Private Rehabilitation Research Articles

The anomalous Mr Hubert H.D. Griffith (1877–1958), Australian field naturalist, collector and benefactor

ABSTRACT Hubert H.D. Griffith was a significant but neglected contributor in the scientific discovery of Australia’s natural heritage. Although his interests were forged in his youth in Tasmania, his return to Adelaide as a young man heralded an energetic engagement with leading scientific societies and figures over nearly two decades at the beginning of the twentieth century. His interests were wide, spanning insects, birds, plants and photography. In particular, he supported J.M. Black in his preparation of the Flora of South Australia. Griffith’s impressive collections of beetles and plants have been consulted by taxonomists for more than a century and are now preserved in various state and national museums and herbaria in Australia. One genus (Griffithia) and 14 species of beetles and an important southern Australian seagrass, Amphibolis griffithii, are named after him in recognition of his contributions to science. A longtime and respected citizen of Adelaide, another enduring legacy of Hubert and his wife May (née Scott) is the Griffith Hospital, a private rehabilitation hospital they endowed in the 1950s, which continues to provide valued services to the South Australian community.

Evaluating cancer rehabilitation services: Insight from Australia and New Zealand

Background: Despite evidence supporting the benefits of rehabilitation for cancer survivors, the nature of cancer rehabilitation programs is inadequately described in Australia and New Zealand. This study provides insight into current service delivery and challenges for healthcare systems in implementation of cancer rehabilitation programs. Methods: A cross-sectional survey of directors of public and private rehabilitation services in hospital and ambulatory settings across Australia and New Zealand using the Australasian Rehabilitation Outcomes Centre (AROC) registry evaluated the current delivery of cancer rehabilitation programs, health professional workforce, core care components delivered, barriers and facilitators to service delivery, and unit/organisation-wide cancer rehabilitation activities. Descriptive statistics analyzed quantitative data, and qualitative analyses interpreted item responses. Results: Of the 300 services, 102 (34%) participants completed the survey. Most services provide non-dedicated cancer rehabilitation programs (n=63), led by rehabilitation physicians, followed by allied health. The common tumour streams referred included central nervous system (67%, n=56), haematological (59%, n=49), prostate (58%, n=48), and lung cancers (58%, n=48). Patients were frequently referred during post-treatment (87%, n=72) and treatment phases (66%, n=55). Core program components were multimodal exercises, fatigue management strategies, and management of medical complications and medications. The main barriers and facilitators toward the uptake of cancer rehabilitation programs were identified. Key activities in education, research, advocacy, and clinical practice improvement were also highlighted. Conclusions: The survey identified key barriers and facilitators for the implementation of cancer rehabilitation programs. Collaborative efforts of relevant stakeholders, clinicians, consumers, and policymakers need to address barriers to broader implementation of cancer rehabilitation services.

Penal-welfare systems in a (post)colonial world: The rise and disregard of alcohol and drug rehabilitation centers in South Africa

Apartheid South Africa developed a notoriously punitive and racist approach to alcohol and drug use. Less reported is that the state gave significant attention to rehabilitation, first for the minority white population and later for black South Africans. This paper asks why in the post-apartheid era—despite a huge influx of cheap heroin, methamphetamines, and other drugs—the government showed a relative disregard for rehabilitation. Addressing this question, the paper points to the configuration of forces driving public rehabilitation in the colonial era included the upliftment of “poor whites,” the need to maintain black workers’ productivity, and the ascendancy of the disease concept of addiction. In the post-1994 period these forces waned as a multiracial middle class came to purchase treatment in private rehabilitation facilities, the disease concept fell into retreat, and mass unemployment helped to position poor black drug users as an “undeserving poor.” The paper contributes to comparative studies on penal-welfare systems and the recent attention to drug histories from the global South.

Caregiver involvement in support services for a child with hearing loss?

Family-centered practices are considered one of the crucial components of services offered to children with hearing loss in early intervention. These practices aim to empower caregivers to support the language development in children with hearing loss through family-centered early intervention. In Turkey, early intervention practices are commonly provided under the supporting services provided by Private Special Education and Rehabilitation Centers (PSERCs). However, there is limited information regarding the ways of involving caregivers in the support service process and about the content shared to empower them. This research was designed as a holistic single case study based on a qualitative approach to examine how caregiver involvement is achieved in support services in PSERC for pre-school children with hearing loss in Turkey. Data obtained through observations, semi-structured interviews, documents (Audiogram, activity items, etc.), and researcher diaries were analyzed inductively. Results demonstrate that a range of practices, such as informational notes, quarterly meetings, and debriefings are implemented at the focal PSERC. However, it found that the only practice that was consistently followed was debriefings. Although the content shared in the debriefings was seemingly supportive for the language skills of children with hearing loss, the information caregivers needed was diverse. The results clearly demonstrate that current attempts to involve caregivers at PSERCs lack family-centered practices. A more comprehensive approach is required to improve services at PSERCs and make them truly family-centered. Further research is crucial to this end.

‘I can’t take my eyes off her’ problems and difficulties experienced by mothers caring for their intellectually disabled children at home: a qualitative research

This qualitative study was conducted to learn the experiences of mothers who care for their children with intellectual disabilities at home about the problems and difficulties they experience. The study was conducted through in-depth interviews with 20 mothers who met the inclusion criteria in private and public special education rehabilitation centers in Zonguldak province between 1 January and 29 March 2024, in Türkiye. The content analysis method was used to analyze the data. As a result of the analysis of the data obtained from the interviews, six themes emerged. These themes are (1) the worn-out psychology of the mother, (2) socializing is too far for us!, (3) I am not enough for my children, (4) my child is at the center of my life, (5) my child’s difficult process, and (6) I am not alone. There were many problems and difficulties experienced by mothers caring for their intellectually disabled children at home. They had created their solutions for these. The mothers who participated in the study made all the materials they used in their home environment suitable for children. They had also taken safety precautions to prevent harm to children through objects. While most of the families suffered economically, not all of the mothers felt psychologically well. However, they did not neglect their priority towards their children. They overcame these problems with the support of family, friends or health personnel. Establishing health services and social programs that support mothers in terms of both psychological issues and home care opportunities will allow mothers to feel better.

ANALYSIS OF HEALTHCARE QUALITY: PUBLIC CLINICS AND PRIVATE REHABILITATION CENTERS FROM PATIENTS' PERSPECTIVE

Introduction: Continuous analysis of healthcare quality is crucial to ensure optimal health experiences for patients. In this study, we focus on comparing the quality of care provided between public clinics and private rehabilitation centers, considering the perspective of patients. Objective: To examine the attitudes of the general population towards satisfaction with care provided in private rehabilitation centers compared to public institutions of physical medicine. Materials and methods: In this cross-sectional study conducted in February 2023, 125 participants were surveyed via an online Google Form to gather sociodemographic data and explore perceptions of physical therapy. The subsequent statistical analysis, using Microsoft Excel 2007 and IBM SPSS 23.0, encompassed descriptive and inferential statistics, revealing significant insights into respondents' perspectives and forming the foundation for a comprehensive discussion. Results: Research results indicate higher satisfaction with care provided in private centers compared to public institutions, while simultaneously highlighting issues with the organization of the public sector system. The findings suggest that both types of institutions excel in specific areas, with other areas identified as potential areas for improvement. Conclusion: Based on the analysis of patient perspectives, we conclude that both public clinics and private rehabilitation centers play a pivotal role in providing quality healthcare. While public clinics emphasized their role inaccessibility and comprehensive care, private rehabilitation centers stood out for their personalized approach, prompt patient reception, and utilization of manual techniques. Keywords:healthcare quality analysis, public clinics, private rehabilitation centers, patients' perspective

Perception of Caregiver on Physical Therapy Management for Pediatric Burn Patients

Background: Burn injuries are among the most severe types of child injuries, leading to significant functional, social, and psychological disabilities. Physiotherapy plays a crucial role in the rehabilitation of pediatric burn patients, and caregivers are essential in facilitating the treatment process. Understanding caregivers' perceptions and adherence to physiotherapy treatment can inform better care strategies. Objective: This study aimed to assess the perceptions of caregivers towards physiotherapy treatment for pediatric burn patients and to evaluate adherence to prescribed exercise regimens. Methods: A descriptive cross-sectional study was conducted from June 2023 to December 2023. Data were collected from caregivers at two public hospitals and one private rehabilitation center using a non-probability convenience sampling method. The sample included 53 caregivers of children aged 1-5 years with burn injuries covering more than 20% of their total body surface area and who had been undergoing physiotherapy for 3-4 weeks. Exclusion criteria were caregivers not actively involved in daily care, those unable to communicate in English or Urdu, and patients without a caregiver. Data were collected using a semi-structured questionnaire based on the Measure of Processes of Care (MPOC). The questionnaire was validated and had a Cronbach’s alpha of 0.703. Data were analyzed using SPSS version 25, with descriptive statistics presented as frequencies, percentages, means, and standard deviations. Results: Among the caregivers, 64.2% were mothers, 15.1% were fathers, and 20.8% were other relatives. A total of 81.1% of caregivers agreed and 18.9% strongly agreed that the physiotherapist encouraged active participation in decision-making. Comfort in discussing concerns was reported by 69.3% agreeing and 18.9% strongly agreeing. Emotional and social aspects were adequately addressed according to 39.6% of caregivers, with 41.5% neutral and 15.5% disagreeing. Clear communication of treatment plans was reported by 75.5% agreeing and 24.5% neutral. Adherence to exercise routines varied, with 47.2% often, 32.1% always, and 20.8% sometimes helping with exercises. However, 39.6% reported that the child always refused to do exercises, and 64.2% noted the child always complained of pain during therapy. Conclusion: The study concluded that caregivers generally have a positive perception of physiotherapy for pediatric burn patients and actively participate in their care. Challenges such as pain during exercises and time constraints highlight the need for enhanced support and communication to improve adherence and outcomes.

The Effectiveness of Augmented Reality Offered with Constant Time Delay Procedure in Teaching the Functions of Organs to Students with Intellectual Disabilities

Introduction: Science course allows student to follow scientific developments, understand and interpret the events that occur around them, and develop scientific process skills. Different methods are employed in teaching science to student childeren with intellectual disabilities. There has been a recent increase in technology-supported methods. One of the technology-supported methods is Augmented Reality. For this reason, the effectiveness of the augmented reality provided with the constant time delay procedure in teaching the functions of the organs to childeren with intellectual disabilities was investigated in the present study. The study was conducted in the individual education setting of a private special education and rehabilitation center. Method: Three students who had intellectual disabilities participated in the study. The multiple probe design with probe conditions. Phases across behaviors, which is one of the single-case research designs, was used in the study. Findings: According to the study results, it was found that all participants acquired the target behaviors successfully and the participants retained the behaviors they acquired after the teaching of organs and their functions ended and they were able to generalize the behaviors they acquired to different materials. Discussion: Based on the results of the study, it can be argued that the Augmented Reality offered with the Constant Time Delay Procedure is effective in teaching science subjects to childeren with intellectual disabilities. It can also be argued that the permanence of the acquired behaviors is high when students who have mental disabilities are taught science subjects by using Augmented Reality along with the Constant Time Delay Procedure. To generalize the results obtained in the present study, it may be suggested that the same practice be performed with other experimenters and different age groups. For the social validity of the study, the teachers of the participants expressed positive opinions about the Augmented Reality offered with target behaviors and Constant Time Delay Procedure.

민간갱생보호시설 운영개선 방안 연구

The purpose of this study was to explore effective operating strategies for private rehabilitation facilities by conducting a focus group interview with seven practitioners who work at private rehabilitation facilities. Results of the focus group interview identified two main themes, seven sub-themes, and sixteen units of meaning that influence the effective operation of private rehabilitation facilities. As the first main theme, the factors contributing to the effective operation of private rehabilitation facilities were analyzed into two sub-themes: ‘inclusive mindset towards ex-offenders’ and ‘experience-based practice.’ As the second main theme, the factors hindering the effective operation of private rehabilitation facilities were analyzed into five sub-themes: ‘insufficient operating budget’, ‘poor staffing situation’, ‘ineffective services’, ‘inefficient administrative supervision’, and ‘institutional discrimination and exclusion.’ Based on these research findings, this study discussed practical and policy implications for the effective operation strategies for private rehabilitation facilities targeting ex-offenders.

Examination of Academic Human Resource Management Policies of Private Special Education Institutions and Rehabilitation Centers

This research aims to examine the human resource management policies of private special education institutions and rehabilitation centers based on the managers’ views. The basic qualitative research design was adopted in the research. The participants of the study consisted of managers of private special education institutions and rehabilitation centers operating in the province of Adıyaman. Criterion sampling technique was adopted in determining the participants. In this context, semi-structured interviews were conducted with 15 managers of private special education institutions and rehabilitation centers. The data obtained from the interviews with managers has been analyzed through content analysis. In the research, the opinions of the institution managers regarding the teacher employment process of their institutions were discussed under the themes of "employment criteria“, “employment process," and "problems encountered in the employment process." Policies for teacher development were examined under the themes of "personal development" and "professional development", while policies for teacher integration were examined under the themes of "rewarding". Policies for teacher evaluation were studied under the themes of "in-house evaluation" and "external evaluation". According to research results, the policies that shape the employment process are related to the nature of pre-service education and the professional and academic qualifications of teacher candidates. Additionally, based on the views of school administrators, it has been concluded that the shortage of subject experts is one of the problems encountered in the human resources management process of teacher employment. However, it has been stated that career planning and policies for professional development are insufficient in the process of teacher training and development, and teacher evaluation policies are shaped within the framework of internal and external evaluation criteria.

Using Performance Status to Identify Risk of Acute Care Transfer in Inpatient Cancer Rehabilitation

ObjectiveTo identify patient factors associated with acute care transfer (ACT) among cancer survivors admitted for inpatient medical rehabilitation. DesignAn exploratory, observational design was used to analyze retrospective data from electronic medical records. SettingData were obtained from 3 separate inpatient rehabilitation hospitals within a private rehabilitation hospital system in the Northeast. ParticipantsMedical records were reviewed and analyzed for a total of 416 patients with a confirmed oncologic diagnosis treated in 1 of the inpatient rehabilitation hospitals between January and December 2020. InterventionsNot applicable. Main Outcome MeasuresThe primary outcome measure was the incidence of an ACT. Covariates included the adapted Karnofsky Performance Scale (KPS) for inpatient rehabilitation, demographic information, admission date, re-admission status, discharge destination, and cancer-related variables, such as primary cancer diagnosis and presence/location of metastases. ResultsOne in 5 patients (21.2%) were transferred to acute care. Patients with hematologic cancer had a higher risk of ACT compared with those with central nervous system (CNS) cancer. Lower functional status, measured by the adapted KPS, was associated with a higher likelihood of ACT. Patients with an admission KPS score indicating the need for maximum assistance had the highest transfer rate (59.1%). ConclusionsThese findings highlight the medical complexity of this population and increased risk of an interrupted rehabilitation stay. Considering patients’ performance status, cancer type, and extent of disease may be important when assessing the appropriateness of IRF admission relative to patient quality of life. Earlier and improved understanding of the patient's prognosis will allow the cancer rehabilitation program to meet the patient's unique needs and facilitate an appropriate discharge to the community in an optimal window of time.

Moving towards a continuous health care system—payment reform for post-acute care in Changsha City Of China

Introduction: As an integral component of a healthcare system，PAC is not fully developed in China largely attributing to the lack of sound medical insurance coverage and payment for PAC . Changsha City in the middle-south of China draws on international experience to carry out the value-based payment reform for post-acute rehablitation, in order to facilitate the development of rehablitative system and promote the continuity and integration of current health care system. 
 Practice change implementation: According to the characteristics and rehabilitation intensity of inpatients, rehabilitation treatment is divided into two stages: recovery stage and chronic stage. For each stage, different patient classification systems are applied. For recovery phase Functional-Related Groups（FRGs）,a case based payment system is established locally. For chronic phase, payment is made on per-diem basis, and Patient-Driven Chronic Rehabilitation Groups (PDCRG) are applied as casemix groups. The adapted version of International Classification of Functioning, Disability and Health(ICF) scale is used to collect patient data as well as measure their functional gain, which enables the implementation of value-based payment. 
 Aim and theory of change: The pilot reform is to support the effective and quality delivery of rehabilitation services, promote the development of PAC system, and push forward the value-based payment of the medical insurance.
 Targeted population and stakeholders: ·Inpatients with intensive or chronic rehabilitation needs in Changsha City
 ·Rehabilitation service providers (including general hospitals, public and private rehabilitation specialist hospitals and other facilities providing medical rehabilitation services）in Changsha City
 ·Social Medical Insurance Department of Changsha City
 Timeline: The payment policy was introduced in Jun. 2022 and the development is ongoing. 
 Highlights: The key outcomes, impact and innovation include:
 ·Continuous rehabilitation: recovery stage and chronic stage, with acute care before and long-term care after
 ·The refinement of ICF assessment scale to local practice and the development of PAC insurance information system based on the assessment
 ·Value-based payment: provide a method to measure the functional gain of rehabilitation inpatients and link hospital payment to patient outcomes
 ·Offer practical experience for reform of medical insurance payment mode of rehabilitation
 Sustainability: ·The proposed mode stimulates the development of rehabilitation care services, meanwhile, decreases the burden on the medical and long-term care systems
 ·As a supplement of other payment modes, value-based payment mode fills the gap of rehabilitation medical insurance and supports integration of medical services.
 Transfer-ability: Nowadays, China has been pushing ahead with the payment reform of acute hospitalization and developing long-term care insurance for disabled elderly. The Value-based payment model for PAC could reliably classify the needs of rehabilitation inpatients, promoting the development of PAC system. There is significant potential for the model to be replicated.
 Conclusions (comprising key findings, discussion and lessons learned): Aimed at building a sound payment system for post-acute rehabilitaion, the payment reform for PAC in Changsha put forward a value-oriented payment model based mainly on patients’ functional conditions and classified rehabilitative patients into two stages. In the future, the criteria of the two stages and the referral mechanisms in the system need to be further explored and established.

Conceptual Development on Factors influencing Customers Satisfaction in Private Rehabilitation Hospitals in Klang Valley

Rehabilitation medicine is a specialized interdisciplinary medicine that requires the cooperation and involvement of multiple healthcare teams working together towards the recovery and improvement of the quality of the involved patients. The increasing incidence of acute diseases such as stroke and the ageing population brings an increasing need for rehabilitation in Malaysia. However, there are limited academic studies conducted on customer satisfaction in private rehabilitation services, especially in Malaysia. Thus, this conceptual paper is visualized to demonstrate the antecedents of customer satisfaction in private rehabilitation hospitals from a Malaysian perspective, particularly in Klang Valley. A total of fifteen studies with regard to patient and family satisfaction in various healthcare services were reviewed and analysed. In order to determine the independent variables for conceptual framework development, a frequency analysis was done. The finding specified that information communication, treatment service quality, healthcare delivery process, infrastructure and facilities and physician factors are significantly influencing customer satisfaction in healthcare services. Based on the conceptual framework, an empirical study is planned in the future to investigate the factors influencing customer satisfaction in private rehabilitation hospitals. All five independent variables are found to correspond with the five dimensions of the SERVQUAL model.

Personality predicting relapse: A facet analysis of the NEO PI-R.

Revised NEO Personality Inventory (NEO PI-R) domains are associated with substance use disorders (SUD), including potential for relapse. However, individual facets of the NEO PI-R domains have not been rigorously analyzed. This paper assesses NEO PI-R individual facets among participants with SUD and their value in predicting relapse. Between 2015 and 2018, all patients admitted to a single private rehabilitation center (n = 642) were offered participation in this study. Participants who completed NEO PI-R questionnaires at the start of treatment and with known relapse outcomes up to 1-year posttreatment were included (n = 441). Statistical analysis included a series of unadjusted univariate logistic regressions and additional adjusted multivariate regression controlling for employment status in healthcare. Neuroticism, Agreeableness, and Conscientiousness domains had significant impacts on relapse. Three individual facets of Neuroticism were significant predictors of relapse, and seven individual facets within the Conscientiousness and Agreeableness domains were inversely related to relapse. When controlling for employment, Conscientiousness and three of its individual facets (Dutifulness, Competence, and Self-Discipline) continued to be significant in predicting relapse. The individual facets Impulsiveness and Straightforwardness also continued to be significant in predicting relapse. Several personality domains and facets were significantly related to relapse, confirming and expanding on prior literature. This study focuses on the risk of relapse as it relates to NEO PI-R individual facets, which have not been previously explored with a sample size of this magnitude. These findings can guide clinical care of patients with SUD, allowing for more targeted treatment.

Implementing a guideline-based education and exercise program for people with knee and hip osteoarthritis-Practical experiences of providers and clinic leaders: Aqualitative study.

The Good Life with osteoArthritis: Denmark (GLA:DTM ) program is an evidence-based education and exercise program designed for individuals with symptomatic hip and knee osteoarthritis. Launched in Denmark, it has been implemented across Europe, Australia, and North America. The authors assessed the feasibility of GLADTM implementation in Canada (Alberta) by applying the RE-AIM framework. An evaluation objective was to identify factors impacting the implementation of the program in both publicly funded and private rehabilitation settings, based on the experience of the initial cohort of providers and clinic leaders who set up and delivered the program. Semi-structured telephone interviews were conducted with GLA:DTM -trained providers, managers, or directors of clinics across Alberta. Braun and Clarke's thematic approach was used to code the data and identify emergent categories and themes. Those relevant to the implementation were identified and by consensus, categorized as facilitators of and challenges to the implementation process. Eighteen GLA:DTM -trained providers and three clinic leaders from a range of clinical settings completed an interview. Seven common themes emerged in relation to implementation across the study settings. Three themes reflect facilitators of implementation (program acceptability by providers, multi-level support mechanisms, and program flexibility) and four implementation challenges (direct and indirect costs, lack of external referrals, program access issues, and lack of suitable space). The initial implementation of the program was exploratory with limited focus on long-term sustainability. The GLA:DTM program is a translatable program that can be implemented with relative ease in both public and private rehabilitation settings; however, costs, space constraints, and having an adequate referral base were noted challenges. Further work is warranted to explore equitable access across public and private settings and program sustainability.

Digital vs. physical ear-nose-and-throat specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid treatment: a randomized controlled trial.

This study introduces a digital assessment tool for asynchronous and remote ear-nose-and-throat (ENT) specialist assessment screening for complicated hearing loss and serious ear disorders in hearing-impaired adults prior to hearing aid (HA) treatment. The +60 population will nearly double from 12% to 22% between 2015 and 2050 increasing the incidence of age-induced hearing impairment and the need for hearing rehabilitation. If un-diagnosed, age-related hearing loss negatively affects quality of life by accelerating social distancing and early retirement as well as increasing risk of anxiety, depression, and dementia. Therefore, innovative measures are essential to provide timely diagnostics and treatment. A total of 751 hearing-impaired adults without previous HA usage or experience were randomly assigned to digital or physical ENT specialist assessment screening prior to HA treatment initiation in 20 public and private hearing rehabilitation and ENT specialist clinics in the North Denmark Region. A total of 501 test group participants were assigned to digital assessment screening and 250 control group participants to physical assessment screening prior to HA treatment. In all, 658 (88%) participants completed the trial and were eligible for analysis. Digital screening sensitivity (0.85, 95% confidence interval (CI) 0.71-0.94) was significantly higher than physical screening sensitivity (0.2, 95% CI: 0.03-0.56). Screening specificity was high for both assessment methods. In a setting where hearing-impaired adults were assessed for HA treatment, digital ENT specialist assessment screening did not compromise patient safety or increase the risk of misdiagnosis in patients with complicated hearing loss and/or serious ear disorders when compared to physical ENT specialist assessment screening. https://clinicaltrials.gov/ct2/show/NCT05154539, identifier: NCT05154539.

Social Support, Self-Acceptance, and Adversity Quotient Among Residents of Selected Drug Treatment and Rehabilitation Center

The adversity quotient is essential especially among individuals in the clinical setting. The study aims to determine the role of social support and self-acceptance to the level of adversity quotient among rehab patients. The social support was measured in terms of emotional, companionship, informational, and tangible support. Control, ownership, reach, and endurance were the variables to measure adversity quotients. The respondents were 106 residents from private drug treatment and rehabilitation centers in the Philippines. The findings revealed that the patients have a high level of social support and self-acceptance and low level of adversity quotient. Social support and self-acceptance have significant positive relationships with control which suggests that the external support received by the residents and unconditional acceptance of oneself contributes to better handling of adversities in the life of the residents. Moreover, emotional, companionship, and tangible support and self-acceptance helps the residents not to suffer from the consequences of their negative experiences. The study recommends the importance of strong social support and self-acceptance in the residents’ ability to deal with adversities in life. Results and implications are further discussed in the study

Barriers and Facilitators to the Acceptance of eHealth Interventions by Dutch Pediatric Physical Therapists in Times of the COVID-19 Pandemic: A Mixed-Methods Approach.

The COVID-19 pandemic created an urgent need for eHealth as the relevance of infection control and social distancing continues. Evidence describing the acceptability of implementing eHealth into pediatric physical therapy services is limited. To investigate the determinants of eHealth acceptance by Dutch pediatric physical therapists during the COVID-19 pandemic. A mixed-methods approach was used. It included a quantitative exploratory questionnaire of 154 pediatric physical therapists and qualitative in-depth interviews of 16 pediatric physical therapists. The eHealth interventions were beneficial for collaboration between health care professionals and in addition to face-to-face therapy. eHealth interventions were, however, found to be unsuitable especially in the diagnostic phase. Barriers to more extensive application include costs, technical difficulties, and a perceived negative attitude of children. Pediatric physical therapists used eHealth interventions extensively in times of the COVID-19 pandemic. However, the acceptance of eHealth interventions is dependent on the pediatric physical therapist's perception of usefulness in private practice, rehabilitation setting, or clinical hospital.

A Web-based Survey on the Telerehabilitation Knowledge, Attitude, and Practice of Physical Therapists in a Developing Country during the COVID-19 Pandemic: An Analytical Cross-sectional Study.

Pre-pandemic, various healthcare settings were not used to seeing patients virtually. The unprecedented need to adopt virtual care during the COVID-19 pandemic may have caught physical therapists (PTs) unready for it. This study aimed to determine the telerehabilitation knowledge, attitude, and practice of PTs in the Philippines during the COVID-19 pandemic and determine the association between demographic and study outcome variables. This is an analytical cross-sectional study among members of the Philippine Physical Therapy Association, Inc. (PPTA) practicing in the Philippines. Purposive sampling (total enumeration) was employed. All PPTA members were invited to the study through e-mail and official social media group chats. A self-administered questionnaire was used to obtain data on telerehabilitation knowledge (through test questions on various theoretical aspects), attitude, and practice. The questionnaire items had a content validity index of >0.80. The study yielded a 40% response rate. Most respondents were practicing clinicians in urban-based, private rehabilitation centers. Approximately half had average telerehabilitation knowledge, while the majority had agreeable telerehabilitation attitudes across different constructs. Among the respondents, 15.9% used telerehabilitation pre-pandemic, while 64.8% used it during the pandemic. Hybrid (synchronous and asynchronous) telerehabilitation sessions usually lasted one hour per patient, mostly using Facebook Messenger. Telerehabilitation was not widely practiced locally pre-pandemic, which may explain their average telerehabilitation knowledge. The positive telerehabilitation attitudes may represent a small group of PTs favoring telerehabilitation, while information from the larger population remains unknown. Early adopters of telerehabilitation may help introduce virtual care to colleagues and guide them in developing relevant knowledge and skills amid and beyond the enduring COVID-19 crisis.

Relationship Between Functional Classification Systems in Children With Cerebral Palsy

Objective: Cerebral palsy refers to a group of postural and movement disorders that limit movements and can be related to a non-progressive disorder in the developing brain. The international classification of disability emphasizes the child's functional abilities and routine performance. Some classification tools have been developed to describe and evaluate child's functions in daily activities such as walking, manipulating objects, and everyday communication. The present study aimed to investigate the relationship between classification systems (gross motor function, manual ability, communication function, and eating and drinking ability) in children with cerebral palsy. Materials & Methods: This study was performed by cross-sectional correlation method and of descriptive analytical type. Children with cerebral palsy aged 12-144 months were recruited by convenience sampling from patients referred to clinics and public and private rehabilitation centers in Tehran and Arak cities, Iran, in 2019-2020. After completing the demographic information questionnaire by the child's primary caregiver, the gross motor function classification system (GMFCS), manual ability classification system (MACS), Communication function classification system (CFCS), and eating and drinking ability classification system (EDACS) were completed by a child therapist. Results: In the present study, 154 children with a Mean±SD age of 49.45±32.22 months participated. also, 87 children (56.5%) were boys, and 67(43.5%) were girls. According to GMFCS, the highest percentage distributions at levels II and IV were 31.2% and 26%, respectively. In other words, more than 57% of children were distributed in these two levels. According to MACS, the distributions of the highest percentages at levels II, III, and IV were 28.6%, 22.1%, and 20.8%, respectively. In other words, more than 70% of the children were distributed in these three levels. According to EDACS, the distribution of almost all levels was equal except the V level, with 4.3% having the lowest percentage. According to CFCS, the distribution of the highest percentage at levels V and IV was 23.5%. In examining the relationship between functional systems, significant relationships were observed in all cases: MACS and GMFCS, r=0.672; CFCS and GMFCS, r=0.581; EADCS and GMFCS, r=0.593; CFCS and MACS, r=0.555; EADCS and MACS, r=664; EADCS and CFCS, r=0. 547 (P<0.01). Conclusion: It seems that children with more motor function limitations show more limitations in other performance classification systems, too. Of course, the number of studies in this field is limited and needs further investigation.