Number Of Physiotherapists Research Articles

Is the continuity of the therapist-patient relationship relevant for the discharge outcome in orthopaedic physical rehabilitation?

Continuity of care has been linked to patient satisfaction and self-reported outcomes. Following hip fractures in the elderly, rehabilitation aims at restoring patients' mobility and independence at the pre-fracture level and at the earliest possible time. Despite the potential role of physiotherapists' continuity on functional outcomes, this correlation has not yet been studied in an acute orthopaedic setting. Guaranteeing the presence of the same physical therapist on individual patients is challenging from an organizational point of view. An observational retrospective study was conducted on 129 aged patients (84 ± 8years) who underwent surgery for proximal hip fracture. Indicators of outcomes were ILOA score at discharge, length of stay and achievement of rehabilitation goals as defined by the Individual Rehabilitation Project. The number of physical therapists taking care of patients was monitored during the patient's hospital stay. No correlation was found between the number of physical therapists and functional goals at discharge. The frequent change of physical therapists providing rehabilitation to elderly patients who underwent surgery for hip fragile fracture is not related to functional outcomes.

Temporal, seasonal, and spatial patterns in fall-related mortality in Japan: Analysis of national vital statistics from 1975 to 2019

BackgroundFalls are a significant public health issue in aging societies. This study aimed to examine the temporal, seasonal, and spatial patterns in fall-related mortality in Japan, and to investigate the potential factors associated with fall-related mortality. MethodsThe number of unintentional fall-related deaths from 1979 to 2019 were obtained from Japanese vital statistics and crude and direct age-standardized mortality rates (DSR) were calculated. We also calculated the standardized mortality ratio (SMR) to determine seasonal and prefectural differences. In addition, spatial regression was conducted to examine the potential factors associated with fall-related mortality. ResultsThe DSR among those over 65 years old showed a decreasing trend from 1979, but remained unchanged from 1990 to 2019. Based on the spatial regression model, the factors significantly associated with SMRs were the proportion of the aged population (Coefficient: 0.049), the number of hospitals (0.118), the number of clinics (1.169), the number of hospital beds (-0.060), and the number of physiotherapists (-0.069) for men; and the proportion of aged single households (-0.060), the number of hospitals (0.132), the number of clinics (1.498), the number of hospital beds (-0.051), and the number of physicians (-0.308) for women. ConclusionsFall-related mortality among Japanese elderly people has remained unchanged in recent years. In addition, seasonal and spatial patterns were also observed, and it was found that demographic data and healthcare resources in the prefectures affected fall-related mortality rates. Appropriate prevention measures of fall-related deaths should be considered according to the region-specific characteristics and issues.

Evidence-practice Gaps And Structures Associated With Practice In Stroke Rehabilitation: Claims Database Study In Japan

<h3>Research Objectives</h3> To investigate evidence-practice gaps in the rehabilitation of patients with stroke. <h3>Design</h3> A retrospective cohort study among 9 years. <h3>Setting</h3> Medical practitioners' receipt for health insurance claim (Shizuoka Kokuho Database in Japan). <h3>Participants</h3> The subjects included 142,457 patients (47.2% male, 74.7±10.3 years old) who were selected from 537,003 patients with a diagnosis of stroke (cerebral hemorrhage, cerebral infarction, subarachnoid hemorrhage) between April 2012 and September 2020. Moreover, patients who had passed one year since the start of the observation period were also included. Patients who with suspected disease and who died within three days from the onset date were excluded. <h3>Interventions</h3> Not applicable. <h3>Main Outcome Measures</h3> Evidence-practice gap is measured based on the percentage of rehabilitation performed in the same month of or within 7 days from onset. Furthermore, the number of units of post-onset rehabilitation and structural factors related to the number of units (e.g., number of rehabilitation physicians, number of physical therapists, number of occupational therapists, number of hospital beds) were analyzed. <h3>Results</h3> Rehabilitation was performed in 25.4% of cases, and the percentage varied by region. Factors that were mainly related to the number of units included age, number of rehabilitation physicians, and number of physical therapists. <h3>Conclusions</h3> Although interpreted differently depending on stroke severity and medical resources, post-stroke rehabilitation is performed in approximately one fourth of the cases, which is not very common. <h3>Author(s) Disclosures</h3> All authors declare no conflicts of this study.

Changes in the number of healthcare professionals in European healthcare systems between 2000 and 2018

Introduction: Ensuring the supply of healthcare professionals is an important health policy issue nowadays. Objective: The aim of our research is to provide a comprehensive picture of the health workforce situation in the European OECD countries. Data and methods: Indicators analyzed regarding the numbers of practising midwives, nurses, physiotherapists and total hospital beds were derived from the “OECD Health Statistics 2021” database for the period 2000–2018. 24 European OECD countries were grouped according to the type of healthcare system and geographical location. Data were subsequently compared by parametric and nonparametric tests, focusing especially on years 2000, 2010, 2018. Results: Between 2000 and 2018, there was a 14% increase in the average number of midwives, a 30% increase in the average number of nurses, and a 41% increase in the average number of physiotherapists per 100,000 population in the OECD countries examined. Per 100 hospital beds, the average number of midwives increased by 72%, the number of nurses by 86%, and the number of physiotherapists by 97%. Significant results for all three years analyzed were obtained in the number of physiotherapists per 100 hospital beds (p = 0.014; p<0.001; p = 0.002) when comparing the Western and Eastern European countries examined. As for the healthcare systems, significant results were obtained only in the number of nurses per 100 hospital beds for the year 2010 (p = 0.048). Conclusion: Among healthcare professional groups, the number of physiotherapists increased the most in Europe. The numbers of healthcare professionals per 100 beds are significantly higher in Western European countries analyzed compared to Eastern European countries.

Distribuição dos profissionais e serviços de fisioterapia na saúde pública em Goiás: cobertura assistencial de acordo com variáveis socioeconômicas

Abstract Introduction Public health in Brazil goes beyond social production, with an expanded view of health. Its complex structure includes physical therapy. Objective To characterize physical therapy in Goiás based on the National Registry of Health Facilities (CNES in Portuguese). Methods Data on specialty, municipality, place of employment, working hours, employment relationship, type of contract and establishment, number of physical therapists, administrative setting, macroregion and health region were tabulated. The following were correlated: municipal population; people dependent on the National Health System (SUS in Portuguese); municipal per capita gross domestic product (GDP); municipal Human Development Index (HDI); percentage of inhabitants dependent on the municipal SUS; number of people covered by municipal physiotherapy (NPCAF). Results In the CNES, (reference July/2019) in Goiás, we found 2,187 physiotherapists in public/private facilities, in 3,353 workplaces. In establishments that serve the SUS, we identified 1,673 physiotherapists in 2,436 workplaces, 32.9% of which are linked to primary and 67.1% to specialized care. The weekly workload was 38 hours and 26 hours per workplace. Only 30.1% of the municipalities had adequate NPCAF. Health regions and macroregions had inadequate coverage. The NPCAF showed an inverse correlation with GDP (r = -0.20; p &lt; 0.001) and HDI (r = -0.14; p = 0.02) and a direct correlation with the population (r = 0.46; p &lt; 0.001). Conclusion Goiás has inadequate coverage in 69.9% of the municipalities, in the macroregions and health regions. Expanding the number of workplaces available to physiotherapists is essential to achieve universal and comprehensive health care, reducing inequity and favoring equitable distribution.

Factors influencing attitudes toward, education, skills, barriers, and application of evidence-based practice among physiotherapists in South Korea

IntroductionThis study aimed to identify whether sociodemographic factors of physiotherapists had a significant effect on attitudes toward, education, skills, barriers to, and clinical applications of evidence-based practice (EBP) in South Korea.MethodsA questionnaire-based survey was conducted among 971 physiotherapists working in the clinical field. The survey was performed online by using a Google form.ResultsAmong the sociodemographic characteristics, age, educational background, and working experience had a significant effect on EBP attitude, education, and skills, while age, educational background, type of facility, patients per day, and number of physiotherapists at the facility had a significant effect on the EBP barrier. In addition, socio-demographic factors such as gender, age, and educational background exerted a significant impact on EBP clinical application.ConclusionsThese findings suggest that sociodemographic factors of physiotherapists can influence the EBP attitudes, education, skills, barriers, and clinical applications. Therefore, it is necessary to develop various educational programmes that deal with EBP components and procedures in physiotherapy. In addition, extensive support and resources from institutions may help to improve the quality of physiotherapy in health care and medical fields.

Gait Improvement in Chronic Stroke Survivors by Using an Innovative Gait Training Machine: A Randomized Controlled Trial.

Chronic stroke leads to the impairment of lower limb function and gait performance. After in-hospital rehabilitation, most individuals lack continuous gait training because of the limited number of physical therapists. This study aimed to evaluate the effects of a newly invented gait training machine (I-Walk) on lower limb function and gait performance in chronic stroke individuals. Thirty community-dwelling chronic stroke individuals were allocated to the I-Walk machine group (n = 15) or the overground gait training (control) group (n = 15). Both groups received 30 min of upper limb and hand movement and sit-to-stand training. After that, the I-Walk group received 30 min of I-Walk training, while the control followed a 30-minute overground training program. All the individuals were trained 3 days/week for 8 weeks. The primary outcome of the motor recovery of lower limb impairment was measured using the Fugl–Meyer Assessment (FMA). The secondary outcomes for gait performance were the 6-minute walk test (6 MWT), the 10-meter walk test (10 MWT), and the Timed Up and Go (TUG). The two-way mixed-model ANOVA with the Bonferroni test was used to compare means within and between groups. The post-intervention motor and sensory subscales of the FMA significantly increased compared to the baseline in both groups. Moreover, the 6 MWT and 10 MWT values also improved in both groups. In addition, the mean difference of TUG in the I-Walk was higher than the control. The efficiency of I-Walk training was comparable to overground training and might be applied for chronic stroke gait training in the community.

Assessing Cranial Nerves in Physical Therapy Practice: Findings from a Cross-Sectional Survey and Implication for Clinical Practice.

Background and objective: Serious pathologies of the neck can potentially result in cranial nerve palsy. Knowledge about cranial nerve examination (CNE) seems sparse, and its use is still unknown. We aim to investigate the knowledge, skills, and utilization of CNE of Italian physiotherapists. Materials and Methods: An online cross-sectional survey. Results: 396 completed the survey, reaching the required sample size. Although Italian physiotherapists consider CNE relevant (mean ± SD = 7.6/10 ± 2.0), over half of all responders (n = 229 (57.8%)) were not trained in the fundamentals and around a third did not use it in their daily practice (n = 138 (34.8%)). Additionally, participants were unconfident and insecure in conducting (n = 152 (38.4%) and n = 147 (37.1%)), interpreting (n = 140 (35.4%) and n = 164 (41.4%)), and managing the CNE (n = 141 (35.6%) and n = 154 (38.9%)). Possessing a musculoskeletal specialization was associated with an increased value attributed to clinical practice guidelines and reduced the lack of confidence in conducting, interpreting, and managing the CNE (respectively, n = 35 (25.5%), p = 0.0001; n = 32 (23.4%) p = 0.0002; n = 32 (23.4%) p = 0.0002). Working in a direct access setting significantly increased the considered relevance of guidelines and the concerns about arterial (p = 0.004) and other serious pathologies (p = 0.021). Pain and visual disturbances were considered the main indicators to CNE, demonstrating limited knowledge of signs and symptoms’ indicating CNE. Participants considered specific training in CNE as relevant (mean ± SD = 7.6/10 = 2.1). Conclusions: a substantial proportion of Italian physiotherapists are not schooled in the fundamentals of cranial nerve examination. Given the number of physiotherapists who work in first contact roles, this is a professional concern.

The physiotherapy workforce in the Brazilian Unified Health Care System

BackgroundMaintaining sufficient health care workforce is a global priority to achieve universal health coverage. Therefore this study addresses the availability of physiotherapists in Brazil.ObjectiveTo describe secular trends of the physiotherapy workforce-to-population ratio in the Unified Health System, considering public and private sector and care level (primary, secondary, tertiary) in Brazil and its regions.MethodDescriptive exploratory quantitative study based on secondary sources. All data related to the distribution of physiotherapists between August 2007 and September 2016 regarding facilities types, location and public and private sectors was obtained from the Brazilian National Registry of Health Care Facilities. Data related to the population of Brazil was extracted from Brazilian Institute of Geography and Statistics. The physiotherapy workforce-to-population ratio was calculated by the number of physiotherapists per 1000 population (public and private sector and care level) by ANOVA test. The distribution trends are represented on maps. Annual growth rates were estimated with Prais–Winsten linear regression models, with a significance level of 0.05, autocorrelation was checked by the Durbin–Watson test.ResultsThe physiotherapists ratio in Brazil was 0.22/1000 population in 2007 and 0.41 in 2016, showing growth of 86%, with an increasing trend of 0.5% on an annual average. The public sector had the biggest physiotherapy workforce in the country in 2007 and 2016. The primary health care had the smallest physiotherapy workforce-to-population ratio (2007: p > 0.001 and 2016: p = 0.003), even though it had the largest growth trend in annual average (0.9% p > 0.001), followed by public and private tertiary health care sectors (0.8% p > 0.001). The workforce in secondary health care was bigger in the private sector than in the public sector (0.6% p > 0.001 vs. 0.2% p = 0.004). Overall, all regions had greater growth of physiotherapy workforce-to-population ratio in public primary and tertiary health care sectors, and private secondary health care sector, mainly the Southeast, South and Central-West regions.ConclusionAlthough the physiotherapy workforce in Brazil is relatively small, there was a trend towards growth with differences among care levels, and public and private sectors. The physiotherapy workforce-to-population ratio is bigger in the private secondary health care sector, followed by public tertiary, secondary and primary health care sectors. Sub-national regions show similar trends to the national estimates, with minor variations by region.

Prevalence of Thumb Pain Among Physiotherapists Perform Manual Techniques During Clinical Practice

Th u m b p a i n a m o n g t h e physiotherapists is common occupational hazards. The physiotherapists working in their fields perform repetitively manual techniques, massage, mobilization and glides etc. This occupation needs tofind out the number of physiotherapists having thumb pain due to manual work they perform during clinicalpractice in different rehabilitation centers. Objective: To determine the frequency of thumb pain among physiotherapists perform manual techniques in clinical practice; a cross sectional study Methodology: A cross-sectional study design with convenient sampling technique was used, with sample size 190 to determine the frequency of thumbpain among physiotherapists in Lahore and data was analyzed by SPSS, mean and standard deviation wascalculated for the quantitative variable while qualitative variable was presented in the form of frequency and percentage.Results: In the present study a self-made questionnaire was distributed among 190 physiotherapists. Among 190 participants 58(30.5%)were male and 132(69.5%) were Females. 40(21.1%) felt pain while performing ischemic pressure release from thumb. 38(20.0%) felt pain while giving massage. 12(6.3%) felt pain while holding an objectbetween thumb and index finger. 2(1.1%) felt pain in circumduction. (5.3%) felt pain while making snuff box. 24(12.6%) felt pain in isometric exercises of thumb. 27(14.2%) felt pain in hyper flexion at DIP. 17(8.9%) felt pain in hyper flexion at PIP. 51(26.8%) rated 3 pain and 15(7.9%) rate 5 pain on VAS. Conclusions: Study concluded that frequency of thumb pain among physiotherapists working in different hospitals of Lahore was found to be 35.26%. This thumb pain was due to their professional techniques including, manual therapy, ischemic pressure release, massage, mobilization, and gliding etc.

Transforming a paediatric ICU to an adult ICU for severe Covid-19: lessons learned.

During the first Covid-19 wave, our paediatric intensive care unit (PICU), like many others across the globe, was transformed into an adult ICU for patients with severe Covid-19, due to a shortage of adult ICU beds. Here, we provide a comprehensive description of all the conditions that must be fulfilled to successfully accomplish this transformation. Strong support from all hospital departments was crucial, as their activity was modified by the change. Healthcare workers from various units, notably the paediatric anaesthesiology department, worked in the adult ICU to ensure sufficient staffing. The number of physiotherapists and psychologists was increased. A support system for both healthcare workers and patients’ relatives was set up with the help of the mobile paediatric palliative care and support team. Supplies suitable for adults were ordered. Protocols for numerous procedures were written within a few days. Video tutorials, checklists, and simulation sessions were circulated to the entire staff. The head nurses guided and supported the new staff and usual PICU staff. The transformation was achieved within a week. The main difficulties were healthcare worker stress, changes in recommendations over time, absence of visits from relatives, and specific adult issues that paediatricians are unfamiliar with.Conclusion: For the staff, caring for adult patients was made easier by working in their familiar unit instead of being moved to an adult hospital with unfamiliar staff members and equipment. Strong support from the hospital and the assistance of consultants from adult hospital departments were crucial.What is Known:• The dramatic spread across the world of coronavirus disease 2019 generated critical care needs that drastically exceeded resources in many countries worldwide.• Paediatric ICU activity during this period decreased due to lockdown measures and the fact that children rarely required ICU for coronavirus disease 2019.What is New:• We describe how an 18-bed adult Covid-19 ICU was successfully set up in a paediatric hospital during the first wave of the Covid-19 pandemic.• Specific requirements regarding supply, human resources, and procedures, as well as difficulties encountered, are described.

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints: protocol for a cluster randomized controlled trial

BackgroundNeck and shoulder complaints are common in primary care physiotherapy. These patients experience pain and disability, resulting in high societal costs due to, for example, healthcare use and work absence. Content and intensity of physiotherapy care can be matched to a patient’s risk of persistent disabling pain. Mode of care delivery can be matched to the patient’s suitability for blended care (integrating eHealth with physiotherapy sessions). It is hypothesized that combining these two approaches to stratified care (referred to from this point as Stratified Blended Approach) will improve the effectiveness and cost-effectiveness of physiotherapy for patients with neck and/or shoulder complaints compared to usual physiotherapy.MethodsThis paper presents the protocol of a multicenter, pragmatic, two-arm, parallel-group, cluster randomized controlled trial. A total of 92 physiotherapists will be recruited from Dutch primary care physiotherapy practices. Physiotherapy practices will be randomized to the Stratified Blended Approach arm or usual physiotherapy arm by a computer-generated random sequence table using SPSS (1:1 allocation). Number of physiotherapists (1 or > 1) will be used as a stratification variable. A total of 238 adults consulting with neck and/or shoulder complaints will be recruited to the trial by the physiotherapy practices. In the Stratified Blended Approach arm, physiotherapists will match I) the content and intensity of physiotherapy care to the patient’s risk of persistent disabling pain, categorized as low, medium or high (using the Keele STarT MSK Tool) and II) the mode of care delivery to the patient’s suitability and willingness to receive blended care. The control arm will receive physiotherapy as usual. Neither physiotherapists nor patients in the control arm will be informed about the Stratified Blended Approach arm. The primary outcome is region-specific pain and disability (combined score of Shoulder Pain and Disability Index & Neck Pain and Disability Scale) over 9 months. Effectiveness will be compared using linear mixed models. An economic evaluation will be performed from the societal and healthcare perspective.DiscussionThe trial will be the first to provide evidence on the effectiveness and cost-effectiveness of the Stratified Blended Approach compared with usual physiotherapy in patients with neck and/or shoulder complaints.Trial registrationNetherlands Trial Register: NL8249. Officially registered since 27 December 2019. Date of first enrollment: 30 September 2020. Study status: ongoing, data collection.

Knowledge, Attitude, and Barriers to Telerehabilitation-Based Physical Therapy Practice in Saudi Arabia.

(1) Telerehabilitation (TR) is a part of telemedicine involved in providing rehabilitation services to people in remote locations. TR in physical therapy in the kingdom of Saudi Arabia is still in its infancy and its implementation may pose different challenges in the physical therapy settings. The purpose of this nation-wide survey is to explore physiotherapists (PTs) knowledge, attitudes, and barriers towards implementation of TR in physical therapy settings; (2) Methods: A 14 item questionnaire was developed and mailed to PTs working in hospitals and rehabilitation centers across 13 provinces in Saudi Arabia; (3) Results: 347 PTs responded. Results are as follows: 58.8% (n = 204) of PTs reported that they had sufficient knowledge about TR. About31.7% (n = 110) of PTs reported that their hospital and rehabilitation center had installed TR, yet only 19.9% (n = 69) utilized the TR facility. Image-based TR was more frequently used (n = 33) as compared to sensor-based TR (n = 29) and virtual reality TR (n = 10).The main barriers were technical issues and cost related to implement TR in physical therapy settings; and (4) Conclusions: There is a relatively high number of PTs with self-reported knowledge about TR, however facilities and usage were limited. The main barriers were technical issues, staff skills, and the high cost involved in the introduction of TR in the PT-based health care settings.

Development of a Musculoskeletal Imaging Competency Examination for Physical Therapists.

The number of physical therapists with imaging ordering privileges is increasing; however, a known level of competency and knowledge is generally lacking within the profession, as is a method to determine practitioner competency. The purpose of this study was to develop a valid musculoskeletal (MSK) imaging competency examination for physical therapists. This 3-round Delphi method study utilized experts to reach consensus on examination content and development. Round 1 was completed by 37 experts. The last 2 rounds were completed by 35 experts. Experts rated questions on a 5-point Likert rating scale of importance (1=not at all important, 5=very important). Consensus was achieved with an a priori decision of (1) >75% agreement of the expert panel rating and≥4 on the Likert scale, and (2)≥.90 on Cronbach alpha and intraclass correlation coefficients. Experts recommended a passing score of 75%. The examination was subsequently reviewed by a panel of 5 radiologists. The Delphi method and radiologist panel review resulted in the 151-question Burley Readiness Examination (BRE) for MSK Imaging Competency. Interrater agreement and internal consistency of the Delphi panel were excellent, with an average intraclass correlation coefficient and Cronbach alpha of .928 and .950, respectively. The BRE is a tool that has the potential to demonstrate practitioners' level of baseline competency with MSK imaging. Additional testing among physical therapists will provide further validation and reliability of the examination. The use and application of diagnostic imaging is becoming more widespread in physical therapist practice throughout the United States. The BRE could potentially have broader implications for health care utilization and cost in the area of MSK imaging.

Development of Walking indicators to advance the quality of spinal cord injury rehabilitation: SCI-High Project

Objective: To describe the development of structure, process and outcome indicators that will advance the quality of walking rehabilitation for Canadians with spinal cord injury or disease (SCI/D) by 2020.Method: A framework for the evaluation of the quality of walking rehabilitation was developed by experts in walking after SCI/D. A systematic literature review identified factors influencing walking outcomes and potential walking indicators. A Driver diagram analysis summarized the factors affecting walking outcomes and subsequently informed the selection of structure and process indicators. Psychometric properties and clinical utility of potential walking indicators were considered during the selection of outcome indicators.Results: The structure indicator is the number of physical therapists using evidence-based walking interventions per number of ambulatory individuals with SCI/D. The process indicator is the number of received hours of walking interventions during inpatient rehabilitation per number of ambulatory individuals with SCI/D. The intermediary outcome indicator, which is collected at discharge from inpatient rehabilitation, is either the modified Timed Up and Go or the 10-Meter Walk Test, the choice of measure is dictated by the stage of walking recovery, as defined by the Standing and Walking Assessment Tool. The final outcome indicator, collected at 18 months post-discharge, is the Spinal Cord Independence Measure III-Mobility subscale.Conclusion: The selected indicators align with current clinical practice in Canada. The indicators will direct the timing and enhance the volume of walking therapy delivered, to ultimately increase the proportion of patients who achieve their walking potential by 18 months post-rehabilitation.

Professional training in physiotherapy: barriers to the diversification of practical learning scenarios and for teaching-service integration

Abstract Introduction: Professional training in health, at present, aims to develop competencies and skills for a performance according the principles of the Unified Health System (SUS, in Portuguese). In this sense, the Ministries of Health and Education have set up devices for training reorientation that prioritize teaching-service integration and diversification of learning scenarios. Objective: To describe barriers to the diversification of practical learning scenarios and for teaching-service integration in a physiotherapy course from the perspective of teachers and students. Methods: This is a qualitative research developed according to the case study method, with the participation of 16 students and 11 teachers-physiotherapists. During the data collection three focus groups were established, two with students and one with professors, besides individual interviews with both the course coordinator and the pedagogical articulator of the National Program for the Reorientation of Professional Health Training of the assessed course. Data were analyzed through thematic content analysis. Results: Among the identified barriers there are students’ low participation in public health services; saturation of public health services for students to carry out practical activities; low number of physiotherapists in Primary Care; indirect relationship of Clinical School with SUS. Conclusion: In order to improve the teaching-service interaction and to diversify the learning scenarios it is necessary to prioritize an integrated planning of actions to overcome identified barriers, including the participation of both the university managers and health services.

Development of wearable rehabilitation device using parallel link mechanism: rehabilitation of compound motion combining palmar/dorsi flexion and radial/ulnar deviation

In recent years, the total number of physical therapists is increasing in Japan. However, it is not sufficient to nurse of patients requiring long-term care. In order to cope with the shortage of manpower, it is desirable to develop the rehabilitation equipment. This paper describes the development of a wearable wrist rehabilitation training device using the parallel link mechanism. It is possible to train the translational and rotational motion of the wrist joint by the adoption of parallel links. Training of the translational motion of the wrist joint has not been discussed in existing methods. Therefore, compared to existing methods, this method can be expected to reduce the burden on the wrist joint. And it is possible to move about 60% of the wrist joint movable range of motion. This device performs repetitive training to prevent contracture of the wearer’s joints. In experiments, assumed wrist circumduction motion was trained to the six subjects. The correlation coefficient between the target trajectory and the training result was obtained and evaluated whether correct operation was trained. The validity of the proposed method was demonstrated.

Are they publishing? A descriptive cross-sectional profile and bibliometric analysis of the journal publication productivity of Italian physiotherapists

BackgroundIn a clinical science-based profession such as physiotherapy, research is mandatory to update knowledge and to provide cost-effective, high quality treatments. This study aimed to provide point prevalence of Italian physiotherapists who are academics, holding a PhD degree, or being authors of scientific papers. The scientific journal productivity of physiotherapists was also thoroughly analyzed.MethodsA descriptive cross-sectional study was carried out on all Italian physiotherapists. Academics, postdoctoral research fellows, and PhD graduates were identified by searching the Italian Ministry of Education, University and Research (MIUR), Italian Society of Physiotherapy, and university websites. Then, authors of articles indexed in Scopus were searched. The following data were extracted: type of affiliation, authorship order, H-index, number of publications and citations, name of journals, year of publication, and journal’s Impact Factor.ResultsThe prevalence of academics, physiotherapists holding a PhD, or being author was 0.01%, 0.05%, and 0.56%, respectively. We identified 1083 papers co-authored by Italian physiotherapists, and their number has progressively increased over the years (p < 0.001). There was a significant difference between researchers and clinicians in both publication productivity (p < 0.01), citations (p < 0.01), and H-Index (p = 0.05). Articles were published in 359 different journals, receiving a total of 13,373 citations.ConclusionsDespite the low prevalence of faculty members and the reduced availability of PhD programs in Italy (forcing some students to study abroad), the quantity and quality of journal productivity is growing fast, and an increasing number of physiotherapists are involved in research activities.

Translating Evidence-Based Protocols Into the Home Healthcare Setting.

Activity-limiting pain is common among older home care patients and pain management is complicated by the high prevalence of physical frailty and multimorbidity in the home care population. A comparative effectiveness study was undertaken at a large urban home care agency to examine an evidence-based pain self-management program delivered by physical therapists (PTs). This article focuses on PT training, methods implemented to reinforce content after training and to encourage uptake of the program with appropriate patients, and therapists' fidelity to the program. Seventeen physical therapy teams were included in the cluster randomized controlled trial, with 8 teams (155 PTs) assigned to a control and 9 teams (165 PTs) assigned to a treatment arm. Treatment therapists received interactive training over two sessions, with a follow-up session 6 months later. Additional support was provided via emails, e-learning materials including videos, and a therapist manual. Program fidelity was assessed by examining PT pain documentation in the agency's electronic health record. PT feedback on the program was obtained via semistructured surveys. There were no between-group differences in the number of PTs documenting program elements with the exception of instruction in the use of imagery, which was documented by a higher percentage of intervention therapists (p = 0.002). PTs felt comfortable teaching the program elements, but cited time as the biggest barrier to implementing the protocol. Possible explanations for study results suggesting limited adherence to the program protocol by intervention-group PTs include the top-down implementation strategy, competing organizational priorities, program complexity, competing patient priorities, and inadequate patient buy-in. Implications for the implementation of complex new programs in the home healthcare setting are discussed.

The Spectrum of Student Enrollment-Related Outcomesin Physiotherapy Education Programs in Westafrica

Background:&nbsp;This cross-sectional study investigated student enrollment-related outcomes from physiotherapy education programs in West Africa.Methods:&nbsp;The Head of Department of all physiotherapy education programs in Nigeria and Ghana universities (N=14) completed a questionnaire that sought information on admission capacity/goal, student enrollment, baccalaureate (BPT/BS) and postgraduate (MS, Ph.D.) degrees conferred and the student-core faculty ratio (SFR).Results:&nbsp;In Nigeria, 4,748 BPT, 325 MS and 50 Ph.D. degrees in physiotherapy were conferred over a 50 year period; 2,038 BPT, 160 MS, and 42 Ph.D. students are currently enrolled. In Ghana, over a 14 year period, 277 BS degrees were conferred and 162 students are currently enrolled. The mean SFR for the undergraduate program in Nigeria and Ghana was 17.6 and 13.5, respectively. In Nigeria, 83.3% of the physiotherapy programs are located in Federal owned university; while in Ghana 100% of the programs are in State-owned university (χ² = 8.556; p =.014). Admission goal and university ownership are significantly (p&lt;.05) influenced by the number of students annually admitted, students enrolled and SFR.Conclusion: The number of physiotherapists currently produced by universities in West Africa is inadequate to meet the regional physiotherapist needs.