Physiotherapy [JOURNAL]
Sun
200 papers
Views and experiences of non-medical prescribing: a national survey of prescribing physiotherapists.
Parkinson DI, Hartley SE
Physiotherapy · 2024 Sep · PMID 38986243 · Publisher ↗
BACKGROUND: Physiotherapy non-medical prescribing (NMP) is a contemporary development whereby physiotherapists can prescribe medications within their scope of practice. Despite institutional and professional support for...
BACKGROUND: Physiotherapy non-medical prescribing (NMP) is a contemporary development whereby physiotherapists can prescribe medications within their scope of practice. Despite institutional and professional support for its implementation, data regarding physiotherapists' views and experiences of NMP is limited. OBJECTIVES: To explore the views and experiences of NMP for UK prescribing physiotherapists. DESIGN: Cross-sectional study, using an anonymous, online survey. METHODS: Recruitment involved non-probability sampling targeting UK physiotherapists with a NMP qualification. Data was gathered about the role, scope, and activity of prescribing physiotherapists via closed and open-ended questions. Descriptive statistics and inductive content analysis were undertaken. RESULTS: Of the 552 respondents, most worked in FCP roles (122/552, 22%) and 82% (450/552) prescribed medication. NSAIDs were the most prescribed drug class (267/450, 59%). Perceived benefits were enhanced patient care, reduced burden on other prescribers, and improved medication access. Challenges included restrictions on prescribing or deprescribing controlled drugs (CDs), limited scope of practice, and inadequate CPD. Themes identified to improve physiotherapy NMP were increasing the CDs that physiotherapists can independently prescribe and deprescribe, improving CPD and supervision, and increasing awareness amongst the public and healthcare professionals. CONCLUSIONS: This study provides novel findings of the perceived benefits, challenges, and development areas for physiotherapy prescribing. There is a need to review and potentially expand the drug formulary for physiotherapists. Improving education and supervision is crucial for the sustainable growth of physiotherapy NMP. Increasing the awareness amongst the public and healthcare professionals may enhance the acceptance of physiotherapy prescribing. CONTRIBUTION OF THE PAPER.
Prevalence of burnout among physiotherapists: a systematic review and meta-analysis.
Venturini E, Ugolini A, Bianchi L … +2 more , Di Bari M, Paci M
Physiotherapy · 2024 Sep · PMID 38943718 · Publisher ↗
BACKGROUND: Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the quality of care delivered to patients. OBJ...
BACKGROUND: Work-related burnout is a significant concern amongst healthcare professionals, including physiotherapists. It can negatively impact on both staff well-being and the quality of care delivered to patients. OBJECTIVES: To estimate the prevalence of burnout among physiotherapists. DATA SOURCES: PubMed, CINAHL, Web of Science, Embase, Scopus and PsycINFO, from inception to February 1st, 2022. STUDY SELECTION OR ELIGIBILITY CRITERIA: Studies reporting burnout prevalence among physiotherapists. DATA EXTRACTION AND DATA SYNTHESIS: Prevalence of burnout. Sub-analyses were performed grouping studies based on countries where surveys were conducted, classified as developed or developing countries. The risk of bias was assessed using a modified version of the Newcastle-Ottawa Scale. RESULTS: 32 studies were included in the systematic review and 31 in the meta-analysis, enrolling a total of 5984 physiotherapists from 17 countries. Pooled prevalence (95% confidence interval) of burnout was 8% (4-15). Prevalence figures for Maslach Burnout Inventory dimensions were: (i) emotional exhaustion, 27% (21-34) (ii) depersonalization, 23% (15-32) (iii) low personal accomplishment, 25% (15-40). Both overall and single components prevalence was higher, although not significantly, in studies from developing than in developed countries. LIMITATIONS: Tools used to assess burnout and cut-off scores chosen to identify the burnout prevalence differed across studies. CONCLUSION AND IMPLICATIONS OF KEY FINDINGS: Prevalence of burnout reported by physiotherapists appears high worldwide, in particular in developing countries, and compares with that reported by nurses and physicians. Substantial heterogeneity in the prevalence of burnout, in its definition and assessment methods across studies, and limited quality of most studies precludes drawing definitive conclusions. SYSTEMATIC REVIEW REGISTRATION NUMBER: PROSPERO CRD42022307876 CONTRIBUTION OF THE PAPER.
Rehabilitation guidelines following arthroscopic shoulder stabilisation surgery for traumatic instability - a Delphi consensus.
Willmore E, Bateman M, Maher N … +6 more , Chester R, O'Sullivan J, Horsley I, Blacknall J, Gibson J, Jaggi A
Physiotherapy · 2024 Sep · PMID 38908262 · Publisher ↗
BACKGROUND: There is no consistent approach to rehabilitation following arthroscopic shoulder stabilisation surgery (ASSS) in the UK. The aim of this study was to agree a set of post-operative guidelines for clinical pra...
BACKGROUND: There is no consistent approach to rehabilitation following arthroscopic shoulder stabilisation surgery (ASSS) in the UK. The aim of this study was to agree a set of post-operative guidelines for clinical practice. METHOD: Expert stakeholders (surgeons, physiotherapists and patients) were identified via professional networks and patient involvement and engagements groups. A three-stage online Delphi study was undertaken. Consensus was defined by the OMERACT threshold of 70% agreement. RESULTS: 11 surgeons, 22 physiotherapists and 4 patients participated. It was agreed patients should be routinely immobilised in a sling for up to 3 weeks but can discard earlier if able. During the immobilisation period, patients should move only within a defined "safe zone." Permitted functional activities include using cutlery, lifting a drink, slicing bread, using kitchen utensils, wiping a table, light dusting, pulling up clothing, washing/drying dishes. Closing car doors or draining saucepans should be avoided. Through range movements can commence after 4 weeks, resisted movements at 6 weeks. Patients can resume light work as they feel able and return to manual work after 12 weeks. Return to non-contact sports when functional markers for return to play are met was agreed. Return to contact sport is based on function & confidence after a minimum of 12 weeks. Additional factors to consider when determining rehabilitation progression: functional/physical milestones, patient's confidence and presence of kinesiophobia. The preferred outcome measure is the Oxford Instability Shoulder Score. CONCLUSION: This consensus provides expert recommendations for the development of rehabilitation guidelines following ASSS. CONTRIBUTION OF THE PAPER.
Patients', physiotherapists' and other stakeholders' experiences and perceptions about supported home physiotherapy for people with musculoskeletal conditions: a qualitative study.
Withers HG, Liu H, Glinsky JV … +21 more , Chu J, Jennings MD, Hayes AJ, Starkey I, Palmer BA, Szymanek L, Cruwys JJ, Wong D, Duong K, Barnett A, Tindall M, Lucas B, Lambert TE, Taylor D, Sherrington C, Ferreira M, Maher C, Zadro J, Hart K, Hodge W, Harvey LA
Physiotherapy · 2024 Sep · PMID 38901217 · Publisher ↗
OBJECTIVES: Exercise, support and advice are the key treatment strategies of musculoskeletal problems. The aims of this study were to determine patients', physiotherapists', and other stakeholders' perspectives about sup...
OBJECTIVES: Exercise, support and advice are the key treatment strategies of musculoskeletal problems. The aims of this study were to determine patients', physiotherapists', and other stakeholders' perspectives about supported home physiotherapy for the management of musculoskeletal problems and to identify the barriers and facilitators to rolling out this model of physiotherapy service delivery. METHODS: This study was conducted as part of a process evaluation run alongside a large trial designed to determine whether supported home physiotherapy is as good or better than a course of in-person physiotherapy. Forty interviews were conducted with 20 trial participants, 15 physiotherapists, and 5 other stakeholders. The interviews were semi-structured and based on interview guides. Each interview was transcribed and a three-tiered coding tree was developed. RESULTS: Six key themes were identified. Supported home physiotherapy (i) is convenient for some patients, (ii) does not always align with patients' and therapists' expectations about treatment (iii) is suitable for some but not all, (iv) can reduce personal connection and accountability, (v) has implications for physiotherapists' workloads, and (vi) has barriers and facilitators to future implementation. CONCLUSIONS: Findings suggest that patients are far more accepting of supported home physiotherapy than physiotherapists assume. This model of service delivery could be rolled out to improve access to physiotherapy and to provide a convenient and effective way of delivering physiotherapy to some patients with musculoskeletal conditions if our trial results indicate that supported home physiotherapy is as good or better than in-person physiotherapy. CLINICAL TRIAL REGISTRY NUMBER: ACTRN12619000065190 CONTRIBUTIONS OF THIS PAPER.
Neuropathic pain is a feature in patients with symptomatic femoral acetabular impingement.
Wood S, Coxon L, Glyn-Jones S … +1 more , Barker KL
Physiotherapy · 2024 Sep · PMID 38896948 · Publisher ↗
UNLABELLED: Femoral acetabular impingement syndrome (FAIS) is a cause of hip pain thought to be nociceptive, although pain phenotypes e.g., burning, pain attacks, prickling, numbness etc., are reported, mimicking neuropa...
UNLABELLED: Femoral acetabular impingement syndrome (FAIS) is a cause of hip pain thought to be nociceptive, although pain phenotypes e.g., burning, pain attacks, prickling, numbness etc., are reported, mimicking neuropathic pain. Although no lesion to the somatosensory system is identified, neuropathic pain (NeP) may explain why nociceptive-focussed treatments are not always successful. OBJECTIVE: To identify NeP in patients with FAIS and investigate if related to poorer outcomes. DESIGN: A secondary analysis of the Femoral Acetabular Impingement Trial (FAIT). Outcome of interest: PainDETECT questionnaire; secondary outcomes of interest; International Hip Outcome Tool (iHOT33), Hospital Anxiety and Depression Scale (HADS) and VAS 'average pain over a month', at baseline and 8 months follow-up. Intervention (surgery or physiotherapy) were pooled. RESULTS: 173 data sets at baseline; 123 at 8 months follow-up. Baseline painDETECT identified three groups: 69% nociceptive, 19% unclear and 12% neuropathic pain phenotypes. Baseline, median scores were higher for the neuropathic group compared to the nociceptive group demonstrating borderline anxiety (9.5(5.3 to 14.2), 5(3 to 8), higher normal values for depression (7.5(2.3 to 11.8), (4(2 to 9), higher average pain (7 (6 to 8), 5(4 to 6) and lower iHOT33 14.2(9 to 21.1), 38.4(26.2 to 55.7). Post treatment, there was a median change in the neuropathic score in both iHOT33 (40.8 (25 to 76.5) with a median difference of 24.13 (CI 95% 10.46 to 45.92) and average pain 4.5(1.5 to 7) with a median difference of 2 (CI 95% 1 to 5) but to a lesser amount than the nociceptive group, iHOT33 (64(38.2 to 86.6) with a median difference of 15.50 (CI 95% 6.41 to 21.82) and average pain 3(1 to 5.7) with a median difference of 1 (CI 95% 0.5 to 1). CONCLUSION: NeP exists in symptomatic FAIS patients and is associated with increased average pain, and functional limitations. Nociceptive-targeted treatment improves hip function and pain but with less improvement in the NeP group when compared to the nociceptive group. Pain phenotyping before intervention may improve outcomes. CONTRIBUTION OF PAPER.
Clinical negligence and physiotherapy: UK survey of physiotherapists' experiences of litigation.
Yeowell G, Leech R, Greenhalgh S … +2 more , Willis E, Selfe J
Physiotherapy · 2024 Sep · PMID 38889595 · Publisher ↗
AIM: To investigate the extent and impact of litigation on the UK physiotherapy profession. DESIGN: An online cross-sectional questionnaire survey design was used. The survey was open to all qualified physiotherapists wh...
AIM: To investigate the extent and impact of litigation on the UK physiotherapy profession. DESIGN: An online cross-sectional questionnaire survey design was used. The survey was open to all qualified physiotherapists who have practiced in the UK, from any speciality, of any grade and from any setting including NHS, non-NHS, and private practice. RESULTS: 688 respondents completed the survey (96% CI). All UK nations were represented. 73% were female, 44% were qualified >20 Years. Most worked in the NHS (74%) and worked in a neuromusculoskeletal setting (62%). 10% of respondents had been involved in litigation. 128 claims were reported with some respondents being involved in more than 1 case. Litigation was a highly stressful experience for those who experienced it and was a source of concern for many others. The personal impact was stress (76%) and worry and anxiety (67%). The most common professional impact was defensive practice (68%). Most respondents incorrectly identified who should provide their legal support. 46% were not satisfied with the support received. Most (77%) reported that litigation training should be included in pre-registration, as well as postgraduate (68%) programs. CONCLUSION: This is the first UK survey that has investigated the experiences of litigation on the UK physiotherapy profession. Ten percent of physiotherapists in our survey had been involved in litigation. Litigation impacted physiotherapists' physical and mental wellbeing and their clinical practice. Improved support, both emotional and legal is required. Clinical negligence training should be included in pre-registration and postgraduate programs. CONTRIBUTION OF THE PAPER.
Metabolic syndrome is prevalent and undiagnosed in clients attending private practice physiotherapy: a cross-sectional study.
Mastwyk S, Taylor NF, Lowe A … +2 more , Dalton C, Peiris CL
Physiotherapy · 2024 Sep · PMID 38878590 · Publisher ↗
OBJECTIVES: To determine the prevalence of metabolic syndrome in clients presenting for primary care physiotherapy within private practice settings, and the factors that may be associated with metabolic syndrome. The sec...
OBJECTIVES: To determine the prevalence of metabolic syndrome in clients presenting for primary care physiotherapy within private practice settings, and the factors that may be associated with metabolic syndrome. The secondary aim was to determine client's attitudes towards lifestyle change. DESIGN: A cross-sectional study in which self-report and biometric data were collected. The study was conducted in physiotherapy private practices across metropolitan and regional areas, Australia. PARTICIPANTS: 230 clients (mean age 54 (SD18) years, 64% women) presenting for physiotherapy participated. MAIN OUTCOME MEASURES: Participant socio-demographic and lifestyle characteristics were collected. Metabolic syndrome presence was determined by the existence of three or more risk factors on physical examination and capillary blood sample: abdominal obesity, hypertension, elevated random blood glucose, elevated triglycerides and/or reduced HDL cholesterol. RESULTS: Thirty-seven percent of participants had metabolic syndrome, but none knew they had it. Metabolic syndrome was associated with older age and poorer socio-economic status and may have been associated with lower levels of physical activity but not diet. Of those identified as having hypertension and elevated triglycerides, many were undiagnosed (56% and 29% respectively). CONCLUSION: Metabolic syndrome is prevalent and undiagnosed in clients attending private practice physiotherapy. Clients felt lifestyle change was important and they were willing to make changes. This study highlights the need for greater screening of metabolic risk factors in primary care and presents an opportunity for physiotherapists in private practice to identify risk and intervene to improve the overall health of their clients and contribute to chronic disease prevention. CONTRIBUTION OF THE PAPER.
Response to Letter to the Editor on: The concurrent validity and reliability of virtual reality to measure shoulder flexion and scaption range of motion.
Dejaco B, de Jong LD, Staal JB … +3 more , van Goor H, Stolwijk N, Lewis J
Physiotherapy · 2024 Dec · PMID 38876910 · Publisher ↗
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Letter to Editor regarding article, "Physiotherapy students are underprepared to work with people living with dementia: a qualitative study".
Barotia C, Soni N
Physiotherapy · 2025 Mar · PMID 38876909 · Publisher ↗
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Effectiveness of supervised physiotherapy versus a home exercise program in patients with distal radius fracture: a randomized controlled trial with a 2-year follow-up.
Gutiérrez-Espinoza H, Gutiérrez-Monclus R, Román-Veas J … +3 more , Valenzuela-Fuenzalida J, Hagert E, Araya-Quintanilla F
Physiotherapy · 2024 Sep · PMID 38875842 · Publisher ↗
OBJECTIVE: To determine in the long term whether supervised physiotherapy is more effective than a home exercise program for functional improvement and pain relief in patients with distal radius fracture (DRF). DESIGN: R...
OBJECTIVE: To determine in the long term whether supervised physiotherapy is more effective than a home exercise program for functional improvement and pain relief in patients with distal radius fracture (DRF). DESIGN: Randomized controlled trial. SETTING: Rehabilitation hospital. PARTICIPANTS: A total of 74 patients older than 60 years with extra-articular DRF were randomly allocated into two groups. INTERVENTIONS: The experimental group received 6 weeks of supervised physiotherapy (n = 37) and the control group received 6 weeks of home exercise program (n = 37). MAIN OUTCOME MEASURES: The primary outcome was wrist/hand function assessed using the Patient-Rated Wrist Evaluation (PRWE) questionnaire; secondary outcomes were the pain visual analogue scale (VAS), grip strength and wrist flexion-extension active range of motion. RESULTS: All patients completed the trial. For the primary outcome, at 6-weeks and 1-year follow-up, the PRWE questionnaire showed a mean difference between groups of 18.6 (95% CI 12.8 to 24.3) and 18.5 points (95% CI 12.7 to 24.2) respectively, these differences are clinically important. Conversely, at 2-year follow-up this effect decreases to 3.3 points (95% CI -2.4 to 9.0). For secondary outcomes, at 6-weeks and 1-year follow-up, in all measurements the effect size range from medium to large. Conversely, at 2-year follow-up only grip strength showed large effect size in favor of supervised physiotherapy, the rest of outcomes did not show difference between groups. CONCLUSION: At the 6-week and 1-year follow-up, supervised physiotherapy was more effective for functional improvement and pain relief compared with a home exercise program in patients older than 60 years with extra-articular DRF. However, this effect decreases over time, at the 2-year follow-up, only grip strength showed a difference in favor of supervised physiotherapy. TRIAL REGISTRATION: Brazilian registry of clinical trials UTN no. U1111- 1249-2492. Registered 17 March 2020. CONTRIBUTION OF THE PAPER.
Reference values for the 1-minute sit-to-stand and 5 times sit-to-stand tests to assess functional capacity: a cross-sectional study.
Vilarinho R, Montes AM, Noites A … +2 more , Silva F, Melo C
Physiotherapy · 2024 Sep · PMID 38875841 · Publisher ↗
OBJECTIVES: To establish age-specific and sex-specific reference values and equations for the 1-minute sit-to-stand (1MSTS) and 5 times sit-to-stand (5TSTS) tests for Portuguese adults. DESIGN: Cross-sectional study. Des...
OBJECTIVES: To establish age-specific and sex-specific reference values and equations for the 1-minute sit-to-stand (1MSTS) and 5 times sit-to-stand (5TSTS) tests for Portuguese adults. DESIGN: Cross-sectional study. Descriptive statistics were explored to compute reference values and reference equations were established with a forward stepwise multiple regression. SETTING: Community. PARTICIPANTS: 546 adult volunteers without disabilities [age range 18 to 95 years; 58% female] were recruited. MAIN OUTCOME MEASURES: Data on age, sex, height, weight, body mass index (BMI), smoking status and physical activity were collected using a structured questionnaire developed specifically for this study. PROCEDURE: Participants performed three repetitions of the 1MSTS and 5TSTS and the best repetition was used for analysis. RESULTS: Normative values were provided by sex for each age decade. Reference equations were: 1MSTS= 61.53 - (0.34 x age) - (3.57 x sex) - (0.33 x BMI), r = 26%; and 5TSTS= 3.89 + (0.10 x age) - (0.96 x physical activity), r = 27%. CONCLUSIONS: The proposed reference values and equations will help to interpret the results of functional capacity obtained from healthy or diseased adult populations. CONTRIBUTION OF THE PAPER.
"You don't know what you don't know": Knowledge, attitudes, and current practice of physiotherapists in recognising and managing metabolic syndrome, a mixed methods study.
Mastwyk S, Taylor NF, Lowe A … +2 more , Dalton C, Peiris CL
Physiotherapy · 2024 Sep · PMID 38875840 · Publisher ↗
OBJECTIVES: To determine the knowledge, attitudes, and current practice of primary care physiotherapists in recognising and managing clients with metabolic syndrome. DESIGN: Mixed-methods research design comprising an on...
OBJECTIVES: To determine the knowledge, attitudes, and current practice of primary care physiotherapists in recognising and managing clients with metabolic syndrome. DESIGN: Mixed-methods research design comprising an online survey and focus groups. PARTICIPANTS: Australian and English physiotherapists (n = 183) working in a primary care setting responded to the survey. Twelve physiotherapists participated in focus groups. RESULTS: Metabolic syndrome was not on physiotherapists radar. They did not screen for metabolic syndrome nor provide management for it in primary care. Although most physiotherapists had some awareness of metabolic syndrome, they were not knowledgeable. Physiotherapists reported a need to focus on their clients' presenting condition, and there was uncertainty on whether metabolic syndrome management was within their scope of practice. Despite this, physiotherapists felt they had an important role to play in exercise and physical activity prescription for chronic disease management and were keen to further their knowledge and skills related to metabolic syndrome. Survey responses and focus group data were convergent. CONCLUSION: Physiotherapists working in primary care settings are well-placed to identify metabolic risk factors in their clients and provide physical activity interventions to enhance management but currently lack knowledge to embed this in clinical practice. Training and resources are required to enable physiotherapists to identify and manage metabolic syndrome within their practice. CONTRIBUTION OF PAPER.
Will my shoulder pain get better? - secondary analysis of data from a multi-arm randomised controlled trial.
Dubé MO, Desmeules F, Lewis J … +2 more , Chester R, Roy JS
Physiotherapy · 2024 Sep · PMID 38875839 · Publisher ↗
OBJECTIVE: To determine whether higher level or improvements over time in pain self-efficacy (PSE) and expectations of intervention effectiveness lead to better outcomes and whether the intervention used to manage rotato...
OBJECTIVE: To determine whether higher level or improvements over time in pain self-efficacy (PSE) and expectations of intervention effectiveness lead to better outcomes and whether the intervention used to manage rotator cuff related shoulder pain (RCRSP) impacts PSE and expectations over time. DESIGN: Secondary analysis of data from a randomised controlled trial. PARTICIPANTS: 123 individuals (48 [15] years old; 51% female) with RCRSP. INTERVENTIONS: Participants randomised into one of three 12-weeks interventions (education; education and motor control exercises; education and strengthening exercises). MAIN OUTCOME MEASURES: QuickDASH and Western Ontario Rotator Cuff Index (WORC) were administered at baseline and 12 weeks. Pain self-efficacy was assessed at 0 and 6 weeks. Patients' expectations regarding intervention effectiveness were assessed before randomisation and after the first and the last intervention sessions. NparLD were used for the analyses. A time effect indicated a significant change in patients' expectations or PSE over time, while a resolution effect indicated a significant difference in patients' expectations or PSE between those whose symptoms resolved and those whose did not. RESULTS: Patients' expectations (-3 to 3) increased over time (0.33/3 [0.19 to 0.77]). Overall expectations were higher for those who experienced symptom resolution based on the WORC (0.19/3 [0.05 to 0.33]). PSE increased over time (5.5/60 [3.6 to 7.4]). Overall PSE was higher for those who experienced symptom resolution based on the WORC (7.0 [3.9 to 10.1]) and the QuickDASH (4.9 [1.7 to 8.2]). CONCLUSION: Clinicians should consider monitoring PSE and patients' expectations as they are important indicators of outcome. CONTRIBUTION OF THE PAPER.
Transabdominal ultrasonography-guided biofeedback training for pelvic floor muscles integrated with stabilization exercise improved pregnancy-related pelvic girdle pain and disability: a randomized controlled trial.
Kuo YL, Lin KY, Wu MH … +2 more , Wu CH, Tsai YJ
Physiotherapy · 2024 Sep · PMID 38875838 · Publisher ↗
OBJECTIVES: Investigate effects of integrated training for pelvic floor muscles (PFM) with and without transabdominal ultrasonography (TAUS) imaging-guided biofeedback in postpartum women with pregnancy-related pelvic gi...
OBJECTIVES: Investigate effects of integrated training for pelvic floor muscles (PFM) with and without transabdominal ultrasonography (TAUS) imaging-guided biofeedback in postpartum women with pregnancy-related pelvic girdle pain (PPGP). DESIGN: Three-arm, single-blinded randomized controlled trial SETTING: University laboratory PARTICIPANTS: Fifty-three postpartum women with PPGP randomized into stabilization exercise with TAUS-guided biofeedback (BIO+EXE), exercise (EXE), and control (CON) groups. INTERVENTIONS: The BIO+EXE and EXE groups underwent an 8-week exercise program, with the BIO+EXE group receiving additional TAUS-guided biofeedback for PFM training during the first 4 weeks. The CON group only received a pelvic educational session. MAIN OUTCOME MEASURES: Primary outcomes included self-reported pain (numeric rating scale) and disability (pelvic girdle questionnaire). Secondary outcomes included functional tests (active straight leg raising [ASLR] fatigue, timed up-and-go, and 6-meter walking tests) and muscle contractibility indicated by muscle thickness changes for abdominal muscles and bladder base displacement for PFM (ultrasonographic measures). RESULTS: The BIO+EXE group had lower pain [1.8 (1.5) vs. 4.4 (1.5), mean difference -2.6, 95% confidence interval (CI) -3.9 to -1.2] and disability [14% (10) vs. 28% (21), mean difference -14, 95% CI -25 to -2] and faster walking speed [3.1 seconds (1) vs. 3.3 seconds (1), mean difference -0.2, 95% CI -1.0 to -0.2] than the CON group. The EXE group only had lower pain intensity compared to the CON group [2.7 (2.0) vs. 4.4 (1.5), mean difference -1.7, 95% CI -3.1 to -0.4]. No significant differences were observed among groups in timed up-and-go, ASLR fatigue, or muscle contractibility. CONCLUSIONS: Integrated training for PFM and stabilization with TAUS-guided biofeedback seems to be beneficial for reducing pain and disability in postpartum women with PPGP. CONTRIBUTION OF THE PAPER.
Carriage of Neisseria meningitidis (meningococci) in the sputum of people with cystic fibrosis (CF): occupational health risks and mitigating interventions for physiotherapists.
Millar BC, Bell J, Rendall JC … +1 more , Moore JE
Physiotherapy · 2024 Sep · PMID 38875837 · Publisher ↗
OBJECTIVES: To estimate the carriage of Neisseira meningitidis (meningococci) in expectorated sputum from people with cystic fibrosis (CF) and to evaluate potential ramifications of such carriage for the health and (NM)...
OBJECTIVES: To estimate the carriage of Neisseira meningitidis (meningococci) in expectorated sputum from people with cystic fibrosis (CF) and to evaluate potential ramifications of such carriage for the health and (NM) wellbeing of physiotherapists performing airway clearance techniques. DESIGN: Descriptive observational study. MAIN OUTCOME MEASURES: Meningococcal carriage rate, CFTR mutation type and time to first meningococcal culture were determined. RESULTS: Microbiological data was examined from 100 patients from birth to present (31/12/2021), equating to 2455 patient years. NM was isolated from 6/100 (6%) adult CF patients who had F508del/F508del (homozygous), F508del/other (heterozygous) and other mutations. The median and mean time to first isolation of NM was 213 months and 230 months (standard deviation = 27.6 months), respectively, shortest time was 209 months, longest time 278 months. CONCLUSIONS: Physiotherapists should be aware of the risks to themselves of acquiring Neisseria meningtidis from CF patients' respiratory aerosols, whilst performing airway clearance techniques. Physiotherapists with underlying medical conditions or with specific concerns about meningococcal disease should discuss their circumstances with their occupational health team, to ensure optimal protection.
Allied health assistant management of people with hip fracture is feasible and may improve patient adherence to hip fracture mobilisation guidelines: a feasibility randomised controlled trial.
Snowdon DA, Vincent P, Callisaya ML … +4 more , Collyer TA, Brusco NK, Wang YT, Taylor NF
Physiotherapy · 2024 Sep · PMID 38870622 · Publisher ↗
OBJECTIVES: Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital. DESIGN: Assessor-blind, parallel, feasibility randomised controlled trial with qualitative...
OBJECTIVES: Determine the feasibility of allied health assistant (AHA) management of people with hip fracture an acute hospital. DESIGN: Assessor-blind, parallel, feasibility randomised controlled trial with qualitative component. SETTING: Acute orthopaedic ward. PARTICIPANTS: People with surgically-managed hip fracture, who walked independently pre-fracture and had no cognitive impairment. INTERVENTIONS: Rehabilitation from an AHA, under the supervision of a physiotherapist, compared with rehabilitation from a physiotherapist. MAIN OUTCOME MEASURES: Feasibility was evaluated according to focus areas of demand, acceptability, practicality and implementation. Secondary outcomes included estimates of effect of adherence to hip fracture mobilisation guidelines, discharge destination, 30-day readmission, functional activity, and length of stay. RESULTS: Fifty people were allocated to receive rehabilitation from an AHA (n = 25) or physiotherapist (n = 25). AHA rehabilitation had high demand with 60% of eligible participants recruited. Satisfaction with AHA rehabilitation was comparable with physiotherapy rehabilitation (acceptability). The AHA group received an average of 11 min (95% CI 4 to 19) more therapy per day than the physiotherapy group (implementation). The AHA group may have had lower cost of acute care (MD -$3 808 95% CI -7 651 to 35) and adverse events were comparable between groups (practicality). The AHA group may have been 22% (HR 1.22, 95% CI 0.92 to 1.61) more likely to walk on any day and may have had a shorter length of stay (MD -0.8 days, 95% CI -2.3 to 0.7). CONCLUSIONS: AHA management of patients with hip fracture was feasible and may improve adherence to mobilisation guidelines and reduce cost of care and length of stay. CLINICAL TRIAL REGISTRATION NUMBER: ACTRN12620000877987. CONTRIBUTION OF THE PAPER.
Exploring the experiences of UK-based private physiotherapists when running and progressing a physiotherapy business: a hermeneutic phenomenological study.
Watson EE, Minns Lowe CJ
Physiotherapy · 2024 Sep · PMID 38870621 · Publisher ↗
AIM: To explore the experiences of UK-based private physiotherapists when running and progressing a physiotherapy business. DESIGN: A hermeneutic phenomenological approach. PARTICIPANTS: Six UK-based private physiotherap...
AIM: To explore the experiences of UK-based private physiotherapists when running and progressing a physiotherapy business. DESIGN: A hermeneutic phenomenological approach. PARTICIPANTS: Six UK-based private physiotherapy practice owners were recruited via purposive and snowball sampling. METHODS: In-depth, semi-structured video interviews (2 per participant), audio-recorded and transcribed. Field notes, respondent validation and a reflexive diary were used. Data underwent line-by-line analysis, identifying codes and themes. Constant comparison of data, codes and themes occurred throughout. Peer review was utilised, small sections of data and all emerging codes were independently reviewed. RESULTS: Three interconnecting themes. Working for myself: participants highlighted the freedom, flexibility and independence of business ownership, whilst acknowledging the additional pressures/challenges associated with this. Evolution of a practice: business growth was slow, requiring income supplementation initially. Successful growth often utilised luck and unexpected opportunities. Working with others: participants faced decisions regarding solo or joint ownership, when/what additional staff were required, whether staff should be employed or self-employed, and how to appropriately manage/support staff. CONCLUSIONS: Private practice ownership brings an array of benefits and challenges. Areas for future research include exploring the stresses of private roles and business ownership, the evolution of private physiotherapy practices, small-scale business partnerships, and employment vs self-employment. CONTRIBUTION OF THE PAPER.
Assessing impaired bed mobility in patients with Parkinson's disease: a scoping review.
Taniguchi S, Yamamoto A, D'cruz N
Physiotherapy · 2024 Sep · PMID 38870620 · Publisher ↗
BACKGROUND: Although most patients with Parkinson's disease (PD) experience difficulties in bed mobility, evidence on the suitability of the methods for assessing impaired bed mobility in PD are lacking. OBJECTIVES: To i...
BACKGROUND: Although most patients with Parkinson's disease (PD) experience difficulties in bed mobility, evidence on the suitability of the methods for assessing impaired bed mobility in PD are lacking. OBJECTIVES: To identify objective methods for assessing impaired bed mobility in PD and to discuss their clinimetric properties and feasibility for use in clinical practice. DATA SOURCES: PubMed, Web of Science, and Cochrane Library were searched between 1995 and 2022. SELECTION CRITERIA: Studies were included if they described an objective assessment method for assessing impaired bed mobility in PD. DATA EXTRACTION AND DATA SYNTHESIS: Characteristics of the identified measurement methods such as clinimetric properties and feasibility were extracted by two authors. The methodological quality of studies was evaluated using the Appraisal of studies tool. RESULTS: Twenty-three studies were included and categorised into three assessment methods: sensor-based assessments (48%), rating scales (39%), and timed-tests (13%). The risk of bias was low for all but one study, which was medium. LIMITATIONS: Despite applying wide selection criteria, a relatively small number of studies were identified in our results. CONCLUSION: Rating scales may be the most preferred for assessing impaired bed mobility in PD in clinical practice, until clinimetric validity are adequately demonstrated in the other assessment methods. CONTRIBUTION OF PAPER.
Erratum to "Maximum tolerable daily dose of mirror movement therapy ankle exercises after stroke: an early phase dose screening study" [Physiotherapy 122 (2024) 30-39].
Bajuaifer S, Grey MJ, Hancock NJ … +2 more , Chandler E, Pomeroy VM
Physiotherapy · 2024 Dec · PMID 38866648 · Publisher ↗
Abstract loading — click title to view on PubMed.
"I haven't got a clue what policies are in place for this!": physiotherapy students' preparedness to deal with self-harm.
Gamblin K, McNaughton RJ, Raby P
Physiotherapy · 2024 Sep · PMID 38865764 · Publisher ↗
OBJECTIVES: The prevalence of self-harm and the potential link with suicidal ideation highlights the need to prepare future physiotherapists to deal with the potentially catastrophic outcomes to which a lack of understan...
OBJECTIVES: The prevalence of self-harm and the potential link with suicidal ideation highlights the need to prepare future physiotherapists to deal with the potentially catastrophic outcomes to which a lack of understanding in this area can lead. The aim of this research was to investigate if final year physiotherapy students felt prepared to assess risk of suicide or self-harm following patient disclosure, or showing signs of intention to harm themselves. DESIGN: An interpretive phenomenological methodology (IPA) was implemented to aid in the understanding and interpretation of participants' own experiences. In conjunction with the overarching design, semi-structured interviews, via two focus groups, were used to explore participants' views. SETTING: Focus groups were conducted via an online platform. PARTICIPANTS: Purposive sampling was employed as a sampling method to recruit final year physiotherapy students. The final sample consisted of ten participants. RESULTS: Four main themes were identified: Experiences of disclosure; Encountering mental health; Lack of mental health education, and Lack of knowledge regarding policy and procedure. CONCLUSIONS: The findings highlight a deficit with regards to the preparedness of final year students in dealing with disclosure to self-harm. A lack of both formal education regarding mental illness and of practice experience in the field of mental health contribute to this. Therefore, a more rigorous and directed approach to education regarding mental illness is essential. Furthermore, involvement in mental health practice placements would allow for a greater level of experiential learning and understanding of the issues faced by those living with mental illness. CONTRIBUTION OF THE PAPER: Contribution to the evidence: Contribution to knowledge.
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