-07-01

What is the economic value for an individual to invest in physiotherapy undergraduate education in Australia? How is this affected by increased education costs or decreased wages? A cost-benefit analysis using a net present value (NPV) approach was conducted and reported in Australian dollars. In relation to physiotherapy education, the NPV represents future earnings as a physiotherapist minus the direct and indirect costs in obtaining the degree. Sensitivity analyses were conducted to consider varying levels of experience, public versus private sector, and domestic versus international student fees. Comparable calculations were made for educational investments in medicine and nursing/midwifery. Assuming an expected discount rate of 9.675%, investment in education by domestic students with approximately 34 years of average work experience yields a NPV estimated at $784,000 for public sector physiotherapists and $815,000 for private sector therapists. In relation to international students, the NPV results for an investment and career as a physiotherapist is estimated at $705,000 in the public sector and $736,000 in the private sector. With an approximate payback period of 4 years, coupled with strong and positive NPV values, physiotherapy education in Australia is a financially attractive prospect and a viable value proposition for those considering a career in this field. Copyright © 2015 Australian Physiotherapy Association. Published by Elsevier B.V. All rights reserved.

Multilevel lumbar fusion and postoperative physiotherapy rehabilitation in a patient with persistent pain.

Science.gov (United States)

Pons, Tracey; Shipton, Edward A

2011-04-01

There are no comparative randomised controlled trials of physiotherapy modalities for chronic low back and radicular pain associated with multilevel fusion. Physiotherapy-based rehabilitation to control pain and improve activation levels for persistent pain following multilevel fusion can be challenging. This is a case report of a 68-year-old man who was referred for physiotherapy intervention 10 months after a multilevel spinal fusion for spinal stenosis. He reported high levels of persistent postoperative pain with minimal activity as a consequence of his pain following the surgery. The physiotherapy interventions consisted of three phases of rehabilitation starting with pool exercise that progressed to land-based walking. These were all combined with transcutaneous electrical nerve stimulation (TENS) that was used consistently for up to 8 hours per day. As outcome measures, daily pain levels and walking distances were charted once the pool programme was completed (in the third phase). Phase progression was determined by shuttle test results. The pain level was correlated with the distance walked using linear regression over a 5-day average. Over a 5-day moving average, the pain level reduced and walking distance increased. The chart of recorded pain level and walking distance showed a trend toward decreased pain with the increased distance walked. In a patient undergoing multilevel lumbar fusion, the combined use of TENS and a progressive walking programme (from pool to land) reduced pain and increased walking distance. This improvement was despite poor medication compliance and a reported high level of postsurgical pain.

Goal clarity and financial planning activities as determinants of retirement savings contributions.

Science.gov (United States)

Stawski, Robert S; Hershey, Douglas A; Jacobs-Lawson, Joy M

2007-01-01

Retirement counselors, financial service professionals, and retirement intervention specialists routinely emphasize the importance of developing clear goals for the future; however, few empirical studies have focused on the benefits of retirement goal setting. In the present study, the extent to which goal clarity and financial planning activities predict retirement savings practices was examined among 100 working adults. Path analysis techniques were used to test two competing models, both of which were designed to predict savings contributions. Findings provide support for the model in which retirement goal clarity is a significant predictor of planning practices, and planning, in turn, predicts savings tendencies. Two demographic variables-income and age-were also revealed to be important elements of the model, with income accounting for roughly half of the explained variance in savings contributions. The results of this study have implications for the development of age-based models of planning, as well as implications for retirement counselors and financial planners who advise workers on long-term saving strategies.

SHOULD I STAY OR SHOULD I GO? CONCEPTUAL UNDERPINNINGS OF GOAL-DIRECTED ACTIONS

Directory of Open Access Journals (Sweden)

GIOVANNI eMIRABELLA

2014-11-01

Full Text Available All actions, even the simplest like moving an arm to grasp a pen, are associated with energy costs. Thus all mobile organisms possess the ability to evaluate resources and select those behaviours that are most likely to lead to the greatest accrual of valuable items (rewards in the near or, especially in the case of humans, distant future. The evaluation process is performed at all possible stages of the series of decisions that lead to the building of a goal-directed action or to its suppression. This is because all animals have a limited amount of energy and resources; to survive and be able to reproduce they have to minimize the costs and maximize the outcomes of their actions. These computations are at the root of behavioral flexibility. Two executive functions play a major role in generating flexible behaviors: i the ability to predict future outcomes of goal-directed actions; and ii the ability to cancel them when they are unlikely to accomplish valuable results. These two processes operate continuously during the entire course of a movement: during its genesis, its planning and even its execution, so that the motor output can be modulated or suppressed at any time before its execution.In this review, functional interactions of the extended neural network subserving generation and inhibition of goal-directed movements will be outlined, leading to the intriguing hypothesis that the performance of actions and their suppression are not specified by independent sets of brain regions. Rather, it will be proposed that acting and stopping are functions emerging from specific interactions between largely overlapping brain regions, whose activity is intimately linked (directly or indirectly to the evaluations of pros and cons of an action. Such mechanism would allow the brain to perform as a highly efficient and flexible system, as different functions could be computed exploiting the same components operating in different configurations.

Preoperative physiotherapy for the prevention of respiratory complications after upper abdominal surgery: pragmatic, double blinded, multicentre randomised controlled trial

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Skinner, Elizabeth H; Browning, Laura; Reeve, Julie; Anderson, Lesley; Hill, Cat; Robertson, Iain K; Story, David; Denehy, Linda

2018-01-01

Abstract Objective To assess the efficacy of a single preoperative physiotherapy session to reduce postoperative pulmonary complications (PPCs) after upper abdominal surgery. Design Prospective, pragmatic, multicentre, patient and assessor blinded, parallel group, randomised placebo controlled superiority trial. Setting Multidisciplinary preadmission clinics at three tertiary public hospitals in Australia and New Zealand. Participants 441 adults aged 18 years or older who were within six weeks of elective major open upper abdominal surgery were randomly assigned through concealed allocation to receive either an information booklet (n=219; control) or preoperative physiotherapy (n=222; intervention) and followed for 12 months. 432 completed the trial. Interventions Preoperatively, participants received an information booklet (control) or an additional 30 minute physiotherapy education and breathing exercise training session (intervention). Education focused on PPCs and their prevention through early ambulation and self directed breathing exercises to be initiated immediately on regaining consciousness after surgery. Postoperatively, all participants received standardised early ambulation, and no additional respiratory physiotherapy was provided. Main outcome measures The primary outcome was a PPC within 14 postoperative hospital days assessed daily using the Melbourne group score. Secondary outcomes were hospital acquired pneumonia, length of hospital stay, utilisation of intensive care unit services, and hospital costs. Patient reported health related quality of life, physical function, and post-discharge complications were measured at six weeks, and all cause mortality was measured to 12 months. Results The incidence of PPCs within 14 postoperative hospital days, including hospital acquired pneumonia, was halved (adjusted hazard ratio 0.48, 95% confidence interval 0.30 to 0.75, P=0.001) in the intervention group compared with the control group, with an absolute

Total joint arthroplasty: practice variation of physiotherapy across the continuum of care in Alberta

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C. Allyson Jones

2016-11-01

Full Text Available Abstract Background Comprehensive and timely rehabilitation for total joint arthroplasty (TJA is needed to maximize recovery from this elective surgical procedure for hip and knee arthritis. Administrative data do not capture the variation of treatment for rehabilitation across the continuum of care for TJA, so we conducted a survey for physiotherapists to report practice for TJA across the continuum of care. The primary objective was to describe the reported practice of physiotherapy for TJA across the continuum of care within the context of a provincial TJA clinical pathway and highlight possible gaps in care. Method A cross-sectional on-line survey was accessible to licensed physiotherapists in Alberta, Canada for 11 weeks. Physiotherapists who treated at least five patients with TJA annually were asked to complete the survey. The survey consisted of 58 questions grouped into pre-operative, acute care and post-acute rehabilitation. Variation of practice was described in terms of number, duration and type of visits along with goals of care and program delivery methods. Results Of the 80 respondents, 26 (33 % stated they worked in small centres or rural settings in Alberta with the remaining respondents working in two large urban sites. The primary treatment goal differed for each phase across the continuum of care in that pre-operative phase was directed at improving muscle strength, functional activities were commonly reported for acute care, and post-acute phase was directed at improving joint range-of-motion. Proportionally, more physiotherapists from rural areas treated patients in out-patient hospital departments (59 %, whereas a higher proportion in urban physiotherapists saw patients in private clinics (48 %. Across the continuum of care, treatment was primarily delivered on an individual basis rather than in a group format. Conclusions Variation of practice reported with pre-and post-operative care in the community will stimulate

Total joint arthroplasty: practice variation of physiotherapy across the continuum of care in Alberta.

Science.gov (United States)

Jones, C Allyson; Martin, Ruben San; Westby, Marie D; Beaupre, Lauren A

2016-11-04

Comprehensive and timely rehabilitation for total joint arthroplasty (TJA) is needed to maximize recovery from this elective surgical procedure for hip and knee arthritis. Administrative data do not capture the variation of treatment for rehabilitation across the continuum of care for TJA, so we conducted a survey for physiotherapists to report practice for TJA across the continuum of care. The primary objective was to describe the reported practice of physiotherapy for TJA across the continuum of care within the context of a provincial TJA clinical pathway and highlight possible gaps in care. A cross-sectional on-line survey was accessible to licensed physiotherapists in Alberta, Canada for 11 weeks. Physiotherapists who treated at least five patients with TJA annually were asked to complete the survey. The survey consisted of 58 questions grouped into pre-operative, acute care and post-acute rehabilitation. Variation of practice was described in terms of number, duration and type of visits along with goals of care and program delivery methods. Of the 80 respondents, 26 (33 %) stated they worked in small centres or rural settings in Alberta with the remaining respondents working in two large urban sites. The primary treatment goal differed for each phase across the continuum of care in that pre-operative phase was directed at improving muscle strength, functional activities were commonly reported for acute care, and post-acute phase was directed at improving joint range-of-motion. Proportionally, more physiotherapists from rural areas treated patients in out-patient hospital departments (59 %), whereas a higher proportion in urban physiotherapists saw patients in private clinics (48 %). Across the continuum of care, treatment was primarily delivered on an individual basis rather than in a group format. Variation of practice reported with pre-and post-operative care in the community will stimulate dialogue within the profession as to what is the minimal

Towards understanding the availability of physiotherapy services in rural Australia.

Science.gov (United States)

Adams, Robyn; Jones, Anne; Lefmann, Sophie; Sheppard, Lorraine

2016-01-01

A recent exploration of factors affecting rural physiotherapy service provision revealed considerable variation in services available between communities of the study. Multiple factors combined to influence local service provision, including macro level policy and funding decisions, service priorities and fiscal constraints of regional health services and capacity and capabilities at the physiotherapy service level. The aim of this article is to describe the variation in local service provision, the factors influencing service provision and the impact on availability of physiotherapy services. A priority-sequence mixed methods design structured the collection and integration of qualitative and quantitative data. The investigation area, a large part of one Australian state, was selected for the number of physiotherapy services and feasibility of conducting site visits. Stratified purposive sampling permitted exploration of rural physiotherapy with subgroups of interest, including physiotherapists, their colleagues, managers, and other key decision makers. Participant recruitment commenced with public sector physiotherapists and progressed to include private practitioners, team colleagues and managers. Surveys were mailed to key physiotherapy contacts in each public sector service in the area for distribution to physiotherapists, their colleagues and managers within their facility. Private physiotherapist principals working in the same communities were invited by the researcher to complete the physiotherapy survey. The survey collected demographic data, rural experience, work setting and number of colleagues, services provided, perspectives on factors influencing service provision and decisions about service provision. Semi-structured interviews were conducted with consenting physiotherapists and other key decision makers identified by local physiotherapists. Quantitative survey data were recorded in spreadsheets and analysed using descriptive statistics. Interviews

Using video podcasting to enhance the learning of clinical skills: A qualitative study of physiotherapy students' experiences.

Science.gov (United States)

Hurst, Kay M

2016-10-01

Video podcasts, or vodcasts are increasingly used by a range of healthcare professions in the mastery of new skills. Little is known about the experiences of using vodcasts in physiotherapy education. Traditional pedagogic strategies have been employed in order to master those skills required for physiotherapy practice. There have been advances in the use of technology in medical education in the nursing, dentistry and medical fields. Vodcasts offer great versatility and potential when used as a pedagogical tool, embedded within a physiotherapy curriculum. To explore students' experiences of using technology enhanced learning, namely vodcasts, in the Physiotherapy curriculum to develop the learning of clinical skills. A series of focus groups were carried out with undergraduate and pre-registration physiotherapy students (n=31). Students valued the versatility and audio-visual nature of vodcasts; helpful in revising for practical examinations and practising their skills prior to, during and after taught skills classes. Watching and practising simultaneously allowed students to practice repeatedly and formulate a process for each skill. When learning a new skill, a combination of teaching and learning approaches was favoured, marrying traditional approaches with those that utilise technology. This study's findings add to the existing body of evidence in skills based teaching and support a multi-media, blended approach in those disciplines involved in the learning and teaching of clinical skills. Crown Copyright © 2016. Published by Elsevier Ltd. All rights reserved.

Patient satisfaction with private physiotherapy for musculoskeletal pain.

LENUS (Irish Health Repository)

Casserley-Feeney, Sarah N

2008-01-01

BACKGROUND: Despite emphasis on patient centred healthcare, healthcare professionals have been slow to use validated measurements of patient satisfaction in physiotherapy practice. The aim of this cross sectional survey was to measure patient satisfaction with private physiotherapy in Ireland, for patients with musculoskeletal pain, using a previously validated survey instrument. METHODS: A multidimensional patient satisfaction questionnaire \\'PTOPS\\

Evidence for and cost-effectiveness of physiotherapy in haemophilia: a Dutch perspective.

Science.gov (United States)

de Kleijn, P; Mauser-Bunschoten, E P; Fischer, K; Smit, C; Holtslag, H; Veenhof, C

2016-11-01

Musculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their 'list of chronic conditions', and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based on lack of scientific evidence and not being in accordance with 'state of science and practice'. In general, evidence regarding physiotherapy is limited, and especially in rare diseases like haemophilia. 'Evidence based medicine' classifies and recommends evidence based on meta-analyses, systematic reviews and randomized controlled trials, but also means integrating evidence with individual clinical expertise. For the evaluation of physiotherapy - usually individualized treatment - case studies, observational studies and Case Based Reasoning may be more beneficial. Overall annual treatment costs for haemophilia care in the Netherlands are estimated over 100 million Euros, of which 95% is covered by clotting factor concentrates. The cost for physiotherapy assessments in all seven Dutch HTCs (seven centres for adult PWH and seven centres for children) is limited at approximately 500 000 Euros annually. Costs of the actual physiotherapy sessions, carried out in our Dutch first-line care system, will also not exceed 500 000 Euros. Thus, implementation of physiotherapy in haemophilia care the Netherlands in a most optimal way would cost less than 1% of the total budget. The present paper describes the role of physiotherapy in haemophilia care including available evidence and providing suggestions regarding generation of evidence. Establishing the effectiveness and cost-effectiveness of physiotherapy in haemophilia care is a major topic for the next decennium. © 2016 John Wiley & Sons Ltd.

Impaired cognitive plasticity and goal-directed control in adolescent obsessive-compulsive disorder.

Science.gov (United States)

Gottwald, Julia; de Wit, Sanne; Apergis-Schoute, Annemieke M; Morein-Zamir, Sharon; Kaser, Muzaffer; Cormack, Francesca; Sule, Akeem; Limmer, Winifred; Morris, Anna Conway; Robbins, Trevor W; Sahakian, Barbara J

2018-01-22

Youths with obsessive-compulsive disorder (OCD) experience severe distress and impaired functioning at school and at home. Critical cognitive domains for daily functioning and academic success are learning, memory, cognitive flexibility and goal-directed behavioural control. Performance in these important domains among teenagers with OCD was therefore investigated in this study. A total of 36 youths with OCD and 36 healthy comparison subjects completed two memory tasks: Pattern Recognition Memory (PRM) and Paired Associates Learning (PAL); as well as the Intra-Extra Dimensional Set Shift (IED) task to quantitatively gauge learning as well as cognitive flexibility. A subset of 30 participants of each group also completed a Differential-Outcome Effect (DOE) task followed by a Slips-of-Action Task, designed to assess the balance of goal-directed and habitual behavioural control. Adolescent OCD patients showed a significant learning and memory impairment. Compared with healthy comparison subjects, they made more errors on PRM and PAL and in the first stages of IED involving discrimination and reversal learning. Patients were also slower to learn about contingencies in the DOE task and were less sensitive to outcome devaluation, suggesting an impairment in goal-directed control. This study advances the characterization of juvenile OCD. Patients demonstrated impairments in all learning and memory tasks. We also provide the first experimental evidence of impaired goal-directed control and lack of cognitive plasticity early in the development of OCD. The extent to which the impairments in these cognitive domains impact academic performance and symptom development warrants further investigation.

Goal-directed action control in children with autism spectrum disorders

NARCIS (Netherlands)

Geurts, H.M.; de Wit, S.

2014-01-01

Repetitive behavior is a key characteristic of autism spectrum disorders. Our aim was to investigate the hypothesis that this abnormal behavioral repetition results from a tendency to over-rely on habits at the expense of flexible, goal-directed action. Twenty-four children with autism spectrum

Motivational beliefs, values, and goals.

Science.gov (United States)

Eccles, Jacquelynne S; Wigfield, Allan

2002-01-01

This chapter reviews the recent research on motivation, beliefs, values, and goals, focusing on developmental and educational psychology. The authors divide the chapter into four major sections: theories focused on expectancies for success (self-efficacy theory and control theory), theories focused on task value (theories focused on intrinsic motivation, self-determination, flow, interest, and goals), theories that integrate expectancies and values (attribution theory, the expectancy-value models of Eccles et al., Feather, and Heckhausen, and self-worth theory), and theories integrating motivation and cognition (social cognitive theories of self-regulation and motivation, the work by Winne & Marx, Borkowski et al., Pintrich et al., and theories of motivation and volition). The authors end the chapter with a discussion of how to integrate theories of self-regulation and expectancy-value models of motivation and suggest new directions for future research.

Functional Magnetic Resonance Imaging of Goal-Directed Reaching in Children with Autism Spectrum Disorders: A Feasibility Study

Directory of Open Access Journals (Sweden)

Nicole M. G. Salowitz

2014-04-01

motor behaviors in autistic and typically developing children. The findings also suggest the presence of marked changes in neural activation during a sensorimotor task requiring goal-directed movement.

Physiotherapy clinical educators' perceptions and experiences of clinical prediction rules.

Science.gov (United States)

Knox, Grahame M; Snodgrass, Suzanne J; Rivett, Darren A

2015-12-01

Clinical prediction rules (CPRs) are widely used in medicine, but their application to physiotherapy practice is more recent and less widespread, and their implementation in physiotherapy clinical education has not been investigated. This study aimed to determine the experiences and perceptions of physiotherapy clinical educators regarding CPRs, and whether they are teaching CPRs to students on clinical placement. Cross-sectional observational survey using a modified Dillman method. Clinical educators (n=211, response rate 81%) supervising physiotherapy students from 10 universities across 5 states and territories in Australia. Half (48%) of respondents had never heard of CPRs, and a further 25% had never used CPRs. Only 27% reported using CPRs, and of these half (51%) were rarely if ever teaching CPRs to students in the clinical setting. However most respondents (81%) believed CPRs assisted in the development of clinical reasoning skills and few (9%) were opposed to teaching CPRs to students. Users of CPRs were more likely to be male (pphysiotherapy (pStudents are unlikely to be learning about CPRs on clinical placement, as few clinical educators use them. Clinical educators will require training in CPRs and assistance in teaching them if students are to better learn about implementing CPRs in physiotherapy clinical practice. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Do physiotherapy staff record treatment time accurately? An observational study.

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Bagley, Pam; Hudson, Mary; Green, John; Forster, Anne; Young, John

2009-09-01

To assess the reliability of duration of treatment time measured by physiotherapy staff in early-stage stroke patients. Comparison of physiotherapy staff's recording of treatment sessions and video recording. Rehabilitation stroke unit in a general hospital. Thirty-nine stroke patients without trunk control or who were unable to stand with an erect trunk without the support of two therapists recruited to a randomized trial evaluating the Oswestry Standing Frame. Twenty-six physiotherapy staff who were involved in patient treatment. Contemporaneous recording by physiotherapy staff of treatment time (in minutes) compared with video recording. Intraclass correlation with 95% confidence interval and the Bland and Altman method for assessing agreement by calculating the mean difference (standard deviation; 95% confidence interval), reliability coefficient and 95% limits of agreement for the differences between the measurements. The mean duration (standard deviation, SD) of treatment time recorded by physiotherapy staff was 32 (11) minutes compared with 25 (9) minutes as evidenced in the video recording. The mean difference (SD) was -6 (9) minutes (95% confidence interval (CI) -9 to -3). The reliability coefficient was 18 minutes and the 95% limits of agreement were -24 to 12 minutes. Intraclass correlation coefficient for agreement between the two methods was 0.50 (95% CI 0.12 to 0.73). Physiotherapy staff's recording of duration of treatment time was not reliable and was systematically greater than the video recording.

Physiotherapy managers' perceptions of their leadership effectiveness: a multi-frame analysis.

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McGowan, Emer; Walsh, Cathal; Stokes, Emma

2017-09-01

The purpose of this study was to investigate the leadership frames of physiotherapy managers in Ireland. To be effective leaders in today's challenging healthcare environment physiotherapy managers must employ a comprehensive, adaptable and balanced leadership style. This was a purposive, cross-sectional study. Physiotherapy managers were surveyed using the Bolman and Deal Leadership Orientations Instrument. The survey was administered to members of the Chartered Physiotherapists in Management employment group (n=73) of the Irish Society of Chartered Physiotherapists via email. Forty-five physiotherapy managers responded to the survey to give a response rate of 62%. The human resource frame was the most frequently used (61%) and the political frame was the least (9%). The majority of respondents reported using only one or no frames at all (65%). When asked about their effectiveness as a manager 33% of respondents (n=14) gave themselves the top rating of 5, whereas 19% of respondents (n=8) gave themselves the top rating for their leadership effectiveness. There was a statistically significant trend between the number of leadership frames a physiotherapy manager used and their perceived effectiveness as a manager (T JT =380, z=1.975, p=0.048) and as a leader (T JT =431, z=3.245, p=0.001). The physiotherapy managers' use of the human resource frame demonstrates that they see the building of relationships as key to effective leadership. Development of physiotherapy managers' underused skills through appropriate leadership development training may enhance their leadership skill set and make them more confident as leaders. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Behavioral activation in TFP: The role of the treatment contract in transference-focused psychotherapy.

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Yeomans, Frank E; Delaney, Jill C; Levy, Kenneth N

2017-09-01

Transference-focused psychotherapy (TFP) is a manualized evidence-based treatment for borderline and other severe personality disorders that is based on psychoanalytic object relations theory. Similar to other psychodynamic psychotherapies, TFP focuses on changing psychological structures, but also focuses on symptom and behavioral change, particularly the importance of being active (e.g., obtaining a job or involvement in similar activities). In TFP, the establishment of the treatment contract, also known as the treatment frame, is where goals such as work and other activities are agreed upon. The focus on such activities is particularly relevant to the concept of behavioral activation. We provide a clinical vignette to illustrate how TFP utilizes behavioral activation in facilitating treatment outcome both at the behavioral level and at the psychological level. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

[Physiotherapy and physical therapy in pain management].

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Egan, M; Seeger, D; Schöps, P

2015-10-01

Patients attend physiotherapy and physical therapy (PT) due to pain problems and/or functional impairments. Although the main focus for therapists has traditionally been physical examination and treatment of tissue structures and biomechanics, over the last few decades a growing body of research has highlighted the importance of central nervous system processing and psychosocial contributors to pain perception. Treatment with PT aims to reduce disability and suffering by reducing pain and increasing tolerance to movement. In Germany, pain management conducted by physiotherapists is currently undergoing major changes. Firstly, PT education is transitioning from a vocational to a degree level and additionally new concepts for improved multidisciplinary treatment approaches are being developed. However, there still remain substantial differences between therapists working in multidisciplinary pain clinics and those following medical referral in private practices. This article provides information on how national and international impulses have contributed to the development of different concepts of passive therapies and active/functional pain rehabilitation in Germany. In the future PT will need to provide more evidence about efficiency and modes of actions for different treatment options to selectively reason the application to patients with acute, subacute and chronic pain.

Cost-effectiveness of an intensive group training protocol compared to physiotherapy guideline care for sub-acute and chronic low back pain: design of a randomised controlled trial with an economic evaluation. [ISRCTN45641649

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Franken Willemien K

2004-11-01

Full Text Available Abstract Background Low back pain is a common disorder in western industrialised countries and the type of treatments for low back pain vary considerably. Methods In a randomised controlled trial the cost-effectiveness and cost-utility of an intensive group training protocol versus physiotherapy guideline care for sub-acute and chronic low back pain patients is evaluated. Patients with back pain for longer than 6 weeks who are referred to physiotherapy care by their general practitioner or medical specialist are included in the study. The intensive group training protocol combines exercise therapy with principles of behavioural therapy ("graded activity" and back school. This training protocol is compared to physiotherapy care according to the recently published Low Back Pain Guidelines of the Royal Dutch College for Physiotherapy. Primary outcome measures are general improvement, pain intensity, functional status, work absenteeism and quality of life. The direct and indirect costs will be assessed using cost diaries. Patients will complete questionnaires at baseline and 6, 13, 26 and 52 weeks after randomisation. Discussion No trials are yet available that have evaluated the effect of an intensive group training protocol including behavioural principles and back school in a primary physiotherapy care setting and no data on cost-effectiveness and cost-utility are available.

Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis

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Rossman, C.M.; Waldes, R.; Sampson, D.; Newhouse, M.T.

1982-07-01

We studied the effectiveness of some of the components of a physiotherapy regimen on the removal of mucus from the lungs of 6 subjects with cystic fibrosis. On 5 randomized study days, after inhalation of a /sup 99/mTc-human serum albumin aerosol to label primarily the large airways, the removal of lung radioactivity was measured during 40 min of (a) spontaneous cough while at rest (control), (b) postural drainage, (c) postural drainage plus mechanical percussion, (d) combined maneuvers (postural drainage, deep breathing with vibrations, and percussion) administered by a physiotherapist, (e) directed vigorous cough. Measurements continued for an additional 2 h of quiet rest. Compared with the control day, all forms of intervention significantly improved the removal of mucus: cough (p less than 0.005), physiotherapy maneuvers (0.005 less than or equal to p less than 0.01), postural drainage (p less than 0.05), and postural drainage plus percussion (p less than 0.01). However, there was no significant difference between regimented cough alone and therapist-administered combined maneuvers, nor between postural drainage alone and with mechanical percussion. We conclude that in cystic fibrosis, vigorous, regimented cough sessions may be as effective as therapist-administered physiotherapy in removing pulmonary secretions. Postural drainage, although better than the control maneuver, was not as effective as cough and was not enhanced by mechanical percussion. Frequent, vigorous self-directed cough sessions are potentially as useful as more complex measures for effective bronchial toilet.

Effect of chest physiotherapy on the removal of mucus in patients with cystic fibrosis

International Nuclear Information System (INIS)

Rossman, C.M.; Waldes, R.; Sampson, D.; Newhouse, M.T.

1982-01-01

We studied the effectiveness of some of the components of a physiotherapy regimen on the removal of mucus from the lungs of 6 subjects with cystic fibrosis. On 5 randomized study days, after inhalation of a 99 mTc-human serum albumin aerosol to label primarily the large airways, the removal of lung radioactivity was measured during 40 min of (a) spontaneous cough while at rest (control), (b) postural drainage, (c) postural drainage plus mechanical percussion, (d) combined maneuvers (postural drainage, deep breathing with vibrations, and percussion) administered by a physiotherapist, (e) directed vigorous cough. Measurements continued for an additional 2 h of quiet rest. Compared with the control day, all forms of intervention significantly improved the removal of mucus: cough (p less than 0.005), physiotherapy maneuvers (0.005 less than or equal to p less than 0.01), postural drainage (p less than 0.05), and postural drainage plus percussion (p less than 0.01). However, there was no significant difference between regimented cough alone and therapist-administered combined maneuvers, nor between postural drainage alone and with mechanical percussion. We conclude that in cystic fibrosis, vigorous, regimented cough sessions may be as effective as therapist-administered physiotherapy in removing pulmonary secretions. Postural drainage, although better than the control maneuver, was not as effective as cough and was not enhanced by mechanical percussion. Frequent, vigorous self-directed cough sessions are potentially as useful as more complex measures for effective bronchial toilet

How completely are physiotherapy interventions described in reports of randomised trials?

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Yamato, Tiê P; Maher, Chris G; Saragiotto, Bruno T; Hoffmann, Tammy C; Moseley, Anne M

2016-06-01

Incomplete descriptions of interventions are a common problem in reports of randomised controlled trials. To date no study has evaluated the completeness of the descriptions of physiotherapy interventions. To evaluate the completeness of the descriptions of physiotherapy interventions in a random sample of reports of randomised controlled trials (RCTs). A random sample of 200 reports of RCTs from the PEDro database. We included full text papers, written in English, and reporting trials with two arms. We included trials evaluating any type of physiotherapy interventions and subdisciplines. The methodological quality was evaluated using the PEDro scale and completeness of intervention description using the Template for Intervention Description and Replication (TIDieR) checklist. The proportion and 95% confidence interval were calculated for intervention and control groups, and used to present the relationship between completeness and methodological quality, and subdisciplines. Completeness of intervention reporting in physiotherapy RCTs was poor. For intervention groups, 46 (23%) trials did not describe at least half of the items. Reporting was worse for control groups, 149 (75%) trials described less than half of the items. There was no clear difference in the completeness across subdisciplines or methodological quality. Our sample were restricted to trials published in English in 2013. Descriptions of interventions in physiotherapy RCTs are typically incomplete. Authors and journals should aim for more complete descriptions of interventions in physiotherapy trials. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Early Childhood Inclusion in the United States: Goals, Current Status, and Future Directions

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Guralnick, Michael J.; Bruder, Mary Beth

2016-01-01

The current status and future directions of early childhood inclusion in the United States are discussed from the perspective of 4 key goals: access, accommodations and feasibility, developmental progress, and social integration. Recommendations are put forward to promote inclusion goals emphasizing administrative structures, personnel…

Swedish female physiotherapy students have more stress than Dutch female physiotherapy students

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Hodselmans, Audy Paul; Svantesson, Ulla; Hobbelen, Hans

2016-01-01

Health care students’ report high levels of stress with academic pressure as the greatest source. Physiotherapy (PT) curriculum in Sweden is 3 years (180 EC’s) and in the Netherlands 4 years (240 Ec’s) Aim : to determine differences in overall level of stress, stressors and reactions to stressors

Combination of Citicoline and Physiotherapy in Children with Cerebral Palsy

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Jafar Nasiri

2014-01-01

Conclusions: Results demonstrated that citicoline in combination to physiotherapy appears to be a promising agent to improve gross motor function in patients with cerebral palsy versus physiotherapy alone. Although, further studies are need to be done.

Constructing a Global Learning Partnership in Physiotherapy: An Ireland–Uganda Initiative

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Cliona O’Sullivan

2017-06-01

Full Text Available Background and aimThere is a strong correlation between disability and poverty and it is acknowledged that until disability issues are addressed, the goal of poverty reduction in low-income countries is unlikely to be achieved. Despite the high prevalence of disability in developing countries, there remains a significant shortage of rehabilitation professionals as highlighted by the WHO report, Human resources for Health (2006. The purpose of this project was to develop a collaborative and sustainable partnership to strengthen educational and research capacity in global health, disability, and rehabilitation between two physiotherapy schools; University College Dublin, Ireland, and Mbarara University of Science and Technology, Uganda. This article aims to describe the approach used and initial project outcomes.MethodsThis project involved a bilateral visit to both institutions by two members of staff of respective physiotherapy programs. These visits entailed stakeholder meetings, clinical site visits, and workshops to identify the priorities for the partnership and shape the collaboration going forward. Appreciative inquiry methodology was used during the workshops and the four-dimensional framework for curriculum development was used to guide analysis and underpin findings.FindingsThe key priorities identified were (i development of joint global health learning initiative, (ii to explore the possibility of postgraduate learning and research opportunities for Ugandan colleagues, and (iii to develop joint clinical placements. The rationale and context and a plan of action is described.Discussion and conclusionThe project is ambitious and in order to be sustainable, the importance of long-term interinstitutional commitment and further funding cannot be ignored. This work provides a framework for other universities and institutions wishing to undertake similar activities. Such partnerships provide rich learning opportunities for students and

Constructing a Global Learning Partnership in Physiotherapy: An Ireland-Uganda Initiative.

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O'Sullivan, Cliona; Kazibwe, Herman; Whitehouse, Zillah; Blake, Catherine

2017-01-01

There is a strong correlation between disability and poverty and it is acknowledged that until disability issues are addressed, the goal of poverty reduction in low-income countries is unlikely to be achieved. Despite the high prevalence of disability in developing countries, there remains a significant shortage of rehabilitation professionals as highlighted by the WHO report, Human resources for Health (2006). The purpose of this project was to develop a collaborative and sustainable partnership to strengthen educational and research capacity in global health, disability, and rehabilitation between two physiotherapy schools; University College Dublin, Ireland, and Mbarara University of Science and Technology, Uganda. This article aims to describe the approach used and initial project outcomes. This project involved a bilateral visit to both institutions by two members of staff of respective physiotherapy programs. These visits entailed stakeholder meetings, clinical site visits, and workshops to identify the priorities for the partnership and shape the collaboration going forward. Appreciative inquiry methodology was used during the workshops and the four-dimensional framework for curriculum development was used to guide analysis and underpin findings. The key priorities identified were (i) development of joint global health learning initiative, (ii) to explore the possibility of postgraduate learning and research opportunities for Ugandan colleagues, and (iii) to develop joint clinical placements. The rationale and context and a plan of action is described. The project is ambitious and in order to be sustainable, the importance of long-term interinstitutional commitment and further funding cannot be ignored. This work provides a framework for other universities and institutions wishing to undertake similar activities. Such partnerships provide rich learning opportunities for students and health professionals and facilitate a deeper understanding of global health

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline*

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Wilson, Christine; Dentice, Ruth; Cox, Narelle S.; Middleton, Anna; Tannenbaum, Esta; Bishop, Jennifer; Cobb, Robyn; Burton, Kate; Wood, Michelle; Moran, Fiona; Black, Ryan; Bowen, Summar; Day, Rosemary; Depiazzi, Julie; Doiron, Katherine; Doumit, Michael; Dwyer, Tiffany; Elliot, Alison; Fuller, Louise; Hall, Kathleen; Hutchins, Matthew; Kerr, Melinda; Lee, Annemarie L.; Mans, Christina; O'Connor, Lauren; Steward, Ranjana; Potter, Angela; Rasekaba, Tshepo; Scoones, Rebecca; Tarrant, Ben; Ward, Nathan; West, Samantha; White, Dianne; Wilson, Lisa; Wood, Jamie; Holland, Anne E.

2016-01-01

Abstract Physiotherapy management is a key element of care for people with cystic fibrosis (CF) throughout the lifespan. Although considerable evidence exists to support physiotherapy management of CF, there is documented variation in practice. The aim of this guideline is to optimize the physiotherapy management of people with CF in Australia and New Zealand. A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken. Recommendations were formulated based on National Health and Medical Research Council (Australia) guidelines and considered the quality, quantity and level of the evidence; the consistency of the body of evidence; the likely clinical impact; and applicability to physiotherapy practice in Australia and New Zealand. A total of 30 recommendations were made for airway clearance therapy, inhalation therapy, exercise assessment and training, musculoskeletal management, management of urinary incontinence, managing the newly diagnosed patient with CF, delivery of non‐invasive ventilation, and physiotherapy management before and after lung transplantation. These recommendations can be used to underpin the provision of evidence‐based physiotherapy care to people with CF in Australia and New Zealand. PMID:27086904

Individualized unsupervised exercise programs and chest physiotherapy in children with cystic fibrosis

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Bogdan ALMĂJAN-GUȚĂ

2013-12-01

Full Text Available Traditionally, physiotherapy for cystic fibrosis focused mainly on airway clearance (clearing mucus from the lungs. This still makes up a large part of daily treatment, but the role of the physiotherapist in cystic fibrosis has expanded to include daily exercise, inhalation therapy, posture awareness and, for some, the management of urinary incontinence. The purpose of this study is to demonstrate the necessity and the efficiency of various methods of chest physiotherapy and individualized unsupervised exercise program, in the improvement of body composition and physical performance. This study included 12 children with cystic fibrosis, with ages between 8-13 years. Each subject was evaluated in terms of body composition, effort capacity and lower body muscular performance, at the beginning of the study and after 12 months.The intervention consisted in classic respiratory clearance and physiotherapy techniques (5 times a week and an individualized unsupervised exercise program (3 times a week. After 12 months we noticed a significant improvement of the measured parameters: body weight increased from 32.25±5.5 to 33.53±5.4 kg (p <0.001, skeletal muscle mass increased from a mean of 16.04±4.1 to 17.01±4.2 (p<0.001, the fitness score, increased from a mean of 71±3.8 points to73±3.8, (p<0.001 and power and force also registered positive evolutions (from 19.3±2.68 to 21.65±2.4 W/kg and respectively 19.68±2.689 to 20.81±2.98 N/kg.The association between physiotherapy procedures and an individualized (after a proper clinical assessment unsupervised exercise program, proved to be an effective, relatively simple and accessible (regardless of social class intervention.

With a little help from my goals: integrating intergoal facilitation with the theory of planned behaviour to predict physical activity.

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Presseau, Justin; Sniehotta, Falko F; Francis, Jill J; Gebhardt, Winifred A

2010-11-01

Integration of a multiple goal theory approach into the theory of planned behaviour (TPB) to investigate how the perceived facilitating and conflicting relationships in multiple goal pursuit predict performance of a health-related behaviour. Prospective design with 8-week follow-up. At baseline, perceived intergoal facilitation and intergoal conflict were measured using personal projects analysis supplemented with standard TPB measures for physical activity (PA). Self-reported PA was measured at follow-up 8 weeks later. N=137 participants completed measures at both time points (55.4% response rate at follow-up). Hierarchical regression showed that perceived intergoal facilitation, but not intergoal conflict, directly predicted PA beyond intention and perceived behavioural control (PBC), accounting for more than 4% of additional variance in PA. Intergoal facilitation had an indirect effect on intention through attitude and PBC, and intention partially mediated the effect of intergoal facilitation on behaviour. The perceived facilitating effect of pursuing other personal goals predicts the performance of a health-related behaviour over and above single behaviour-focused social cognitions.

Relevance of physiotherapy in primary health care | Hamzat | East ...

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Physiotherapy is often regarded as a second-contact health service suitable only for secondary and tertiary health facilities that are usually located in urban centres. Yet many patients who require the professional services of a physiotherapist are unable to access it either as a result of non-availability of physiotherapy ...

Comrades marathon for short-term experiential learning as perceived by physiotherapy students: A short report

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U. Useh

2011-01-01

Full Text Available This  study  described  the  learning  experiences  of physiotherapy students during the 2009 comrades marathon. A quali-tative  approach  using  focus  group  discussions  was  employed  for  this study.The population for this study was all the 43 B.Sc. physiotherapy final year students of the university of limpopo, who provided physio-therapy services at the 2009 comrades Marathon. forty (93% students participated in this study. All the participants were black with majo-rity 23 (58% of them from the limpopo province. Twenty one (52% of the participants were females with ages ranging between 21 and 30 years. The field trip provided both sport specific and general learning experiences. participants had the opportunity to handle sports injuries and athletes, work and learn as a team and were quite independent. This trip also provided participants the opportunity experiencing workplace communication and interaction, the reality of the real workplace experience of heavy workload, experience of prejudice, time management and an unsafe environment.Despite organizational challenges of the trip, the event provided an opportunity for the participants to practice sport physiotherapy. Participants appreciated the opportunity to experience the dynamics of team and collaborative learning. To ensure effective use of this event for experiential learning, it is recommended that proper guidance and support be provided by the faculty.

Physiotherapy devices able to generate ethical dilemmas

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Roman Nadinne

2017-01-01

Full Text Available Physical therapy is a medical specialty where the professionals help restore movement and function when someone is affected by injury, illness or disability. This paper wishes to establish the connection between ethics, physiotherapy and bioengineering. The research method was achieved using academic database searches based on specific keywords. A SWOT analysis of the physiotherapy devices utilization and design was made, for extracting ethical considerations. The main results suggest that physiotherapy devices are able to generate ethical dilemmas, classified in 4 main items: (1 Bioengineering in physical therapy, ethical and clinical standards for manufacturers; (2 Social impact of physical therapy devices and ethical issues; (3 Inter-professional lack of communication and ethical concerns; (4 Bioengineering ethical research and education. As conclusions, for the physical therapy or electrotherapy research equipment development, a multidisciplinary team is needed. The equipment used in rehabilitation must fulfil specific technical and scientific requirements drafted by the professionals.

Addition of motivational interventions to exercise and traditional physiotherapy: a review and meta-analysis.

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McGrane, N; Galvin, R; Cusack, T; Stokes, E

2015-03-01

Incontestable epidemiological trends indicate that, for the foreseeable future, mortality and morbidity will be dominated by an escalation in chronic lifestyle-related diseases. International guidelines recommend the implementation of evidence-based approaches to bring about health behaviour changes. Motivational interventions to increase adherence and physical activity are not part of traditional physiotherapy for any condition. To evaluate the evidence for the effectiveness of adding motivational interventions to traditional physiotherapy to increase physical activity and short- and long-term adherence to exercise prescriptions. A literature search of PubMed, EMBASE, Scopus, CINAHL, PsychINFO, AMED and Allied Health Evidence database using keywords and subject headings. Only randomised controlled trials comparing two or more arms, with one arm focused on motivational interventions influencing exercise and one control arm, were included. The search identified 493 titles, of which 14 studies (comprising 1504 participants) were included. The principal investigator extracted data that were reviewed independently by another author. Methodological quality was assessed independently by two authors using the Cochrane Risk of Bias tool and the PEDro scale. Outcomes were measured at the level of impairment, activity limitation and participation restriction. The standardised mean difference between the control and intervention groups at follow-up time points was used as the mode of analysis. I2≤50% was used as the cut-off point for acceptable heterogeneity, above which a random effects model was applied. Exercise attendance was measured in six studies (n=378), and the results indicate that there was no significant difference in exercise attendance between the groups (Random effects model, standardised mean difference 0.33, 95% confidence interval -0.03 to 0.68, I2 62%). Perceived self-efficacy results were pooled from six studies (n=722), and a significant difference was

Implementing communication and decision-making interventions directed at goals of care: a theory-led scoping review.

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Cummings, Amanda; Lund, Susi; Campling, Natasha; May, Carl R; Richardson, Alison; Myall, Michelle

2017-10-06

To identify the factors that promote and inhibit the implementation of interventions that improve communication and decision-making directed at goals of care in the event of acute clinical deterioration. A scoping review was undertaken based on the methodological framework of Arksey and O'Malley for conducting this type of review. Searches were carried out in Medline and Cumulative Index to Nursing and Allied Health Literature (CINAHL) to identify peer-reviewed papers and in Google to identify grey literature. Searches were limited to those published in the English language from 2000 onwards. Inclusion and exclusion criteria were applied, and only papers that had a specific focus on implementation in practice were selected. Data extracted were treated as qualitative and subjected to directed content analysis. A theory-informed coding framework using Normalisation Process Theory (NPT) was applied to characterise and explain implementation processes. Searches identified 2619 citations, 43 of which met the inclusion criteria. Analysis generated six themes fundamental to successful implementation of goals of care interventions: (1) input into development; (2) key clinical proponents; (3) training and education; (4) intervention workability and functionality; (5) setting and context; and (6) perceived value and appraisal. A broad and diverse literature focusing on implementation of goals of care interventions was identified. Our review recognised these interventions as both complex and contentious in nature, making their incorporation into routine clinical practice dependent on a number of factors. Implementing such interventions presents challenges at individual, organisational and systems levels, which make them difficult to introduce and embed. We have identified a series of factors that influence successful implementation and our analysis has distilled key learning points, conceptualised as a set of propositions, we consider relevant to implementing other complex

Frequency of depression, anxiety and stress among the undergraduate physiotherapy students.

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Syed, Annosha; Ali, Syed Shazad; Khan, Muhammad

2018-01-01

To assess the frequency of Depression, Anxiety and Stress (DAS) among the undergraduate physiotherapy students. A descriptive cross sectional study was conducted in various Physiotherapy Institutes in Sindh, Pakistan among undergraduate physiotherapy students. The total duration of this study was 4 months from September, 2016 to January, 2017. Data was collected from 267 students with no physical and mental illness; more than half were female students 75.3%. They were selected through Non probability purposive sampling technique. A self-administered standardized DASS (depression, anxiety and stress scale) was used to collect data and result was analyzed using its severity rating index. Data was entered and analyzed by using SPSS version 21. Descriptive statistics including the frequency of depression, anxiety, stress and demographic characteristic of the participant was collected. The mean age of students was 19.3371±1.18839 years. The Frequency of depression, anxiety and stress found among undergraduates Physiotherapy students was 48.0%, 68.54% and 53.2%, respectively. It was observed that the frequency of depression, anxiety and stress among physiotherapy undergraduates students were high. It suggests the urgent need of carrying out evidence based Psychological health promotion for undergraduate Physiotherapy students to control this growing problem.

Effectiveness of physiotherapy in Parkinson's disease: the feasibility of a randomised controlled trial.

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Keus, S.H.J.; Bloem, B.R.; Hilten, J.J. van; Ashburn, A.; Munneke, M.

2007-01-01

To study the feasibility of a large randomised controlled trial (RCT) evaluating the effectiveness of physiotherapy in Parkinson's disease (PD), 173 patients were asked to participate in a study with random allocation to best practice physiotherapy, or to no physiotherapy. The primary outcome

An audit of the physiotherapy management of paraplegic patients with sacral pressure sores

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D. Pather

2013-01-01

Full Text Available Introduction: Pressure sores are the most common complication post spinal cord injury that requires patients to be on bed rest. Patient bed rest delay rehabilitation and may lead to other complications associated with immobility. This study sought to establish the treatment interventions physiotherapists provide to patients with sacral pressure sores and the factors that they consider when deciding whether the patient should receive physiotherapy in the ward or gym. Methods: This was a questionnaire based survey of physiotherapists working in spinal cord injury rehabilitation units in South Africa. The self-designed questionnaire was sent to all the main spinal rehabilitation units in the country (14 located in Gauteng, Kwa-Zulu Natal, Western Cape, Eastern Cape and Free State provinces. Results: Thirty-nine physiotherapists from a total of 51 completed the questionnaires (76% response rate. The most common treatment practice for patients with sacral pressure sores was bed rest (98%. The most common physio-therapy practices (70% included were upper limb muscle strengthening, upper and lower limb passive movements, positioning into prone and side lying and passive stretching. The choice of treatment environment was influenced by doctors’ orders and the size, grade and duration of the pressure sores. Conclusion: Direct involvement in pressure sore management in South Africa seem to be less than in other parts of the world. If we are to minimise the pressure sore impact, it appears like we need more focus on gait re-education and standardised ADL programmes and patient treatment in the gym to possibly maximise healing and rehabilitation.

Drunk decisions: Alcohol shifts choice from habitual towards goal-directed control in adolescent intermediate-risk drinkers.

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Obst, Elisabeth; Schad, Daniel J; Huys, Quentin Jm; Sebold, Miriam; Nebe, Stephan; Sommer, Christian; Smolka, Michael N; Zimmermann, Ulrich S

2018-05-01

Studies in humans and animals suggest a shift from goal-directed to habitual decision-making in addiction. We therefore tested whether acute alcohol administration reduces goal-directed and promotes habitual decision-making, and whether these effects are moderated by self-reported drinking problems. Fifty-three socially drinking males completed the two-step task in a randomised crossover design while receiving an intravenous infusion of ethanol (blood alcohol level=80 mg%), or placebo. To minimise potential bias by long-standing heavy drinking and subsequent neuropsychological impairment, we tested 18- to 19-year-old adolescents. Alcohol administration consistently reduced habitual, model-free decisions, while its effects on goal-directed, model-based behaviour varied as a function of drinking problems measured with the Alcohol Use Disorders Identification Test. While adolescents with low risk for drinking problems (scoring towards goal-directed decision-making, such that alcohol possibly even improved their performance. We assume that alcohol disrupted basic cognitive functions underlying habitual and goal-directed decisions in low-risk drinkers, thereby enhancing hasty choices. Further, we speculate that intermediate-risk drinkers benefited from alcohol as a negative reinforcer that reduced unpleasant emotional states, possibly displaying a novel risk factor for drinking in adolescence.

Associative theories of goal-directed behaviour: a case for animal-human translational models

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de Wit, S.; Dickinson, A.

2009-01-01

Associative accounts of goal-directed action, developed in the fields of human ideomotor action and that of animal learning, can capture cognitive belief-desire psychology of human decision-making. Whereas outcome-response accounts can account for the fact that the thought of a goal can call to mind

Does taping in addition to physiotherapy improve the outcomes in subacromial impingement syndrome? A systematic review.

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Saracoglu, Ismail; Emuk, Yusuf; Taspinar, Ferruh

2018-04-01

Taping is used with or without other interventions for many purposes, especially to manage pain and improve functional activity in patients with shoulder pain. The aim of this review was to determine whether any taping technique in addition to physiotherapy care is more effective than physiotherapy care alone in patients with shoulder impingement syndrome. A systematic search of Cochrane Database of Systematic Review, MEDLINE (EBSCO), Physiotherapy Evidence Database (PEDro), CINAHL (EBSCO), PUBMED, AMED, EMBASE (OVID), The Kinesio Kinesio® Taping Method, Kinesio® Tex Tape UK and International websites ( www.kinesiotaping.co.uk ; www.kinesiotaping.com ) was conducted to June 2015. The outcome measures were pain, disability, range of motion and muscle strength. As data were not suitable for meta-analysis, narrative synthesis were applied. Three randomized controlled trials and one controlled trial (135 patients) were included. The results were conflicting and weak on the effectiveness of taping as an adjunct therapy for improvement of pain, disability, range of motion and muscle strength. Clinical taping in addition to physiotherapy interventions (e.g. exercise, electrotherapy, and manual therapy) might be an optional modality for managing patients with shoulder impingement syndrome, especially for the initial stage of the treatment; however, we need further robust, placebo controlled and consistent studies to prove whether it is more effective than physiotherapy interventions without taping.

Weight stigma in physiotherapy practice: Patient perceptions of interactions with physiotherapists.

Science.gov (United States)

Setchell, Jenny; Watson, Bernadette; Jones, Liz; Gard, Michael

2015-12-01

Weight management is increasingly considered part of physiotherapists' scope of practice in order to improve patient outcomes by, for example, reducing load on joints, or improving chronic pain. However, interactions with patients involving weight may result in patient perceptions of negative judgement from health professionals, which can result in poorer health outcomes. How physiotherapist/patient interactions involving weight are perceived by patients has not yet been investigated. To explore patients' perceptions of interactions with physiotherapists that involved weight, and investigate how these perceptions may inform physiotherapy practice. Face-to-face interviews with physiotherapy patients, with follow up interviews conducted by telephone. Data were analysed thematically. First interviews were held in a physiotherapy practice with follow up interviews conducted two weeks later. Interviews were audio recorded, transcribed and analysed using an inductive thematic method established by Braun and Clarke. Thirty interviews with 15 patients were analysed. Four main themes relevant to weight were identified: 1) perceptions of being 'in physiotherapy' including pre-conceptions, the physical environment, and exposing the body, 2) emphasis placed on weight in physiotherapy interactions, 3) communication styles, and 4) judgement perception. Some patients perceived negative weight judgements from elements of physiotherapy interactions and environments. Physiotherapists need to be aware of this perception because it may result in poorer patient outcomes and patients avoiding physiotherapy appointments. The results suggest strategies to counteract weight stigma include: adjusting the physical environment of the clinic, portraying an understanding of complex determinants of weight, and employing collaborative, non-judgemental communication styles. Copyright © 2015 Elsevier Ltd. All rights reserved.

Goal-Directed Action Control in Children with Autism Spectrum Disorders

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Geurts, Hilde M; de Wit, Sanne

2014-01-01

Repetitive behavior is a key characteristic of autism spectrum disorders. Our aim was to investigate the hypothesis that this abnormal behavioral repetition results from a tendency to over-rely on habits at the expense of flexible, goal-directed action. Twenty-four children with autism spectrum disorders and 24 age- and gender-matched controls…

Goal Direction and Effectiveness, Emotional Maturity, and Nuclear Family Functioning

Science.gov (United States)

Klever, Phillip

2009-01-01

Differentiation of self, a cornerstone concept in Bowen theory, has a profound influence over time on the functioning of the individual and his or her family unit. This 5-year longitudinal study tested this hypothesis with 50 developing nuclear families. The dimensions of differentiation of self that were examined were goal direction and…

Physiotherapy in Rheumatoid Arthritis

Science.gov (United States)

Kavuncu, Vural; Evcik, Deniz

2004-01-01

Rheumatoid arthritis (RA) is a chronic and painful clinical condition that leads to progressive joint damage, disability, deterioration in quality of life, and shortened life expectancy. Even mild inflammation may result in irreversible damage and permanent disability. The clinical course according to symptoms may be either intermittent or progressive in patients with RA. In most patients, the clinical course is progressive, and structural damage develops in the first 2 years. The aim of RA management is to achieve pain relief and prevent joint damage and functional loss. Physiotherapy and rehabilitation applications significantly augment medical therapy by improving the management of RA and reducing handicaps in daily living for patients with RA. In this review, the application of physiotherapy modalities is examined, including the use of cold/heat applications, electrical stimulation, and hydrotherapy. Rehabilitation treatment techniques for patients with RA such as joint protection strategies, massage, exercise, and patient education are also presented. PMID:15266230

Purposeful Goal-Directed Movements Give Rise to Higher Tactile Discrimination Performance

Directory of Open Access Journals (Sweden)

Georgiana Juravle

2011-10-01

Full Text Available Tactile perception is inhibited during goal-directed reaching movements (sensory suppression. Here, participants performed simple reaching or exploratory movements (where contact with the table surface was maintained. We measured tactile discrimination thresholds for vibratory stimuli delivered to participants' wrists while executing the movement, and while at rest. Moreover, we measured discrimination performance (in a same vs. different task for the materials covering the table surface, during the execution of the different movements. The threshold and discrimination tasks could be performed either singly or together, both under active movement and passive conditions (ie, no movement required, but with tactile stimulation. Thresholds measured at rest were significantly lower than thresholds measured during both active movements and passive touches. This provides a clear indication of sensory suppression during movement execution. Moreover, the discrimination data revealed main effects of task (single vs. dual, movement execution type (passive vs. active, and movement type (reach vs. exploration: Discrimination performance was significantly higher under conditions of single-tasking, active movements, as well as exploratory movements. Therefore, active movement of the hand with the purpose of gaining tactual information about the surface of the table gives rise to enhanced performance, thus suggesting that we feel more when we need to; It would appear that tactual information is prioritized when relevant for the movement being executed.

Physiotherapy for cystic fibrosis in Australia and New Zealand: A clinical practice guideline.

Science.gov (United States)

Button, Brenda M; Wilson, Christine; Dentice, Ruth; Cox, Narelle S; Middleton, Anna; Tannenbaum, Esta; Bishop, Jennifer; Cobb, Robyn; Burton, Kate; Wood, Michelle; Moran, Fiona; Black, Ryan; Bowen, Summar; Day, Rosemary; Depiazzi, Julie; Doiron, Katherine; Doumit, Michael; Dwyer, Tiffany; Elliot, Alison; Fuller, Louise; Hall, Kathleen; Hutchins, Matthew; Kerr, Melinda; Lee, Annemarie L; Mans, Christina; O'Connor, Lauren; Steward, Ranjana; Potter, Angela; Rasekaba, Tshepo; Scoones, Rebecca; Tarrant, Ben; Ward, Nathan; West, Samantha; White, Dianne; Wilson, Lisa; Wood, Jamie; Holland, Anne E

2016-05-01

Physiotherapy management is a key element of care for people with cystic fibrosis (CF) throughout the lifespan. Although considerable evidence exists to support physiotherapy management of CF, there is documented variation in practice. The aim of this guideline is to optimize the physiotherapy management of people with CF in Australia and New Zealand. A systematic review of the literature in key areas of physiotherapy practice for CF was undertaken. Recommendations were formulated based on National Health and Medical Research Council (Australia) guidelines and considered the quality, quantity and level of the evidence; the consistency of the body of evidence; the likely clinical impact; and applicability to physiotherapy practice in Australia and New Zealand. A total of 30 recommendations were made for airway clearance therapy, inhalation therapy, exercise assessment and training, musculoskeletal management, management of urinary incontinence, managing the newly diagnosed patient with CF, delivery of non-invasive ventilation, and physiotherapy management before and after lung transplantation. These recommendations can be used to underpin the provision of evidence-based physiotherapy care to people with CF in Australia and New Zealand. © 2016 The Authors Respirology published by John Wiley & Sons Australia, Ltd on behalf of Asian Pacific Society of Respirology.

Outcome producing potential influences twelve-month-olds' interpretation of a novel action as goal-directed.

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Biro, Szilvia; Verschoor, Stephan; Coalter, Esther; Leslie, Alan M

2014-11-01

Learning about a novel, goal-directed action is a complex process. It requires identifying the outcome of the action and linking the action to its outcome for later use in new situations to predict the action or to anticipate its outcome. We investigated the hypothesis that linking a novel action to a salient change in the environment is critical for infants to assign a goal to the novel action. We report a study in which we show that 12-month-old infants, who were provided with prior experience with a novel action accompanied with a salient visible outcome in one context, can interpret the same action as goal-directed even in the absence of the outcome in another context. Our control condition shows that prior experience with the action, but without the salient effect, does not lead to goal-directed interpretation of the novel action. We also found that, for the case of 9-month-olds infants, prior experience with the outcome producing potential of the novel action does not facilitate a goal-directed interpretation of the action. However, this failure was possibly due to difficulties with generalizing the learnt association to another context rather than with linking the action to its outcome. Copyright © 2014 Elsevier Inc. All rights reserved.

Does Competition Have an Effect on Price and Quality in Physiotherapy?

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Pekola, Piia; Linnosmaa, Ismo; Mikkola, Hennamari

2017-10-01

We estimate the effect of competition on quality and prices in physiotherapy organised and financed by the Social Insurance Institution of Finland for disabled individuals. Within the physiotherapy market, firms participate in competitive bidding, prices are determined by the market, services are free at the point of use and firms are allowed to react to patient choice only by enhancing quality. Firm-level data (n = 854) regarding quality and price were analysed. Using 2SLS estimation techniques, we analysed the relationship between quality and competition, and price and competition. Our study found that competition has a negative (yet weak) effect on quality. Prices on the other hand are not affected by competition. The result is likely caused by imperfect information, because it seems that the Social Insurance Institution of Finland has provided too little information for patients to make adequate choices about proper service providers. We argue that by publishing quality information, it is possible to ease the decision-making of patients and influence the quality strategies of firms active in the physiotherapy market. Moreover, we found that competition appeared as an exogenous variable in this study. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Cost effectiveness of brace, physiotherapy, or both for treatment of tennis elbow

NARCIS (Netherlands)

Struijs, P. A. A.; Korthals-de Bos, I. B. C.; van Tulder, M. W.; van Dijk, C. N.; Bouter, L. M.; Assendelft, W. J. J.

2006-01-01

BACKGROUND: The annual incidence of tennis elbow in the general population is high (1-3%). Tennis elbow often leads to limitation of activities of daily living and work absenteeism. Physiotherapy and braces are the most common treatments. OBJECTIVES: The hypothesis of the trial was that no

Towards a three-dimensional framework of centrally regulated and goal-directed exercise behaviour: a narrative review.

Science.gov (United States)

Venhorst, Andreas; Micklewright, Dominic; Noakes, Timothy D

2017-08-23

The Central Governor Model (CGM) ignited a paradigm shift from concepts of catastrophic failure towards central regulation of exercise performance. However, the CGM has focused on the central integration of afferent feedback in homeostatic control. Accordingly, it neglected the important role of volitional self-regulatory control and the integration of affective components inherently attached to all physiological cues. Another limitation is the large reliance on the Gestalt phenomenon of perceived exertion. Thus, progress towards a comprehensive multidimensional model of perceived fatigability and exercise regulation is needed. Drawing on Gate Control Theory of pain, we propose a three-dimensional framework of centrally regulated and goal-directed exercise behaviour, which differentiates between sensory, affective and cognitive processes shaping the perceptual milieu during exercise. We propose that: (A) perceived mental strain and perceived physical strain are primary determinants of pacing behaviour reflecting sensory-discriminatory processes necessary to align planned behaviour with current physiological state, (B) core affect plays a primary and mediatory role in exercise and performance regulation, and its underlying two dimensions hedonicity and arousal reflect affective-motivational processes triggering approach and avoidance behaviour, and (C) the mindset-shift associated with an action crisis plays a primary role in volitional self-regulatory control reflecting cognitive-evaluative processes between further goal-pursuit and goal-disengagement. The proposed framework has the potential to enrich theory development in centrally regulated and goal-directed exercise behaviour by emphasising the multidimensional dynamic processes underpinning perceived fatigability and provides a practical outline for investigating the complex interplay between the psychophysiological determinants of pacing and performance during prolonged endurance exercise. © Article author

A randomized controlled trial on early physiotherapy intervention versus usual care in acute care unit for elderly: potential benefits in light of dietary intakes.

NARCIS (Netherlands)

Blanc-Bisson, C.; Dechamps, A.A.; Gouspillou, G.; Dehail, P.; Bourdel-Marchasson, I.

2008-01-01

OBJECTIVE: To evaluate effects of early intensive physiotherapy during acute illness on post hospitalization activity daily living autonomy (ADL). DESIGN: Prospective randomized controlled trial of intensive physiotherapy rehabilitation on day 1 to 2 after admission until clinical stability or usual

Physiotherapy in hip and knee osteoarthritis: development of a practice guideline concerning initial assessment, treatment and evaluation.

Science.gov (United States)

Peter, W F; Jansen, M J; Hurkmans, E J; Bloo, H; Dekker, J; Dilling, R G; Hilberdink, W; Kersten-Smit, C; de Rooij, M; Veenhof, C; Vermeulen, H M; de Vos, R J; Schoones, J W; Vliet Vlieland, T P

2011-01-01

An update of a Dutch physiotherapy practice guideline in Hip and Knee Osteoarthritis (HKOA) was made, based on current evidence and best practice. A guideline steering committee, comprising 10 expert physiotherapists, selected topics concerning the guideline chapters: initial assessment, treatment and evaluation. With respect to treatment a systematic literature search was performed using various databases, and the evidence was graded (1-4). For the initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated. A first draft of the guideline was reviewed by 17 experts from different professional backgrounds. A second draft was field-tested by 45 physiotherapists. In total 11 topics were selected. For the initial assessment, three recommendations were formulated, pertaining to history taking, red flags, and formulating treatment goals. Concerning treatment, 7 recommendations were formulated; (supervised) exercise therapy, education and self management interventions, a combination of exercise and manual therapy, postoperative exercise therapy and taping of the patella were recommended. Balneotherapy and hydrotherapy in HKOA, and thermotherapy, TENS, and Continuous Passive Motion in knee OA were neither recommended nor discouraged. Massage therapy, ultrasound, electrotherapy, electromagnetic field, Low Level Laser Therapy, preoperative physiotherapy and education could not be recommended. For the evaluation of treatment goals the following measurement instruments were recommended: Lequesne index, Western Ontario and McMaster Universities osteoarthritis index, Hip disability and Osteoarthritis Outcome Score and Knee injury and Osteoarthritis Outcome Score, 6-minute walktest, Timed Up and Go test, Patient Specific Complaint list, Visual Analoge Scale for pain, Intermittent and Constant OsteoArthritis Pain Questionnaire, goniometry, Medical Research Council for strength, handheld

Neural systems analysis of decision making during goal-directed navigation.

Science.gov (United States)

Penner, Marsha R; Mizumori, Sheri J Y

2012-01-01

The ability to make adaptive decisions during goal-directed navigation is a fundamental and highly evolved behavior that requires continual coordination of perceptions, learning and memory processes, and the planning of behaviors. Here, a neurobiological account for such coordination is provided by integrating current literatures on spatial context analysis and decision-making. This integration includes discussions of our current understanding of the role of the hippocampal system in experience-dependent navigation, how hippocampal information comes to impact midbrain and striatal decision making systems, and finally the role of the striatum in the implementation of behaviors based on recent decisions. These discussions extend across cellular to neural systems levels of analysis. Not only are key findings described, but also fundamental organizing principles within and across neural systems, as well as between neural systems functions and behavior, are emphasized. It is suggested that studying decision making during goal-directed navigation is a powerful model for studying interactive brain systems and their mediation of complex behaviors. Copyright © 2011. Published by Elsevier Ltd.

Physiotherapy in Ordinary Schools.

Science.gov (United States)

Davies, Jean; Hunt, Agnes

1980-01-01

A program to provide physiotherapy to mainstreamed physically handicapped English school children (from preschool through high school) is described. Begun in 1978, the once a week service has increased the independence of the children served and brought a better understanding of the handicapped students' capabilities to their teachers. (PHR)

Loss of lateral prefrontal cortex control in food-directed attention and goal-directed food choice in obesity.

Science.gov (United States)

Janssen, Lieneke K; Duif, Iris; van Loon, Ilke; Wegman, Joost; de Vries, Jeanne H M; Cools, Roshan; Aarts, Esther

2017-02-01

Loss of lateral prefrontal cortex (lPFC)-mediated attentional control may explain the automatic tendency to eat in the face of food. Here, we investigate the neurocognitive mechanism underlying attentional bias to food words and its association with obesity using a food Stroop task. We tested 76 healthy human subjects with a wide body mass index (BMI) range (19-35kg/m 2 ) using fMRI. As a measure of obesity we calculated individual obesity scores based on BMI, waist circumference and waist-to-hip ratio using principal component analyses. To investigate the automatic tendency to overeat directly, the same subjects performed a separate behavioral outcome devaluation task measuring the degree of goal-directed versus automatic food choices. We observed that increased obesity scores were associated with diminished lPFC responses during food attentional bias. This was accompanied by decreased goal-directed control of food choices following outcome devaluation. Together these findings suggest that deficient control of both food-directed attention and choice may contribute to obesity, particularly given our obesogenic environment with food cues everywhere, and the choice to ignore or indulge despite satiety. Copyright © 2016 Elsevier Inc. All rights reserved.

Predicting objectively assessed physical activity from the content and regulation of exercise goals: evidence for a mediational model.

Science.gov (United States)

Sebire, Simon J; Standage, Martyn; Vansteenkiste, Maarten

2011-04-01

Grounded in self-determination theory (Deci & Ryan, 2000), the purpose of this work was to examine effects of the content and motivation of adults' exercise goals on objectively assessed moderate-to-vigorous physical activity (MVPA). After reporting the content and motivation of their exercise goals, 101 adult participants (Mage = 38.79 years; SD = 11.5) wore an ActiGraph (GT1M) accelerometer for seven days. Accelerometer data were analyzed to provide estimates of engagement in MVPA and bouts of physical activity. Goal content did not directly predict behavioral engagement; however, mediation analysis revealed that goal content predicted behavior via autonomous exercise motivation. Specifically, intrinsic versus extrinsic goals for exercise had a positive indirect effect on average daily MVPA, average daily MVPA accumulated in 10-min bouts and the number of days on which participants performed 30 or more minutes of MVPA through autonomous motivation. These results support a motivational sequence in which intrinsic versus extrinsic exercise goals influence physical activity behavior because such goals are associated with more autonomous forms of exercise motivation.

Bi-directional Exchange: the Cornerstone of Globally Focused Social Work.

Science.gov (United States)

Parker, Gary; Ali, Samira; Ringell, Kassia; McKay, Mary

2014-03-01

Social work holds a unique place relative to other professions in that it prioritizes the elimination of human suffering as its primary goal. The roots of the profession are firmly planted in Western theories, historically and culturally specific perspectives, and knowledge. History has repeatedly demonstrated an association between the arrival of Westerners and the subsequent control of natural resources. Some argue that the development of global social work practice has serious pitfalls, including diverting needed resources away from local contexts and inadvertently spreading western world-views, paradigms and practices. However, the social work profession is uniquely positioned to offer expertise and collaborate with those experiencing the serious consequences of social inequity and the dearth of economic and social resources locally and across the globe. Grounded in anti-oppressive theory, guided by the difficult, yet acute awareness of western privilege and racism, and drawing from social/collective action and collaborative paradigms, a bi-directional exchange and action are detailed as the foundations for globally focused social work. The skills and knowledge base for global social work are essential as populations locally and worldwide are impacted by a global economic system that innately increases serious social inequity. Comprehensive training and preparation for globally focused social work, critical to successful engagement in global practice are outlined.

Musculoskeletal complaints among physiotherapy and occupational therapy rehabilitation professionals in Bangladesh.

Science.gov (United States)

Islam, Md Shofiqul; Habib, Md Monjurul; Hafez, Md Abdul; Nahar, Nazmun; Lindstrom-Hazel, Debra; Rahman, Mohammad Khalilur

2015-01-01

Physiotherapy and occupational therapy professionals are at high risk of developing occupational musculoskeletal injuries globally. Musculoskeletal pain is the most common problem. To determine the extent of discomfort that physiotherapy and occupational therapy health professionals report while working at a physical rehabilitation centre. Physiotherapy and occupational therapy professionals which include both graduate and diploma physiotherapists and occupational therapists as well as physiotherapy and occupational therapy assistants. A self administered questionnaire (survey) was conducted on a convenient sample of 101 physiotherapy and occupational therapy personnel. The mean age of the 101 participants was 27.8 (± 4.5) years and most of the participants (62%) had less than 5 years of work experience. Ninety-five percent of the participants complained of work related pain. Most of the participants reported pain in the lower back (n=84) followed by upper back (n=71) and neck (n=66). Significant associations were found for pain in ankles/feet with age (p=0.05) and pain in neck with gender (p=0.01). Physiotherapy and occupational therapy professionals suffer from pain in relation to the work they do as therapists which may be due to non-practice of appropriate body mechanics. Mechanism to assess level of practice during dealing with patients may be introduced to enable corrective measures. Incentives should be considered for appropriate practice.

INTERDISCIPLINARY MODULE IN PREVENTION AND HEALTH PROMOTION IN POPULATION HEALTH FOR OCCUPATIONAL THERAPY AND PHYSIOTHERAPY STUDENTS

DEFF Research Database (Denmark)

Brandt, Jørgen

-operate towards appropriate solutions. The groups suggest and present preventive and health promotion solutions and strategies especially designed for this particular situation. The groups are supervised by an interdisciplinary team of occupational therapy and physiotherapy lecturers. In addition......PURPOSE: The purpose is to provide physiotherapy and occupational therapy students at the University College Cvu vita in Holstebro, Denmark, the opportunity to develop competences for interdisciplinary working situations concerning promotion of population health. RELEVANCE: The Danish Ministry...... of the Interior and Health participates in co-operation within the European Union on health areas, which focuses on efforts with respect to public health (Article 152 of the Treaty on EU). The curricula for both educations underline the importance of preparing the students for interdisciplinary co...

Professional roles in physiotherapy practice: Educating for self-management, relational matching, and coaching for everyday life.

Science.gov (United States)

Solvang, Per Koren; Fougner, Marit

2016-11-01

The patient's active participation in treatment and rehabilitation represents a cultural change in clinical practice as well as a major change in physiotherapist and patient roles. This article presents findings from a study aimed at gaining a better understanding of how physiotherapists in actual practice understand their interactions with patients during the treatment process. This article reports on the findings from focus-group interviews with physiotherapists working in three different settings. Analyses of the interview data identified three modes of physiotherapy practice. In one, physiotherapists educate their patients to be self-managing in conducting exercise programs based on sound evidence. Educational films available on the Internet are included in these efforts to teach patients. In another, physiotherapists emphasize the importance of a close relationship to the patient. A good personal chemistry is believed to improve the treatment process. And finally, what physiotherapists learn about the living conditions and the biographies of their patients was shown to be very important. Understanding the importance of the life-world and taking this into consideration in the treatment process were factors considered to be central to good practice. The article concludes with a discussion linking these findings to those of other studies identifying those factors contributing to our knowledge of what is involved in biopsychosocial practice in physiotherapy.

Reliance on habits at the expense of goal-directed control following dopamine precursor depletion

OpenAIRE

de Wit, Sanne; Standing, Holly R.; DeVito, Elise E.; Robinson, Oliver J.; Ridderinkhof, K. Richard; Robbins, Trevor W.; Sahakian, Barbara J.

2011-01-01

Rationale Dopamine is well known to play an important role in learning and motivation. Recent animal studies have implicated dopamine in the reinforcement of stimulus?response habits, as well as in flexible, goal-directed action. However, the role of dopamine in human action control is still not well understood. Objectives We present the first investigation of the effect of reducing dopamine function in healthy volunteers on the balance between habitual and goal-directed action control. Metho...

Materialistic Values and Goals.

Science.gov (United States)

Kasser, Tim

2016-01-01

Materialism comprises a set of values and goals focused on wealth, possessions, image, and status. These aims are a fundamental aspect of the human value/goal system, standing in relative conflict with aims concerning the well-being of others, as well as one's own personal and spiritual growth. Substantial evidence shows that people who place a relatively high priority on materialistic values/goals consume more products and incur more debt, have lower-quality interpersonal relationships, act in more ecologically destructive ways, have adverse work and educational motivation, and report lower personal and physical well-being. Experimentally activating materialistic aims causes similar outcomes. Given these ills, researchers have investigated means of decreasing people's materialism. Successful interventions encourage intrinsic/self-transcendent values/goals, increase felt personal security, and/or block materialistic messages from the environment. These interventions would likely be more effective if policies were also adopted that diminished contemporary culture's focus on consumption, profit, and economic growth.

Exploring barriers to accessing physiotherapy services for stroke patients at Tema general hospital, Ghana.

Science.gov (United States)

Nketia-Kyere, Mercy; Aryeetey, Genevieve Cecilia; Nonvignon, Justice; Aikins, Moses

2017-01-01

Physiotherapy has been shown to reduce the risk of disability among stroke patients. Poor adherence to physiotherapy can negatively affect outcomes and healthcare cost. However, very little is known about barriers especially to physiotherapy services in Ghana. The objective of this study was to assess the barriers to physiotherapy services for stroke patients at Tema General Hospital (TGH). The individual/personal and health system barriers to physiotherapy services at TGH were determined. A cross-sectional study design was employed. A simple random sampling technique was used to recruit 207 respondents for a face-to-face interview. Interviewer-administered questionnaires were used to collect data on individual/personal barriers of respondents to physiotherapy services and were described using the Likert's scale. Health system barriers were assessed using a self-structured questionnaire which had section under the following heading: human factors, physiotherapy modalities, physical barriers and material/equipment factors. The time spent waiting for physiotherapy and attitude of physiotherapist towards patients; physiotherapy modality such as electrotherapy, exercise therapy and massage therapy among others were some of the indices measured. Respondents' adherence to Medication was assessed with the Morisky 8-item medication adherence questionnaire. Data were entered and analysed using Epi info 7 and STATA 12.0. Associations between the variables were determined using a chi-square test and logistic regression model was used to test the strength of associations between the independent and the dependent variables. The level of statistical significance was set at p  Tema General Hospital.

Building capacity in the rural physiotherapy workforce: a paediatric training partnership.

Science.gov (United States)

Williams, E N; McMeeken, J M

2014-01-01

Building capacity in the rural physiotherapy workforce: a paediatric training partnership' provided 6 months postgraduate paediatric clinical and academic training for two physiotherapists in rural Australia. It is described as a model for improving services and workforce retention. The need for 'an appropriate, skilled and well-supported health workforce' is the third goal in Australia's National Strategic Framework for Rural and Remote Health 2011. The World Health Organization recently published its first global policy for improving the retention of rural and remote health workers. Education is its first recommendation and aims to 'design continuing education and professional development programmes that meet the needs of rural health workers and that are accessible from where they live and work, so as to support their retention …'. Additionally, '… to be successful, continuing education needs to be linked to career paths, as well as with other education interventions'. The problem is a lack of paediatric physiotherapy expertise in rural areas due to an absence of postgraduate clinical training opportunities in the rural workforce. The result is fragmented local services for families who are forced to travel to metropolitan services, costly in terms of both time and money. The aims were to improve local paediatric physiotherapy clinical services, provide physiotherapists additional access to professional development and subsequently provide a career path to retain these health professionals. Evaluation of the project used purpose-built questionnaires as there are no specific indicators to monitor the performance of systems and services that are available to children and families in Australia. The paediatric physiotherapy training program was enabled through initial funding for a 12-month pilot project. Further government funding built on that success for this reported 6-month project. Funding to employ the postgraduate physiotherapists was essential to the

The Influence of Kinesio Taping on the Effects of Physiotherapy in Patients after Laparoscopic Cholecystectomy

Directory of Open Access Journals (Sweden)

Marcin Krajczy

2012-01-01

Full Text Available Physiotherapy in patients after laparoscopic cholecystectomy (CHL is impeded by postoperative pain which causes a decline in patients’ activity, reduces respiratory muscles’ function, and affects patients’ ability to look after themselves. The objective of this work was to assess the influence of Kinesio Taping (KT on pain level and the increase in effort tolerance in patients after CHL. The research included 63 patients after CHL. Test group and control group included randomly selected volunteers. Control group consisted of 32 patients (26 females, 6 males, test group consisted of 31 patients (22 females, 9 males. Both groups were subjected to complex physiotherapy, and control group had additional KT applications. Before surgery, during and after physiotherapy, patients were given the following tests: 100-meter walk tests, subjective pain perception assessment, and pain relief medicines intake level assessment. The level of statistical significance for all tests was established at <0.05. Statistical analysis showed a significant decrease in the time required to cover a 100-meter distance and a decrease in pain perception presented by significantly lower painkillers' intake in the test group in comparison with the control group. The improvement in clinical condition observed in the research indicates the efficiency of KT as a method complementing physiotherapy in patients after laparoscopic cholecystectomy.

Do people differentiate between intrinsic and extrinsic goals for physical activity?

Science.gov (United States)

McLachlan, Sarah; Hagger, Martin S

2011-04-01

The distinction between intrinsic and extrinsic goals, and between goal pursuit for intrinsically and extrinsically motivated reasons, is a central premise of self-determination theory. Proponents of the theory have proposed that the pursuit of intrinsic goals and intrinsically motivated goal striving each predict adaptive psychological and behavioral outcomes relative to the pursuit of extrinsic goals and extrinsically motivated goal striving. Despite evidence to support these predictions, research has not explored whether individuals naturally differentiate between intrinsic and extrinsic goals. Two studies tested whether people make this differentiation when recalling goals for leisure-time physical activity. Using memory-recall methods, participants in Study 1 were asked to freely generate physical activity goals. A subsample (N = 43) was asked to code their freely generated goals as intrinsic or extrinsic. In Study 2, participants were asked to recall intrinsic and extrinsic goals after making a decision regarding their future physical activity. Results of these studies revealed that individuals' goal generation and recall exhibited significant clustering by goal type. Participants encountered some difficulties when explicitly coding goals. Findings support self-determination theory and indicate that individuals discriminate between intrinsic and extrinsic goals.

Inter-individual differences in decision-making, flexible and goal-directed behaviors: novel insights within the prefronto-striatal networks.

Science.gov (United States)

Fitoussi, Aurélie; Renault, Prisca; Le Moine, Catherine; Coutureau, Etienne; Cador, Martine; Dellu-Hagedorn, Françoise

2018-03-01

Inflexible behavior is a hallmark of several decision-making-related disorders such as ADHD and addiction. As in humans, a subset of healthy rats makes poor decisions and prefers immediate larger rewards despite suffering large losses in a rat gambling task (RGT). They also display a combination of traits reminiscent of addiction, notably inflexible behavior and perseverative responses. The goal of the present work was twofold: (1) to elucidate if behavioral inflexibility of poor decision-makers could be related to a lower quality of goal-directed behavior (action-outcome associations); (2) to uncover the neural basis of inter-individual differences in goal-directed behavior. We specifically assessed inter-individual differences in decision-making in the RGT, flexibility in the RGT-reversed version and goal-directed behavior in a contingency degradation test, i.e., response adaptation when dissociating reward delivery from the animal's action. The contributions of the medial prefrontal cortex and the dorsal striatum to action-outcome associations were assessed using Zif268 immunodetection. Inflexible behavior was related to a lower sensitivity to contingency degradation in all poor decision-makers and only in a few good decision-makers. This poorer sensitivity was associated with a lower immunoreactivity in prelimbic and infralimbic cortices and a higher one in the dorsomedial and dorsolateral striatum. These findings suggest that an imbalanced prefronto-striatal activity could underlie inaccurate goal representation in changing environments and may promote maladaptive habit formation among poor decision-makers. These data strengthen our previous work identifying biomarkers of vulnerability to develop psychiatric disorders and demonstrate the relevance of inter-individual differences to model maladaptive behaviors.

Physiotherapy management of knee osteoarthritis.

Science.gov (United States)

Page, Carolyn J; Hinman, Rana S; Bennell, Kim L

2011-05-01

Knee osteoarthritis (OA) is a prevalent chronic joint disease causing pain and disability. Physiotherapy, which encompasses a number of modalities, is a non-invasive treatment option in the management of OA. This review summarizes the evidence for commonly used physiotherapy interventions. There is strong evidence to show short-term beneficial effects of exercise on pain and function, although the type of exercise does not seem to influence treatment outcome. Delivery modes, including individual, group or home exercise are all effective, although therapist contact may improve benefits. Attention to improving adherence to exercise is needed to maximize outcomes in the longer-term. Knee taping applied with the aim of realigning the patella and unloading soft tissues can reduce pain. There is also evidence to support the use of knee braces in people with knee OA. Biomechanical studies show that lateral wedge shoe insoles reduce knee load but clinical trials do not support symptomatic benefits. Recent studies suggest individual shoe characteristics also affect knee load and there is current interest in the effect of modified shoe designs. Manual therapy, while not to be used as a stand-alone treatment, may be beneficial. In summary, although the research is not equivocal, there is sufficient evidence to indicate that physiotherapy interventions can reduce pain and improve function in those with knee OA. © 2011 The Authors. International Journal of Rheumatic Diseases © 2011 Asia Pacific League of Associations for Rheumatology and Blackwell Publishing Asia Pty Ltd.

Framing the frame: How task goals determine the likelihood and direction of framing effects

OpenAIRE

Todd McElroy; John J. Seta

2007-01-01

We examined how the goal of a decision task influences the perceived positive, negative valence of the alternatives and thereby the likelihood and direction of framing effects. In Study 1 we manipulated the goal to increase, decrease or maintain the commodity in question and found that when the goal of the task was to increase the commodity, a framing effect consistent with those typically observed in the literature was found. When the goal was to decrease, a framing effect opposite to the ty...

A test of an adherence-enhancing adjunct to physiotherapy steeped in the protection motivation theory.

Science.gov (United States)

Bassett, Sandra F; Prapavessis, Harry

2011-07-01

The primary aim of this study was to test the effect of a Protection Motivation Theory (PMT)-based patient education intervention on physiotherapy patients' beliefs about their injury and physiotherapy, intentions to adhere, rehabilitation adherence, and ankle function. A secondary aim was to explore the relationships between the patients' injury and physiotherapy beliefs, intentions, adherence behaviours, and ankle function. A randomized controlled trial was undertaken in New Zealand; 71 people with ankle sprains were allocated to either PMT present video information or two control groups (non-PMT information about ankle sprains and no formal information) before commencing their course of physiotherapy. The two information groups watched a video about ankle sprains and physiotherapy before answering the Beliefs about Ankle Sprains and Physiotherapy Scale and behavioural intentions questionnaires that measured the PMT constructs. Adherence was assessed at each treatment and ankle function was measured before and after the physiotherapy program. After viewing the video, the PMT present information group's beliefs about severity, vulnerability, and response efficacy were significantly higher than the other two groups. The groups did not differ significantly on their self-efficacy, intentions, rehabilitation adherence, and post-physiotherapy program ankle function. Significant correlations existed between the patients' PMT-based beliefs and intentions, intentions and adherence, and adherence and post-physiotherapy ankle function. With the exception of self-efficacy, the findings indicate that persuasive information grounded in PMT does enhance physiotherapy patients' beliefs about their injury and treatment.

Effect of self-efficacy and physical activity goal achievement on arthritis pain and quality of life in patients with rheumatoid arthritis.

Science.gov (United States)

Knittle, Keegan P; De Gucht, Véronique; Hurkmans, Emalie J; Vlieland, Thea P M Vliet; Peeters, André J; Ronday, H Karel; Maes, Stan

2011-11-01

To examine physical activity and achievement of physical activity goals in relation to self-reported pain and quality of life among patients with rheumatoid arthritis (RA). At baseline, 271 patients with RA were asked to specify a physical activity goal, and filled in questionnaires assessing physical activity, motivation, and self-efficacy for physical activity, arthritis pain, and quality of life. Six months later, patients indicated to what extent they had achieved their baseline physical activity goal and completed the same set of questionnaires. These data were used to construct multiple mediation models that placed physical activity and physical activity goal achievement as mediators between self-efficacy and motivation on one hand, and arthritis pain and quality of life on the other. A total of 106 patients with RA completed both questionnaires. Self-efficacy at baseline predicted subsequent level of physical activity and achievement of physical activity goals. Goal achievement had a direct effect upon quality of life outcomes. Bootstrapping confidence intervals revealed indirect effects of self-efficacy upon arthritis pain and quality of life through goal achievement, but not through physical activity. Higher levels of self-efficacy for physical activity increase the likelihood that patients will achieve their physical activity goals. Achievement of physical activity goals seems to be related to lower self-reported arthritis pain, and higher levels of quality of life. In practice, clinicians can foster self-efficacy and goal achievement by assisting patients in setting realistic and attainable exercise goals, developing action plans, and by providing feedback on goal progress. Copyright © 2011 by the American College of Rheumatology.

Monitoring of peri-operative fluid administration by individualized goal-directed therapy

DEFF Research Database (Denmark)

Bundgaard-Nielsen, M; Holte, Kathrine; Secher, N H

2007-01-01

BACKGROUND: In order to avoid peri-operative hypovolaemia or fluid overload, goal-directed therapy with individual maximization of flow-related haemodynamic parameters has been introduced. The objectives of this review are to update research in the area, evaluate the effects on outcome and assess...

Physiotherapy in hip and knee osteoarthritis : evidence and daily practice

NARCIS (Netherlands)

Peter, Willem Frederik Hendrik (Wilfred)

2015-01-01

In the first part an update of a guideline for the physiotherapy treatment of patients with hip and knee OA is described. Then a set of quality indicators for the physiotherapy management is developed to be used as an instrument to measure guideline adherence. Subsequently the effect of educational

Postural health in women: the role of physiotherapy.

Science.gov (United States)

Britnell, S J; Cole, J V; Isherwood, L; Sran, M M; Britnell, N; Burgi, S; Candido, G; Watson, L

2005-05-01

To advise obstetric and gynaecology care providers of the physical, psychological, and environmental factors that affect women's posture throughout their lifespan, from adolescence to menopause. To outline the physiotherapy management of obstetrics, osteoporosis, and urinary incontinence in women and to identify recommendations for referral to a physiotherapist. Knowledge of abnormal postures, contributing factors and recommendations for physiotherapy management. MEDLINE, PEDro, and Cochrane Library Search from 1992 to 2003 for English-language articles and references from current textbooks related to posture and women's health conditions that are managed by physiotherapists. The evidence collected was reviewed by the authors and quantified using the evaluation of evidence guidelines developed by the Canadian Task Force on the Periodic Health Exam. 1. Pelvic floor muscle training with a physiotherapist is recommended to prevent urinary incontinence during pregnancy and after delivery (I-A). 2. Core stability training with a physiotherapist is recommended to prevent and treat back and pelvic pain during and following pregnancy (I-B). 3. Physiotherapist-prescribed exercises are recommended for women to elicit positive changes in bone mass and to reduce fall and fracture risk (I-A). 4. Pelvic floor muscle training with a physiotherapist is recommended for women with stress urinary incontinence (I-A). The Canadian Physiotherapy Association and Society of Obstetricians and Gynaecologists of Canada have developed this joint policy statement regarding posture in women's health that highlights the physical, psychological, and environmental factors that affect women's posture throughout their lifespan, from adolescence to menopause. This statement outlines the role of physiotherapy in the assessment and treatment of women's posture; outlines the physiotherapy management of obstetrics, osteoporosis, and urinary incontinence; and identifies recommendations for referral to a

Does physiotherapy based on the Bobath concept, in conjunction with a task practice, achieve greater improvement in walking ability in people with stroke compared to physiotherapy focused on structured task practice alone?: a pilot randomized controlled trial.

Science.gov (United States)

Brock, Kim; Haase, Gerlinde; Rothacher, Gerhard; Cotton, Susan

2011-10-01

To compare the short-term effects of two physiotherapy approaches for improving ability to walk in different environments following stroke: (i) interventions based on the Bobath concept, in conjunction with task practice, compared to (ii) structured task practice alone. Randomized controlled trial. Two rehabilitation centres Participants: Twenty-six participants between four and 20 weeks post-stroke, able to walk with supervision indoors. Both groups received six one-hour physiotherapy sessions over a two-week period. One group received physiotherapy based on the Bobath concept, including one hour of structured task practice. The other group received six hours of structured task practice. The primary outcome was an adapted six-minute walk test, incorporating a step, ramp and uneven surface. Secondary measures were gait velocity and the Berg Balance Scale. Measures were assessed before and after the intervention period. Following the intervention, there was no significant difference in improvement between the two groups for the adapted six-minute walk test (89.9 (standard deviation (SD) 73.1) m Bobath versus 41 (40.7) m task practice, P = 0.07). However, walking velocity showed significantly greater increases in the Bobath group (26.2 (SD 17.2) m/min versus 9.9 (SD = 12.9) m/min, P = 0.01). No significant differences between groups were recorded for the Berg Balance Scale (P = 0.2). This pilot study indicates short-term benefit for using interventions based on the Bobath concept for improving walking velocity in people with stroke. A sample size of 32 participants per group is required for a definitive study.

Reliance on habits at the expense of goal-directed control following dopamine precursor depletion.

Science.gov (United States)

de Wit, Sanne; Standing, Holly R; Devito, Elise E; Robinson, Oliver J; Ridderinkhof, K Richard; Robbins, Trevor W; Sahakian, Barbara J

2012-01-01

Dopamine is well known to play an important role in learning and motivation. Recent animal studies have implicated dopamine in the reinforcement of stimulus-response habits, as well as in flexible, goal-directed action. However, the role of dopamine in human action control is still not well understood. We present the first investigation of the effect of reducing dopamine function in healthy volunteers on the balance between habitual and goal-directed action control. The dietary intervention of acute dietary phenylalanine and tyrosine depletion (APTD) was adopted to study the effects of reduced global dopamine function on action control. Participants were randomly assigned to either the APTD or placebo group (ns = 14) to allow for a between-subjects comparison of performance on a novel three-stage experimental paradigm. In the initial learning phase, participants learned to respond to different stimuli in order to gain rewarding outcomes. Subsequently, an outcome-devaluation test and a slips-of-action test were conducted to assess whether participants were able to flexibly adjust their behaviour to changes in the desirability of the outcomes. APTD did not prevent stimulus-response learning, nor did we find evidence for impaired response-outcome learning in the subsequent outcome-devaluation test. However, when goal-directed and habitual systems competed for control in the slips-of-action test, APTD tipped the balance towards habitual control. These findings were restricted to female volunteers. We provide direct evidence that the balance between goal-directed and habitual control in humans is dopamine dependent. The results are discussed in light of gender differences in dopamine function and psychopathologies.

Contact with Young Adults with Disability Led to a Positive Change in Attitudes toward Disability among Physiotherapy Students

OpenAIRE

Shields, Nora; Taylor, Nicholas F.

2014-01-01

Purpose: To determine whether contact over 8 weeks with a person with disability benefits physiotherapy students' attitudes toward disability and their development of professional behaviours and skills. Methods: Sixteen adults with Down syndrome were matched with 16 physiotherapy students (13 women, 3 men; mean age 22.5 [SD 3.0] years) and randomized to either an 8-week, twice-weekly walking programme or an 8-week, once-weekly social activities programme. Students completed the Interaction wi...

Distinct roles of theta and alpha oscillations in the involuntary capture of goal-directed attention.

Science.gov (United States)

Harris, Anthony M; Dux, Paul E; Jones, Caelyn N; Mattingley, Jason B

2017-05-15

Mechanisms of attention assign priority to sensory inputs on the basis of current task goals. Previous studies have shown that lateralized neural oscillations within the alpha (8-14Hz) range are associated with the voluntary allocation of attention to the contralateral visual field. It is currently unknown, however, whether similar oscillatory signatures instantiate the involuntary capture of spatial attention by goal-relevant stimulus properties. Here we investigated the roles of theta (4-8Hz), alpha, and beta (14-30Hz) oscillations in human goal-directed visual attention. Across two experiments, we had participants respond to a brief target of a particular color among heterogeneously colored distractors. Prior to target onset, we cued one location with a lateralized, non-predictive cue that was either target- or non-target-colored. During the behavioral task, we recorded brain activity using electroencephalography (EEG), with the aim of analyzing cue-elicited oscillatory activity. We found that theta oscillations lateralized in response to all cues, and this lateralization was stronger if the cue matched the target color. Alpha oscillations lateralized relatively later, and only in response to target-colored cues, consistent with the capture of spatial attention. Our findings suggest that stimulus induced changes in theta and alpha amplitude reflect task-based modulation of signals by feature-based and spatial attention, respectively. Copyright © 2017 Elsevier Inc. All rights reserved.

Goal Clarity and Financial Planning Activities as Determinants of Retirement Savings Contributions

Science.gov (United States)

Stawski, Robert S.; Hershey, Douglas A.; Jacobs-Lawson, Joy M.

2007-01-01

Retirement counselors, financial service professionals, and retirement intervention specialists routinely emphasize the importance of developing clear goals for the future; however, few empirical studies have focused on the benefits of retirement goal setting. In the present study, the extent to which goal clarity and financial planning activities…

Perceptions of Norwegian physiotherapy students: cultural diversity in practice.

Science.gov (United States)

Fougner, Marit; Horntvedt, And Tone

2012-01-01

At the Faculty of Health Sciences, Oslo University College there is a growing recognition of the need for cultural competency training among students at the bachelor programmes. At the Mensendieck-physiotherapy bachelor programme the students are engaged in leading physical activity groups for Muslim women. This qualitative study describes ethnically Norwegian students experiencing cultural diversity in practice. Twenty-two female physiotherapy students participated in the interviews; 6 students were interviewed individually by telephone, and 16 students were interviewed in person in 8 pairs. The students' framework for dealing with diversity is based on preconceived notions about Muslim women and is reflected in two particular ways. One is how the values and norms of Norwegian "ideology of sameness" are pursued by the students. The other is how the students constructed images of the women as "the others." The interview responses indicate difficulties in uniting the reality of diversity and the "need" for integration. The curriculum requires additional attention on cultural competency for health care professionals in a multicultural society.

Effectiveness of individualized physiotherapy on pain and functioning compared to a standard exercise protocol in patients presenting with clinical signs of subacromial impingement syndrome. A randomized controlled trial

Directory of Open Access Journals (Sweden)

de Bie Rob A

2010-06-01

Full Text Available Abstract Background Shoulder impingement syndrome is a common musculoskeletal complaint leading to significant reduction of health and disability. Physiotherapy is often the first choice of treatment although its effectiveness is still under debate. Systematic reviews in this field highlight the need for more high quality trials to investigate the effectiveness of physiotherapy interventions in patients with subacromial impingement syndrome. Methods/Design This randomized controlled trial will investigate the effectiveness of individualized physiotherapy in patients presenting with clinical signs and symptoms of subacromial impingement, involving 90 participants aged 18-75. Participants are recruited from outpatient physiotherapy clinics, general practitioners, and orthopaedic surgeons in Germany. Eligible participants will be randomly allocated to either individualized physiotherapy or to a standard exercise protocol using central randomization. The control group will perform the standard exercise protocol aiming to restore muscular deficits in strength, mobility, and coordination of the rotator cuff and the shoulder girdle muscles to unload the subacromial space during active movements. Participants of the intervention group will perform the standard exercise protocol as a home program, and will additionally be treated with individualized physiotherapy based on clinical examination results, and guided by a decision tree. After the intervention phase both groups will continue their home program for another 7 weeks. Outcome will be measured at 5 weeks and at 3 and 12 months after inclusion using the shoulder pain and disability index and patients' global impression of change, the generic patient-specific scale, the average weekly pain score, and patient satisfaction with treatment. Additionally, the fear avoidance beliefs questionnaire, the pain catastrophizing scale, and patients' expectancies of treatment effect are assessed. Participants

Caring for an Ageing Population: Are Physiotherapy Graduates Adequately Prepared?

Science.gov (United States)

Ramklass, Serela S.; Butau, Anne; Ntinga, Nomusa; Cele, Nozipho

2010-01-01

In view of South African policy developments related to the care of older persons, it was necessary to examine the nature of the geriatrics content within physiotherapy curricula. A survey was conducted amongst final-year student physiotherapists at South African universities, together with content analysis of physiotherapy curricula. Very little…

Goal-Directed Visual Attention Drives Health Goal Priming: An Eye-Tracking Experiment

NARCIS (Netherlands)

Laan, van der Laura N.; Hooge, I.T.C.; Smeets, P.A.M.

2017-01-01

Objective: Several lab and field experiments have shown that goal priming interventions can be highly effective in promoting healthy food choices. Less is known, however, about the mechanisms by which goal priming affects food choice. This experiment tested the hypothesis that goal priming affects

Reflections on Andes' Goal-Free User Interface

Science.gov (United States)

VanLehn, Kurt

2016-01-01

Although the Andes project produced many results over its 18 years of activity, this commentary focuses on its contributions to understanding how a goal-free user interface impacts the overall design and performance of a step-based tutoring system. Whereas a goal-aligned user interface displays relevant goals as blank boxes or empty locations that…

PHYSIOTHERAPY PRACTICES ACROSS DIFFERENT PLACES: A REVIEW OF LITERATURE

OpenAIRE

Mukesh Goyal; Salil Jandyal

2014-01-01

The present review study is carried out in order to study various practices in physiotherapy across different places. Physiotherapy is the health care profession primarily concerned with the remediation of impairments and disabilities and the promotion of mobility, functional ability, quality of life and movement potential through examination, evaluation, diagnosis and physical intervention. Physical therapy is a professional career which has many specialties including sports, neurology, woun...

Comparing the achievement goal orientation of mathematics ...

African Journals Online (AJOL)

A quantitative, exploratory research design was used. ... Goals affect how learners approach mathematics learning activities, which could ... research on academic success and ADHD has focused on reading ... from the data analysis process. ... Achievement goal orientation is based on a ...... Research design: Qualitative,.

Physiotherapy Students' Attitudes toward Psychiatry and Mental Health: A Cross-Sectional Study.

Science.gov (United States)

Connaughton, Joanne; Gibson, William

Purpose: A cross-sectional exploration of Notre Dame Australia physiotherapy students' attitudes toward psychiatry and mental illness, students' perceptions regarding preparation in this area for general clinical practice, and a cross-sectional investigation of current mental health-and psychiatry-related content in physiotherapy curricula across Australia and New Zealand. Methods: A questionnaire including demographic details, level of exposure to mental illness, and the Attitudes Toward Psychiatry-30 items (ATP-30) was completed by pre-clinical and clinically experienced physiotherapy students from the University of Notre Dame Australia. Students with clinical experience were asked additional questions about preparedness for practice. Staff of 10 of 17 physiotherapy programmes across Australia and New Zealand responded to an online questionnaire investigating relevant content and quantity of learning experiences in mental health. Results: Student response rate was 89%. Students generally had a positive attitude about psychiatry and mental health. Women were significantly more positive than men, and students who had completed clinical experience had a significantly more positive attitude. Physiotherapy program responses (response rate=59%) highlighted disparate approaches to psychiatry and mental health learning opportunities in terms of quantity and content. Conclusion: Entry-level physiotherapy students who have clinical experience generally have a more positive attitude toward psychiatry and people with mental illness. Given the prevalence of mental health problems and the increase in physical and mental health comorbidities, it is imperative that future clinicians have positive educational experiences in psychiatry. A coherent, integrated approach to mental illness and psychiatry is suggested for entry-level physiotherapy programmes in Australia and New Zealand.

Cervical spine mobilisation forces applied by physiotherapy students.

Science.gov (United States)

Snodgrass, Suzanne J; Rivett, Darren A; Robertson, Val J; Stojanovski, Elizabeth

2010-06-01

Postero-anterior (PA) mobilisation is commonly used in cervical spine treatment and included in physiotherapy curricula. The manual forces that students apply while learning cervical mobilisation are not known. Quantifying these forces informs the development of strategies for learning to apply cervical mobilisation effectively and safely. This study describes the mechanical properties of cervical PA mobilisation techniques applied by students, and investigates factors associated with force application. Physiotherapy students (n=120) mobilised one of 32 asymptomatic subjects. Students applied Grades I to IV central and unilateral PA mobilisation to C2 and C7 of one asymptomatic subject. Manual forces were measured in three directions using an instrumented treatment table. Spinal stiffness of mobilised subjects was measured at C2 and C7 using a device that applied a standard oscillating force while measuring this force and its concurrent displacement. Analysis of variance was used to determine differences between techniques and grades, intraclass correlation coefficients (ICC) were used to calculate the inter- and intrastudent repeatability of forces, and linear regression was used to determine the associations between applied forces and characteristics of students and mobilised subjects. Mobilisation forces increased from Grades I to IV (highest mean peak force, Grade IV C7 central PA technique: 63.7N). Interstudent reliability was poor [ICC(2,1)=0.23, 95% confidence interval (CI) 0.14 to 0.43], but intrastudent repeatability of forces was somewhat better (0.83, 95% CI 0.81 to 0.86). Higher applied force was associated with greater C7 stiffness, increased frequency of thumb pain, male gender of the student or mobilised subject, and a student being earlier in their learning process. Lower forces were associated with greater C2 stiffness. This study describes the cervical mobilisation forces applied by students, and the characteristics of the student and mobilised

Goal-directed behaviour and instrumental devaluation: a neural system-level computational model

Directory of Open Access Journals (Sweden)

Francesco Mannella

2016-10-01

Full Text Available Devaluation is the key experimental paradigm used to demonstrate the presence of instrumental behaviours guided by goals in mammals. We propose a neural system-level computational model to address the question of which brain mechanisms allow the current value of rewards to control instrumental actions. The model pivots on and shows the computational soundness of the hypothesis for which the internal representation of instrumental manipulanda (e.g., levers activate the representation of rewards (or `action-outcomes', e.g. foods while attributing to them a value which depends on the current internal state of the animal (e.g., satiation for some but not all foods. The model also proposes an initial hypothesis of the integrated system of key brain components supporting this process and allowing the recalled outcomes to bias action selection: (a the sub-system formed by the basolateral amygdala and insular cortex acquiring the manipulanda-outcomes associations and attributing the current value to the outcomes; (b the three basal ganglia-cortical loops selecting respectively goals, associative sensory representations, and actions; (c the cortico-cortical and striato-nigro-striatal neural pathways supporting the selection, and selection learning, of actions based on habits and goals. The model reproduces and integrates the results of different devaluation experiments carried out with control rats and rats with pre- and post-training lesions of the basolateral amygdala, the nucleus accumbens core, the prelimbic cortex, and the dorso-medial striatum. The results support the soundness of the hypotheses of the model and show its capacity to integrate, at the system-level, the operations of the key brain structures underlying devaluation. Based on its hypotheses and predictions, the model also represents an operational framework to support the design and analysis of new experiments on the motivational aspects of goal-directed behaviour.

Using Debates as Assessment in a Physiotherapy Capstone Course: A Case Example

Science.gov (United States)

Weeks, Benjamin K.; Laakso, Liisa

2016-01-01

While not a new teaching and learning approach, debating may be considered novel when included in a suite of more traditional teaching and learning activities. Despite the potential benefits of debates for the development of generic skills, their use in physiotherapy education remains unreported. Thus, our aim was to evaluate student satisfaction…

Testing a path-analytic mediation model of how motivational enhancement physiotherapy improves physical functioning in pain patients.

Science.gov (United States)

Cheing, Gladys; Vong, Sinfia; Chan, Fong; Ditchman, Nicole; Brooks, Jessica; Chan, Chetwyn

2014-12-01

Pain is a complex phenomenon not easily discerned from psychological, social, and environmental characteristics and is an oft cited barrier to return to work for people experiencing low back pain (LBP). The purpose of this study was to evaluate a path-analytic mediation model to examine how motivational enhancement physiotherapy, which incorporates tenets of motivational interviewing, improves physical functioning of patients with chronic LBP. Seventy-six patients with chronic LBP were recruited from the outpatient physiotherapy department of a government hospital in Hong Kong. The re-specified path-analytic model fit the data very well, χ (2)(3, N = 76) = 3.86, p = .57; comparative fit index = 1.00; and the root mean square error of approximation = 0.00. Specifically, results indicated that (a) using motivational interviewing techniques in physiotherapy was associated with increased working alliance with patients, (b) working alliance increased patients' outcome expectancy and (c) greater outcome expectancy resulted in a reduction of subjective pain intensity and improvement in physical functioning. Change in pain intensity also directly influenced improvement in physical functioning. The effect of motivational enhancement therapy on physical functioning can be explained by social-cognitive factors such as motivation, outcome expectancy, and working alliance. The use of motivational interviewing techniques to increase outcome expectancy of patients and improve working alliance could further strengthen the impact of physiotherapy on rehabilitation outcomes of patients with chronic LBP.

Safe physiotherapy interventions in large cervical disc herniations.

LENUS (Irish Health Repository)

Keramat, Keramat Ullah

2012-01-01

A 34-year-old woman was seen in a physiotherapy department with signs and symptoms of cervical radiculopathy. Loss of cervical lordosis and a large paracentral to intraforaminal disc prolapse (8 mm) at C5-C6 level was reported on MRI. She was taking diclofenac sodium, tramadol HCl, diazepam and pregabalin for the preceding 2 months and no significant improvement, except temporary relief, was reported. She was referred to physiotherapy while awaiting a surgical opinion from a neurosurgeon. In physiotherapy she was treated with mobilisation of the upper thoracic spine from C7 to T6 level. A cervical extension exercise was performed with prior voluntary extension of the thoracic spine and elevated shoulders. She was advised to continue the same at home. General posture advice was given. Signs and symptoms resolved within the following four sessions of treatment over 3 weeks. Surgical intervention was subsequently deemed unnecessary.

Physiotherapy: Key to the kinetics of orofacial musculature

Directory of Open Access Journals (Sweden)

Amandeep Sodhi

2014-01-01

Full Text Available Orofacial pain disorders involve a variety of postural and functional disorders of the oral and craniofacial system. These disorders are multifactorial with muscular pain being the most common manifestation. Orofacial pain can interfere with the emotional, psychological and social well-being of the patient which in turn can affect the quality of life. Physiotherapy is a primary health care profession aimed at enhancing mobility, physical independence and quality of life. The purpose of this review is to provide an insight in to the role of physiotherapy in managing orofacial pain conditions. Using the phrase ′physiotherapy in orofacial conditions′ a literature search was conducted via Pubmed, Copernicus, Scopus database and Google scholar. The first reported article in Pubmed was published in 1990 and the recently reported article was in 2014. For this systematic review, seven articles from Pubmed, two from Copernicus, two from Google Scholar, and one from Scopus database were included.

Embodiment and aging in contemporary physiotherapy.

Science.gov (United States)

Hay, Melissa E; Connelly, Denise M; Kinsella, Elizabeth Anne

2016-05-01

Contemporary discourses in the health sciences vary in their treatment of aging bodies and the mind-body relationship, yet our understanding of aging experiences and health care practices can be limited by an overreliance on biomedical or social constructionist approaches alone. This paper offers a conceptual exploration of embodiment as an innovative approach to enhance our understandings of aging bodies and health in physiotherapy practice. Embodiment attends to body and mind, nature and culture, structure and agency, while appreciating differences in aging bodies and health in aging. Conclusions consider embodiment in the practice and disciplinary discourse of contemporary physiotherapy, specifically, considering the ways embodied perspectives can support therapists in their health care practice and relationships with people with aging bodies.

Physiotherapy Commenced Within the First Four Weeks Post-Spinal Surgery Is Safe and Effective: A Systematic Review and Meta-Analysis.

Science.gov (United States)

Snowdon, Megan; Peiris, Casey L

2016-02-01

To determine whether physiotherapy commenced within the first 4 weeks post-spinal surgery is safe and effective. Electronic databases CINAHL, MEDLINE, AMED, PubMed, Embase, and PEDro were searched from the earliest date possible through May 2015. An additional trial was identified through reference list scanning. Controlled trials evaluating comprehensive physiotherapy rehabilitation commenced within 4 weeks postoperatively compared with a control group receiving no physiotherapy, standard postoperative care, rest, less active physiotherapy, or sham physiotherapy after spinal surgery of a musculoskeletal etiology. Two reviewers independently applied inclusion and exclusion criteria, with disagreements discussed until consensus could be reached. Searching identified 3162 potentially relevant articles, of which 4 trials with 250 participants met the inclusion criteria. Data were extracted using a predefined data extraction form. Methodological quality of trials was assessed independently by 2 reviewers using the Downs and Black checklist. Pooled analyses were performed using a random-effects model with inverse variance methods to calculate risk differences and 95% confidence intervals (CIs) (dichotomous outcomes), and standardized mean differences (SMDs) and 95% CIs (continuous outcomes). When compared with no or sham physiotherapy, early comprehensive physiotherapy did not increase the risk of adverse events (risk difference, -.01; 95% CI, -.07 to .05; I(2)=0%). In addition, there is moderate-quality evidence demonstrating a reduction in pain by a moderate and significant amount at 12 weeks (SMD=-.38; 95% CI, -.66 to -.10; I(2)=0%) and at 12+ months (SMD=-.30; 95% CI, -.59 to -.02; I(2)=0%). Early comprehensive physiotherapy commenced within the first 4 weeks post-spinal surgery does not increase the potential for an adverse event and leads to a moderate, statistically significant reduction in pain when compared with a control group. Copyright © 2016 American

An exploration of undergraduate nursing and physiotherapy students' views regarding education for patient handling.

Science.gov (United States)

Kneafsey, Rosie; Ramsay, Jill; Edwards, Helen; Callaghan, Helen

2012-12-01

To ascertain the views of undergraduate student nurses and physiotherapists regarding their education in patient handling. Musculo-skeletal injuries are an important cause of staff sickness absence and attrition from the nursing profession and are a recognised problem within the physiotherapy profession. Nurses and physiotherapists are at risk of musculo-skeletal injuries as a result of their role in assisting patients with movement. A questionnaire survey was undertaken of undergraduate nursing and physiotherapy students (n = 371) at one university. Most students agreed that university teaching about moving and handling prepared them for clinical practice (64%). Over a third reported that they had never undertaken a written moving and handling risk assessment in clinical practice (38%). Almost half of the sample (40%) admitted undertaking unsafe moving and handling activities. Half (50%) also stated that they would rather 'fit' into the team than challenge unsafe practice. Almost a third (29%) stated that they had begun to experience pain since becoming a student. There were significant differences between nursing and physiotherapy students. Physiotherapy students were more likely to report being supervised when moving and handling and reported being more assertive about adhering to safe practice. The well-being of both nursing and physiotherapy undergraduate students is threatened when students undertake work placements in clinical settings. University-based education in safe patient handling, though important, can be undermined by workplace settings where unsafe practices occur. Collaboration is needed between university educators, managers and practice-based mentors to support students to maintain safe approaches to moving and handling patients. A third of students reported developing pain since becoming a healthcare student. Students entering their professions already injured may leave the workforce owing to poor physical well-being. It is vital that the

Characteristics of patients with rheumatoid arthritis presenting for physiotherapy management: a multicentre study.

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Kennedy, Norelee; Keogan, Fiona; Fitzpatrick, Martina; Cussen, Grainne; Wallace, Lorraine

2007-03-01

To describe the characteristics of patients with rheumatoid arthritis (RA) attending for physiotherapy management in Ireland. Managers of physiotherapy departments in the 53 hospitals in Ireland were invited to participate in a multi-centre observational study over a 6-month period. Data on patients with RA the day of presentation for physiotherapy management were recorded. These data related to patient demographic details, disease management, aids and appliances, splint and orthoses usage and occupational issues. The Health Assessment Questionnaire was also recorded for each patient. A total of 273 patients from eight physiotherapy departments participated in the survey (n = 199; 73% female). Mean age of the participants was 59.3 (SD 12.5) years with mean disease duration of 13.8 (SD 10.6) years. The majority of the patients were inpatients (n = 170, 62%). Sixty-eight per cent of patients had attended for previous physiotherapy treatment and 98% were under current rheumatologist care. Biologic therapies were prescribed to 11% of patients. Use of splint and foot orthoses was high with 133 patients (49%) wearing splints and 75 (31%) wearing foot orthoses. The majority of patients had moderate (n = 119, 44%) or severe (n = 94, 35%) disability as per Health Assessment Questionnaire (HAQ) score. Mean HAQ score was 1.5, with HAQ scores showing increasing disability with increasing age, disease duration and erythrocyte sedimentation rate (ESR) levels. Patients with RA attending for physiotherapy management present with varied profiles. This study provides valuable information on the characteristics of patients with RA attending for physiotherapy management which will contribute to physiotherapy service planning and delivery and will optimize patient care.

Fulbright project focuses on rehabilitation technician education and ...

African Journals Online (AJOL)

Rehabilitation technician education and physiotherapy practice 272. Fulbright project focuses on ... particularly those qualified to mentor and teach entry-level learners, there are ... to reinforce classroom didactic knowledge as ongoing learning .... utilization of limited resources, and development of linkages with professional ...

Four Weeks of Goal-Directed Learning in Primary Physical Education Classes

NARCIS (Netherlands)

Platvoet, Sebastiaan W. J.; Elferink-Gemser, Marije T.; Kannekens, Rianne; de Niet, Mark; Visscher, Chris

Relatively little is known about how practice relates to children's improvement in gross motor skill performance. The aim of this study is to determine to what extent 6- and 7-year-old children improve their gross motor skill performance in a four-week period, in which goal-directed learning is

A pragmatic implementation of a 6-day physiotherapy service in a mixed inpatient rehabilitation unit.

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Caruana, Erin L; Kuys, Suzanne S; Clarke, Jane; Bauer, Sandra G

2017-08-01

This study determined the impact of a pragmatic 6-day physiotherapy service on length of stay, functional independence, gait and balance in people undergoing inpatient rehabilitation, compared to a 5-day service. A prospective cohort study with historical comparison was undertaken in a mixed inpatient rehabilitation unit. Intervention period participants (2011) meeting inclusion criteria were eligible for a 6-day physiotherapy service. All other participants, including the historical cohort (2010) received usual care (5-day physiotherapy). Length of stay, functional independence, gait and balance performance were measured. A total of 536 individuals participated in this study; 270 in 2011 (60% received 6-day physiotherapy) and 266 in 2010. Participants in 2011 showed a trend for reduced length of stay (1.7 days, 95%CI -0.53 to 3.92) compared to 2010. Other measures showed no significant differences between cohorts. In 2011, those receiving 6-day physiotherapy were more dependent, but showed significantly improved functional independence and balance compared to those receiving 5-day physiotherapy (p physiotherapy service in a "real-world" rehabilitation setting demonstrated a trend towards reduced length of stay, and improved functional gains. This service could lead to cost-savings for hospitals and improved patient flow. Implications for Rehabilitation "Real-world" implementation of a 6-day physiotherapy service in rehabilitation shows a trend for reducing length of stay. This reduction in length of stay may lead to cost-savings for the hospital system, and improve patient flow into rehabilitation. Patients receiving 6-day physiotherapy made significant gains in balance and functional independence compared to patients receiving 5-day physiotherapy services in the rehabilitation setting.

Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation.

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Lebel, Andrea; Lebel, Victoria Ashley

2016-01-01

Scoliosis is a complex three-dimensional (3D) spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE) despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving scoliosis curves, vital capacity, and overall quality of life in scoliosis patients. This case presentation shows that indeed adult curve progression can be stopped and even reversed with scoliosis specific Schroth physiotherapy (SSSPT) in an adult patient with scoliosis. This is a retrospective case presentation involving a 23-year-old female scoliosis patient who began an outpatient Schroth physiotherapy exercise program and was initially monitored monthly and then annually for improvement in measurements of angle of trunk rotation (ATR) and chest expansion and improvement in vital capacity measured with incentive spirometry. Photos were taken to document body image periodically throughout Schroth physiotherapy treatment. Additionally, the patient completed SRS-22 quality of life questionnaires every 2 years to evaluate daily function, pain, self-imagine, mental health, and scoliosis management satisfaction. Within one month of beginning SSSPT, the patient reported no more back pain and within 2 months, reported improved breathing. The patient also benefitted from improved chest expansion, reduced scoliosis curve angles (measured in Cobb degrees), increased vital capacity, decreased ATR, and higher SRS-22 scores. She became more active and resumed all athletic activity within 8 months of beginning Schroth physiotherapy. Adult scoliosis patients are not routinely referred for PSSE in Canada, even though Schroth physiotherapy, a form of PSSE, is shown to be effective in this case presentation

Severe progressive scoliosis in an adult female possibly secondary thoracic surgery in childhood treated with scoliosis specific Schroth physiotherapy: Case presentation

Directory of Open Access Journals (Sweden)

Andrea Lebel

2016-10-01

Full Text Available Abstract Background Scoliosis is a complex three-dimensional (3D spinal deformity. Acquired scoliosis in early childhood may progress into adulthood and pose an increased risk of health problems and reduction in quality of life. In Canada, patients with scoliosis are not referred for physiotherapeutic scoliosis-specific exercises (PSSE despite the fact that Schroth physiotherapy, a scoliosis-specific 3D posture training and exercise program, can be effective in reducing pain and improving scoliosis curves, vital capacity, and overall quality of life in scoliosis patients. This case presentation shows that indeed adult curve progression can be stopped and even reversed with scoliosis specific Schroth physiotherapy (SSSPT in an adult patient with scoliosis. Methods This is a retrospective case presentation involving a 23-year-old female scoliosis patient who began an outpatient Schroth physiotherapy exercise program and was initially monitored monthly and then annually for improvement in measurements of angle of trunk rotation (ATR and chest expansion and improvement in vital capacity measured with incentive spirometry. Photos were taken to document body image periodically throughout Schroth physiotherapy treatment. Additionally, the patient completed SRS-22 quality of life questionnaires every 2 years to evaluate daily function, pain, self-imagine, mental health, and scoliosis management satisfaction. Results Within one month of beginning SSSPT, the patient reported no more back pain and within 2 months, reported improved breathing. The patient also benefitted from improved chest expansion, reduced scoliosis curve angles (measured in Cobb degrees, increased vital capacity, decreased ATR, and higher SRS-22 scores. She became more active and resumed all athletic activity within 8 months of beginning Schroth physiotherapy. Conclusions Adult scoliosis patients are not routinely referred for PSSE in Canada, even though Schroth physiotherapy, a form

'There's so much to it': the ways physiotherapy students and recent graduates experience practice.

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Barradell, S; Peseta, T; Barrie, S

2018-05-01

Health science courses aim to prepare students for the demands of their chosen profession by learning ways appropriate to that profession and the contexts they will work and live in. Expectations of what students should learn become re-contextualised and translated into entry-level curriculum, with students operating as a connection between what is intended and enacted in curriculum, and required in the real world. Drawing on phenomenology, this paper explores how students understand practice-the collective, purposeful knowing, doing and being of a community-in entry-level physiotherapy programs. Ways of thinking and practising (WTP)-a framework attentive to the distinctive nature of a discipline, its values, philosophies and world-view (McCune and Hounsell in High Educ 49(3):255-289, 2005)-provides the conceptual lens. Six themes describing how students see the WTP of physiotherapy practice emerged from the analysis: discovery of new knowledge; problem solving client related contexts; adopting a systems based approach to the body; contributing to a positive therapeutic alliance; developing a sense of self and the profession; and the organisation of the workforce. The study produces knowledge about practice by focusing on physiotherapy students' experiences of disciplinary learning. Including students in educational research in this way is an approach that can help students realise their potential as part of a community of practice.

Children with paralytic poliomyelitis: utilization of physiotherapy services in Zamfara State, Nigeria.

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Ogwumike, Omoyemi O; Kaka, Bashir; Adeniyi, Ade F

2013-02-01

Physiotherapy is usually indicated for health promotion and the rehabilitation of individuals with paralytic poliomyelitis. The endemic nature of this condition in children in Zamfara State, Nigeria necessitated investigation into the utilization of physiotherapy services by parents or primary caregivers of children affected with polio in this sub-region. Parents and primary caregivers of children with paralytic poliomyelitis were recruited using a purposive multi-stage sampling procedure in a cross-sectional survey. Factors associated with the utilization of physiotherapy services were assessed based on questions extracted from a 4-part, 52-item structured questionnaire originally designed for a study which investigated knowledge, attitude, and beliefs of parents of children with paralytic poliomyelitis. A total of 217 participants were included in this study. The mean age was 32.29 ± 9.89 years and the mean knowledge of polio score was 62.0 ± 17.3%. The mean age of the children with paralytic poliomyelitis was 6.41 ± 2.50 years. Only 27.2% of the parents or primary caregivers had utilized physiotherapy service for their children at some point. No association existed between utilization of physiotherapy service and 'knowledge of paralytic poliomyelitis', 'employment status', and 'family income' of respondents. Explanations for low utilization of physiotherapy services for children with paralytic poliomyelitis by parents or primary caregivers are discussed.

Participant perceptions of a novel physiotherapy approach ("Blue Prescription") for increasing levels of physical activity in people with multiple sclerosis: a qualitative study following intervention.

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Smith, Catherine M; Hale, Leigh A; Mulligan, Hilda F; Treharne, Gareth J

2013-07-01

The aim of this study was to investigate experiences of participating in a feasibility trial of a novel physiotherapy intervention (Blue Prescription). The trial was designed to increase participation in physical activity for people with multiple sclerosis living in the community. We individually interviewed 27 volunteers from two New Zealand metropolitan areas at the conclusion of their participation in Blue Prescription. We asked volunteers about what participation in Blue Prescription had meant to them; how participants intended to continue with their physical activity; how the approach differed from previous experiences of physiotherapy encounters; and how Blue Prescription could be improved. Interviews were semi-structured, audio-recorded, transcribed verbatim, and analysed using a General Inductive Approach. 'Support' was identified as a key theme with three sub-themes: 'The therapeutic relationship'; 'The Blue Prescription approach'; and 'Supporting themselves'. We identified two additional themes 'Motivation to participate' and 'Improving the Blue Prescription approach'. A novel approach (Blue Prescription) which facilitates engagement in higher levels of desirable physical activity was perceived by participants to be supportive, motivating and enabling. This approach might be particularly useful for people with multiple sclerosis ready to adopt new health-related behaviours. For future studies, this approach requires further refinement, particularly with regards to methods of communication and evaluation.

Physiotherapy students' perceptions and experiences of clinical prediction rules.

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Knox, Grahame M; Snodgrass, Suzanne J; Stanton, Tasha R; Kelly, David H; Vicenzino, Bill; Wand, Benedict M; Rivett, Darren A

2017-09-01

Clinical reasoning can be difficult to teach to pre-professional physiotherapy students due to their lack of clinical experience. It may be that tools such as clinical prediction rules (CPRs) could aid the process, but there has been little investigation into their use in physiotherapy clinical education. This study aimed to determine the perceptions and experiences of physiotherapy students regarding CPRs, and whether they are learning about CPRs on clinical placement. Cross-sectional survey using a paper-based questionnaire. Final year pre-professional physiotherapy students (n=371, response rate 77%) from five universities across five states of Australia. Sixty percent of respondents had not heard of CPRs, and a further 19% had not clinically used CPRs. Only 21% reported using CPRs, and of these nearly three-quarters were rarely, if ever, learning about CPRs in the clinical setting. However most of those who used CPRs (78%) believed CPRs assisted in the development of clinical reasoning skills and none (0%) was opposed to the teaching of CPRs to students. The CPRs most commonly recognised and used by students were those for determining the need for an X-ray following injuries to the ankle and foot (67%), and for identifying deep venous thrombosis (63%). The large majority of students in this sample knew little, if anything, about CPRs and few had learned about, experienced or practiced them on clinical placement. However, students who were aware of CPRs found them helpful for their clinical reasoning and were in favour of learning more about them. Copyright © 2016 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

The Use of Physiotherapy among Patients with Subacromial Impingement Syndrome: Impact of Sex, Socio-Demographic and Clinical Factors

Science.gov (United States)

Christiansen, David Høyrup; Frost, Poul; Frich, Lars Henrik; Falla, Deborah; Svendsen, Susanne Wulff

2016-01-01

Background Physiotherapy with exercises is generally recommended in the treatment of patients with subacromial impingement syndrome (SIS). Objective We aimed to investigate the use of physiotherapy in patients with SIS in Danish hospital settings as part of initial non-surgical treatment and after SIS-related surgery and to evaluate to which extent sex, socio-demographic and clinical factors predict the use of physiotherapy. Methods Using national health registers, we identified 57,311 patients who had a first hospital contact with a diagnosis of ICD-10, groups M75.1–75.9, 1 July 2007 to 30 June 2011. Records of physiotherapy were extracted within 52 weeks after first contact (or until surgery), and for surgically treated patients within 26 weeks after surgery. Predictors of the use of physiotherapy after first contact and after surgery were analysed as time-to-event. Results Within 52 weeks after first contact, 43% of the patients had physiotherapy and 30% underwent surgery. Within 26 weeks after surgery, 80% had a record of physiotherapy. After first contact and after surgery, exercise was part of physiotherapy in 65% and 84% of the patients, respectively. A public hospital contact, physiotherapy before hospital contact, administrative region, female sex, a diagnosis of other or unspecified disorders (M75.8-M75.9), and surgical procedure predicted higher use of physiotherapy. Low education level predicted slightly lower use of physiotherapy after first contact, but not after surgery. Conclusion In patients with SIS in Danish hospital settings, physiotherapy was more often used after surgery than as part of initial non-surgical treatment. The use of physiotherapy was less common among men than women, whereas unequal use of physiotherapy in relation to education level was not noticeable. The use of physiotherapy with exercises in initial non-surgical treatment was relatively limited. PMID:26954692

Physiotherapy Rehabilitation for People With Progressive Multiple Sclerosis: A Systematic Review.

Science.gov (United States)

Campbell, Evan; Coulter, Elaine H; Mattison, Paul G; Miller, Linda; McFadyen, Angus; Paul, Lorna

2016-01-01

To assess the efficacy of physiotherapy interventions, including exercise therapy, for the rehabilitation of people with progressive multiple sclerosis. Five databases (Cochrane Library, Physiotherapy Evidence Database [PEDro], Web of Science Core Collections, MEDLINE, Embase) and reference lists of relevant articles were searched. Randomized experimental trials, including participants with progressive multiple sclerosis and investigating a physiotherapy intervention or an intervention containing a physiotherapy element, were included. Data were independently extracted using a standardized form, and methodologic quality was assessed using the PEDro scale. Thirteen studies (described by 15 articles) were identified and scored between 5 and 9 out of 10 on the PEDro scale. Eight interventions were assessed: exercise therapy, multidisciplinary rehabilitation, functional electrical stimulation, botulinum toxin type A injections and manual stretches, inspiratory muscle training, therapeutic standing, acupuncture, and body weight-supported treadmill training. All studies, apart from 1, produced positive results in at least 1 outcome measure; however, only 1 article used a power calculation to determine the sample size and because of dropouts the results were subsequently underpowered. This review suggests that physiotherapy may be effective for the rehabilitation of people with progressive multiple sclerosis. However, further appropriately powered studies are required. Copyright © 2016 American Congress of Rehabilitation Medicine. Published by Elsevier Inc. All rights reserved.

A clinical assessment tool used for physiotherapy students--is it reliable?

Science.gov (United States)

Lewis, Lucy K; Stiller, Kathy; Hardy, Frances

2008-01-01

Educational institutions providing professional programs such as physiotherapy must provide high-quality student assessment procedures. To ensure that assessment is consistent, assessment tools should have an acceptable level of reliability. There is a paucity of research evaluating the reliability of clinical assessment tools used for physiotherapy students. This study evaluated the inter- and intrarater reliability of an assessment tool used for physiotherapy students during a clinical placement. Five clinical educators and one academic participated in the study. Each rater independently marked 22 student written assessments that had been completed by students after viewing a videotaped patient physiotherapy assessment. The raters repeated the marking process 7 weeks later, with the assessments provided in a randomised order. The interrater reliability (Intraclass Correlation Coefficient) for the total scores was 0.32, representing a poor level of reliability. A high level of intrarater reliability (percentage agreement) was found for the clinical educators, with a difference in section scores of one mark or less on 93.4% of occasions. Further research should be undertaken to reevaluate the reliability of this clinical assessment tool following training. The reliability of clinical assessment tools used in other areas of physiotherapy education should be formally measured rather than assumed.

EARLY GOAL DIRECTED THERAPY AT SEPTIC SYOK

Directory of Open Access Journals (Sweden)

Ayu Widyanti

2013-04-01

Full Text Available Sepsis is the most commom cause of death in children with critically ill. Using WHO criteria (severe sepsis defined as sepsis with acidosis, hypotension or both, it was determined that in 1995 there were more than 42.000 cases of severe sepsis in children in the United States with mortality rate was 10.3%. To answer that finding, evicende based protocol was made, it called early goal directed therapy (EGDT. EGDT is a comprehensive strategy to evaluate patient with septic shock include, challenge of fluid, antibiotic, vasopressor, measurement of central vein oxygen saturation, PRC transfusion, administering inotropic dan mechanic ventilation. All of these must be done in the first 6 hours since sepsis or septic shock was found, because if there is a delay of resuscitation, anything we do to increase oxygenation level of the cell will be useless.

Treating gynecological pain: the experiences of bachelor students in physiotherapy performing somatocognitive therapy.

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Fougner, Marit; Haugstad, Gro Killi

2015-07-01

Longstanding gynecological pain affects large numbers of women in the Western world. In recently published studies, we have found that a hybrid of physiotherapy and cognitive psychotherapy called somatocognitive therapy (SCT) ameliorates physical symptoms and psychological distress. In this paper, we report on the experiences of undergraduate physiotherapy students performing the therapy to patients with provoked vestibulodynia (PVD). The study aimed to investigate the nature of the collaborative interaction between female physiotherapy students and patients with PVD, focusing on critical factors for the students' learning of professional skills through SCT applied on patients suffering from an especially demanding pain condition. In a qualitative study design, data were collected from two group interviews with four female students in pairs, and subjected to a thematic analysis. We found that students perceive the patient encounter as critical incidents in the sense of strong emotional encounters. From the data material, there emerged a four-step process ranging from distance to proximity, highlighting factors that influence the development of professional skills. The four steps are defined respectively as: (1) the students' prejudices; (2) identification and empathy; (3) senses of responsibility in the therapeutic relationship and (4) collaborative engagement for change. Contrary to expectations, the students experienced the application of this combined approach (SCT) as an interesting and rewarding way of working with patients, and that they had achieved skills and a sufficient set of tools to cope with the challenges that patients with longstanding gynecological pain represent.

Quality indicators for physiotherapy care in hip and knee osteoarthritis: development and clinimetric properties.

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Peter, W F; van der Wees, P J; Hendriks, E J M; de Bie, R A; Verhoef, J; de Jong, Z; van Bodegom-Vos, L; Hilberdink, W K H A; Vliet Vlieland, T P M

2013-12-01

The aim of the present study was to develop process quality indicators for physiotherapy care based on key recommendations of the Dutch physiotherapy guideline on hip and knee osteoarthritis (OA). Guideline recommendations were rated for their relevance by an expert panel, transformed into potential indicators and incorporated into a questionnaire, the Quality Indicators for Physiotherapy in Hip and Knee Osteoarthritis (QIP-HKOA). Adherence with each indicator was rated on a Likert scale (0 = never to 4 = always). The QIP-HKOA was administered to groups of expert (n = 51) and general (n = 134) physiotherapists (PTs) to test its discriminative power. Reliability was tested in a subgroup of 118 PTs by computing the intraclass correlation coefficient (ICC). QIP-HKOA items were included if they were considered to be related to the cornerstones of physiotherapy in hip and knee OA (exercises and education), had discriminative power and/or if they were followed by physiotherapy care; six indicators had discriminative power and/or were followed by physiotherapy guideline on hip and knee OA was found to be reliable and discriminated between expert and general PTs. Its ability to measure improvement in the quality of the process of physiotherapy care needs to be further examined. Copyright © 2012 John Wiley & Sons, Ltd.

Processes in the development of international specialist competencies and standards: the Sports Physiotherapy for All Project.

Science.gov (United States)

Bulley, Catherine; Donaghy, Marie

2008-01-01

In a world of rapidly developing knowledge it is important that professions describe their roles and capabilities. The need for a thorough description of sports physiotherapy was addressed through collaboration between the International Federation of Sports Physiotherapy (IFSP) and five European higher education institutions. This resulted in the Sports Physiotherapy for All Project, which has been successful in developing internationally accepted competencies and standards for sports physiotherapists. This article describes and reflects on the process to communicate useful lessons. A competency model was chosen to facilitate differentiation and communication of aspects of sports physiotherapy practice. Documentation relating to sports physiotherapy practice was collected from 16 countries and analysed thematically. A cut and paste method was used by a panel of experts to allocate themes to areas of practice within the competency model. Theme groups were used to select areas of practice for description in competency form. Standards were derived from competencies following in depth discussion with the expert panel, and triangulation with themes derived from international documentation. A rigorous process of international review and revision led to the final list of 11 competencies and related standards, both accepted by the IFSP. This work provides a foundation for the development of an audit toolkit to guide demonstration and evaluation of competencies and standards. This provides a foundation for targeted career development activities, appropriate provision of training opportunities, and quality enhancement. The experiences gained during this project can inform other health professions and their specialisms when embarking on a similar journey.

[Effectiveness of physiotherapy on painful shoulder impingement syndrome].

Science.gov (United States)

Gomora-García, Mónica; Rojano-Mejía, David; Solis-Hernández, José Luis; Escamilla-Chávez, Carolina

2016-01-01

Painful shoulder impingement syndrome is one of the first reasons for care in rehabilitation centres. As the evidence regarding the effectiveness of physical measures as adjuvant treatment is limited, the aim of this study was to determine the effectiveness of physiotherapy on shoulder pain. A retrospective and analytical study was conducted using the medical records of patients with shoulder pain who attended in a rehabilitation centre from October 2010 to September 2011. The demographic and clinical data were collected, and the clinical improvement was determined as: complete, incomplete, or no improvement. Chi squared was used to determine whether there were differences between the different modalities of physiotherapy, as well as the level of improvement. The study included a total of 181 patients, with a mean age of 54.3 years, and a mean of 4.6 months of onset of pain. The physiotherapy treatments included: warm compresses plus interferential current (60.2%), and warm compresses plus ultrasound (17.1%). Just over half (53.6%) obtained a moderate recovery, 36.4% slight improvement, and 9.9% no improvement. No significant differences were found between the different forms of therapy. The supervised rehabilitation program consists of 9 sessions of physiotherapy. A functional improvement of 90% was obtained, without finding any statistical differences between the therapies used. Copyright © 2015 Academia Mexicana de Cirugía A.C. Published by Masson Doyma México S.A. All rights reserved.

IDENTIFICATION OF THE LEARNING OUTCOME FROM REFLECTIVE JOURNAL WRITING WITH PHYSIOTHERAPY STUDENTS

DEFF Research Database (Denmark)

Brandt, Jørgen

involves debate on the use and sense of evidence thinking in education. This project was looking for evidence based outcome from reflective journal writing. The outcome was understood as acquirement of: 1) physiotherapy competences aiming for aspects of humanistic practice accentuated in the Danish...... rehabilitation area. 2) An ability for reflective thinking as a generic competence in connection to ideas of knowledge society and late modern thinking. PARTICIPANTS: 21 physiotherapy students (13 female, 8 male) participated in their 5th term, during their second clinical course. All students had attended...... sensitive to categories of competence for physiotherapy practice and levels of reflective thinking. Rating was based on consensus between judges. ANALYSIS: Fisher Exact Test was used for nominal scale categories of competence in physiotherapy practice. Mann-Whitney Rank Sum Test was used for ordinal scale...

Clinical course and prognosis of musculoskeletal pain in patients referred for physiotherapy

DEFF Research Database (Denmark)

de Vos Andersen, Nils-Bo; Kent, Peter; Hjort, Jakob

2017-01-01

BACKGROUND: Danish patients with musculoskeletal disorders are commonly referred for primary care physiotherapy treatment but little is known about their general health status, pain diagnoses, clinical course and prognosis. The objectives of this study were to 1) describe the clinical course...... of patients with musculoskeletal disorders referred to physiotherapy, 2) identify predictors associated with a satisfactory outcome, and 3) determine the influence of the primary pain site diagnosis relative to those predictors. METHODS: This was a prospective cohort study of patients (n = 2,706) newly...... referred because of musculoskeletal pain to 30 physiotherapy practices from January 2012 to May 2012. Data were collected via a web-based questionnaire 1-2 days prior to the first physiotherapy consultation and at 6 weeks, 3 and 6 months, from clinical records (including primary musculoskeletal symptom...

The Role of Physiotherapy Extended Scope Practitioners in Musculoskeletal care with Focus on Decision Making and Clinical Outcomes: A Systematic Review of Quantitative and Qualitative Research.

Science.gov (United States)

Thompson, Jonathan; Yoward, Samantha; Dawson, Pamela

2017-06-01

Physiotherapy extended scope practitioner (ESP) roles are widely utilized in the management of musculoskeletal conditions. The present article reviews the current literature, with particular emphasis on the decision-making process, patient/clinician interaction and clinical outcomes. A systematic review of musculoskeletal extended scope practice was carried out. The review focused on the outcome of interventions, and the interactions and decision-making processes between ESPs and their patients. A wide search strategy was employed, through multiple databases, grey literature and experts in the field. Qualitative and quantitative studies alike were included and a mixed-methods synthesis approach was undertaken in analysing the findings of included studies. A total of 476 articles were identified for inclusion, 25 of which (22 quantitative and three qualitative) meeting the criteria for full quality appraisal and synthesis. It was not possible to conduct a meta-analysis owing to data heterogeneity. The results showed high patient satisfaction with the ESP role, support for ESP staff listing patients for orthopaedic surgery, a high positive correlation of decision making between ESPs and orthopaedic surgeons and evidence of a positive impact on patient outcomes. Qualitative themes reflected the importance of ESP clinical decision making and interpersonal skills and their role in patient education. There is broad support for the physiotherapy ESP role and evidence of favourable outcomes from ESP intervention. Clinical decisions made by ESPs correlate well with those of medical colleagues, although there is a lack of detail explaining the ESP decision-making process itself and the influences and mechanisms by which this occurs. Copyright © 2016 John Wiley & Sons, Ltd. Copyright © 2016 John Wiley & Sons, Ltd.

Chest associated to motor physiotherapy improves cardiovascular variables in newborns with respiratory distress syndrome

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de Abreu Luiz

2011-10-01

Full Text Available Abstract Background We aimed to evaluate the effects of chest and motor physiotherapy treatment on hemodynamic variables in preterm newborns with respiratory distress syndrome. Methods We evaluated heart rate (HR, respiratory rate (RR, systolic (SAP, mean (MAP and diastolic arterial pressure (DAP, temperature and oxygen saturation (SO2% in 44 newborns with respiratory distress syndrome. We compared all variables between before physiotherapy treatment vs. after the last physiotherapy treatment. Newborns were treated during 11 days. Variables were measured 2 minutes before and 5 minutes after each physiotherapy treatment. We applied paired Student t test to compare variables between the two periods. Results HR (148.5 ± 8.5 bpm vs. 137.1 ± 6.8 bpm - p 2%. Conclusions Chest and motor physiotherapy improved cardiovascular parameters in respiratory distress syndrome newborns.

Collaborative competency in physiotherapy students: Implications for interprofessional education

Directory of Open Access Journals (Sweden)

M Rowe

2016-11-01

Full Text Available Background. It has been suggested that improved collaborative competency in multidisciplinary teams may help understand how health professionals can address problems that no single-disciplinary expert can manage independently.Objective. To describe the development of the ability to collaborate in a South African university physiotherapy department.Methods. Focus group discussions and interviews were conducted with 3rd- and 4th-year physiotherapy students and lecturers, respectively. Participantresponses were analysed thematically and evaluated against a self-developed framework that described the key and enabling competencies in collaboration.Results. The study found that students and lecturers had a basic understanding of collaboration, but lacked a more comprehensive perspective. Students and lecturers suggested that group work had the potential to develop collaborative competency, but expressed concerns about task design and implementation. While interprofessional education was a required component of the curriculum, both students and lecturers questioned the value of the module as it related to collaboration. Finally, challenges to the development of collaborative competency in the clinical context were highlighted.Conclusion. The study found that the development of collaborative competency, while recognised as important for addressing complex health needs, had several challenges that need to be addressed in order to be effective. Recommendations are provided for curriculum developers.

Effect of physiotherapy in respiratory diseases during healing stays

OpenAIRE

Schneebergerová, Jana

2013-01-01

Title: Effect of physiotherapy in respiratory diseases during healing stays Objective: The main objective of this work is to analyze the importance of physiotherapy as one of the treatments used in the care of pediatric patients with bronchial asthma. Method: In the theoretic part of the dissertation anatomy and physiology of the respiratory tract, respiratory biomechanics, problems of asthma bronchiale, possibilities of asthma treatment, prevention and improvement of quality of life in child...

The results of early physiotherapy on a child with incontinentia pigmenti with encephalocele

Science.gov (United States)

Kara, Ozgun Kaya; Mutlu, Akmer; Gunel, Mintaze Kerem

2010-01-01

This study aimed to exhibit the effects of early physiotherapy and discusses post-treatment results on a patient with incontinentia pigmenti (IP) with encephalocele. Physiotherapy evaluations of the child included cognitive, fine and gross motor development assessed with the Bayley Scales of Infant and Toddler Development – Third Edition (Bayley-III), disability level with the gross motor function classification system, gross motor function with the gross motor function measurement (GMFM), and tonus evaluation with the Modified Ashworth Scale. The child was included in a physiotherapy and rehabilitation programme based on neurodevelopmental treatment three times a week. Although cognitive and motor development according to Bayley-III improved in the present case, motor and cognitive retardation became more apparent with growth. GMFM results indicated a large improvement from 5.88% to 47.73%. Presentation of this case shows the significance of early physiotherapy in this first study on physiotherapy for IP during the early rehabilitation process. PMID:22767665

Some evidence for the usefulness of an optimal foraging theory perspective on goal conflict and goal facilitation.

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Tomasik, Martin J; Knecht, Michaela; Freund, Alexandra M

2017-12-01

Based on optimal foraging theory, we propose a metric that allows evaluating the goodness of goal systems, that is, systems comprising multiple goals with facilitative and conflicting interrelations. This optimal foraging theory takes into account expectancy and value, as well as opportunity costs, of foraging. Applying this approach to goal systems provides a single index of goodness of a goal system for goal striving. Three quasi-experimental studies (N = 277, N = 145, and N = 210) provide evidence for the usefulness of this approach for goal systems comprising between 3 to 10 goals. Results indicate that persons with a more optimized goal-system are more conscientious and open to new experience, are more likely to represent their goals in terms of means (i.e., adopt a process focus), and are more satisfied and engaged with their goals. Persons with a suboptimal goal system tend to switch their goals more often and thereby optimize their goal system. We discuss limitations as well as possible future directions of this approach. (PsycINFO Database Record (c) 2017 APA, all rights reserved).

Evidence for and cost-effectiveness of physiotherapy in haemophilia : a Dutch perspective

NARCIS (Netherlands)

de Kleijn, P; Mauser-Bunschoten, E P; Fischer, K; Smit, C; Holtslag, H; Veenhof, C

2016-01-01

INTRODUCTION: Musculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their 'list of chronic conditions', and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based

A possible utilization of the mice forced swim test for modeling manic-like increase in vigor and goal-directed behavior.

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Flaisher-Grinberg, Shlomit; Einat, Haim

2009-01-01

The lack of appropriate animal models for bipolar disorder (BPD) is a major factor hindering the research of its pathophysiology and the development of new drug treatments. In line with the notion that BPD might represent a heterogeneous group of disorders, it was suggested that models for specific domains of BPD should be developed. The present study tested the possible utilization of the forced swim test (FST) as a model for the heightened vigor and goal-directed behavior domain of mania, using mice with low baseline immobility. Black Swiss mice were previously identified to have low immobility in the FST but similar spontaneous activity levels compared with several other mice strains. Thus, spontaneous activity and behavior in the FST were evaluated following treatment with the mood stabilizer valproate and the antidepressant imipramine. The results indicated that valproate increased immobility in the FST without affecting spontaneous activity whereas imipramine had no effect in the FST but increased spontaneous activity. These findings suggest that in mice with low baseline immobility scores, the FST might be a useful model for the elevated vigor and goal-directed behavior domain of mania. As such, this test might be well integrated into a battery of models for different domains of BPD.

Effect of biomagnetic therapy versus physiotherapy for treatment of knee osteoarthritis: a randomized controlled trial.

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Gremion, Gerald; Gaillard, David; Leyvraz, Pierre-Francois; Jolles, Brigitte M

2009-11-01

To assess the effectiveness of pulsed signal therapy in the treatment of knee osteoarthritis (Kellgren II or III). A randomized, double-blind controlled clinical trial. The first 95 patients sent to the clinic with knee osteo-arthritis were selected and randomized into treatment with pulsed signal therapy or conventional physiotherapy. Assessment included recording of usual demographic data, pertinent history, baseline medication and radiographs. Clinical evaluation was made at baseline, 6 weeks and 6 months after the end of treatment by the same blinded doctor. At each follow-up time, the patient was asked to complete a visual analogue pain scale and a Lequesne score. The doctor recorded the degree of pain on motion and the ability to move the affected knee. Both treatments resulted in significant improvements in pain and physical function. A statistical difference was observed only for activities of daily living, where the physiotherapy was more efficient (pphysiotherapy. Like physiotherapy, pulsed signal therapy has improved the clinical state of treated patients but with no significant statistical difference. Pulsed signal therapy is, however, more expensive.

A physiotherapy perspective of musculoskeletal imaging in sport.

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Callaghan, M J

2012-08-01

This paper presents a physiotherapy perspective on the role that imaging is now playing in the diagnosis and management of musculoskeletal and sporting injuries. Although the Royal College of Radiologists and the UK Chartered Society of Physiotherapy were founded in the latter part of the nineteenth century, it is 100 years later that developments in the UK NHS have led to increased roles for non-medical healthcare professionals and allied health professionals, such as physiotherapists, in an extended clinical role. Physiotherapists, perhaps because of their knowledge of clinical and applied anatomy, have keenly taken up the opportunities offered to request and interpret imaging in its various forms; the most commonly available are plain radiography, musculoskeletal ultrasound and MRI. This has meant taking formal courses under the auspices of universities with mentorship and tutoring within the clinical setting, which are part of a continuing professional development. The ability to request several forms of imaging has enhanced physiotherapy practice and has increased the appreciation of the responsibilities which accompany this new role.

Simulation can contribute a part of cardiorespiratory physiotherapy clinical education: two randomized trials.

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Blackstock, Felicity C; Watson, Kathryn M; Morris, Norman R; Jones, Anne; Wright, Anthony; McMeeken, Joan M; Rivett, Darren A; O'Connor, Vivienne; Peterson, Raymond F; Haines, Terry P; Watson, Geoffrey; Jull, Gwendolen Anne

2013-02-01

Simulated learning environments (SLEs) are used worldwide in health professional education, including physiotherapy, to train certain attributes and skills. To date, no randomized controlled trial (RCT) has evaluated whether education in SLEs can partly replace time in the clinical environment for physiotherapy cardiorespiratory practice. Two independent single-blind multi-institutional RCTs were conducted in parallel using a noninferiority design. Participants were volunteer physiotherapy students (RCT 1, n = 176; RCT 2, n = 173) entering acute care cardiorespiratory physiotherapy clinical placements. Two SLE models were investigated as follows: RCT 1, 1 week in SLE before 3 weeks of clinical immersion; RCT 2, 2 weeks of interspersed SLE/clinical immersion (equivalent to 1 SLE week) within the 4-week clinical placement. Students in each RCT were stratified on academic grade and randomly allocated to an SLE plus clinical immersion or clinical immersion control group. The primary outcome was competency to practice measured in 2 clinical examinations using the Assessment of Physiotherapy Practice. Secondary outcomes were student perception of experience and clinical educator and patient rating of student performance. There were no significant differences in student competency between the SLE and control groups in either RCT, although students in the interspersed group (RCT 2) achieved a higher score in 5 of 7 Assessment of Physiotherapy Practice standards (all P Students rated the SLE experience positively. Clinical educators and patients reported comparability between groups. An SLE can replace clinical time in cardiorespiratory physiotherapy practice. Part education in the SLE satisfied clinical competency requirements, and all stakeholders were satisfied.

Intercultural comparison of patient satisfaction with physiotherapy care in Australia and Korea: an exploratory factor analysis.

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Hush, Julia M; Lee, Haejung; Yung, Vivian; Adams, Roger; Mackey, Martin; Wand, Benedict M; Nelson, Roger; Beattie, Paul

2013-05-01

The aim of this study was to conduct a cross-cultural comparison of the factors that influence patient satisfaction with musculoskeletal physiotherapy care in Australia and Korea. Prospective studies were conducted in Australia and Korea. Patient satisfaction data were collected using the MedRisk Instrument for Measuring Patient Satisfaction with Physical Therapy Care (MRPS) from a total of 1666 patients who were attending clinics for physiotherapy treatment of a musculoskeletal condition. Exploratory factor analysis was conducted to identify factors determining patient satisfaction in each cohort. A four-factor solution for the MRPS was found for the Australian and Korean data sets, explaining 61 and 55% of the variance respectively. Communication and respect, convenience and quality time and person-focused care were factors common to both countries. One factor unique to Korea was courtesy and propriety. For both cultures, global patient satisfaction was significantly but weakly correlated with the outcome of treatment. The interpersonal aspect of care, namely effective communication and respect from the therapist, appears to be the predominant and universal factor that influences patient satisfaction with physiotherapy care, although other culturally specific factors were identified. Physiotherapists can maximize patient satisfaction with care by addressing those features that uniquely contribute to patient satisfaction in the cultural context in which they are working.

Evidence for and cost-effectiveness of physiotherapy in haemophilia: a Dutch perspective

NARCIS (Netherlands)

de Kleijn, P.; Mauser-Bunschoten, E. P.; Fischer, K.; Smit, C.; Holtslag, H.; Veenhof, C.

2016-01-01

Musculoskeletal impact of haemophilia justifies physiotherapy throughout life. Recently the Dutch Health Care Institute constrained their 'list of chronic conditions', and withdrew financial coverage of physiotherapy for elderly persons with haemophilia (PWH). This decision was based on lack of

Attitudes of European physiotherapy students towards their chosen career in the context of different educational systems and legal regulations pertaining to the practice of physiotherapy: implications for university curricula.

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Gotlib, Joanna; Białoszewski, Dariusz; Opavsky, Jaroslav; Garrod, Rachel; Fuertes, Nicolas Estévez; Gallardo, Lucia Pérez; Lourido, Berta Paz; Monterde, Sonia; Serrano, Carmen Suarez; Sacco, Marc; Kunicka, Irena

2012-03-01

Differences in the organisation of educational systems and regulations pertaining to the practice of a profession can influence the attitudes of students towards their chosen career and their perceptions of employment possibilities. The aim of this paper was to discuss the different educational systems and legal regulations pertaining to the practice of physiotherapy in selected countries of the European Union (EU), and to present some conclusions regarding the influence of these differences on the perceptions of first-year physiotherapy students on their chosen career. Quantitative questionnaire-based study. Twenty-one university-level schools in the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. Six hundred and sixty-seven first-year physiotherapy students. The mean response rate was 74%. Most students (79%) reported that a personal interest was the main reason why they had decided to study physiotherapy (79%). Most students from Spain and the Czech Republic reported that, on completion of their studies, they would like to work as physiotherapists (61/120, 51% Czech Republic; 140/250, 56% Spain), compared with only 4% of Polish students (Pstudents from Poland and Spain were not familiar with employment opportunities in their respective countries (202/250, 81% Spain; 212/250, 85% Poland), and claimed that it is difficult to find employment as a physiotherapist in their country. Most students from the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. claimed that it is easy to find a job in other EU countries. Most physiotherapy students chose their course because of an interest in physiotherapy. They were not familiar with employment possibilities for graduates, and believed that it is easier to find work in other EU countries. Both factors may further aggravate the problem of unemployment among physiotherapists. Copyright © 2011 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.

Attitude of physiotherapy students in Nigeria toward persons with disability.

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Vincent-Onabajo, Grace O; Malgwi, Wasinda S

2015-01-01

Attitudes of students of health care professions, such as physiotherapy, toward persons with disability may influence their attitude and practice post-qualification. To examine attitudes toward persons with disability among undergraduate physiotherapy students in Universities in Nigeria. The 30-item Attitudes toward Disabled Persons--Form A (ATDP-A) scale was used to assess the attitudes of penultimate and final year physiotherapy students in 3 Nigerian universities. Overall and item-by-item analyzes of responses to the ATDP-A scale were carried out. Differences in attitude by sex, age, year and university of study were also examined using independent t-test and one-way ANOVA. One hundred and sixty-nine students with a male majority (56.2%) participated in the study. Mean score on the ATDP-A was 94.95 ± 17.50 with more students (60.4%) having a score >90 which depicts positive attitude. Item-by-item analysis of responses to the 30 items on the ATDP-A showed that negative attitudes were preponderant on items relating to the emotional component of the personality of persons with disability. Only age of students and their university of study however resulted in statistically significant differences in attitudes and older students reported better attitudes toward persons with disability. Although the overall attitude of the physiotherapy students was positive, negative stereotypes and discriminatory tendencies were observed in issues relating to the perceived emotional capacity of persons with disabilities. Educational strategies capable of effecting more positive attitudes in physiotherapy students in Nigeria toward persons with disability are urgently needed. Copyright © 2015 Elsevier Inc. All rights reserved.

International Continence Society supported pelvic physiotherapy education guideline.

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Bakker, Els; Shelly, Beth; Esch, Fetske H; Frawley, Helena; McClurg, Doreen; Meyers, Peter

2018-02-01

To provide a guideline of desired knowledge, clinical skills and education levels in Pelvic Physiotherapy (PT). Physiotherapy (PT) involves "using knowledge and skills unique to physiotherapists" and, "is the service only provided by, or under the direction and supervision of a physiotherapist." 1 METHODS: The PT Committee, within the body of the International Continence Society (ICS), collected information regarding existing educational levels for pelvic floor PT. Through face to face and on on-line discussion consensus was reached which was summarized in three progressive educational levels based on knowledge and skills and brought together in a guideline. The guideline was submitted to all physiotherapists and the Educational Committee of the ICS, and after approval, submitted to the Executive Board of the ICS. The guideline lists, in a progressive way, knowledge areas and skills to be achieved by education. It is broad and allows for individual interpretation based on local situations regarding education and healthcare possibilities. It is intended to be dynamic and updated on a regular basis. The proposed Pelvic PT education guideline is a dynamic document that allows course creators to plan topics for continuing course work and to recognize educational level of a therapist in the field of Pelvic PT. This education guideline can be used to set minimum worldwide standards resulting in higher skill levels for local pelvic physiotherapists and thereby better patient care outcome. © 2018 Wiley Periodicals, Inc.

Physiotherapy following elective orthopaedic procedures.

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De Kleijn, P; Blamey, G; Zourikian, N; Dalzell, R; Lobet, S

2006-07-01

As haemophilic arthropathy and chronic synovitis are still the most important clinical features in people with haemophilia, different kinds of invasive and orthopaedic procedures have become more common during the last decades. The availability of clotting factor has made arthroplasty of one, or even multiple joints possible. This article highlights the role of physiotherapy before and after such procedures. Synovectomies are sometimes advocated in people with haemophilia to stop repetitive cycles of intra-articular bleeds and/or chronic synovitis. The synovectomy itself, however, does not solve the muscle atrophy, loss of range of motion (ROM), instability and poor propriocepsis, often developed during many years. The key is in taking advantage of the subsequent, relatively safe, bleed-free period to address these important issues. Although the preoperative ROM is the most important variable influencing the postoperative ROM after total knee arthroplasty, there are a few key points that should be considered to improve the outcome. Early mobilization, either manual or by means of a continuous passive mobilization machine, can be an optimal solution during the very first postoperative days. Muscle isometric contractions and light open kinetic chain exercises should also be started in order to restore the quadriceps control. Partial weight bearing can be started shortly after, because of quadriceps inhibition and to avoid excessive swelling. The use of continuous clotting factor replacement permits earlier and intensive rehabilitation during the postoperative period. During the rehabilitation of shoulder arthroplasty restoring the function of the rotator cuff is of utmost importance. Often the rotator cuff muscles are inhibited in the presence of pain and loss of ROM. Physiotherapy also assists in improving pain and maintaining ROM and strength. Functional weight-bearing tasks, such as using the upper limbs to sit and stand, are often discouraged during the first 6

Procedural Pain Management for Children Receiving Physiotherapy

OpenAIRE

von Baeyer, Carl L.; Tupper, Susan M.

2010-01-01

Purpose: This article provides an overview of literature relevant to the prevention and relief of pain and distress during physiotherapy procedures, with guidance for physiotherapists treating children.

Tryptophan Depletion Promotes Habitual over Goal-Directed Control of Appetitive Responding in Humans.

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Worbe, Yulia; Savulich, George; de Wit, Sanne; Fernandez-Egea, Emilio; Robbins, Trevor W

2015-02-05

Optimal behavioral performance results from a balance between goal-directed and habitual systems of behavioral control, which are modulated by ascending monoaminergic projections. While the role of the dopaminergic system in behavioral control has been recently addressed, the extent to which changes in global serotonin neurotransmission could influence these 2 systems is still poorly understood. We employed the dietary acute tryptophan depletion procedure to reduce serotonin neurotransmission in 18 healthy volunteers and 18 matched controls. We used a 3-stage instrumental learning paradigm that includes an initial instrumental learning stage, a subsequent outcome-devaluation test, and a slip-of-action stage, which directly tests the balance between hypothetical goal-directed and habitual systems. We also employed a separate response inhibition control test to assess the behavioral specificity of the results. Acute tryptophan depletion produced a shift of behavioral performance towards habitual responding as indexed by performance on the slip-of-action test. Moreover, greater habitual responding in the acute tryptophan depletion group was predicted by a steeper decline in plasma tryptophan levels. In contrast, acute tryptophan depletion left intact the ability to use discriminative stimuli to guide instrumental choice as indexed by the instrumental learning stage and did not impair inhibitory response control. The major implication of this study is that serotonin modulates the balance between goal-directed and stimulus-response habitual systems of behavioral control. Our findings thus imply that diminished serotonin neurotransmission shifts behavioral control towards habitual responding. © The Author 2015. Published by Oxford University Press on behalf of CINP.

How to Build an Intentional Android: Infants' Imitation of a Robot's Goal-Directed Actions

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Itakura, Shoji; Ishida, Hiraku; Kanda, Takayuki; Shimada, Yohko; Ishiguro, Hiroshi; Lee, Kang

2008-01-01

This study examined whether young children are able to imitate a robot's goal-directed actions. Children (24-35 months old) viewed videos showing a robot attempting to manipulate an object (e.g., putting beads inside a cup) but failing to achieve its goal (e.g., beads fell outside the cup). In 1 video, the robot made eye contact with a human…

Ethics of physiotherapy practice in terminally ill patients in a developing country, Nigeria.

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Chigbo, N N; Ezeome, E R; Onyeka, T C; Amah, C C

2015-12-01

Physiotherapy has been widely defined as a healthcare profession that assesses, diagnoses, treats, and works to prevent disease and disability through physical means. The World Confederation for Physical Therapy describes physiotherapy as providing services to people and populations to develop, maintain, and restore maximum movement and functional ability throughout the lifespan. Physiotherapists working with terminally ill patients face a myriad of ethical issues which have not been substantially discussed in bioethics especially in the African perspective. In the face of resource limitation in developing countries, physiotherapy seems to be a cost-effective means of alleviating pain and distressing symptoms at the end-of-life, ensuring a more dignified passage from life to death, yet referrals to physiotherapy are not timely. Following extensive literature search using appropriate keywords, six core ethical themes related to physiotherapy in terminally ill patients were identified and using the four principles of bioethics (patient's autonomy, beneficence, nonmaleficence, and justice), an ethical analysis of these themes was done to highlight the ethical challenges of physiotherapists working in a typical African setting such as Nigeria.

Barriers and facilitators to providing undergraduate physiotherapy clinical education in the primary care setting: a three-round Delphi study.

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McMahon, S; Cusack, T; O'Donoghue, G

2014-03-01

With the global shift in health care from secondary to primary care, employment opportunities for newly qualified physiotherapists are likely to be in the primary care setting. However, to date, undergraduate physiotherapy clinical education has been centred around secondary care, focusing on acute services in large teaching hospitals. For contemporary physiotherapists to become effective first-contact primary care providers, they need to be exposed to the primary care environment during their undergraduate education. To explore the concept and identify perceived barriers and facilitators to providing physiotherapy undergraduate clinical placements in the primary healthcare setting A three-round Delphi survey was used. Participants were asked to answer open-ended questions with regard to: (i) student preparation for and (ii) provision of primary care placements (Round 1). Content analysis was employed to identify key themes. These themes generated statements for Round 2. In Round 2, participants were asked to rate their level of agreement/disagreement with the generated statements. In Round 3, a final rating process was conducted. Level of consensus was established as ≥70% agreement, with an interquartile range of ≤1. One hundred and ninety-eight primary care physiotherapy staff. Barriers identified included shortage of resources (e.g. staff) and a lack of tradition; in other words, students are not traditionally educated in the primary care setting. Response rates were 60% (120/198), 70% (84/120) and 76% (64/84) for Rounds 1, 2 and 3, respectively. All seven key facilitators identified reached consensus. They included additional support for staff taking students and motivated students. This study revealed that there is support for the provision of physiotherapy clinical education in the primary care setting. Through careful consideration with clear planning and collaboration with all stakeholders, it may be possible to convert the main barriers identified into

Prevalence of Low Back Pain among Undergraduate Physiotherapy Students in Nigeria

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Grace O. Vincent-Onabajo

2016-01-01

Full Text Available Background. Low back pain (LBP is a major cause of disability and the most common work-related musculoskeletal disorder among physiotherapists. This study examined the prevalence of low back pain among students undergoing training to become physiotherapists. Methods. Participants were 207 undergraduate clinical physiotherapy students at three universities in Nigeria. A modified version of a questionnaire used in a previous study was utilized to obtain demographic, educational activities, and LBP data. Prevalence of LBP was examined with descriptive statistics while factors associated with prevalence were explored using chi-square statistics. Results. More male students (53.1% and those in the penultimate year of study (53.1% participated in the study. Lifetime, 12-month, 1-month, and 7-day prevalence of LBP were 45.5%, 32.5%, 17.7%, and 11.5%, respectively. Prevalence of LBP was not significantly associated with any of the demographic variables. Educational activities, namely, “having techniques practiced on self for ≤10 hours” and “treating patients for ≥30 hours,” a month prior to the study were significantly (P<0.05 associated with higher 1-month and 7-day LBP prevalence, respectively. Conclusions. Although the prevalence of LBP was comparatively low, its association with educational activities emphasizes the need to incorporate effective LBP preventive strategies in the training of physiotherapy students.

Physiotherapy for adult patients with critical illness: recommendations of the European Respiratory Society and European Society of Intensive Care Medicine Task Force on Physiotherapy for Critically Ill Patients.

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Gosselink, R; Bott, J; Johnson, M; Dean, E; Nava, S; Norrenberg, M; Schönhofer, B; Stiller, K; van de Leur, H; Vincent, J L

2008-07-01

The Task Force reviewed and discussed the available literature on the effectiveness of physiotherapy for acute and chronic critically ill adult patients. Evidence from randomized controlled trials or meta-analyses was limited and most of the recommendations were level C (evidence from uncontrolled or nonrandomized trials, or from observational studies) and D (expert opinion). However, the following evidence-based targets for physiotherapy were identified: deconditioning, impaired airway clearance, atelectasis, intubation avoidance, and weaning failure. Discrepancies and lack of data on the efficacy of physiotherapy in clinical trials support the need to identify guidelines for physiotherapy assessments, in particular to identify patient characteristics that enable treatments to be prescribed and modified on an individual basis. There is a need to standardize pathways for clinical decision-making and education, to define the professional profile of physiotherapists, and increase the awareness of the benefits of prevention and treatment of immobility and deconditioning for critically ill adult patients.

Evaluating the Effectiveness of a Health Promotion Intervention Program Among Physiotherapy Undergraduate Students

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Korn, Liat; Ben-Ami, Noa; Azmon, Michal; Einstein, Ofira; Lotan, Meir

2017-01-01

This study evaluated the effectiveness of a health promotion (HP) intervention program among physiotherapy undergraduate students in an academic institution by examining pre- and post-intervention health perceptions and behaviors compared to a control group (non-physiotherapy students). Participants completed questionnaires on their health perceptions and behaviors at T1 (April 2009–May 2009) before the intervention program was initiated, and at T2 (April 2015–May 2015) after the intervention program was implemented for several years. At T1, 1,087 undergraduate students, including 124 physiotherapy students, participated. At T2, 810 undergraduate students, including 133 physiotherapy students participated. Self-reported health-related perceptions and behaviors were compared in the study group (physiotherapy students) over time (T1 versus T2), and between the study group and the control group (non-physiotherapy students) pre-intervention (T1) and post-intervention (T2). Findings showed more positive perceptions and behaviors at T2 compared to T1 in the study group (51.0% at T2 versus 35.2% at T1; p<0.05). There was no significant difference at T2 compared to T1 in health perceptions reported by the control group (37.8% at T2 versus 32.8% at T1; non-significant difference). Our findings demonstrated the effectiveness of the intervention program. PMID:28735335

The flexible focus: whether spatial attention is unitary or divided depends on observer goals.

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Jefferies, Lisa N; Enns, James T; Di Lollo, Vincent

2014-04-01

The distribution of visual attention has been the topic of much investigation, and various theories have posited that attention is allocated either as a single unitary focus or as multiple independent foci. In the present experiment, we demonstrate that attention can be flexibly deployed as either a unitary or a divided focus in the same experimental task, depending on the observer's goals. To assess the distribution of attention, we used a dual-stream Attentional Blink (AB) paradigm and 2 target pairs. One component of the AB, Lag-1 sparing, occurs only if the second target pair appears within the focus of attention. By varying whether the first-target-pair could be expected in a predictable location (always in-stream) or not (unpredictably in-stream or between-streams), observers were encouraged to deploy a divided or a unitary focus, respectively. When the second-target-pair appeared between the streams, Lag-1 sparing occurred for the Unpredictable group (consistent with a unitary focus) but not for the Predictable group (consistent with a divided focus). Thus, diametrically different outcomes occurred for physically identical displays, depending on the expectations of the observer about where spatial attention would be required.

Transforming Cognitive and Emotional Dissonance for Physiotherapy Students Learning Medical Anthropology

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H. Macdonald

2013-12-01

Full Text Available Since the 1980s physiotherapy has shifted concerns towardscultural, economic, philosophical, political and social questions, and moreflexible ways of speaking about and practicing physiotherapy. In response to bothglobal shifts and local demands, the Physiotherapy Division at the University ofCape Town (UC T approached their Social Anthropology colleagues to teacha broader range of perspectives to their physiotherapy students. The objectiveof this research was to explore the changes experienced by UC T physiotherapystudents exposed to a cross-disciplinary teaching environment, and discuss thepossible role of the course in affecting their experience. A qualitative researchdesign drew data from multiple sources and was analysed using an interpretivecontent analysis method. Using an anthropological model of transformation,the changes experienced by students were categorised into three sub-categories of ‘separation’, ‘transition’ and ‘incorporation’.Emotional and cognitive changes were attributable to the course material. By attending to their emotional discomfort, physiotherapystudents not only successfully incorporated anthropological concepts to healthcare but also improved their professional identitiesand personal self-worth.

A randomized trial of specialized versus standard neck physiotherapy in cervical dystonia.

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Counsell, Carl; Sinclair, Hazel; Fowlie, Jillian; Tyrrell, Elaine; Derry, Natalie; Meager, Peter; Norrie, John; Grosset, Donald

2016-02-01

Anecdotal reports suggested that a specialized physiotherapy technique developed in France (the Bleton technique) improved primary cervical dystonia. We evaluated the technique in a randomized trial. A parallel-group, single-blind, two-centre randomized trial compared the specialized outpatient physiotherapy programme given by trained physiotherapists up to once a week for 24 weeks with standard physiotherapy advice for neck problems. Randomization was by a central telephone service. The primary outcome was the change in the total Toronto Western Spasmodic Torticollis Rating (TWSTR) scale, measured before any botulinum injections that were due, between baseline and 24 weeks evaluated by a clinician masked to treatment. Analysis was by intention-to-treat. 110 patients were randomized (55 in each group) with 24 week outcomes available for 84. Most (92%) were receiving botulinum toxin injections. Physiotherapy adherence was good. There was no difference between the groups in the change in TWSTR score over 24 weeks (mean adjusted difference 1.44 [95% CI -3.63, 6.51]) or 52 weeks (mean adjusted difference 2.47 [-2.72, 7.65]) nor in any of the secondary outcome measures (Cervical Dystonia Impact Profile-58, clinician and patient-rated global impression of change, mean botulinum toxin dose). Both groups showed large sustained improvements compared to baseline in the TWSTR, most of which occurred in the first four weeks. There were no major adverse events. Subgroup analysis suggested a centre effect. There was no statistically or clinically significant benefit from the specialized physiotherapy compared to standard neck physiotherapy advice but further trials are warranted. Copyright © 2015 Elsevier Ltd. All rights reserved.

Knowledge and perception of physiotherapy by final year medical students of a Nigerian university.

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Odebiyi, D O; Omotunde, A O; Aiyejusunle, C B; Olalekan, T A

2008-01-01

It has been shown that multidisciplinary interactions have become a feature of the changing medical education system. It is not clear to what extent medical students have been integrated into this newer model, more especially at the College of Medicine of the University of Lagos (CMUL), AIM: To assess the level of knowledge and perception of physiotherapy by the final year medical students of CMUL about physiotherapy. Ninety eight final year medical students of CMUL participated in the study. They were required to complete a standard 22 item closed-ended questionnaire which was self administered. Data were presented as mean +/- standard deviation; Inferential statistics of chi-square and t-tests were used to compare differences between variables. The respondents displayed above average knowledge of physiotherapy as the mean scores obtained for knowledge of physiotherapy were 20.25 +/- 4.50 and 18.77 +/- 4.60 for males and females respectively. They also showed a fair perception towards physiotherapy as the mean scores obtained were 32.70 +/- 7.20 and 34.33 +/- 7.30 for males and females respectively. However there was a significant gender difference in the medical students' knowledge of physiotherapy (p students of CMUL had a good knowledge and fair perception of physiotherapy. Their main source of knowledge was classroom lectures. The need for further education of medical students with particular emphasis on clinical interaction was identified. It is hereby suggested that interprofessional courses and communication should be given greater attention during medical training.

Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy

OpenAIRE

Hák, Jaroslav

2016-01-01

Title of diploma thesis: Chaining of the musculoskeletal disorders from various viewpoints in physiotherapy Objective: The purpouse of this thesis is to research available literary sources describing the possible mechanisms of chaining of musculoskeletal disorders from various viewpoints in physiotherapy. Methods: This diploma thesis has descriptively-analytical character. It is structured in the form of literary research. Results: On the basis of the researched literary sources, the thesis s...

Physiotherapy rehabilitation after total knee or hip replacement: an evidence-based analysis.

Science.gov (United States)

2005-01-01

The objective of this health technology policy analysis was to determine, where, how, and when physiotherapy services are best delivered to optimize functional outcomes for patients after they undergo primary (first-time) total hip replacement or total knee replacement, and to determine the Ontario-specific economic impact of the best delivery strategy. The objectives of the systematic review were as follows: To determine the effectiveness of inpatient physiotherapy after discharge from an acute care hospital compared with outpatient physiotherapy delivered in either a clinic-based or home-based setting for primary total joint replacement patientsTo determine the effectiveness of outpatient physiotherapy delivered by a physiotherapist in either a clinic-based or home-based setting in addition to a home exercise program compared with a home exercise program alone for primary total joint replacement patientsTo determine the effectiveness of preoperative exercise for people who are scheduled to receive primary total knee or hip replacement surgery Total hip replacements and total knee replacements are among the most commonly performed surgical procedures in Ontario. Physiotherapy rehabilitation after first-time total hip or knee replacement surgery is accepted as the standard and essential treatment. The aim is to maximize a person's functionality and independence and minimize complications such as hip dislocation (for hip replacements), wound infection, deep vein thrombosis, and pulmonary embolism. THE THERAPY: The physiotherapy rehabilitation routine has 4 components: therapeutic exercise, transfer training, gait training, and instruction in the activities of daily living. Physiotherapy rehabilitation for people who have had total joint replacement surgery varies in where, how, and when it is delivered. In Ontario, after discharge from an acute care hospital, people who have had a primary total knee or hip replacement may receive inpatient or outpatient

Is gaze following purely reflexive or goal-directed instead? Revisiting the automaticity of orienting attention by gaze cues.

Science.gov (United States)

Ricciardelli, Paola; Carcagno, Samuele; Vallar, Giuseppe; Bricolo, Emanuela

2013-01-01

Distracting gaze has been shown to elicit automatic gaze following. However, it is still debated whether the effects of perceived gaze are a simple automatic spatial orienting response or are instead sensitive to the context (i.e. goals and task demands). In three experiments, we investigated the conditions under which gaze following occurs. Participants were instructed to saccade towards one of two lateral targets. A face distracter, always present in the background, could gaze towards: (a) a task-relevant target--("matching" goal-directed gaze shift)--congruent or incongruent with the instructed direction, (b) a task-irrelevant target, orthogonal to the one instructed ("non-matching" goal-directed gaze shift), or (c) an empty spatial location (no-goal-directed gaze shift). Eye movement recordings showed faster saccadic latencies in correct trials in congruent conditions especially when the distracting gaze shift occurred before the instruction to make a saccade. Interestingly, while participants made a higher proportion of gaze-following errors (i.e. errors in the direction of the distracting gaze) in the incongruent conditions when the distracter's gaze shift preceded the instruction onset indicating an automatic gaze following, they never followed the distracting gaze when it was directed towards an empty location or a stimulus that was never the target. Taken together, these findings suggest that gaze following is likely to be a product of both automatic and goal-driven orienting mechanisms.

Transfer standard device to improve the traceable calibration of physiotherapy ultrasound machines

NARCIS (Netherlands)

Hekkenberg, R.T.; Richards, A.; Beissner, K.; Zeqiri, B.; Bezemer, R.A.; Hodnett, M.; Prout, G.; Cantrall, C.

2006-01-01

Ultrasound (US) physiotherapy as a clinical treatment is extremely common in the Western world. Internationally, regulation to ensure safe application of US physiotherapy by regular calibration ranges from nil to mandatory. The need for a portable power standard (PPS) has been addressed within a

Predicting who will undergo surgery after physiotherapy for female stress urinary incontinence

NARCIS (Netherlands)

Labrie, J.; Lagro-Janssen, A. L. M.; Fischer, K.; Berghmans, L. C. M.; van der Vaart, C. H.

To predict who will undergo midurethral sling surgery (surgery) after initial pelvic floor muscle training (physiotherapy) for stress urinary incontinence in women. This was a cohort study including women with moderate to severe stress incontinence who were allocated to the physiotherapy arm from a

The PIT: SToPP Trial—A Feasibility Randomised Controlled Trial of Home-Based Physiotherapy for People with Parkinson's Disease Using Video-Based Measures to Preserve Assessor Blinding

Directory of Open Access Journals (Sweden)

Emma Stack

2012-01-01

Full Text Available Purpose. To trial four-week's physiotherapy targeting chair transfers for people with Parkinson's disease (PwPD and explore the feasibility of reliance on remote outcome measurement to preserve blinding. Scope. We recruited 47 PwPD and randomised 24 to a focused home physiotherapy programme (exercise, movement strategies, and cueing and 23 to a control group. We evaluated transfers (plus mobility, balance, posture, and quality of life before and after treatment and at followup (weeks 0, 4, 8, and 12 from video produced by, and questionnaires distributed by, treating physiotherapists. Participants fed back via end-of-study questionnaires. Thirty-five participants (74% completed the trial. Excluding dropouts, 20% of questionnaire data and 9% of video data were missing or unusable; we had to evaluate balance in situ. We noted trends to improvement in transfers, mobility, and balance in the physiotherapy group not noted in the control group. Participant feedback was largely positive and assessor blinding was maintained in every case. Conclusions. Intense, focused physiotherapy at home appears acceptable and likely to bring positive change in those who can participate. Remote outcome measurement was successful; questionnaire followup and further training in video production would reduce missing data. We advocate a fully powered trial, designed to minimise dropouts and preserve assessor blinding, to evaluate this intervention.

Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis

OpenAIRE

Michálková, Kateřina

2013-01-01

Title of bachelor's thesis: Case report physiotherapy care of a patient diagnosed with polyarthritis with early rheumatoid arthritis. Summary: The bachelor thesis deals with polyarthritis disease with early rheumatoid arthritis and its physiotherapy care. It consists of two parts. The general part contains a general joint anatomy, deals with the major problems of disease and polyarthritis rheumatoid arthritis, its diagnosis, treatment and physiotherapy care. Special part includes a case repor...

Does Extrinsic Goal Framing Enhance Extrinsic Goal-Oriented Individuals' Learning and Performance? An Experimental Test of the Match Perspective versus Self-Determination Theory

Science.gov (United States)

Vansteenkiste, Maarten; Timmermans, Tinneke; Lens, Willy; Soenens, Bart; Van den Broeck, Anja

2008-01-01

Previous work within self-determination theory has shown that experimentally framing a learning activity in terms of extrinsic rather than intrinsic goals results in poorer conceptual learning and performance, presumably because extrinsic goal framing detracts attention from the learning activity and is less directly satisfying of basic…

Experiences of older adults in a group physiotherapy program at a rehabilitation hospital: A qualitative study.

Science.gov (United States)

Raymond, Melissa J; Burge, Angela T; Soh, Sze-Ee; Jeffs, Kimberley J; Winter, Adele; Holland, Anne E

2016-05-01

Physiotherapy delivered in a group setting has been shown to be effective in a variety of populations. However, little is known about the attitudes of older adults toward participating in group physiotherapy. The objectives of this study were to explore older inpatients' perceptions and experiences of group physiotherapy using qualitative methods. Twelve hospitalized adults aged ≥65 years who were involved in a larger randomized controlled trial undertook individual semistructured interviews regarding their experiences in group physiotherapy. Interviews were transcribed verbatim, and line by line, iterative thematic analysis was undertaken. Descriptive codes were developed, compared, and grouped together to create themes. Analysis revealed 6 major themes and 10 subthemes. All participants reported feeling happy to attend group sessions, a satisfactory alternative to individual physiotherapy. Participants described physical benefits that increased their motivation, and comparisons with their peers either motivated them or made them feel gratitude for their own health. Perceived attentiveness of group instructors contributed to participants reporting that treatment was individualized and similar to individual physiotherapy. Motivation and camaraderie with peers contributed to their enjoyment of group physiotherapy. Hospitalized older adults enjoyed exercising with their peers and valued the physical and social benefits of group physiotherapy. Journal of Hospital Medicine 2016;11:358-362. © 2016 Society of Hospital Medicine. © 2016 Society of Hospital Medicine.

Slips of action and sequential decisions: a cross-validation study of tasks assessing habitual and goal-directed action control

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Zsuzsika Sjoerds

2016-12-01

Full Text Available Instrumental learning and decision-making rely on two parallel systems: a goal-directed and a habitual system. In the past decade, several paradigms have been developed to study these systems in animals and humans by means of e.g. overtraining, devaluation procedures and sequential decision-making. These different paradigms are thought to measure the same constructs, but cross-validation has rarely been investigated. In this study we compared two widely used paradigms that assess aspects of goal-directed and habitual behavior. We correlated parameters from a two-step sequential decision-making task that assesses model-based and model-free learning with a slips-of-action paradigm that assesses the ability to suppress cue-triggered, learnt responses when the outcome has been devalued and is therefore no longer desirable. Model-based control during the two-step task showed a very moderately positive correlation with goal-directed devaluation sensitivity, whereas model-free control did not. Interestingly, parameter estimates of model-based and goal-directed behavior in the two tasks were positively correlated with higher-order cognitive measures (e.g. visual short-term memory. These cognitive measures seemed to (at least partly mediate the association between model-based control during sequential decision-making and goal-directed behavior after instructed devaluation. This study provides moderate support for a common framework to describe the propensity towards goal-directed behavior as measured with two frequently used tasks. However, we have to caution that the amount of shared variance between the goal-directed and model-based system in both tasks was rather low, suggesting that each task does also pick up distinct aspects of goal-directed behavior. Further investigation of the commonalities and differences between the model-free and habit systems as measured with these, and other, tasks is needed. Also, a follow-up cross-validation on the neural

Does extrinsic goal framing enhance extrinsic goal-oriented individuals' learning and performance? An experimental test of the match perspective versus self-determination theory

OpenAIRE

Vansteenkiste, Maarten; Timmermans, Tinneke; Lens, Willy; Soenens, Bart; Van den Broeck, Anja

2008-01-01

Previous work within self-determination theory has shown that experimentally framing a learning activity in terms of extrinsic rather than intrinsic goals results in poorer conceptual learning and performance, presumably because extrinsic goal framing detracts attention from the learning activity and is less directly satisfying of basic psychological needs. According to the match perspective, experimental extrinsic, compared to intrinsic, goal framing should enhance learning and performance f...

How emotion context modulates unconscious goal activation during motor force exertion.

Science.gov (United States)

Blakemore, Rebekah L; Neveu, Rémi; Vuilleumier, Patrik

2017-02-01

Priming participants with emotional or action-related concepts influences goal formation and motor force output during effort exertion tasks, even without awareness of priming information. However, little is known about neural processes underpinning how emotional cues interact with action (or inaction) goals to motivate (or demotivate) motor behaviour. In a novel functional neuroimaging paradigm, visible emotional images followed by subliminal action or inaction word primes were presented before participants performed a maximal force exertion. In neutral emotional contexts, maximum force was lower following inaction than action primes. However, arousing emotional images had interactive motivational effects on the motor system: Unpleasant images prior to inaction primes increased force output (enhanced effort exertion) relative to control primes, and engaged a motivation-related network involving ventral striatum, extended amygdala, as well as right inferior frontal cortex. Conversely, pleasant images presented before action (versus control) primes decreased force and activated regions of the default-mode network, including inferior parietal lobule and medial prefrontal cortex. These findings show that emotional context can determine how unconscious goal representations influence motivational processes and are transformed into actual motor output, without direct rewarding contingencies. Furthermore, they provide insight into altered motor behaviour in psychopathological disorders with dysfunctional motivational processes. Copyright © 2016 Elsevier Inc. All rights reserved.

Patient satisfaction with physiotherapy in the emergency department.

Science.gov (United States)

Sheppard, Lorraine A; Anaf, Sophie; Gordon, Jane

2010-10-01

This research aims to explore patient satisfaction with ED physiotherapy within the Australian context by providing a qualitative perspective with in-depth exploration of the factors underlying patients' satisfaction. The physiotherapist was part of the Emergency Department Allied Health Team of social worker and occupational therapist. A qualitative, interpretive, field-based study using face-to-face interviews were carried out post-physiotherapy treatment within the emergency department, followed-up 2-3 weeks later with telephone interviews. Twenty two participants took part in the face-to-face interviews and 15 in the follow-up interviews. Of the 22 participants who took part in the initial interviews 19 were over 65 years of age, with a mean age of 78 years. Within the category 'Physiotherapy in the emergency department' the themes were; expectations, bedside manner, physiotherapy management (i.e. assessment, advice, hands-on, exercise, follow-up/referral) and satisfaction. The physiotherapist at the Australian emergency department appeared to make an impact on patients' experiences in the emergency department through his thorough subjective assessment of the patients' home environment, coping skills and social supports, his assessment of functional mobility, his provision of exercises, advice and hands-on treatment, as well as his involvement in organising follow-up or referral to other services. The physiotherapist's bedside manner shaped patients' perceptions throughout their assessment and treatment, reassuring and comforting patients within the emergency environment. Participants were satisfied with the experience of attending the physiotherapist in the emergency department and commented the blend of skills of the physiotherapists enhanced the service provision and self reported patient outcomes. Copyright © 2009 Elsevier Ltd. All rights reserved.

Addressing weight stigma in physiotherapy: Development of a theory-driven approach to (re)thinking weight-related interactions.

Science.gov (United States)

Setchell, J; Gard, M; Jones, L; Watson, B M

2017-08-01

In this article, we propose a theory-driven approach to developing interventions for reducing weight stigma in physiotherapy and discuss the design and exploratory trial of such an intervention. Weight stigma has been identified in physiotherapists in empirical investigations. However, there has been little consideration of how this stigma might be addressed. We highlight Goffman's work on stigma that provides social and embodied understandings of stigma. Goffman's approach, however, is notably apolitical, ahistorical and lacks mechanisms for understanding power. We suggest that post-structuralist perspectives can provide insight into these areas. Drawing on these theories, we critically examine the literature on weight stigma reduction, finding that trials have largely been unsuccessful. We argue that this may be due to overly passive and simplistic intervention designs. As context-specific understandings are desirable, we examine the nature of physiotherapy to determine what might be relevant to (re)thinking weight in this profession. We then discuss the development of a multifactorial, active weight stigma intervention we trialed with eight physiotherapists. Supported by theory, the outcomes of the exploratory study suggest that physiotherapy-specific factors such as fostering professional reflexivity and improving understandings of stigma need to be incorporated into an active intervention that considers the complex determinants of weight stigma.

[Quality of life of people with Parkinson's disease in the context of professional work and physiotherapy].

Science.gov (United States)

Cholewa, Joanna; Gorzkowska, Agnieszka; Nawrocka, Agnieszka; Cholewa, Jarosław

2017-10-17

Of many diseases and disorders of the nervous system Parkinson's disease (PD) deserves a particular attention for its specific effects having an impact on the ability to undertake different forms of professional and economic activities. Due to the constantly growing incidence rate and the lowering age of patients, PD is becoming more and more serious social problem. The aim of this study was to determine the effects of professional work and physiotherapy on the quality of live in people with Parkinson's disease. The research was carried out on 109 people with diagnosed PD of stage II according to the Hoehn and Yahr classification. They were divided into professionally working and non-working subjects and those participating and not participating in physiotherapy programs. The Unified Parkinson's Disease Rating Scale (UPDRS), was used to estimate the patients' clinical status. The Parkinson's Disease Questionnaire (PDQ-39), the Quality of Life Short Form (SF-36) Questionnaire and the Parkinson's Disease Quality of Life Questionnaire (PDQL) were used to estimate the quality of life. In all groups statistically significant differences were observed in each of the used scale. The PDQ-39 (F = 5.278, p = 0.04), SF physical component (F = 4.24, p = 0.005), SF mental component (F = 3.45, p = 0.021), PDQL (F = 6.57, p = 0.003). The highest quality of life was noticed in people working professionally and participating in physiotherapy programs. Professional activity and participation in properly planned physiotherapy help reduce the symptoms and improve the quality of life of people with Parkinson's disease. The study showed that the quality of life of people with PD is determined by professional work and participation in the process of rehabilitation. Med Pr 2017;68(6):725-734. This work is available in Open Access model and licensed under a CC BY-NC 3.0 PL license.

Integrated learning through student goal development.

Science.gov (United States)

Price, Deborah; Tschannen, Dana; Caylor, Shandra

2013-09-01

New strategies are emerging to promote structure and increase learning in the clinical setting. Nursing faculty designed a mechanism by which integrative learning and situated coaching could occur more readily in the clinical setting. The Clinical Goals Initiative was implemented for sophomore-, junior-, and senior-level students in their clinical practicums. Students developed weekly goals reflecting three domains of professional nursing practice. Goals were shared with faculty and staff nurse mentors at the beginning of the clinical day to help guide students and mentors with planning for learning experiences. After 6 weeks, faculty and students were surveyed to evaluate project effectiveness. Faculty indicated that goal development facilitated clinical learning by providing more student engagement, direction, and focus. Students reported that goal development allowed them to optimize clinical learning opportunities and track their growth and progress. Faculty and students indicated the goals promoted student self-learning, autonomy, and student communication with nurse mentors and faculty. Copyright 2013, SLACK Incorporated.

Goal Translation: How To Create a Results-Focused Organizational Culture.

Science.gov (United States)

Mourier, Pierre

2000-01-01

Presents a model for changing human and organizational behavior. Highlights include behavioral dynamics; expectations; alignment; organizational structure; organizational culture; individual skills and training; leadership; management systems; developing corporate-level goals; communicating goals to the organization; and developing employee goals.…

Involved and Focused? Students' Perceptions of Institutional Identity, Personal Goal Orientation and Levels of Campus Engagement

Science.gov (United States)

Ferrari, Joseph R.; McCarthy, Brendan J.; Milner, Lauren A.

2009-01-01

The present study explores the relationship between students' perception of their institution's mission identity, personal goal orientation tendencies, and the extent to which they engage in mission-driven activities. Goal orientation research categorizes student motivations in three ways: mastery orientation (MO), performance-approach (PAp)…

Multiple goals and time constraints: perceived impact on physicians' performance of evidence-based behaviours

Directory of Open Access Journals (Sweden)

Francis Jillian J

2009-11-01

Full Text Available Abstract Background Behavioural approaches to knowledge translation inform interventions to improve healthcare. However, such approaches often focus on a single behaviour without considering that health professionals perform multiple behaviours in pursuit of multiple goals in a given clinical context. In resource-limited consultations, performing these other goal-directed behaviours may influence optimal performance of a particular evidence-based behaviour. This study aimed to investigate whether a multiple goal-directed behaviour perspective might inform implementation research beyond single-behaviour approaches. Methods We conducted theory-based semi-structured interviews with 12 general medical practitioners (GPs in Scotland on their views regarding two focal clinical behaviours--providing physical activity (PA advice and prescribing to reduce blood pressure (BP to Results Most GPs reported strong intention to prescribe to reduce BP but expressed reasons why they would not. Intention to provide PA advice was variable. Most GPs reported that time constraints and patient preference detrimentally affected their control over providing PA advice and prescribing to reduce BP, respectively. Most GPs perceived many of their other goal-directed behaviours as interfering with providing PA advice, while fewer GPs reported goal-directed behaviours that interfere with prescribing to reduce BP. Providing PA advice and prescribing to reduce BP were perceived to be facilitated by similar diabetes-related behaviours (e.g., discussing cholesterol. While providing PA advice was perceived to be mainly facilitated by providing other lifestyle-related clinical advice (e.g., talking about weight, BP prescribing was reported as facilitated by pursuing ongoing standard consultation-related goals (e.g., clearly structuring the consultation. Conclusion GPs readily relate their other goal-directed behaviours with having a facilitating and interfering influence on their

Factors affecting poor attendance for outpatient physiotherapy by patients discharged from Mthatha General Hospital with a stroke

Directory of Open Access Journals (Sweden)

N.P. Ntamo

2013-12-01

Full Text Available Background: Stroke is a major cause of disability inthe world and its long term effects require adherence to physiotherapyprotocols for optimal rehabilitation. Clinical impression of data fromMthatha General Hospital (MGH Physiotherapy Department revealedthat there was poor attendance of outpatient physiotherapy by strokepatients discharged from MGH and this had negative effects on outcomesand health care costs.Objective: To determine the extent and the socio-demographic reasonsfor poor attendance for outpatient physiotherapy by stroke patients.Methods: An observational descriptive study was conducted using arandomly selected sample of 103 stroke patients from a population of 139who attended physiotherapy in MGH in 2007. Structured interviews wereconducted and SPSS was used for data analysis.Results: The majority (86% of patients did not attend physiotherapy until discharge from the Physiotherapy Department. Themajor reasons for poor attendance were lack of finances (95%, migration to other areas (36%, and living a long distance fromMGH (38%.Conclusion: Almost 9 out of 10 stroke patients fail to attend for outpatient physiotherapy because of lack of finances.Recommendation: Development of a Provincial Rehabilitation Policy with specific reference to decentralization of rehabilitationservices to address unavailability of physiotherapy services at clinics and health care centers which are proximal to the patients’residential areas is recommended.

Teaching and learning communication skills in physiotherapy: what is done and how should it be done?

Science.gov (United States)

Parry, Ruth H; Brown, Kay

2009-12-01

To survey practice and opinion regarding school-based teaching of communication skills, to summarise relevant research evidence from physiotherapy and beyond, to reflect on practice in light of evidence, and to propose associated recommendations. Survey using customised questionnaires. Basic descriptive statistical analysis and thematic content analysis were used. The results were compared with evidence from systematic reviews to derive recommendations. SURVEY PARTICIPANTS AND SETTING: Educators in all UK centres delivering physiotherapy qualifying programmes in 2006. A response rate of 69% was achieved. The majority of respondents reported delivering communication-specific modules. Lecturing was common, and more experiential methods were also used. Assessment was mainly by written work. Educators commented on challenges and strategies involved in student engagement, provision of authentic experiences, availability of teaching time and expertise, and physiotherapy-specific teaching resources. Evidence from allied health profession, medical and nursing education research emphasises the importance of experiential teaching, formative feedback, observational assessment and a substantial evidence base on which to ground course content. In physiotherapy, the latter is emerging but incomplete. There are also gaps in direct evidence about advantages or otherwise of stand-alone modules and benefits of pre-qualification communication training. Evidence suggests that effective training requires substantial teaching time, expertise and a body of empirical research on specific communication practices and their effects. Curriculum designers and educators should endeavour to maximise the degree to which training in this area is experiential, provide training when students have already had some contact with patients, and assess students by observation if at all possible. Due to gaps in the evidence, some important questions about optimal practice remain unanswered.

Does the use of a university lecturer as a visiting tutor support learning and assessment during physiotherapy students' clinical placements? A survey of higher education institution providers.

Science.gov (United States)

Dean, M; Levis, A

2016-12-01

To establish the rationale for using a lecturer as a visiting tutor, and to identify the activities undertaken during clinical placements to support student learning and assessment in practice. A secure electronic survey was used to incorporate qualitative and quantitative data collection procedures. Thirty-three higher education institution (HEI) providers of physiotherapy education in the UK, registered with the Chartered Society of Physiotherapy. UK HEI physiotherapy placement coordinators. A questionnaire was used to examine HEI perceptions. A pilot focus group consultation informed the questionnaire content. Surveys were analysed based on the proportion of responses to closed questions on an adapted Likert scale, with further thematic analysis of open questions. All 25 respondents (25/33, 76%) indicated their provision of support for students and clinical educators throughout their clinical placements. 'Face-to-face' engagement during the placement visit was viewed as essential to guide the clinical educator to provide a consistent approach to learning and assessment strategies; ensuring cohesion between theoretical and clinical components of the curriculum was viewed as a core objective by visiting academic tutors. However, the emergent themes highlighted key differences between HEIs' perspectives of what this support for clinical placement learning should entail. The majority of HEIs endorse the use of a lecturer as a visiting tutor to inform and maintain the standard of learning and assessment within the clinical placement. However, the value of this interaction requires confirmation via other stakeholders, and exploration of other forms of non-face-to-face support processes warrant further investigation. Copyright © 2015 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.