Clinical Physiotherapists Research Articles

Japanese Clinical Physical Therapists With the Mechanical Diagnosis and Therapy License Are More Competent and Confident in Pain Management Than Those Without It: A Cross-Sectional Study

Japanese Clinical Physical Therapists With the Mechanical Diagnosis and Therapy License Are More Competent and Confident in Pain Management Than Those Without It: A Cross-Sectional Study

Establishing a Specialist Physiotherapy service with a Regional Specialist Memory Clinic

Abstract Background Patients with complex motor-cognitive syndromes (E.g. Dementia with Lewy Bodies, Corticobasal syndrome, Progressive Supranuclear Palsy and Huntington’s disease) present with a wide variety of symptoms. Accordingly, these patients have traditionally been managed under different services from Neurology-led movement disorder clinics to age-related services, without dedicated access to specialist physiotherapy input. Recognising this, the Model of Care for Dementia in Ireland recommended that all regional specialist memory services (RSMC) should have a dedicated Clinical Specialist Physiotherapist. The aim of this study was to provide an overview of clinic activity in the first six months of operation. Methods Physiotherapy referrals were collected from September 2023 to March 2024. Referral details were captured using Microsoft Excel and included patient demographics, reason for referral, diagnosis and previous physiotherapy input. Following triage of referrals, patients were placed in one of the following three care pathways: Results 63 referrals were generated. Of these, 15 patients were referred for pre-diagnostic assessment, 46 were referred for rehabilitation, and 2 were referred for secondary prevention. Of those referred for rehabilitation; 18 patients had a diagnosis of DLB, 27 had another form of atypical Parkinsonism, 1 patient had HD. 22 patients had previous physiotherapy input. Conclusion This is the first specialist physiotherapy service in Ireland within a RSMC. This presents a challenge as there is no specific physiotherapy care pathway established for this service elsewhere, but also opportunity for service development and innovation. This overview will help with strategic and service planning and enables KPIs to be established to ensure patients receive a quality service.

Use of the iPRISM webtool in a learning community to assess implementation context and fit of a novel clinical decision support tool for physical therapy triage in acute care hospitals.

The iPRISM webtool is an interactive tool designed to aid the process of applying the Practical, Robust Implementation and Sustainability Model (PRISM) for the assessment of and fit with context. A learning community (LC) is a multidisciplinary group of partners addressing a complex problem. Our LC coproduced the Physical TheraPy frEqueNcy Clinical decIsion support tooL (PT-PENCIL) to guide the use of physical therapist services in acute care hospitals. To describe our LC's activities to co-produce the PT-PENCIL, use of the iPRISM webtool to assess its preimplementation context and fit, and develop a multicomponent implementation strategy for the PT-PENCIL. A descriptive research design. Three tertiary care hospitals. Thirteen LC partners: six clinical physical therapists, three rehabilitation managers, three researchers, and a bioinformaticist. Not applicable. Using the iPRISM webtool, expected fit of the PT-PENCIL was rated 1 (not aligned) to 6 (well aligned) for each PRISM domain and expected reach, effectiveness, adoption, implementation, and maintenance were rated 1 (not likely at all) to 6 (very likely). Discrete implementation strategies were identified from the Expert Recommendations for Implementing Change. The process spanned 18 meetings over 8 months. Ten LC partners completed the iPRISM webtool. PRISM domains with the lowest expected alignment were the "implementation and sustainability infrastructure" (mean = 4.7 out of 6; range = 3-6) and the "external environment" (mean = 4.9 of 6; range = 4-6). Adoption was the outcome with the lowest expected likelihood (mean = 4.5 out of 6; range = 1-6). Six discrete implementation strategies were identified and combined into a multicomponent strategy. Within a LC, we used existing implementation science resources to co-produce a novel clinical decision support tool for acute care physical therapists and develop a strategy for its implementation. Our methodology can be replicated for similar projects given the public availability of each resource used.

Prevalence of Work-Related Thumb Pain among Clinical Physical Therapists of Rawalpindi & Islamabad

Background: Work-related musculoskeletal disorders (WRMSDs) are prevalent among healthcare professionals, significantly affecting physical therapists due to their hands-on treatment techniques. These disorders, particularly involving the thumb, result from repetitive stress and poor ergonomics, leading to chronic pain and functional impairment. Despite extensive research on WRMSDs in other body regions, the specific prevalence of thumb pain among physical therapists in Pakistan remains underexplored. This study aims to investigate the prevalence and contributing factors of work-related thumb pain among clinical physical therapists in Rawalpindi and Islamabad, addressing a critical gap in the current understanding of occupational health challenges faced by these professionals. Objective: The study was conducted to find out prevalence of work-related thumb pain among clinical physiotherapists of Rawalpindi & Islamabad. Methods: A descriptive cross-sectional study was conducted from September 2022 to February 2023 in Rawalpindi and Islamabad. Data was collected from 270 physiotherapists using self-structured questionnaire. Sample size was calculated using Slovin’s formula with confidence interval 95% and keeping margin of error 0.05%. Non-probability convenient sampling technique was used for collection of data. Data was analyzed by using SPSS version 26. Results: Out of 270 participants, 130 complained of thumb pain whereas 140 had no pain. The overall mean age of sample was 28.15±5.39. Among males 52(43.3%) had thumb pain and 68(56.7%) had no thumb pain. Females 78(52.0%) had thumb pain and 72(48.0%) had no thumb pain. 218(80.7%) participants were working from 1-5 years, 62(23%) worked for less than 15 hours per week, 84(31.1%) worked for 5 hours per day, 108(40%) treated up to 5 patients per day. Moderate intensity pain was present in 82(30.4%) participants. Mostly 67(24.8) were affected with MP joint pain site. Conclusion: Thumb pain was prevalent among clinical physiotherapists. Females were having more thumb pain as compared to male participants. The intensity of pain prevalent was moderate on NPRS. This thumb pain is due to their professional techniques including manual therapy, ischemic pressure release and massage. Most of the participants reported thumb pain due to mobilization and manipulation techniques.

Informing low back pain care from the ground up: Survey of national musculoskeletal triage physiotherapists in Ireland

BackgroundHealthcare is changing to meet the challenge of a rising musculoskeletal burden associated with the expanding, aging population. Clinicians, important stakeholders in healthcare provision, have crucial insights into service improvement, but clinician consultation is a shortcoming in healthcare development. In Ireland, specialist physiotherapist-led musculoskeletal (MSK) triage services operate at the primary-secondary care interface to expedite patient care. ObjectivesTo inform future development of low back pain (LBP) care in Ireland through profiling the operationalisation of the national MSK triage service for LBP, including access, referral management, clinical investigations, onward referral options, access to multidisciplinary team (MDT) services and integration with primary healthcare services. DesignCross-sectional observational study using a bespoke, anonymous electronic survey. ParticipantsThirty-eight clinical specialist physiotherapists working in national programme Irish MSK triage services. ResultsThirty-eight MSK Triage physiotherapists submitted responses (response rate 72%). There was considerable site-dependent variation in LBP service provision, with discrepancies in access to triage services, wait times, referral processing and prioritisation, access to clinical investigations and onward referral options. Most respondents (81%) reported wait times exceeding the three-month target; 75% reported that the level of clinical autonomy associated with their role limited service efficiency; 75% were dissatisfied with primary-secondary care service integration. Respondents identified insufficient availability of primary care multidisciplinary services. ConclusionLack of standardisation of LBP services exists in Ireland. Services would benefit from improved standardisation, reduced wait times, national accreditation and a defined scope of advanced physiotherapy practice and the development of nationwide community multidisciplinary infrastructure with enhanced interservice communication.

CSP2023: 405 - Specialist shoulder clinics in Musculoskeletal Physiotherapy Outpatient settings: Evaluating patient clinical outcomes, patient feedback, and Physiotherapist confidence in delivery

CSP2023: 405 - Specialist shoulder clinics in Musculoskeletal Physiotherapy Outpatient settings: Evaluating patient clinical outcomes, patient feedback, and Physiotherapist confidence in delivery

Primary contact physiotherapy for patients with suggested vestibulopathy for an Australian ENT clinic: a retrospective cohort study.

To examine the newly established role of a primary contact physiotherapist in an ENT clinic, in an Australian cohort and context, over two phases of development. A retrospective cohort study was conducted with data collected from a medical record audit. Over the study duration, the primary contact physiotherapist completed initial appointments with patients; follow-up appointments were subsequently conducted by medical staff. There was a 46 per cent reduction in patients with suggested vestibulopathy requiring an ENT medical review. This reduction could hypothetically increase to 71 per cent with follow-up primary contact physiotherapist appointments. Improvements in the service delivery model and a primary contact physiotherapist arranging diagnostic assessments could improve waitlist times and facilitate better utilisation of medical staff time. The primary contact physiotherapist can help in the management of patients with suspected vestibulopathy on an ENT waitlist. This is achieved through: a reduction of patients requiring ENT review, improvements to waitlist time and improved utilisation of medical specialists' time.

The role of the physiotherapist in concussion.

Concussion is complex. A basic mental health, Vestibular Ocular Motor Screening (VOMS) and four key components relating to concussion management (autonomic, cervicogenic, vestibular oculomotor, and psychological approaches to management) should be included in the undergraduate and postgraduate curriculum. This will aid clinical physiotherapists to support their patients. A call to advance more intradisciplinary physiotherapy teamwork should be encouraged as valuable knowledge sharing is potentially lost within the framework of 'specialisation'. If needed, the skills of a greater interdisciplinary team are imperative to facilitate patient management and recovery from this multi-faceted injury.

Knowledge, Attitude and Skills of Physiotherapists Towards Tele-Rehabilitation

Background: With the rapid integration of information and communication technology in healthcare, telerehabilitation has emerged as a vital tool in physiotherapy, offering an alternative to traditional care methods. This evolution necessitates an understanding of physiotherapists' readiness and capability to employ such technologies in clinical practice. Objective: The study aimed to evaluate the knowledge, attitudes, and skills of physiotherapists regarding telerehabilitation, to ascertain their proficiency and perceptions of its application in clinical settings. Methods: A cross-sectional study was conducted over four months, post-approval of the research synopsis. Data were collected using the Telemedicine - Awareness, Knowledge, Attitude & Skills (AKAS) Questionnaire via an online Google Form from a non-probability convenience sample of 350 clinical and academic physiotherapists in Lahore. Participants had a minimum of six months of clinical experience and were aged 24 years or older. The data were analyzed using SPSS version 21.0 to interpret the survey responses statistically. Results: Among the participants, 89.7% displayed a positive attitude toward the use of telecommunications in telerehabilitation. A significant majority (79.1%) recognized telerehabilitation as a legitimate service, with 80.6% agreeing on its efficacy in patient follow-up. Computer literacy varied, with 27.4% possessing advanced knowledge, 47.1% mediocre, and 25.4% beginner levels. Statistically significant correlations were observed between levels of computer knowledge and attendance at training programs (p < 0.05 for advanced and mediocre knowledge). Conclusion: The study concluded that physiotherapists generally hold a positive view of telerehabilitation, recognizing its importance in the continuum of care. Nonetheless, the variability in ICT skills highlights the need for comprehensive training to fully exploit the capabilities of telerehabilitation in enhancing patient care.

Prevalence of Plantar fasciitis in academic physical therapists of KMU affiliated Institutes and clinical physical therapists in tertiary care hospitals: A cross sectional study

Background: Plantar fasciitis is the most common cause of heel pain affecting both academic and clinical physical therapists. Risk factors for developing PF are; prolong standing, BMI >40, age, gender and inappropriate footwear. Its symptoms particularly aggravates in the morning while taking few steps. In general, PF is a self-limiting condition because of it resolves quickly. Aims: The aim of this study is to find the prevalence of plantar fasciitis and its association in academic and clinical physical therapists. Methods: This was cross sectional study to explore association of plantar fasciitis between academic and clinical physical therapists. 197 physical therapists were examined for plantar fasciitis by PFPS tool for plantar fasciitis pain. Plantar fasciitis Pain Scale questionnaire was filled by physical therapists for checking plantar fasciitis pain in physical therapists. Results: Individuals of mean age 25-28 were more prone to develop plantar fasciitis. Out of 197, 102 (53%) females and 92 (47%) males were likely to develop plantar fasciitis.28.9% of people with plantar fasciitis felt pain at the bottom of the heel. According to our study; regarding the relation between academic PT's, clinical PT's and VAS, data was gathered from PT's in the institutes and hospitals. The results were analyzed using chi-square test. The results of chi-square test revealed that there is a strong positive correlation (p <0.05) between two variables (p = 0.00). When academic and clinical PT's were associated with VAS, for both the percentage of moderate pain was 58.9% as they are more exposed to weight bearing so, there are more chances of plantar fasciitis development. Conclusion: Plantar fasciitis was mostly found among clinical physical therapists commonly affecting bottom sole area of the foot. Plantar fasciitis was positively associated with age, gender; however, PFPS was not associated with it.

Attitudes and Beliefs of Physical Therapists and Physical Therapist Students Toward Working With Older Adults: A Systematic Review.

The aim of this study was to systematically review physical therapists' and physical therapist students' attitudes toward working with older adults. CINAHL, EMBASE, ERIC, MEDLINE, Scopus, PsycINFO, and SocIndex databases were searched in duplicate (from inception to March 2023). Studies that assessed knowledge on aging, intention to work with older adults or attitudes toward older adults for physical therapist students and/or clinicians, and that were written in English, Finnish, Spanish, or Swedish were included. Grey literature, qualitative studies, or articles of people with a specific diagnosis (eg, dementia) were excluded. All articles were reviewed by 2 authors independently, and consensus was required for inclusion. Data extraction was completed using a standardized data extraction sheet. Of 2755 articles screened, 34 met the inclusion criteria. Twenty-five studies recruited only physical therapist students, 6 recruited only physical therapist clinicians, and 3 involved mixed samples of both. Ten intervention studies were included, all of which recruited physical therapist students. Overall, physical therapist students were observed to have predominantly positive attitudes toward older adults, while clinicians had neutral to weak positive attitudes toward older adults. Both physical therapist students and clinicians were observed to have low knowledge on aging and low intentions to work with older adults. Results from intervention studies suggest that education combined with clinical experience with older adults improves attitudes toward older adults. A discrepancy is observed in physical therapists in that although attitudes toward older adults are positive, a lack of knowledge on aging and a disinterest in working with older adults exists. Intervention studies suggest that clinical experience may improve attitudes toward older adults in physical therapist students. Predominantly positive attitudes toward older adults are reported by physical therapist students, while for clinicians mixed results are observed. Education coupled with clinical experiences appears to be effective interventions to improve attitudes toward older adults, but such research has only been explored in student samples.

Exploration of the Perceived Value of Self-Leadership Capacity in Physical Therapist Clinicians

Exploration of the Perceived Value of Self-Leadership Capacity in Physical Therapist Clinicians

Knowledge, Attitudes and Beliefs of Clinical Physiotherapists Towards Chronic Back Pain

Background: Millions of people worldwide suffer from the common and severe ailment known as chronic low back pain. Effective management of this condition involves not only information but also positive attitudes and beliefs on the part of healthcare practitioners. Clinical physiotherapists play an important role in the treatment of individuals suffering from persistent low back pain. The purpose of this study was to investigate clinical physiotherapists' knowledge, attitudes, and beliefs about chronic low back pain. Methods: The study included 98 clinical physiotherapists, representing a diverse population in terms of gender and age in Hayatabad Peshawar. The HC-PAIRS (healthcare providers pain and impairment ratio scale) were filled from the clinical physiotherapists for assessing their Attitudes and beliefs towards chronic low back pain. The NPQ were also filled for checking the knowledge of clinical physiotherapist about chronic low back pain. Results: The average knowledge score of the clinical physiotherapists in the study was 7.7959, showing a relatively good degree of understanding of chronic low back pain. A wide range of knowledge scores, ranging from 2.00 to 12.00, revealed significant heterogeneity. Surprisingly, the study found unfavorable attitudes and beliefs among clinical physiotherapists, with higher scores suggesting stronger agreement that persistent low back pain warrants disability and activity restriction. Conclusion: Presence of unfavorable attitudes highlights the importance of focused interventions and training programs to improve patient care in this environment. The study emphasizes the changing nature of healthcare practice, with personal experiences, exposure to diverse treatment techniques, and evolving viewpoints within the field of physiotherapy possibly influencing attitudes and beliefs.

Prevalence of Poor Body Posture among Physiotherapists Using APECS

Background: Poor posture among healthcare professionals, particularly physiotherapists, can adversely affect their ability to provide care and may lead to musculoskeletal disorders. Despite the physical demands of their profession, there is a lack of routine posture assessment and preventative measures to mitigate these risks. Objective: This study aims to evaluate the prevalence of poor body posture among physiotherapists and to determine the efficacy of the APECS-AI Posture Evaluation and Correction System® (Apecs) mobile application as a tool for posture assessment. Methods: A cross-sectional study was conducted over four months, with 309 clinical physiotherapists from various healthcare institutions in Lahore. Using a non-probability convenient sampling technique, participants were assessed with the APECS app for deviations in the frontal and sagittal planes. The app, serving as a cost-effective alternative to 3D-marker-based systems, was used to categorize postural deviations as normal, mild, or severe disturbances. Data analysis was performed using SPSS version 26.0. Results: The findings revealed that 56% of the participants suffered from severe postural disturbances, while 32% had mild disturbances, and only 12% maintained a normal posture. The mean age was 26.17±2.21 years, with a distribution leaning towards novice practitioners, indicating a need for early intervention in posture management. Conclusion: The high prevalence of poor posture among physiotherapists highlights an occupational health concern. The study supports the use of the APECS mobile app as an accessible and reliable tool for posture assessment, which could lead to improved clinical practices and better healthcare outcomes.

Utilisation of standardised outcomes measures by clinical Physiotherapists working in Namibia: a nationwide cross-sectional study.

The utilisation of standardised outcome measures (SOMs) is crucial for evaluating patients' health status. Physiotherapists are highly recommended to use SOMs routinely. Despite the well-documented benefits of using SOMs, the utilisation of SOMs in clinical practice is still problematic particularly in Africa. In Namibia, there is dearth of information about SOMs utilisation by physiotherapists and the associated factors. This study was aimed at determining the extent of routine utilisation of SOMs and the associated demographic and work-related factors among physiotherapists. A cross-sectional, nationwide, online survey was conducted and all registered qualified physiotherapists and intern physiotherapists working in public or private hospitals/clinics were invited to participate. Data was analysed using Statistical Package for the Social Sciences (SPSS) version 29.0. The Chi-square (χ2) and Fishers exact test investigated the relationship between the associated factors and routine SOMs utilisation. The alpha level was set at 0.05. Of 230 participants who received the invitational link, 99 (43.0%) responded timeously to the call to participate. Although 97.9% (n=94) of the participants indicated having used at least one type of SOMs in the last six months, the frequency of utilisation varied. Routine utilisation, defined as 70%-100% of the time, was reported in only 49.0% of the participants. The Chi-square test only showed significant findings for gender (p=0.01) and clinical specialty (p=0.004). The odds of utilising SOMs were 4.13 greater among physiotherapists with a clinical specialty and 3.88 times greater for females than males. The rates for routine utilisation of SOMs by Namibian physiotherapists are unfavourable. Female gender and clinical specialty influenced the utilisation of SOMs in daily clinical practice. Cognisant of the study limitations, these results call for the need to improve the routine utilisation of the SOMs in Namibia.

‘Look up from the waiting list and see the bigger picture’: a qualitative analysis of clinical specialist physiotherapist perspectives on low back pain care in Ireland

IntroductionHealthcare systems are struggling to deliver high-quality low back pain (LBP) care. In 2012 specialist physiotherapist-led musculoskeletal (MSK) triage services were introduced in Irish hospitals to expedite patient care and alleviate pressure on elective orthopaedic/ rheumatology consultant clinics. Specialist physiotherapists have expertise to inform health service improvement and reform, but their perspectives of LBP healthcare delivery have received scant attention. ObjectivesTo explore specialist physiotherapists’ perspectives on LBP care in Ireland, the barriers and facilitators to quality LBP care and the development of MSK interface services in primary care settings. DesignCross-sectional observational study using an anonymous electronic survey with thematic framework analysis of response data from open-ended questions. ParticipantsThirty-four clinical specialist physiotherapists in Irish MSK triage services. ResultsThematic analysis resulted in six overarching themes, grouped into two categories. One category pertained to LBP healthcare in Ireland with the following three themes: 1) Inadequate health services for patients with LBP; 2) Need for defined LBP clinical pathways; 3) Need for a multisectoral approach to spine health. Themes in the second category, pertaining to the development of community-based MSK interface services, were: 4) Concern regarding isolation from secondary care services; 5) Unrealistic expectations of MSK triage; 6) Improved communication and collaboration with primary care services. ConclusionSpecialist physiotherapists have concerns regarding LBP health services and persistence of a biomedical, secondary care-led approach. They advocate for investment in primary care multi-disciplinary teams, enhanced integration across primary and secondary care, development of a national clinical pathway and a multisectoral approach. Contribution of paper•This study captures, for the first time, the perspectives of specialist physiotherapists on LBP healthcare delivery enabling a better understanding of the ‘on-the-ground’ issues in delivering quality LBP healthcare.•Opportunities for LBP healthcare service improvement are identified at micro, meso and macro health system levels.•The findings can be used to inform the development and implementation of a new national LBP clinical pathway and community-based MSK triage clinics.

LGBTQIA+ Cultural Competence in Physical Therapy: An Exploratory Qualitative Study From the Clinician's Perspective.

The purpose of this study was to understand the lesbian, gay, bisexual, transgender, queer, intersex, agender, and other gender and sexually diverse identities (LGBTQIA+) health care experience and associated cultural competence from the physical therapist perspective (physical therapist and physical therapist assistant). An exploratory qualitative approach implementing semi-structured focus groups and private interviews was utilized. To further anonymity, researchers allowed subjects to keep their camera off on Zoom. An interview protocol included questions guided by Campinha-Bacote domains of cultural competence (cultural awareness, skill, knowledge, encounter, and desire) to collect individual experiences, stories, discussions, thoughts, and opinions. Physical therapist clinicians were recruited from the clinical education affiliation lists of Regis University and Thomas Jefferson University. Seventy-one practicing physical therapists from the USA agreed to be part of the study. Themes were organized using the Social Ecological Model Framework. Themes are in parentheses following each level of the Social Ecological Model and include intrapersonal level (psychological stress and implicit and explicit biases), interpersonal (acceptance and competency), organizational (experience), community (advocacy), and society and policy (explicit biases and policy). Cultural competence in physical therapy is influenced by intrapersonal, interpersonal, organizational, community, and social and policy factors. Themes of psychological stress, limited awareness, decreased acceptance, and competency as well as limited exposure and experience, and a lack of advocacy and broader societal and policy issues prevent adequate LGBTQIA+ cultural competency of physical therapist providers. Further research in the physical therapist profession is needed to elaborate on the student, educator, and patient perspectives and how this information informs the LGBTQIA+ cultural competence of clinicians. This project may have a significant impact on suggestions for the delivery of content for health profession education to best impact health equity goals and save lives. Implementation of this content may have a direct impact on health disparities in LGBTQIA+ populations by reducing stigma and discrimination from health care providers, thus improving quality of health care and decreasing rates of patient mortality for LGBTQIA+ individuals.

Satisfaction and attitudes towards online continuous medical education and its impact on clinical practice among physiotherapists

BackgroundThe traditional face-to-face of medical education is gradually being replaced with online education. However, the rate of adoption of online continuing medical education (OCME) as a learning method among practicing clinical physiotherapists (PTs) is unclear. The objectives of this study were to measure the satisfaction with, attitudes towards, and impact of OCME among practicing clinical PTs in Saudi Arabia (SA) and to examine the factors that affect the findings for satisfaction, attitude, and impact towards OCME.MethodsThis cross-sectional survey was conducted between October 2021 and January 2022. PTs employed at various medical facilities and specialties in Saudi Arabia completed an online survey to assess satisfaction with, attitudes towards, and impact of OCME.ResultsOf the 127 participants, 48 were female (37.8%), 44.1% were aged between 24 and 30 years. Overall, 57.5% of the respondents were satisfied with OCME compared with conventional face-to-face education, and 45.7% agreed and 18.1% strongly agreed that OCME was more flexible. Further, 52.8% of the respondents thought that OCME programs could supplement traditional face-to-face education. The majority of the participants (63.8%) agreed that participating in OCME programs increased their knowledge, and 55.1% and 51.2% agreed that attending these programs improved patient outcomes and increased their confidence in patient management, respectively. However, only 38.6% agreed that participating in OCME programs enhanced their clinical expertise. The mean satisfaction, attitude, and impact scores differed significantly according to age group, marital status, number of years of practice, and specialty (p < 0.0001). Multiple regression analysis showed that older age was independently associated with better satisfaction and more positive attitudes and impact. Further, having a specialization also seemed to improve the impact of OCME.ConclusionThe PTs were satisfied with and had positive attitudes towards OCME, and also found that it had a positive impact on their clinical practice. Thus, existing OCME programs are a good option for expanding the number of PTs proficient in clinical care.

Effects of Cognitive Sensory Motor Training Versus Repetitive Facilitation Exercises of Upper Limb in Hemiparetic Patients

Stroke [CVA] is the sudden loss of neurological function caused by an interruption of blood flow to the brain. Large numbers of people who survive a stroke are left with permanent impairment of arm and hand function, even after completion of conventional rehabilitation programs. The standard neuro physiological facilitation technique use for hemiplegic upper limb have not been confirmed to promote functional recovery of hemiplegic limb. This promote that more research needs to be conducted for same. Cognitive Sensory Motor Training Therapy &amp; The repetitive facilitation exercises (RFEs) Both techniques will promote functional recovery of hemiparetic upper limb and hand by improving joint perception and realization of movement. Hence, this study aims to compare the effectiveness of cognitive sensory motor training versus repetitive facilitation exercises on quality of movement of upper limb, functional activity and Range of motion of upper limb in hemiparetic patients. A blinded randomized clinical trial was conducted 30 patients were divided into 2 groups (GROUP A and GROUP B)- those who performed cognitive Sensory Motor exercises(GROUP A- experimental group) and those who performed repetitive facilitation exercises (GROUP B-control group) Data for measures quality of movement performance of the hemiparetic arm and hand on MESUPES scale, Barthel Index (BI) measures the extent to which somebody can function independently and has mobility in their &amp;, goniometer measuring the joint ranges in each plane of the joint was collected on day 1 (pretreatment session), and on 190 day after the experiment. This study produced a stastically significant increase in overall on quality of movement, functional activity and range of motion in both the group of upper limb in hemiplegic patients. This research also provides evidence that training exercise may be a valuable and important tool in clinical practice and is consistent with the current use by clinical physiotherapist in the treatment of upper limb in hemiplegic patients.

The complex challenge of prescribing as an advanced clinical practice physiotherapist

Non-medical prescribing (NMP) has been developing in the UK over the last couple of decades. As part of their NMP course, the author explores some of the legal, professional and ethical complexities that await them and other Health and Care Professions Council workers upon conclusion of the Royal Pharmaceutical Society's competency framework for all prescribers. Focus is primarily directed towards the application of NMP by an individual with physiotherapists background, working in an advanced clinical practice (ACP) role in paediatric intensive care. This commentary critiques some of the dilemmas that may present regarding legislation, regulation and the inability to prescribe controlled drugs independently. Solutions using clinical management plans are presented, alongside ideas for future development of prescribing ACPs.