The study aimed to explore new United Kingdom (UK) graduate physiotherapists' perceived preparedness for clinical practice to provide valuable information to support curriculum development.
An ...online, mixed method cross-sectional questionnaire was used. Newly qualified UK physiotherapists completed a survey, capturing how physiotherapy degrees prepared them for practice against (1) UK proficiency standards and (2) cross-discipline physiotherapy related clinical skills. Respondents were asked for reflections of their degree course including teaching and effectiveness. Data were converted into proportions with a 95% confidence interval. Likert-scale questions were treated as numeric variables with the mean and standard deviation (SD) calculated for combined responses. Thematic analysis reported patterns of data extracted from open-ended questions.
Of a total of 376 respondents, 365 were included in data analysis. Overall respondents perceived that courses prepared them 'well' against 12 of the 15 standards, on a Likert scale of 1-5. Respondents reported that perceived competence was 'indifferent' for manual therapy skills (mean 3.14 ± SD 1.13), red flag (3.45 ± 1.11) and clinical flag management (2.92 ± 1.16). Exercise prescription (2.42 ± 1.35), psychosocial skills (2.27 ± 1.23) and patient management (2.41 ± 1.12) were areas identified for further teaching focus. Placements were the preferred teaching method most applicable to practice followed by practical seminars.
Respondents felt sufficiently prepared for practice against UK proficiency standards but not physiotherapy related clinical skills. Areas for curricula development included exercise prescription, psychology and pain management.
Concussion is a common injury in sport. Most individuals recover in 7-10 days but some have persistent symptoms. The objective of this study was to determine if a combination of vestibular ...rehabilitation and cervical spine physiotherapy decreased the time until medical clearance in individuals with prolonged postconcussion symptoms.
This study was a randomised controlled trial. Consecutive patients with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion (12-30 years, 18 male and 13 female) were randomised to the control or intervention group. Both groups received weekly sessions with a physiotherapist for 8 weeks or until the time of medical clearance. Both groups received postural education, range of motion exercises and cognitive and physical rest until asymptomatic followed by a protocol of graded exertion. The intervention group also received cervical spine and vestibular rehabilitation. The primary outcome of interest was medical clearance to return to sport, which was evaluated by a study sport medicine physician who was blinded to the treatment group.
In the treatment group, 73% (11/15) of the participants were medically cleared within 8 weeks of initiation of treatment, compared with 7% (1/14) in the control group. Using an intention to treat analysis, individuals in the treatment group were 3.91 (95% CI 1.34 to 11.34) times more likely to be medically cleared by 8 weeks.
A combination of cervical and vestibular physiotherapy decreased time to medical clearance to return to sport in youth and young adults with persistent symptoms of dizziness, neck pain and/or headaches following a sport-related concussion.
NCT01860755.
To determine if global, central, or peripheral adiposity is associated with prevalent and worsening cartilage lesions following anterior cruciate ligament reconstruction (ACLR).
In 107 individuals ...one-year post-ACLR, adiposity was assessed globally (body mass index), centrally (waist circumference), and peripherally (knee subcutaneous adipose tissue thickness) from magnetic resonance imaging (MRI). Tibiofemoral and patellofemoral cartilage lesions were assessed from knee MRIs at 1- and 5-years post-ACLR. Poisson regression evaluated the relation of adiposity with prevalent and worsening tibiofemoral and patellofemoral cartilage lesions adjusting for age, sex, and activity level.
The prevalence ratios of adiposity with tibiofemoral (presence in 49%) and patellofemoral (44%) cartilage lesions ranged from 0.99 to 1.03. Adiposity was more strongly associated with longitudinal changes in tibiofemoral (worsening in 21%) and patellofemoral (44%) cartilage lesions. One-unit increase in global (kg/m2), central (cm), and peripheral (mm) adiposity was associated with a higher risk of worsening tibiofemoral cartilage lesions by 17% (risk ratios 95% confidence interval (CI): 1.17 1.09 to 1.23), 5% (1.05 1.02 to 1.08), and 9% (1.09 1.03 to 1.16), and patellofemoral cartilage lesions by 5% (1.05 1.00 to 1.12), 2% (1.02 1.00 to 1.04) and 2% (1.02 1.00 to 1.04), respectively.
Greater adiposity was a risk factor for worsening cartilage lesions up to 5 years post-ACLR. Clinical interventions aimed at mitigating excess adiposity may be beneficial in preventive approaches for early post-traumatic osteoarthritis.
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.
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.
Focus groups were conducted via an online platform.
Purposive sampling was employed as a sampling method to recruit final year physiotherapy students. The final sample consisted of ten participants.
Four main themes were identified: Experiences of disclosure; Encountering mental health; Lack of mental health education, and Lack of knowledge regarding policy and procedure.
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 to the evidence:•This paper supports existing literature that physiotherapy training falls short in its treatment of mental health related issues.•This shortfall is twofold; relating to gaps in both formal educational settings and practice placements.
Contribution to knowledge:•Participants highlighted clear deficits in knowledge of the relevant policies and procedures concerning disclosure to self-harm.•Overall there was a feeling of unpreparedness for dealing with such issues in practice.
To investigate the extent and impact of litigation on the UK physiotherapy profession.
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.
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.
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.
•This is the first national survey to investigate the extent of litigation in UK physiotherapy, across all employment sectors, specialities and grades.•This is the first national survey to explore the impact of litigation on the UK physiotherapy profession, including physiotherapists who had been involved in litigation and those who had not.•Recommendations have been made to improve the overall experience of physiotherapists involved in litigation with emphasis on their health and wellbeing.
To explore the experiences of UK-based private physiotherapists when running and progressing a physiotherapy business.
A hermeneutic phenomenological approach.
Six UK-based private physiotherapy ...practice owners were recruited via purposive and snowball sampling.
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.
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.
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.
•This research suggests that although private practice ownership brings increased freedom, flexibility, and job satisfaction, this is tempered by an array of increased pressures and responsibilities.•Practice growth was gradual, often involving luck and unexpected opportunities.•Clinic owners face challenging decisions regarding the selection, management and support of additional staff.
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.
To estimate the prevalence of burnout among physiotherapists.
PubMed, CINAHL, Web of Science, Embase, Scopus and PsycINFO, from inception to February 1st, 2022.
Studies reporting burnout prevalence among physiotherapists.
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.
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.
Tools used to assess burnout and cut-off scores chosen to identify the burnout prevalence differed across studies.
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.
PROSPERO CRD42022307876
•This is the first systematic review on prevalence of burnout among physiotherapists worldwide. The pooled prevalence of burnout was 8%.•Both overall and single components prevalence tended to be higher in developing than in developed countries.•Substantial heterogeneity in the prevalence of burnout, in its definition and assessment methods across studies, and limited quality in most studies precludes drawing definitive conclusions.
Background: COVID-19, caused by the SARS-CoV-2 virus, is a novel coronavirus that has led to a global pandemic. Physiotherapy is among the beneficial treatments for this disease. This study ...investigated the impact of the priority and delay of prone positioning and chest physiotherapy (CPT) on patients with COVID-19. Methods: A randomized clinical trial was conducted involving 26 COVID-19 patients who were randomly assigned to two groups: one group prioritizing prone positioning over chest physiotherapy (comprising seven men and six women, with an average age of 67.46 ± 5.91) and the other group prioritizing CPT over prone positioning (comprising eight men and five women, with an average age of 68.38 ± 5.85). Respiratory outcomes, including SpO2, PaO2, FiO2, FEV1, and FVC, were measured using pulse oximetry, arterial blood gas analysis (ABG), and spirometry). FEV1/FVC and SpO2/FiO2 ratios were evaluated both before and after the intervention Results: The demographic characteristics of the patients and the baseline respiratory outcomes between the two groups did not exhibit significant differences (P > 0.05). A significant difference was observed in respiratory outcomes within each group before and after the intervention (P < 0.05). However, after the intervention, there were no significant differences between the two groups in terms of respiratory outcomes (P > 0.05) Conclusion: Both prioritizing prone positioning over CPT and prioritizing CPT over prone positioning appeared to improve each respiratory outcome. Nevertheless, it was not observed that prioritizing or delaying prone positioning and CPT improved respiratory outcomes in patients with COVID-19.
Basic human needs besides clothing, food and housing that are no less important are health. Along with current demands and needs, health is sometimes neglected either intentionally or ...unintentionally. Health awareness is sometimes not a priority when individuals feel healthy, but it becomes very important and expensive when an individual has experienced illness and has disrupted daily activities, suffered material, and material losses. Students, who are part of a social society, have a moral responsibility in promoting healthy lifestyles and healthy living behaviours. Society considers that physiotherapist as a profession has the ability and skills about healthy lifestyles and has positive health attitudes and behaviours. This study aims to determine the description of the healthy behaviour of students. . This study used a descriptive research design, with a sample of 108 students covering semesters one, three and six who attended and filled out the questionnaire at a predetermined time (accidental sampling). Data were taken using a HPLP-II questionnaire that measures healthy behaviour. Data analysis using SPSS program by finding the average value of six healthy behaviours of students. The results of the study: from the average score of six behaviours measured, the highest score on the spiritual behaviour of students was 2,966 and the lowest score was on the physical activity behaviour of the students. The conclusion of this study is that Physiotherapy students have unhealthy behaviours including physical activity behaviour, nutritional, stress management and health responsibilities and healthy behaviour of students including interpersonal and spiritual relationships
To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief ...training in Cognitive Functional Therapy (CFT).
As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions.
The analysis revealed four descriptive categories: "hung out to dry," "stuck," "making sense and taking control," and "holistic approach to care and living," that varied based on six themes.
Although the participants accepted this approach to care well, there was significant variation in patients' conceptions. Restricted access to care within the healthcare system and a lack of social support led some of them to feel they had been left alone to suffer with their pain. On the other hand, based on the results of this study, positive experiences of physiotherapy and good collaboration with the physiotherapist, wider social support outside of physiotherapy, a better understanding of the multidimensional nature of pain and the acquisition of self-management skills were reported as positive aspects of undergoing physiotherapy that may be related to positive treatment outcomes.
Implications for rehabilitation
The participants of this study saw undergoing physiotherapy delivered within biopsychosocial framework as different from their previous physiotherapy experiences and for some the process ended with feeling empty-handed and for others it could be a turning point in their lives.
This study encourages the health care providers to create flexible care pathways and ongoing support for more vulnerable individuals so that they don't feel abandoned by the system.
Professionals could also pay attention to building strong therapeutic alliance, help patients understand pain in biopsychosocial framework, take into consideration social support networks of the patients, and support patients toward effective self-management strategies.
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