Physiotherapy Canada最新文献

{"title":"The Impact of Two Telerehabilitation Supervision Schedules on Physical Activity, Mobility, and Balance Among People with Moderate to Severe Traumatic Brain Injury: A Mixed-Method Single-Subject Design.","authors":"Jennifer O'Neil, Mary Egan, Shawn Marshall, Martin Bilodeau, Luc Pelletier, Heidi Sveistrup","doi":"10.3138/ptc-2021-0040","DOIUrl":"10.3138/ptc-2021-0040","url":null,"abstract":"<p><strong>Background: </strong>Many individuals who experience a moderate or severe traumatic brain injury (TBI) have long-term deficits in physical activity, balance, and mobility requiring specialized care. New delivery models are being investigated for interventions to address challenges caused by living in remote communities, difficulties with transportation, and/or physical distancing requirements. Determining the effectiveness of telerehabilitation is critical given the current movement toward remote health care delivery.</p><p><strong>Objective: </strong>We investigated the effectiveness of two teletherapy supervision schedules used to deliver a home-based, intensive exercise programme on 1) physical activity, mobility, balance, participation, and 2) concerns with falling, and satisfaction with life.</p><p><strong>Methods: </strong>A mixed methods approach with alternating single subject design (SSD) and interviews was used. Five individuals who experienced a moderate or severe TBI completed two intensive home-based telerehabilitation programmes. Programmes differed only by supervision schedule - daily or weekly. Impacts on objective and patient-reported outcomes were measured.</p><p><strong>Results: </strong>Four individuals demonstrated clinically significant improvements in physical activity level, balance, and mobility. One individual experienced less concerns with falling after both schedules, while two other individuals showed a trend in that direction after the weekly remote supervision. Important functional gains (i.e., improved balance and decreased fatigue) were also perceived and reported by family partners regardless of supervision schedule.</p><p><strong>Conclusion: </strong>Although the study has limitations, the findings indicate that exercise programmes delivered via telerehabilitation can improve balance and mobility as well as positively affect concerns with falling and physical activity levels for this population. No clear differences were seen between the two telerehabilitation supervision schedules.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 2","pages":"118-131"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510551/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41141151","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Remotely Supervised Exercise Programmes to Improve Balance, Mobility, and Activity Among People with Moderate to Severe Traumatic Brain Injury: Description and Feasibility.","authors":"Jennifer O'Neil, Mary Egan, Shawn Marshall, Martin Bilodeau, Luc Pelletier, Heidi Sveistrup","doi":"10.3138/ptc-2021-0039","DOIUrl":"10.3138/ptc-2021-0039","url":null,"abstract":"<p><strong>Purpose: </strong>Further investigation into the feasibility of using videoconferencing and activity tracking devices to provide high-intensity home-based exercise programmes for people with a moderate or severe traumatic brain injury (TBI) is needed to inform clinical implementation and patient adoption. This study aimed to (1) determine if home-based telerehabilitation exercise programmes were feasible for people with a moderate or severe TBI and (2) better understand the lived experience of people with a TBI and their family partners with this programme.</p><p><strong>Methods: </strong>A mixed-methods approach consisting of measures of feasibility and semi-structured interviews was used. Five participants with moderate to severe TBI and their family partners completed two high-intensity home-based exercise programmes delivered remotely by a physiotherapist (i.e., daily and weekly).</p><p><strong>Results: </strong>Telerehabilitation services in home-based settings were feasible for this population. Adherence and engagement were high. Dyads were satisfied with the use of technology to deliver physiotherapy sessions.</p><p><strong>Conclusion: </strong>Telerehabilitation provides a delivery option that allows people with TBI to spend energy on therapy rather than on travelling. A pre-programme training on key components, such as the use of technology, safety precautions, and communication methods, likely improved the overall feasibility. Further research is needed to better understand the effectiveness of such a programme on balance, mobility, and physical activity levels.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 2","pages":"146-155"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510548/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41156548","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Canadian Physiotherapists Integrate Virtual Care during the COVID-19 Pandemic.","authors":"Allison M Ezzat, Jean-Francois Esculier, Sarah Lord Ferguson, Christopher Napier, Sabrina T Wong","doi":"10.3138/ptc-2022-0092","DOIUrl":"10.3138/ptc-2022-0092","url":null,"abstract":"<p><strong>Purpose: </strong>To examine Canadian physiotherapists' experiences in adapting their delivery of patient care during the COVID-19 pandemic. We examine the level of strain on the profession and barriers and enablers to virtual care and provide strategies to support future virtual care implementation.</p><p><strong>Methods: </strong>From May to October 2020, a series of eight cross-sectional survey cycles were distributed every 2-4 weeks through branches and divisions of the Canadian Physiotherapy Association, social media, and personal networks. Descriptive statistics summarized the main findings. Open ended questions were first analyzed inductively using thematic analysis, then deductively mapped to the Capability-Opportunity-Motivation Behavioural (COM-B) Model.</p><p><strong>Results: </strong>Between 1,820 (cycle 1) and 334 (cycle 7) physiotherapists responded. Median strain level was 5/5 (cycle 1) and dropped to median 3/5 (cycles 5-8). In cycle 1, 55% of physiotherapists had ceased in-person care, while 41% were providing modified in-person care. Of these physiotherapists, 79% were offering virtual care. As modified in-person care increased, virtual care continued as a substantial aspect of practice. Physiotherapists identified barriers (e.g., lack of hands-on care) and enabling factors (e.g., greater accessibility to patients) for virtual care. In-depth examination of the barriers and enablers through the COM-B lens identified potential interventions to support future virtual care implementation, including education and training resources for physiotherapists and communication and advocacy to patients and the public on the value of virtual care.</p><p><strong>Conclusions: </strong>Canadian physiotherapists exhibited high adaptability in response to COVID-19 through the rapid and widespread use of virtual care. By creating an in-depth understanding of the barriers and enablers to virtual care, along with potential interventions, this work will facilitate future opportunities to support and enhance physiotherapists' delivery of virtual care.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 2","pages":"134-145"},"PeriodicalIF":1.0,"publicationDate":"2023-05-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10510558/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41161060","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Developing a National Consensus of the Physiotherapy Entry-Level Business and Practice Management Core Curriculum Competencies: A Delphi Study","authors":"D. Hopkins-Rosseel, Darryl Yardley, Jennifer Turnnidge, N. Dalgarno, Klodiana Kolomitro","doi":"10.3138/ptc-2022-0054","DOIUrl":"https://doi.org/10.3138/ptc-2022-0054","url":null,"abstract":"Physiotherapists need to develop strong business acumen to make informed decisions, drive positive outcomes, and thrive in their practice. Competencies in these areas are partially reflected in the Competency Profile for Physiotherapists in Canada, however, there is little consistency in how these are applied across academic institutions. The purpose of this study was to develop a set of foundational entry-to-practice (ETP) competencies related to business and practice management (BPM), that can prepare physiotherapy students for work in all Canadian healthcare service sectors upon graduation. We undertook a modified Delphi study. An online call for participants was circulated via the Canadian Physiotherapy Association’s Private Practice and Leadership Divisions, Canadian provincial and territorial physiotherapy regulators, and 15 Canadian university physiotherapy programs. Individuals in the profession with known expertise in management and/or business were also invited to participate. Two rounds of the Delphi were necessary to reach consensus. Forty-one participants were included in the first round of Delphi including academics, regulators, registered physiotherapists, and senior students. Twenty-one (51%) participated in round 2 of the study. Sixty-six ETP BPM foundational curriculum competencies, within nine domains, competencies reached consensus (via the Delphi process). Consideration of the ETP competencies in the areas of business and practice management derived with this national Delphi process may enhance and harmonize the physiotherapy curricula across Canada.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48072430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cognitive Correlates of a Large Time Differential between Timed Up and Go and Gait Speed during Inpatient Stroke Rehabilitation","authors":"H. Kim, Abishek Jaywant, J. Toglia, Amy Meyer, M. Campo, M. O'dell","doi":"10.3138/ptc-2022-0089","DOIUrl":"https://doi.org/10.3138/ptc-2022-0089","url":null,"abstract":"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-Meter Walk Test [10MWT]) could identify patients with subtle cognitive difficulties post-stroke. An observational study was conducted in 141 individuals admitted to acute inpatient rehabilitation after stroke. We computed the percent difference between TUG and 10MWT performance. Cognitive outcome measures were the Trail Making Test A and B (TMT-A and -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. 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). 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.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43891992","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Exploring the Education and Practice Experiences of Pelvic Health Physiotherapists in Canada: A Qualitative Descriptive Study","authors":"Stephanie Scodras, J. Ripat, H. Colquhoun, E. Yeung, S. Jaglal, N. Salbach","doi":"10.3138/ptc-2022-0071","DOIUrl":"https://doi.org/10.3138/ptc-2022-0071","url":null,"abstract":"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. This descriptive qualitative study used semi-structured interviews with physiotherapists providing pelvic health services in Canada and a reflexive thematic analysis approach. 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. 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.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41986522","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Survey of Hospital-based Physiotherapists’ Roles and Responsibilities during the COVID-19 Pandemic in Ontario, Canada","authors":"Mairin Christie, Mehrzad Khademi, A. Muhammad, Disha Naik, Alexander Polanski, Jaimie Coleman, C. MacKay, A. Chu","doi":"10.3138/ptc-2022-0097","DOIUrl":"https://doi.org/10.3138/ptc-2022-0097","url":null,"abstract":"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. Between February and March 2021, we conducted a cross-sectional study using an online survey of physiotherapists employed in acute care and rehabilitation hospitals. 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. 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.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-04-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47248831","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Hip and Knee Total Joint Arthroplasty Online Resources for Patients and Health Care Professionals: A Canadian Environmental Scan","authors":"L. Pacheco-Brousseau, S. Poitras, Sarah Ben Amor, F. Desmeules, Alda Kiss, D. Stacey","doi":"10.3138/ptc-2022-0028","DOIUrl":"https://doi.org/10.3138/ptc-2022-0028","url":null,"abstract":"To appraise the quality of publicly available online Canadian resources for patients with hip or knee osteoarthritis considering total joint arthroplasty (TJA) and health care professionals participating in TJA decision-making processes. An environmental scan. Two independent authors appraised: a) patient resources against the International Patient Decision Aids Standards (IPDAS) criteria and the Patient Education Material Evaluation Tool (PEMAT); and b) health care professional resources against six appropriateness criteria for TJA and eight elements of shared decision-making. Analysis was descriptive. Of 84 included resources, 71 were for patients, 11 for health care professionals, and 2 for both. For patient resources, the median number of IPDAS defining criteria met was 2 of 7, median PEMAT understandability score was 83%, and median PEMAT actionability score was 60%. For health care professional resources, the median number of appropriateness criteria was 3 of 6, and the median number of shared decision-making elements was 3 of 8. Only four of 73 patient resources were structured to help patients consider their options and reach a decision based on their preferences. Health care professional resources were limited to traditional criteria for determining TJA appropriateness (evidence of osteoarthritis, use of conservative treatments) and poorly met key elements of shared decision-making.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43515344","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient-Reported Experiences of Musculoskeletal Virtual Care Delivered by Advanced Practice Physiotherapists","authors":"L. Soever, Andrew Courchene, M. Correale, Tamara Gotal, Marsha Alvares, Emily May, C. Veillette, Y. Rampersaud","doi":"10.3138/ptc-2022-0084","DOIUrl":"https://doi.org/10.3138/ptc-2022-0084","url":null,"abstract":"To better understand patients’ perspectives on virtual care (VC) delivered by advanced practice physiotherapists (APPs) for hip/knee, foot/ankle, shoulder/elbow, and low back related symptoms. A patient satisfaction questionnaire was developed and distributed electronically to all patients seen by APPs from August 1, 2020 to January 31, 2021. The questionnaire contained quantitative items using a 5-point Likert scale and open-ended questions that yielded qualitative findings. Descriptive statistics were applied to the quantitative data. Qualitative findings were analyzed using a qualitative description approach to identify recurrent themes. Response rate was 74% (374/505) across all clinics. Videoconference was the most common delivery method (91.7%). Overall satisfaction with VC was very high (4.7–4.8/5). Emergent qualitative themes were related to Personal Connection; Preparatory Materials; Virtual Physical Examination; Practical Advantages of VC; Virtual Waiting Room; and Technical Issues. Overall, across several facets including personal connection, patient experience with VC for a variety of musculoskeletal conditions was rated high. Clinically, a systematic approach to the physical examination with preparatory patient education materials was key to positive patient experience.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46785002","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Benefits of Combined Upper Body Exercise and Compression Therapy for Breast Cancer Related Lymphedema: A Systematic Review","authors":"Mona M. Al Onazi, K. Campbell, J. Mackey, M. McNeely","doi":"10.3138/ptc-2022-0009","DOIUrl":"https://doi.org/10.3138/ptc-2022-0009","url":null,"abstract":"This systematic review aimed to examine the benefit of combined upper body exercise and compression therapy for breast cancer related lymphedema. Electronic searches were performed in Medline, EMBASE, CINAHL, SPORTDiscus, and PEDRO. We included randomized and controlled clinical trials that examined the effect of upper body exercise with use of compression therapy on arm lymphedema. Where data were available, effect sizes were calculated. Risk of bias was assessed using the Cochrane risk-of-bias tool. The quality of evidence was rated using Grading of Recommendations Assessment, Development and Evaluation (GRADE). Of 444 studies, 11 met all inclusion criteria. Two cross-over trials examined single bouts of upper body exercise with or without compression, three intervention trials examined non-resisted upper body exercise and compression, and six intervention trials examined upper body resistance exercise and compression. Only two studies reported statistically significant benefit from the combined intervention for arm lymphedema volume. Seven studies provided adequate data to allow for calculation of effect size; however, heterogeneity precluded pooling of data. The quality of evidence was moderate in intervention trials comparing combined upper body exercise and compression to standard care ( n = 1) or to exercise alone ( n = 1). For all other trials the grade of evidence was low, with quality ratings downgraded due to small sample sizes and/or high or unclear risk of bias. No clear conclusions could be made regarding the benefit of combined upper body exercise and compression for breast cancer related lymphedema. Further high-quality trials are warranted.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46179157","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}