Physiotherapy Research International最新文献

Background and purpose: Restricted dorsiflexion range of motion (DFROM) could impact dynamic balance in sports. This study aimed to investigate the relationship between dorsiflexion range of motion and the Y-Balance Test (YBT) in elite futsal players.

Methods: Sixty-one asymptomatic male futsal players (mean age 26.57 (5.64) years, a mean body mass index of 25.40 (2.69) kg/m² ) were included. DFROM was measured by the weight-bearing lunge test (WBLT). DFROM data were obtained using smartphone-based motion capture. The Pearson correlation coefficient verified the correlation between the variables.

Results: Dominant and nondominant leg ankle DFROM was significantly correlated with the anterior component of YBT (r = 0.27 and 0.51, respectively). The posteromedial component and the composite score of the YBT were also significantly correlated with nondominant leg ankle DFROM (r = 0.31 and 0.34, respectively)]. The other measures were not statistically significant. DFROM explained between 7% and 24% of the variation of the distances reached in the YBT.

Conclusion: Dorsiflexion range of motion measured by weight bearing lunge test is positively correlated with dynamic balance in futsal players.

Background: In May 2019, the World Health Organization (WHO) added burn out to the list of occupational phenomena in the 11th Revision of the International Classification of Diseases (ICD-11). Soon thereafter, in March 2020, a global pandemic of SARS-COV-2 was declared.

Objective: To investigate the interplay between transformational leadership, a proactive personality, employee proactive behaviors, and burn out in the field of physiotherapy during the SARS-COV-2 pandemic.

Methods: Physiotherapists working at the Meuhedet Health Maintenance Organization (HMO) were asked to fill an online cross-sectional survey, in which they were asked to evaluate the transformational behavior of their manager and to assess their own burn out rate, degree of self-efficacy, proactive personality, and proactive behaviors. Eighty-one physical therapists (average age of 37.3 years (SD = 9.0)) responded to the survey, most of whom were female (67.9%, n = 55).

Results: Transformational leadership and proactive personality were negatively associated with occupational burn out (β = -0.231, p < 0.05, β = -0.243, p < 0.05, respectively) among physiotherapists. The effect of the interaction between transformational leadership and proactive personality on proactive behaviors at work was not significant. However, a strong, significant positive relationship was found between proactive personality and proactive behaviors (β = 0.425, p < 0.001), and between self-efficacy and proactive behaviors (β = 0.479, p < 0.001).

Conclusions: This up-to-date survey of transformational leadership and proactive personality among physiotherapists highlights these traits' important impact on burn out and proactive behaviors during the SARS-COV-2 pandemic. Furthermore, the transformational manager plays an important role in reducing burnout levels among physiotherapists, especially during a crisis such as the SARS-COV-2 pandemic.

Background and purpose: The therapeutic relationship is a central component for developing person-centered care within physiotherapy services. However, it is necessary to understand how this relationship is perceived by both parties involved. The Person Centered Therapeutic Relationship-Patient scale (PCTR-PT) was constructed to identify patients' perceptions. No instruments are currently available to correlate patients' and physiotherapists' perceptions of the therapeutic relationship. This study sought to adapt the PCTR-PT to develop a version for physiotherapists, the Person Centered Therapeutic Relationship Scale for Physiotherapists (PCTR-PHYS) and to determine its psychometric properties.

Methods: A three-stage study was performed: (1) item generation, (2) pretesting of the questionnaire, (3) analysis of psychometric properties. Factor validity and psychometric properties were analyzed by confirmatory factor analysis (CFA). Convergent validity was calculated. Internal consistency was verified using the Cronbach's alpha coefficient. The intraclass correlation coefficient (ICC) was used to examine temporal stability.

Results: Thirty-three physiotherapists participated in two rounds of cognitive interviews and 343 participated in the analysis of psychometric properties. The CFA confirmed the four-structure model. Reliability of the tool was confirmed by Cronbach's alpha (α = 0.863) for all four dimensions, as all were above 0.70, ranging from 0.704 (relational bond) and 0.898 (therapeutic communication). Test-retest was performed with 2-week intervals, indicating an appropriate stability for the scale (ICC = 0.908).

Discussion: The Person Centered Therapeutic Relationship Scale for Physiotherapists is a useful, valid and applicable instrument to evaluate the person-centered therapeutic relationship during physiotherapy interventions. It will enable the comparison of patients' and physiotherapists' perceptions. To provide person-centered care in physiotherapy services, there is a clear need to incorporate specific resources into clinical practice to evaluate the quality of the therapeutic relationship from the perspective of both the persons being treated and the professionals providing care.

Background: Parkinson's disease (PD) is the second most common progressive neurodegenerative disorder. Exercise protocols are promising interventions to improve PD symptoms, however, the best modality and its neural correlates are still unknown.

Objectives: To evaluate the effects of the aerobic, strength and task-oriented upper-limb exercises in motor function, manual dexterity, and brain oscillations of individuals with PD.

Method: In this clinical trial, 44 PD patients aged 40-80 years will be randomized in four groups: aerobic training (AT), strength training (ST), task-oriented training (TOT), and waiting list group (CG). The AT group will perform 30 min of a cycle ergometer on 50%-70% of the reserve heart rate. The ST group will use equipment for upper limb muscles and will perform two series of 8-12 repetitions for each exercise, and intensity between 50% and 70% of one maximum repetition will be used. The TOT group will perform a program consisting of three activities to enhance reaching, grasping, and manipulation. All the groups will perform three sessions per week for 8 weeks. We will use the UPDRS Motor function section, Nine-Hole Peg Test, and quantitative electroencephalography to measure motor function, manual dexterity, and brain oscillations, respectively. ANOVA and regression models will be used to compare outcomes within and between groups.

Background: Physiotherapists had faced a new healthcare scenario characterised by the restrictions caused by the COVID-19 pandemic.

Purpose: To explore the impact of the COVID-19 pandemic on the physiotherapy profession from the perspective of physiotherapists working in the public and private sectors.

Methods: Qualitative study based on semi-structured personal interviews with 16 physiotherapists working in public, private, or public-private partnership sectors in Spain. The data were collected between March and June 2020. Inductive qualitative content analysis was performed.

Results: The participants (13 women, 3 men; aged 24-44 years) had professional experience in diverse healthcare settings (primary, hospital, home, consultations, insurance companies, associations). Five categories were identified: (1) the impact of lockdown on the health of physiotherapy users; (2) managing the demand for physiotherapy services during lockdown; (3) introducing protocols and protective measures in physiotherapy consultations; (4) changes in therapeutic approaches; and (5) future expectations in the physiotherapy care model. Physiotherapists perceived that lockdown caused a decline in the functionality of people with chronic conditions, together with a reduction in the physiotherapy services. Difficulties in prioritising users considered urgent became evident, and the inclusion of prophylactic measures affected treatment duration differently depending on the care setting and the pandemic prompted the use of telerehabilitation.

Discussion: The pandemic affected the functional status of chronic physiotherapy users and made treatment time, quality of care and triage protocols visible. In physiotherapy, technological barriers need to be solved, such as digital literacy, families without resources, situations of dependency and cultural barriers.

Background and purpose: Evidence-based practice (EBP) has been widely implemented in different areas of biomedical sciences. However, no precedents in Argentina have investigated the data regarding the knowledge and difficulties related to EBP in physiotherapists. The purpose was to describe the self-reported behavior, knowledge, skills, opinion, and barriers related to the EBP of Argentinian physiotherapists.

Methods: A customized descriptive survey was conducted among 289 physical therapists in Argentina. The data were analyzed descriptively.

Results: The response rate was 56% (163/289). Argentinian physiotherapists update themselves through scientific articles, meetings, congresses, and courses. They reported having sufficient knowledge to use EBP, informing patients about treatment options, and considering their choices in the decision-making process. However, there were inconsistencies in responses regarding experience with EBP during undergraduate or postgraduate studies. The most frequently reported barriers were lack of time, difficulty in understanding statistics, and difficulties with the English language of scientific articles.

Discussion: EBP in Argentine physiotherapists is still poorly understood. Time, language, and difficulties in understanding statistics are the most important barriers to the implementation of EBP. Undergraduate and postgraduate courses are warranted to improve the clinical decision-making process.

Background and purpose: The World Health Disability Assessment Schedule 2.0 (WHODAS 2.0) was developed to assess health and disability based on the biopsychosocial model. The WHODAS 2.0 has not been validated for Brazilians with chronic non-specific low back pain (LBP). We aimed to evaluate the reliability, internal consistency, and construct validity of the Brazilian version of the WHODAS 2.0 in patients with chronic LBP.

Methods: Methodological study. The Brazilian version of the WHODAS 2.0 was applied to 100 volunteers with chronic nonspecific LBP. Test-retest reliability, internal consistency, and construct validity were assessed using the Spearman correlation test, Cronbach's alpha (α) coefficient, and Spearman's correlation test between WHODAS 2.0, the Oswestry Disability Index (ODI), Roland-Morris Disability Questionnaire (RMDQ), and Fear Avoidance Beliefs Questionnaire (FABQ), respectively.

Results: WHODAS 2.0 showed satisfactory test-retest reliability with a moderate correlation for total WHODAS 2.0 (r = 0.75, p < 0.05). Internal consistency was adequate for all domains and total score (α = 0.82-0.96). Regarding construct validity, WHODAS 2.0, ODI (r = 0.70, p < 0.05), and WHODAS 2.0 and RMDQ (r = 0.71, p < 0.05) had significant correlations. Total WHODAS 2.0 and FABQ-Phys subscale scores correlated moderately (r = 0.66, p < 0.05).

Discussion: The Brazilian WHODAS 2.0 was proved to be a valid and reliable tool for patients with chronic LBP. The item referring to sexual intercourse had 27% and 30% of the missing values during the test and retest stage, respectively and had a high percentage of missing data for work-related questions (41% missing data) in the life activities domain; therefore, the data must be interpreted with caution.

Implications for physiotherapy practice: WHODAS 2.0 can be used as a disability assessment strategy from a biopsychosocial perspective in this population.

Background and purpose: To identify the paediatric curriculum content covered in entry-level physiotherapy programs within the United Kingdom (UK), and report faculties perceived importance. Strengths, weaknesses, barriers and facilitators, to the implementation of paediatric content were explored.

Methods: A cross-sectional online questionnaire captured entry-level physiotherapy programme leaders' perceptions of paediatric programs.

Results: Fifty-five responses were submitted, providing a 67% completion rate. Faculty perceived that students' felt the inclusion of paediatric content within the curricula was 'Important' (Mean 3.60 ± SD 0.74). Of 30 diagnoses surveyed, only two were covered 'Well' within curriculums, despite 23 rated at least 'Important' by respondents. Of the 18 assessment/examination components, 13 were covered 'Well' with five 'Somewhat'. All were considered to be at least 'Important'. Perceived strengths were grouped into three main categories (1) integrated/lifespan approach, (2) links to clinical specialists, and (3) a broad/detailed curriculum. Perceived weaknesses included curriculum time pressures and paediatric placement availability.

Discussion: The majority of paediatric conditions were only somewhat covered by UK curriculums, despite respondents in the main believing they should be an important element of the entry-level syllabus. Some UK physiotherapy entry-level students may not be exposed to any paediatric teaching or clinical placements.

Purpose: Osteoarthritis (OA) is a major threat to public health worldwide and is predicted to increase. Existing interventions to implement clinical practice guidelines (CPGs) seem to be used mainly in the Western world. We conducted a structured educational program on the evidence-based management of OA (BOA) for Indian physical therapists (PT). Our study aimed to describe Indian PTs' knowledge, attitudes and confidence on evidence-based management of OA, and their perceptions of a course on this subject.

Methods: The 2-day course included didactic parts and practical skills training. Thirty-five PTs participated and answered a questionnaire. Fourteen of them participated in focus group interviews. Questionnaire data are presented as medians and full ranges. Manifest content analysis was used to analyze interview data that are presented as catagories illustrated by interview quotes. The formal ethics permission was granted.

Results: 74% of PTs agreed that radiography determines the type of treatment required, and 69% agreed that a prescription for exercise is enough to ensure adherence. PTs agreed (mean 5 on 6-point scale) that exercises increasing pain should be advised against. Confidence in guiding the physical activity was generally high (≥5 on 6-point scales). Five categories reflected participants' perceptions of the course content: Shift in management focus, Need for cultural adaptation, Importance of social support, Development of organization and collaboration, and Feelings of hesitation.

Discussion: Our results indicate that in order to facilitate the implementation of CPGs, PT curricula may consider the inclusion of knowledge on CPGs, focus more on students' own reflections on transforming theory into practice, and incorporate training of basic skills required for implementation of self-management, body awareness, and neuromuscular fitness. If given access and mandates, PTs may play a major role in the early diagnosis and treatment of OA and thus contribute to the prevention of an epidemic of OA in India.

Background and purpose: Pressure biofeedback is a tool that can detect the movement of a structure and may be used as an indicator of muscle function. It's widely used to measure the transversus abdominis (TrA) muscle activity. Pressure biofeedback (PBU) monitors the abdominal wall movement by measuring the pressure change during abdominal hollowing and can indirectly evaluate the TrA muscle function, which is considered as a valuable tool. The evaluation of the training of core muscles, including the transversus abdominis, requires a reliable outcome. Various methods using different positions are used to evaluate the transversus abdominis muscle function. However, it is noted that a standard way of evaluation and training still needs to be improved in research and clinical practice. This technical report discusses the optimal position and technique to measure the TrA muscle activity using PBU, with discussions on the merits and demerits of the body positions.

Methods: The technical report is presented with a literature review of the PBU measurement of TrA and through observation in the clinical practice. The evaluation methods of TrA, including the position to activate and isolate, are discussed in detail.

Results: Training core muscles does not imply TrA activation, and evaluating isolated TrA and multifidus is essential before intervention. The abdominal drawing-in maneuver effectively activates TrA in various evaluation positions of the body, but when using PBUs, it would be valid in a prone position.

Discussion: Different body positions are practiced to train TrA and core muscles using PBU, commonly adopted by practice are in supine. It's noted that most of the studies lack in establishing the effectiveness of the position in evaluating the TrA muscle activity using PBU. The need for insight into an appropriate technique for evaluating TrA activity is addressed in this technical report. This report presents key points on the complete technique and concludes that the prone position is superior to other positions and recommended for measuring and recording the TrA activity using a PBU.