Physiotherapy Canada最新文献

Purpose: Cognitive impairment is highly prevalent after stroke but can be difficult to identify acutely. We aimed to study if a large difference between two common, routine physical therapy assessments (timed up-and-go [TUG] test and 10-metre walk test [10MWT]) could identify patients with subtle cognitive difficulties post-stroke. Method: An observational study was conducted in 141 individuals admitted to acute in-patient rehabilitation after stroke. We computed the per cent difference between TUG and 10MWT performance. Cognitive outcome measures were the trail making tests A and B (TMT-A and TMT-B) and the Functional Independence Measure (FIM)-cognition subscale. Linear and logistic regression analyses were conducted to evaluate if the difference between TUG and 10MWT was associated with cognitive functioning. Results: After adjusting for covariates, there was no significant linear association between TUG-10MWT discrepancy and cognition; however, stroke patients with the largest difference between TUG and 10MWT (highest quartile of scores) exhibited significantly worse attention on the TMT-A (adjusted odds ratio = 2.46, p = 0.04). Conclusions: A large difference between TUG and 10MWT may reflect deficits in complex sustained attention in individuals with stroke. Physical therapy staff may use this difference score to identify patients with potential cognitive deficits and refer them for comprehensive neuropsychological evaluation.

Purpose: Pelvic health physiotherapy involves sensitive practices including internal assessment and treatment of the pelvic floor. Pelvic health physiotherapy education is not standardized in Canada, which may lead to diverse experiences. The purpose of this study was to explore the education and practice experiences of pelvic health physiotherapists in Canada. Method: This descriptive qualitative study used semi-structured interviews with physiotherapists providing pelvic health services in Canada and a reflexive thematic analysis approach. Results: Based on interviews with 20 pelvic health physiotherapists (19 women and one man) from six provinces, we identified four themes: the right fit, managing vulnerability, the holistic nature of pelvic health physiotherapy, and entering pelvic health physiotherapy requires thoughtful consideration. Participants described pelvic health physiotherapy as the right fit for themselves personally and professionally. The clinical practice involved managing their patients' and their own vulnerability and taking a holistic and biopsychosocial approach to treating patients with pelvic health conditions. Participants described the importance of mentorship and a supportive clinical environment when entering the field. Conclusions: This study provides an understanding of pelvic health physiotherapists' experiences, which can help to guide the advancement of pelvic health physiotherapy education and practice supports in Canada.

Purpose: To determine usability, feasibility, and reliability of an online questionnaire to assess clinicians' adherence to 10 postacute rehabilitation quality indicators (QIs) for total hip (THR) and knee replacement (TKR) and explore current rehabilitation practices across Canada. Method: Following usability testing with clinicians in BC and Quebec, we recruited rehabilitation clinicians across Canada to complete the online survey. Respondents rated adherence (past 3 months), importance, and feasibility for 10 QIs. We resent the survey 2-3 weeks later (test-retest reliability). Results: Based on usability testing, we made minor changes in wording, altered response options, and created a French language version. In total, 238 clinicians completed all or parts of the English (n = 123) and French (n = 115) questionnaires. Respondents mostly practised in the public sector (88%) and outpatient settings (42%). On average, clinicians met ("always" or "often" response) 23.3% (SD 13.7%, 95% CI: 21.1, 25.4) of THR and 25.5% (SD 15.1%, 95% CI: 23.0, 27.9) of TKR indicators. There were mixed views on the importance and feasibility of the QIs. Varied rehabilitation formats, duration, and dosage were described. Conclusions: Canadian rehabilitation clinicians report low overall adherence to THR and TKR rehabilitation QIs and differing rehabilitation approaches and models of care.

Purpose: The COVID-19 pandemic and resulting high number of individuals requiring hospitalization has caused health care systems worldwide to alter hospital policies and procedures. This study examined how changes in hospital operations between March 2020 and March 2021 affected physiotherapists' roles and responsibilities in Ontario, Canada. Method: Between February and March 2021, we conducted a cross-sectional study using an online survey of physiotherapists employed in acute care and rehabilitation hospitals. Results: Among 230 respondents, 82 (35.7%) reported being redeployed at some point during the study period to new settings or areas of practice. Physiotherapists typically working in outpatient settings were the most likely to be redeployed (63.3%), with 62.9% of respondents reporting caring for COVID-19 patients. Among 37.1% of respondents reporting undertaking new responsibilities (e.g., personal support work, nursing, infection control), 72.0% reported being confident in their abilities; however, only 49.4% felt adequately trained. Conclusions: Hospital-based physiotherapists in Ontario, Canada took on a variety of traditional and non-traditional responsibilities during the first year of the pandemic. Although confident in their abilities, feelings of being inadequately trained highlight the need for improved processes when taking on new responsibilities to support delivery of patient care and physiotherapists' well-being.

Purpose: To describe programme representatives' perceptions of the: (1) type and work setting of health care professionals who refer to community-based exercise programmes with health care-community partnerships (CBEP-HCPs) by community size; (2) nature, frequency, and utility of strategies used to promote referral from health care professionals to CBEP-HCPs; and (3) facilitators and barriers to CBEP-HCP promotion. Method: We invited individuals involved with the Together in Movement and Exercise (TIME™) programme in 48 centres to participate in a cross-sectional survey. TIME™ is a group, task-oriented CBEP-HCP taught by fitness instructors; health care partners promote referrals. Data were summarized using frequencies and percentages. Content analysis was used for open-ended questions. Results: Twenty-three representatives of 27 TIME™ programmes (56% response rate) participated. Out of 26 health care partners identified, 69% were physical therapists. We report the most common findings: programmes received referrals from physical therapists (16, 70%); programmes gave health care partners promotional materials (e.g., flyers) to facilitate referrals (n = 17, 63%); strong relationships with health care partners facilitated promotion (n = 18, 78%); and representatives perceived their lack of credibility challenged promotion (n = 3, 23%). Conclusions: Physical therapists were the most common referral source. Health Care partners were instrumental in programme promotion. Future research is needed to leverage referrals from physical therapists in settings other than hospitals and to better understand the role of health care partners in CBEP-HCPs.