Specialists In Physical Therapy Research Articles

(084) PERSISTENT GENITAL AROUSAL DISORDER/GENITO-PELVIC DYSESTHESIA (PGAD/GPD) SECONDARY TO TARLOV CYST-INDUCED SACRAL RADICULOPATHY

Abstract Introduction Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) is characterized by persistent, unwanted genital arousal and/or other dysesthesia, including burning, itch and/or pain in the genito-pelvic area such as clitoris, vulva, perineal region and/or peri-anal region (pudendal nerve), umbilicus, urethra, bladder, vagina, and/or rectum (pelvic nerve) and also including the lower extremity buttock, thigh, calf, foot (sciatic nerve). Patients with PGAD/GPD are significantly bothered/distressed, and catastrophization and suicidal ideation are common. In 2012 Komisaruk reported that PGAD/GPD could result from Tarlov cyst-induced sacral radiculopathy. We developed a multidisciplinary step-care management algorithm with specialists in sexual medicine, spine surgery, sex therapy, physical therapy, and neurophysiology to diagnose and treat Tarlov cyst-induced sacral radiculopathy. Objective To utilize a multidisciplinary step-care management algorithm to identify PGAD/GPD patients with Tarlov cyst-induced sacral radiculopathy who could benefit from Tarlov cyst spine surgery and to evaluate long-term safety and efficacy of the surgery. Methods Clinical data were collected on PGAD/GPD patients who underwent Tarlov cyst spine surgery between 2016 and 2020 with at least 1-year follow-up. The management algorithm used to identify and treat Tarlov cyst-induced sacral radiculopathy involves: detailed psychosocial assessment and medical history; non-invasive diagnostic assessments for sacral radiculopathy; sacral MRI with Tarlov cyst protocol; targeted diagnostic caudal epidural injection; and if appropriate, Tarlov cyst spine surgery using minimally invasive surgery techniques. Treatment outcome was based on the validated Patient Global Impression of Improvement (PGI-I) measured at regular intervals post-operatively. Results Ten patients (8 women, 2 men), mean age 40 years (range 19-66), met inclusion criteria. Patients were discharged the same day or following morning post-operatively. No serious complications occurred. Follow-up was >12 months (range 13-22 months). Seven (70%) patients reported post-operative clinical improvement on PGI-I at last follow up: two patients reported “very much better”, three patients reported “much better” and two patients reported “little better”. Two patients had no improvement. Only one patient was much worse, however we believe that the PGI-I score of 6 reflected the worsening of the PGAD/GPD condition and not specifically the result of the surgical procedure. Conclusions Distressing PGAD/GPD symptoms can be caused by Tarlov cyst-induced sacral radiculopathy. A multidisciplinary step-care management algorithm allows selection of appropriate surgical candidates. To the best of our knowledge, this is the largest case series of patients with PGAD/GPD treated with Tarlov cyst spine surgery with at least 1 year follow-up. Using minimally invasive spine surgery techniques, spine surgery on the Tarlov cyst was associated with clinical improvement in 70% of select patients. Disclosure Any of the authors act as a consultant, employee or shareholder of an industry for: Elliquence.

The significance of cervical discopathy diagnosis in patients with mastalgia.

The primary aim of this study was to explore the involvement of cervical discopathy in the development of non-cyclic mastalgia by employing cervical magnetic resonance imaging (MRI). A total of 407 patients were included in the study. Individualized management plans were developed for each patient. Pathological findings in MRI results were assessed by specialists in physical therapy and neurosurgery, and appropriate treatment was administered. Visual assessments of patients were conducted. The Analog Scale (VAS) scoring system was used at the initial presentation, and patients were evaluated at 1 and 3 months following the treatment. In the MRI examinations of the patients included in the study, simultaneous cervical disc protrusion was observed in 29% (n: 124) of those with annular bulging. Comparing the VAS scores of patients before treatment, at the 1st and at the 3rd month showed a significant decrease in mastalgia pain (p < 0.001). The diagnosis of cervical discopathy holds significant importance in the treatment of mastalgia patients. Therefore, clinicians should keep the cervical spine in mind as a potential contributing factor to mastalgia.

Abstract WP99: A Multidisciplinary Approach to Modified Rankin Scale Assessment and Documentation

Objective: The aim of the QI project is to improve the documentation compliance of the Modified Rankin Scale (mRS) through utilizing a multidisciplinary approach. This includes training occupational and physical therapy specialists to assess the mRS scores in the stroke patient population at community hospital primary stroke center. Background: As the most widely used outcome measure for assessment of post-stroke recovery, research confirms that anyone with the appropriate training with regards to performing the mRS can utilize the tool. Initial documentation by nursing began August 2021, and initial documentation compliance of pre-stroke and discharge mRS had not risen above 82%. Methods: A multidisciplinary group consisting of frontline staff members, educators and stroke program administrator was created to implement the proposed practice change. They identified 6 steps to complete this process. ( Table 1 ) The goal for documentation compliance was set at 90% by the end of the first quarter of 2023. The change was implemented on September 15, 2022. Results: Supplementing nursing assessment and documentation of the mRS with the addition of physical and occupational therapy was a successful process change. Documentation compliance improved and reached the predetermined goal set by the multidisciplinary group by the end of January 2023. Documentation compliance reached 100% by March of 2023. Conclusion: Physical therapist and occupational therapist can increase documentation compliance for mRS scores. Increased documentation compliance improve evaluation of inpatient care and post-discharge follow-up to more comprehensively evaluate outcomes of stroke care.

The effectiveness of physical therapy in the rehabilitation of patients after arthroscopy of the knee joint.

Aim: To determine the effectiveness of physical therapy on the functional state of law enforcement officers' knee joints after surgical intervention. Materials and Methods: The research involved law enforcement officers from different units of the National Police of Ukraine (n = 56) who had suffered knee joint injuries in the line of duty, and underwent surgical intervention and rehabilitation procedures. Results: It was found that 78.2 % of respondents had suffered knee joint ligament injuries as a result of falls during rapid movement, while 43.9 % were in full gear (armored protection, helmet, etc.). It was determined that after surgical intervention, the functional state of the knee joint of law enforcement officers who followed the recommendations of physical therapy specialists and systematically performed special sets of physical exercises was significantly different (p < 0.001). Worse results were noted in people who partially followed the recommendations of rehabilitation therapists and performed part of the prescribed procedures and physical exercises. Conclusions: The effectiveness of the complex use of physical rehabilitation means for restoring the functioning of the knee joint after surgical intervention, which included arthroscopy, partial menisectomy of the damaged areas, debridement, vaporization of damaged cartilage, etc. was revealed. The positive effect of physical exercises on the functional state of the knee joint was proven. The sets of exercises that are advisable to use to restore the functioning of the knee joint were determined.

MODERN TRENDS IN OCCUPATIONAL THERAPY SPECIALIST TRAINING IN UKRAINE

The article defines the goal, which is the systematization of modern trends in occupational therapy specialist training (physical rehabilitation, physical therapy combined with human health, etc.), who can independently and consciously choose priority areas of activity, realize professional responsibility for the organization and results of their work, approach creatively to predict work results and plan strategies and technologies for their achievement, acquire and consolidate skills and abilities; develop and implement an individual rehabilitation plan in cooperation with other specialists in the multidisciplinary team and the patient; describe violations of the functioning of organs and systems of the human body; independently and creatively apply acquired knowledge, and carry out scientific, administrative and advisory activities.&#x0D; These trends include: the usage of the latest technologies, such as virtual reality, artificial intelligence, TV-rehabilitation, and others, to improve rehabilitation processes and ensure more effective and individualized treatment methods (technology integration); attention to the development of individualized rehabilitation programs that take into account the unique needs and characteristics of each preson (individualization of activities); establishment of cooperation of specialists in various fields (physiotherapists, psychologists, social workers, etc.) to create comprehensive rehabilitation programs (multidisciplinarity); focus on the development of effective methods of rehabilitation and optimization of resource costs to increase the availability of services (resource matching); providing specialists with modern knowledge and skills necessary for using the latest methods and technologies (pedagogical culture in general); growing attention to the inclusion of persons with disabilities in various spheres of social life, including education, work, and entertainment (strategies of inclusion); creation of programs and initiatives aimed at prevention and early detection of problems to avoid further complications (prevention and early intervention).&#x0D; Modern specialists in human health, physical therapy, and occupational therapy are obliged to formulate modern ideas about a person as a bioenergetic being and the relationship of his health with nature and society by assimilating the worldview and methodological foundations of philosophical knowledge, based on knowledge of anatomy, physiology, valeology, using methods of vale-diagnostics and monitoring of physical development, plan professional and educational activities aimed at ensuring the physical development of the individual.

REGULATORY AND LEGAL SUPPORT OF THE NATURAL AND SCIENTIFIC TRAINING OF PHYSICAL THERAPY AND ERGOTHERAPY SPECIALISTS AT THE PROFESSIONAL AND ADAPTIVE STAGE

The article is devoted to the study of regulatory and legal support of the process of formation of natural and scientific competence of future specialists in physical therapy and ergotherapy at the professional and adaptive stage of training of the second (master’s) level of higher education. The process of natural and scientific training of a specialist in physical therapy and ergotherapy should take into account cause-and-effect relationships and dependencies that appear in the form of leading trends and determine the strategy of this process. These include: humanization, fundamentalization, humanitarization, interdisciplinary and interscientific nature of knowledge, intellectualization. Modern natural and scientific training of a future specialist in physical therapy and ergotherapy is studied by us through a set of scientific ideas, which include the following ideas: optimization of natural and scientific training, formation of the functionality of natural and scientific knowledge, integration of educational disciplines and health-keeping.&#x0D; We conducted a structural analysis of the set of discipline programs of normative and selective parts of natural and scientific training of future specialists in physical therapy and ergotherapy basing on an algorithm that allowed us to unify the requirements for natural and scientific discipline programs and to develop a multi-subject matrix of the content of this training.&#x0D; There were analyzed the content and professional orientation of natural and scientific disciplines, such as «Modern Medical and Biological Methods of Restoring the Functional State in Physical Culture, Sports and Rehabilitation», «Information and Communication Technologies in Natural and Scientific Training», and «Natural and Scientific Foundations of Health-keeping», their place in the system of training of physical therapy and ergotherapy specialist is determined.

CONTENT OF NATURAL AND SCIENTIFIC TRAINING OF FUTURE SPECIALISTS IN PHYSICAL THERAPY AND ERGOTHERAPY AT THE INITIAL (THEORETICAL) STAGE OF TRAINING

The article examines the regulatory and legal provision of natural and scientific training for future specialists in physical therapy and ergotherapy in modern higher education institutions. A structural analysis of the content of natural and scientific training of future specialists in physical therapy and ergotherapy at the initial (theoretical) stage of training has been carried out. A systematic study of the educational disciplines of the natural and scientific training of future specialists in physical therapy and ergotherapy makes it possible to reveal their significant number, the presence of frequent repetitions of the same type of information and situational tasks, that is, the task of mutual coordination of the content component of training, modernization of natural and scientific training and optimization based on structural analysis. The results of the structural analysis of the content of natural and scientific training of future specialists in physical therapy and ergotherapy at the initial (theoretical) stage of training are given.&#x0D; The professionally oriented content of natural science disciplines («Biochemistry», «Human Anatomy», «Human Physiology», «Age Anatomy and Physiology», «Physiology of Motor Activity», «Fundamentals of Hygiene and Ecology», «Biomechanics», «General Theory of Health, Diagnosis and Monitoring of the State of Health»), and their focus on the formation of the components of the natural and scientific competence of a specialist in physical therapy and ergotherapy is determined.&#x0D; The organization of natural and scientific training through the implementation of the methodology for the formation of professional competence of future specialists in physical therapy and ergotherapy integrates practice-oriented teaching techniques and is aimed at defined pedagogical conditions implementation. It is worth noting that in the process of natural and scientific training, the specified pedagogical conditions are implemented based on taking into account the peculiarities of the functioning of the integral integration system and by introducing the initial (theoretical), basic (practically oriented) and final (professionally adaptive) stages of training.

Experimental verification of the effectiveness of the pedagogical model of the formation of natural and scientific competence of future specialists in physical therapy and ergotherapy

The article presents the course and results of a formative experiment to test the effectiveness of a theoretically substantiated pedagogical model of forming the natural and scientific competence of future specialists in physical therapy and ergotherapy. The content, technologies, and mechanisms of the organization of the experimental study of natural and scientific training of future specialists are substantiated, an analysis of the effectiveness of the developed methodics at the relevant stages of natural and scientific training is conducted. The dynamics of quantitative and qualitative indicators of the formation of natural and scientific competence of future specialists in physical therapy and ergotherapy is analyzed on professional and orientative, fundamental professional and specialized professional stages of training. The concept of «competence of a physical therapist, ergotherapist», certified with a document on professional education, includes: competence in the field of theory in physical therapy and ergotherapy; competence in the field of modern rehabilitation technologies and methodics; competence in designing and rehabilitation systems; competence in professional interaction with participants of the rehabilitation process (members of the multidisciplinary team, patients, family members / caregivers of patients); competence in the field of theory and practice of research in the fields of physical therapy and ergotherapy; competence in medical innovations; competence in organization and management; competence in professional self-improvement.&#x0D; The effectiveness of the proposed model is verified through a system of criteria (personal and motivational, cognitive, integrative and substantial, informational and communicative, operational and activity orientated, health-keeping, and professional and reflexive); for each criterion, a number of indicators and levels (elementary, basic, sufficient and creative) of the formation of natural and scientific competence of future specialists are distinguished. Using statistical methods, the reliability of the obtained results and the correctness of the formulated hypothesis are confirmed.

Current State of Entry-level Physical Therapy Oncology Curricula in the United States: A Faculty Survey.

The purpose of this study was to determine the extent of oncology rehabilitation education in current physical therapist educational programs in the United States, including oncology rehabilitation content characteristics, delivery, and instructional resources. By 2030, more than 21 million survivors of cancer in the United States (US) will be living with multisystem side effects depending on the treatment delivered. In addition, the sociopsychological factors associated with cancer treatment require that physical therapists are equipped with a unique body of knowledge, skills, and abilities. Insufficient cancer rehabilitation education is problematic across the health care spectrum. Program directors at 235 US physical therapist educational programs. An online survey was developed in REDCap using the American Board of Physical Therapy Specialist's Description of Specialty Practice: Oncology Physical Therapy as a guide. An electronic link to the survey was sent to the email of the chair/program director at 235 Commission for the Accreditation of Physical Therapy Education-accredited programs. The overall response rate was 40.4% (95/235) and represented 36 of the 50 states. Private universities represented 54.3% of the responses, and 65% of the surveys were completed by core faculty. Four programs reported having an independent oncology course, ranging from 1 to 3 credit hours. Integrated content hours averaged 14.8 contact hours (range: 1-60) in the 69 reporting programs. Fifty-four percent of respondents were aware of published rehabilitation cancer guidelines. The majority of respondents (62%) felt their students received adequate instruction related to oncology rehabilitation. Certified lymphedema therapists (68%) were primarily responsible for teaching the oncology content. Goodmans' Pathophysiology text was most reported (87%), whereas 38% used evidence-based research in Rehabilitation Oncology Journal. About half of the respondents (52%) reported offering students full-time clinical experiences in oncology rehabilitation. This survey demonstrated how oncology rehabilitation education is incorporated into physical therapist educational programs and highlights areas for improvement. The results from this study lay the groundwork for developing core competencies for prelicensure education in oncology rehabilitation.

(134) Development of a Multidisciplinary Step-Care Management Algorithm and Surgical Outcomes of PGAD/GPD Patients with Tarlov Cyst-Induced Sacral Radiculopathy

Abstract Introduction Persistent Genital Arousal Disorder/Genito-Pelvic Dysesthesia (PGAD/GPD) is characterized by persistent, unwanted genital arousal and/or other genito-pelvic dysesthesia, including burning, itch, pain in the clitoris/penis, mons pubis, vulva/scrotum, vagina, urethra, perineal region, bladder, and/or rectum. Patients with PGAD/GPD are significantly bothered/distressed and catastrophization and suicidal ideation are common. In 2012 Komisaruk reported that PGAD/GPD could be mediated by Tarlov cyst-induced sacral radiculopathy. In 2016 we developed a multidisciplinary step-care management algorithm with specialists in sexual medicine, spine surgery, sex therapy, physical therapy, and neurophysiology to diagnose Tarlov cyst-induced sacral radiculopathy. Objective To utilize a novel multidisciplinary step-care management algorithm to identify PGAD/GPD patients with Tarlov cyst-induced sacral radiculopathy who could benefit from Tarlov cyst spine surgery, and to evaluate the long-term safety and efficacy of the surgery. Methods Clinical data were collected on PGAD/GPD patients who underwent Tarlov cyst spine surgery between 2016 and 2020 with at least 1-year follow-up. The management algorithm used to identify and treat Tarlov cyst-induced sacral radiculopathy involves: detailed psychosocial assessment and medical history; non-invasive assessments for sacral radiculopathy; targeted diagnostic caudal epidural injection that results in temporary clinically significant reduction of PGAD/GPD symptoms; and surgical intervention with Tarlov cyst spine surgery. Treatment outcome was based on the validated patient global impression of improvement (PGI-I) measured at intervals post-operatively. Results Ten patients (8 women, 2 men), mean age 40 years (range 19 - 66), met inclusion criteria. Patients were discharged the same day or following morning post-operatively. No serious complications occurred. Follow-up was &amp;gt;12 months (range 13 - 22 months). Seven (70%) patients reported post-operative clinical improvement on PGI-I at last follow up: two patients reported “very much better”, three patients reported “much better” and two patients reported “little better”. Two patients had no improvement. Only one patient was much worse, however we believed that the PGI-I score of 6 reflected the worsening of the PGAD/GPD condition and not a specific result of the surgical procedure. Conclusions Distressing PGAD/GPD symptoms can be caused by Tarlov cyst-induced sacral radiculopathy. This case series with long-term follow-up demonstrates that spine surgery effectively treats PGAD/GPD patients with Tarlov cyst-induced sacral radiculopathy established by a multidisciplinary step-care management algorithm. Imbricating the Tarlov cyst using minimally invasive spine surgery techniques was associated with clinical improvement in 70% of these select patients. Disclosure No

Inclusive physical education by means of adapted fitness in institutions of higher education

Inclusion is the process of including all citizens in society. It involves the development and application of those methods that can allow everyone to participate equally in public life. Today, a comprehensive process of ensuring equal access to quality education for children and youth with disabilities is becoming especially relevant and important. This is inclusive education. And this issue should concern not only the profile and general education disciplines in schools or institutions of higher education, but also physical education. For many years in the system of secondary and higher education, a person with various diseases and, moreover, with a disability was automatically exempted from physical education classes. In addition, obtaining quality education in this case was an extremely difficult process. There are many explanations for this fact: narrow specialization of a teacher of physical education; lack of sufficient specialists in physical therapy; lack of material base (special halls, simulators, facilities, etc.) for such classes; most importantly, such people were not noticed. They were immediately and by definition on the "sidelines of life."&#x0D; In these situations, the physical and psychological condition of people with diseases or disabilities will continue to deteriorate. In fact, the absolute lack of movement and limitations in communication will provoke the progression of the disease and cause a feeling of loneliness and exclusion from society. At the same time, moderate or minimal adapted physical activity will help solve the problem of lack of motor activity. A high emotional background during the class and well-chosen musical accompaniment will have a positive effect on a person's mental state. A large number of modern fitness areas makes it possible to choose the necessary means and methods of conducting physical education classes for people with weakened health and disabilities.

FORMATION OF THE PROFESSIONAL IDENTITY OF PHYSICAL THERAPISTS IN HIGHER EDUCATION INSTITUTIONS

The main provisions of the formation of the professional identity of future specialists in physical therapy in institutions of higher education are considered. The structure of the professional identity of physical therapy specialists, which is formed in

TYPES OF READINESS OF SPECIALISTS IN PHYSICAL THERAPY

The article considers the types of readiness of specialists in physical therapy and occupational therapy to use health-preserving technologies in professional activities, which are determined by: scientific knowledge about the nature, patterns, features, principles, purpose, objectives and content of work to restore public health and implement such technologies. The main indicator of the effectiveness of specialist training is the psychological, pedagogical, professional, practical, social, personal and physical readiness of a specialist in physical therapy and occupational therapy to work to restore the health of the socio-component of our society. It is shown that the main property of a specialist in physical therapy and occupational therapy is a generalized ability to think pedagogically, which implies that the teacher has analytical, prognostic, design and reflexive skills. Features of both practical and professional readiness of the specialist are external (subject) skills, which include organizational and communication skills. The main types of readiness (professional, personal, psychological, physical, social, pedagogical and practical) of specialists in physical therapy and occupational therapy to use health technology in professional activities are described; the peculiarities of use in working with patients when compiling rehabilitation programs based on the International Classification are indicated. functioning, limitation of life and health, which aims to define a unified and standardized language and schemes for describing health and health-related conditions, which introduces the definition of the components of health and some related to health, components of well-being (in particular, such as education and work). This classification has moved away from the classification of "disease consequences" and has become a classification of "health components".

Програмне забезпечення освітньої компоненти «Фізіологія рухової активності» для здобувачів вищої освіти першого (бакалаврського) рівня вищої освіти спеціальності 227 фізична терапія, ерготерапія освітньої програми «Фізична терапія» в Національному фармацевтичному університеті

The purpose of the study was to highlight the issues of the educational program of the educational component “Physiology of Motor Activity” for the applicants for higher education in the educational program “Physical Therapy” of the National University of Pharmacy. Materials and methods. Analysis of scientific and methodical literature, on the basis of which the work program was concluded, was carried out. Results and discussion. Motor activity is an integral part of human behavior, any movement of the human body, which is carried out thanks to the work of skeletal muscles. In a sick body, it helps to reach remission faster, improve physical and emotional state, allows to reduce the pharmacological load on the body, increases its motivation for an active life. The work program of the educational component “Physiology of Motor Activity” for applicants for higher education in the specialty 227 “Physical Therapy, Ergotherapy” of the educational program “Physical Therapy” at the National University of Pharmacy is written in accordance with the requirements of the credit-modular system of organization of the educational process. The purpose of teaching the educational component is to form in higher education applicants an idea of physical rehabilitation in patients, adequate scientific understanding of the laws of physiology of motor activity and features of the structure of functional systems and organs depending on the age of the person, as well as the acquisition of knowledge about the means of effective and early return of patients and disabled people to everyday and labor processes. The working program reflects the introduction of a competency-based approach, which establishes the level of integral, general and special competencies of the future specialists in physical therapy and the acquisition of program learning outcomes. The educational component “Physiology of Motor Activity” is structured into two content modules, which contain 13 topics. The study is completed by passing the final module control and receiving a credit. Effective mastering of the educational component is ensured by the use of various teaching methods, mastering practical skills, performing individual tasks. Conclusion. The system of training highly qualified specialists in the field of physical rehabilitation involves the study of a complex of medical and biological disciplines, among which one of the leading places is occupied by subjects that reveal the essence of movement and mechanisms of motor activity. The educational component “Physiology of Motor Activity” is aimed at studying the physiological mechanisms of voluntary movements and reveals their main characteristics. This knowledge is the foundation of high methodological training of a specialist in the field of “Physical Therapy”, which is of great importance for increasing the competitiveness of graduates of the National University of Pharmacy in the labor market

SELF-EDUCATIONAL – A QUALITY BENCHMARK FOR THE PROFESSIONAL TRAINING OF FUTURE EXPERTS IN PHYSICAL THERAPY AND OCCUPATIONAL THERAPY IN HIGHER EDUCATION INSTITUTIONS

In modern conditions of social development, the requirements for future physical and occupational therapists' professional training are changing.&#x0D; In order to train highly qualified specialists ready for professional activities in today's changing conditions, it is necessary to form their self-educational competence.&#x0D; In order to be competitive in the labor market, it is necessary to increase one’s potential during self-education activities. This determines the relevance of the formation of self-educational competence of future physical rehabilitators, occupational therapists during their studies at higher education institutions.&#x0D; In this article, we aim to substantiate the need for the formation of self-educational competence in future specialists in physical therapy and occupational therapy during their studies at higher education institutions.&#x0D; It has been established that self-educational competence is an integral component of the professional adequacy of a physiotherapist and an occupational therapist. This competence includes the ability to acquire knowledge independently and understand the importance of education throughout life.&#x0D; It was determined that the formed self-educational competence of future physiotherapy specialists ensures their professional mobility, competitiveness in the labor market and promotes the development of adaptive skills.&#x0D; It is emphasized that the formation of self-learning competence is a continuous process carried out throughout a specialist's entire professional activity.&#x0D; The importance of forming basic skills and components of self-educational competence to enable students to carry out the process of self-education in the future is highlighted.&#x0D; The relevance of the development of self-educational competence of future specialists, in particular of physical and occupational therapy in current conditions of remote studying, was noted.&#x0D; It has been established that today's conditions require restructuring the principle of cooperation between teachers and students by reducing classroom classes, devoting more time for independent processing of educational material, as well as optimization of methodical support of the educational process etc.&#x0D; The purpose of the research: to theoretically substantiate the need for the formation of self-educational competence in future specialists in physical and occupational therapy during their studies in institutions of higher education.&#x0D; Materials and methods: systematic analysis of scientific literature; theoretical generalization and systematization of information about the formation of self-educational competence of future physical and occupational therapy specialists during professional training in higher education institutions.&#x0D; As a result of the research, it was concluded that there is a high demand in society for physical and occupational therapists who can independently acquire knowledge and master new methods and technologies.&#x0D; That is why it is necessary that their professional self-development training should be carried out during studying in higher education facilities.&#x0D; Graduates of higher education institutions must maintain scientific knowledge, effective techniques, and skills that allow them to adapt independently and quickly in a changing information environment.&#x0D; We believe that the ability of students to self-educate and the desire to improve their skills contribute to the improvement of the quality of higher education.

Features of clinical reasoning in physical rehabilitation

The article is devoted to the analysis of the clinical reasoning of specialists in the field of physical rehabilitation, in particular, specialists in physical therapy and occupational therapy. Despite numerous studies, the topic of "formation of clinical thinking" remains insufficiently studied and has its own peculiarities in the field of physical therapy.&#x0D; The key features influencing clinical reasoning in physical rehabilitation are revealed. They include the use of movement as one of the main means of diagnosis, rehabilitation, evaluation of effectiveness, as well as the goals of rehabilitation interventions; focus on patient activity and participation (according to the International Classification of Functioning, ICF); patient mobility; interactivity and multidisciplinarity. The autonomy extend in professional activity has a significant impact on the formation of clinical reasoning of specialists.&#x0D; Conceptually, clinical reasoning in physical rehabilitation may be defined as the combination and interaction of cognitive, affective and psychomotor skills. At the same time, effective clinical reasoning is narrative, adaptive and collaborative, contextual and it utilizes a biopsychosocial approach to the patient.

Author Response to Shear et al.

We thank the colleagues who provided meaningful comments to our manuscript.1 A Delphi investigation aims to gather expert opinions, frame future studies, and guide clinical practice in research areas where there is sparse quality literature available.2 Because children can present with orthopedic/musculoskeletal and/or neurological impairments, physical therapists credentialed in those treatment skill sets would be most capable of identifying effective treatment techniques. Therefore, we recruited physical therapists who were board-certified clinical specialists in pediatric physical therapy, were certified in neuro-developmental treatment (C/NDT), or had manual therapy credentials (Fellow of the American Academy of Orthopaedic Manual Physical Therapists [FAAOMPT]) to participate in our Delphi study. Although these credentials are not specific to craniosacral therapy (CST) and visceral manipulation, the Round 1 respondents identified CST and visceral manipulation as manual techniques that could be utilized to treat children. Although we cannot ascertain that the respondents in Rounds 2 and 3 had advanced training (continuing education) in CST or visceral manipulation, no respondent indicated being certified in those specific techniques.

ЗМІСТ ТА СТРУКТУРА ПРОФЕСІЙНОЇ КОМПЕТЕНТНОСТІ МАЙБУТНЬОГО ФАХІВЦЯ З ФІЗИЧНОЇ ТЕРАПІЇ ТА ЕРГОТЕРАПІЇ

The article analyzes the features of professional activity, the content and structure of professional competence of a specialist in physical therapy and occupational therapy. It is determined that the professional competence of a specialist in physical therapy and occupational therapy is the ability of an individual to effectively perform professional activities based on the possession of professional knowledge, skills and abilities, professionally significant personal qualities; striving for professional development and self-improvement. The content and structure of professional competence of future specialists in physical therapy and occupational therapy have been developed, which is the basis of his professional development and self-improvement. The professional competence of a specialist in physical therapy and occupational therapy is considered as a unity of three components: motivational-value, cognitive, activity-reflexive, each of which contains structural components and at the same time are aspects of personality. Motivational and value component is an integral quality and a core component in the structure of professional competence of a specialist. It presupposes the presence of social attitudes, values and motives; interest and positive attitude to activities; striving for professional development and self-improvement. The cognitive component of the professional competence of a specialist in physical therapy and occupational therapy includes general scientific and diagnostic competence. Important professional skills include: gnostic, constructive, diagnostic, organizational and methodological, informational, research. The professionally important qualities of a physical therapist and occupational therapist are well-known: moral, communicative, cognitive, emotional-volitional, reflexive. The activity-reflexive component of professional competence involves the ability to use physical therapy and occupational therapy; mastery of methods of organizing rehabilitation activities, planning tasks and ways to solve them; ability to predict, construct, analyze, consciously evaluate the results of their own activities. Activity-reflexive component of professional competence involves the ability to use physical therapy and occupational therapy; mastery of methods of organizing rehabilitation activities, planning tasks and ways to solve them; ability to plan, forecast, analyze, adequately evaluate the results of their own activities. Competence approach to the training of future specialists in physical therapy and occupational therapy is the acquisition and development of higher, integrated, general and special (professional) competencies in higher education. Key words: specialist in physical therapy and occupational therapy, professional activity, professional competence, structural components of vocational competence.

Testicular Pain – Not Always What it Seems: A Cross-sectional Assessment of Patients Presenting for Chronic Scrotal Content Pain at a Tertiary Care Center

ABSTRACT Introduction Introduction:: Chronic scrotal content pain (CSCP) is generally defined by persistent and bothersome pain present for &amp;gt; 3-months. This symptom complex leads to frustration for patients and providers alike, as the underlying etiology varies and in many instances is unknown. Scrotal pain may arise from outside the scrotal contents, as is seen with musculoskeletal conditions involving the hips, lower back, and pelvic musculature. Identifying those patients who have signs or symptoms of a musculoskeletal etiology earlier in their clinical course will allow for a more streamlined treatment pathway and minimize the need for unnecessary referrals. Objective To review historical and examination findings in patients presenting to a tertiary care center for evaluation of chronic testicular pain. Methods We reviewed our clinical experience with referrals for surgical intervention for “chronic testicular pain” at a tertiary care medical center between July 2019 and October 2020. Prior to scheduling an appointment, patients are queried via a list of questions to gather additional information in order to determine whether specialist consultation is indicated. Pertinent information was collected including historical patient data, physical examination findings, laboratory and imaging results, and treatment as recommended by the assessing physician. In addition, we gathered data on the number of prior consults and interventions performed by outside clinicians. The data was summarized to present a cross-sectional representation of patients presenting for CSCP. Results In total, 126 patients were seen for a primary chief complaint of CSCP. Mean patient age was 45 years [standard deviation (SD) 15]. 31 (24%), 55 (44%), and 40 (32%) were self-referred or referred by their primary care provider or a urologist, respectively. 88 patients (70%) had seen at least one prior urologist. 22/126 (17%) reported bilateral testicular pain. 29 patients (24%) had undergone a prior unsuccessful surgical intervention for their pain. On examination, reproducible testicular tenderness was present in only 57 patients (45%), despite 109 patients (87%) stating testicular pain as their primary chief complaint. Digital rectal examination of the pelvic floor musculature was positive for tenderness in 31/126 patients (25%), suggesting a possible pelvic floor contribution. After thorough assessment, musculoskeletal etiologies were suspected to underlie CSCP in 49 patients (39%), prompting additional evaluation and/or referrals. This included 35 patients (28%) who were specifically referred to a pelvic floor physical therapy specialist. Surgery was recommended in 68/126 patients (54%), including microdenervation of the spermatic cord in 22% (after successful diagnostic spermatic cord block), and epididymectomy in 13%. Conclusions CSCP presents with a wide array of concurrent symptoms. The history and physical examination must include assessments for concurrent abdominal, back, hip, and other genital/pelvic pain that may lend towards an alternative non-urologic treatment pathway. Disclosure No

Principles of Realization of Physical Therapy for Students: Modern Views of Neuropedagogy and Neuropsychology

The article considers the issue of the principles of realization of physical therapy of students from the point of view of neurosciences. The article notes that modern higher education is characterized by the appearance of a new medical specialty "Physical therapy, Ergotherapy". The emphasis is made on the fact that the Ukrainian society badly needed such specialists. The essence of such concepts: "higher education", "specialist", "vocational training", "physical therapy", "Ergotherapy", "rehabilitation therapist", "neuropedagogy", "neuropsychology" is considered. It is noted that physiotherapists from Japan played an important role in assisting athletes during the 2020 Olympic Games. Since 2007, the Ukrainian Association for Physical Therapy has been organized in Ukraine. It is proved that the first appearance of the profession, which is associated with physiotherapy exercises, dates back to the beginning of the XX century. It is noted that the government document gives the right to be in training persons who have special educational problems. A review of articles by domestic and foreign authors on the use of physical therapy to improve human health is made. The main aspects of training a future specialist in physical therapy are disclosed. It is noted that university teachers should think about a modern approach when teaching subjects. The professional training of future specialists in physical therapy to work on improving the health of athletes has been studied in detail. Structural components that should be taken into account by future specialists are noted. The interactive methods and forms of work that are integral to teaching students are named. It is noted that future specialists should have not only knowledge of physical culture, but also pedagogical, psychological and physiological methods of work. In addition, it was noted that for rehabilitation therapists it is important knowledge of intersubject relationships. The active-operational component of the professional activity of students has been investigated. In addition, it is noted that the physiotherapist should be professional in the selection of exercises for remedial gymnastic. Since it was found that the neuropsychological overload of students requires physical therapy.