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Tortoli E, Pellicciari L, Giovannico G, Tak I. Return to running criteria after anterior cruciate ligament reconstruction: an online survey of 1404 Italian physiotherapists. J Sports Med Phys Fitness 2024; 64:931-941. [PMID: 38863416 DOI: 10.23736/s0022-4707.24.15811-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/13/2024]
Abstract
BACKGROUND The aim of this study is to study the clinical decision-making practice of Italian physiotherapists in return to running (RTR) after anterior cruciate ligament (ACL) reconstruction, and the differences in decision-making in relation to physiotherapist's characteristics. METHODS An online survey was developed, 1404 physiotherapists were contacted by email, via chartered association, or via social media. RESULTS Most respondents (83%) indicated that the RTR decision should be made by a multidisciplinary team with RTR clearance around 3-4 months after surgery (47%). The most important criteria guiding the RTR decision were knee flexion range of motion (ROM) >130° (50%), complete extension ROM (95%), no pain (45%) and no effusion (68%). A Limb Symmetry Index (LSI) >70% for quadriceps (49%), hamstring (48%) and LSI >90% for posterolateral hip (45%) and triceps surae strength (42%) should be achieved for RTR. Approximately half of the participants (49%) do not consider ACL laxity tests to be used for RTR decisions. Response differences were found between sample subgroups. More experienced physiotherapists and those with post graduate training had lower thresholds to clear RTR. CONCLUSIONS Experienced physiotherapists who treated a higher number of patients after ACL reconstruction, who had certified specialist training and a specific interest towards ACL rehabilitation, generally reported clinical practice modalities more in line with current evidence.
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Affiliation(s)
- Emanuele Tortoli
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy -
| | | | - Giuseppe Giovannico
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy
| | - Igor Tak
- Sports Rehabilitation and Manual Therapy, Fysiotherapie Utrecht Oost, Utrecht, the Netherlands
- Amsterdam Collaboration on Health and Safety in Sports (ACHSS), AMC/VUmc IOC Research Center, Amsterdam UMC, Amsterdam, the Netherlands
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Bozzolan M, Bighi E, Occhi A, Mottaran S, Simoni G, Valpiani G, Bombardi S, Da Roit M. Professional practice, competence, and education related to COVID-19: A mixed-methods light study of physiotherapists' experiences. Physiother Theory Pract 2024; 40:1215-1231. [PMID: 36369771 DOI: 10.1080/09593985.2022.2142083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2022] [Revised: 10/16/2022] [Accepted: 10/16/2022] [Indexed: 11/13/2022]
Abstract
BACKGROUND Coronavirus Disease 2019 (COVID-19) became a significant challenge for the work and personal experience of physiotherapists (PTs). OBJECTIVE To investigate how the work activities of PTs in a region in Italy have changed, describe the reasons for change, perceived competence, and effectiveness of professional education, and explore their personal experience. METHODS We adopted a monocentric convergent mixed-methods light-questionnaire variant study. The questionnaire contains both closed-ended and open-ended questions. Quantitative and qualitative data were combined to interpret the results. RESULTS Among 78 respondents (response rate 24.4%), 87.2% worked during the pandemic, 52.9% treated patients with COVID-19, and 45.6% changed their working activities. Professional competence was perceived as low in intensive and sub-intensive care settings. The major critical aspect of professional education was respiratory rehabilitation. Life-learning education was judged as effective, even if mainly focused on safety. Nine themes emerged from the analysis of the PTs' experiences: 1) Physiotherapy during COVID-19; 2) Fear and negative feelings; 3) Positive aspects; 4) Organization and management; 5) Prevention measures; 6) Patients; 7) Change; 8) Information; and 9) Professional education. CONCLUSIONS PTs who have direct experience with patients with COVID-19 showed great resilience. They overcame the first phase of disorientation and fear, despite a specific lack of competence in the respiratory field.
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Affiliation(s)
- Michela Bozzolan
- Interdepartmental Educational Service, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Elisa Bighi
- Fondazione "San Salvatore" Via Piave, Ficarolo (RO), Italy
| | - Antonella Occhi
- Rehabilitation Medicine Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Silvia Mottaran
- Acquired Brain Injuries Unit - S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | | | - Giorgia Valpiani
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Sandra Bombardi
- Research Innovation Quality and Accreditation Unit, S. Anna University Hospital of Ferrara via Aldo Moro, Ferrara, Italy
| | - Marco Da Roit
- Belluno Community Hospital, Azienda AULSS1 Dolomiti via Feltre, Belluno, Italy
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Binuyo OT, Onigbinde OA, Arogundade SJ, Akaeme DC, Alqahtani B, Alkhathami KM. Exposure to Meta-Analysis During Graduate and Postgraduate Trainings Predicts the Good Knowledge and Use of Randomized Controlled Trials, Systematic Reviews, and Meta-Analyses Among Nigerian Physiotherapists. Cureus 2024; 16:e58251. [PMID: 38745790 PMCID: PMC11093586 DOI: 10.7759/cureus.58251] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/14/2024] [Indexed: 05/16/2024] Open
Abstract
Background Evidence-based practice (EBP) is essential for physiotherapy as an integral part of the multidisciplinary rehabilitation team. Randomized controlled trials (RCTs), systematic reviews, and meta-analyses are the gold standard in the hierarchy of evidence. However, the extent of knowledge, attitudes, and professional use of RCTs and meta-analyses among physiotherapists in Nigeria remains unclear. Therefore, this study aimed to describe and explore the predictors of Nigerian physiotherapists' knowledge, attitudes, and professional behaviors toward RCTs, systematic reviews, and meta-analyses. Methods In this observational study, an electronic version of an adapted questionnaire assessing the knowledge, attitudes, and professional use of RCTs and meta-analyses was shared across electronic platforms of Nigerian physiotherapy professional organizations. Results We found good overall knowledge (76 {80.8%}) and attitude (83 {88.3%}) toward the use of RCTs, systematic reviews, and meta-analyses for evaluating health interventions. Exposure to meta-analysis during graduate and postgraduate training (odds ratio {OR}, 7.102; 95% CI, 1.680-30.021; p = 0.008) and the presence of a medical library at the workplace (OR, 0.264; 95% CI, 0.070-0.997; p = 0.049) were significant predictors of good knowledge of RCTs, systematic reviews, and meta-analyses. Self-rated (OR, 56.476; 95% CI, 1.356-2357.430; p = 0.034) and overall levels of knowledge (OR, 0.013; 95% CI, 0.000-0.371; p = 0.011) predicted the good use of RCTs, systematic reviews, and meta-analyses among respondents. Discussion To equip physiotherapy practitioners with the requisite skill in using RCTs, systematic reviews, and meta-analyses, graduate and postgraduate trainings should prioritize education on the use of RCTs, systematic reviews, and meta-analyses to inform clinical decisions and practice, while capable workplaces may set up medical libraries to ease access and enhance the use of RCTs, systematic reviews, and meta-analyses.
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Affiliation(s)
| | - Omotola A Onigbinde
- Department of Wellness and Physiotherapy, OneHealth Medical Center, Ikeja, NGA
| | - Sunday J Arogundade
- Department of Physiotherapy, University of Medical Sciences Teaching Hospital, Ondo City, NGA
| | - Daniel C Akaeme
- Department of Physiotherapy, Federal Medical Centre, Asaba, NGA
| | - Bijad Alqahtani
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, SAU
| | - Khalid M Alkhathami
- Department of Health Rehabilitation Sciences, College of Applied Medical Sciences, Shaqra University, Shaqra, SAU
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Muntessu DLN, Ghassi HT, Buh FC, Nietho AW, Siewe JR, Mpatoutou MM. Assessment of Evidence-Based Practice (EBP) among physiotherapists in Cameroon: a cross-sectional survey. BMC MEDICAL EDUCATION 2024; 24:332. [PMID: 38520000 PMCID: PMC10960476 DOI: 10.1186/s12909-024-05273-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/09/2023] [Accepted: 03/07/2024] [Indexed: 03/25/2024]
Abstract
BACKGROUND Evidence-Based Practice (EBP) is reported to ease effective and adequate decision making for all works of life including health professionals. Investigating the level of implementation of EBP among physiotherapists helps to identify barriers and propose solutions for its extensive implementation. Despite available data on EBP elsewhere, it remains limited or non-existent in Cameroon. This study was designed to establish the current state of EBP among physiotherapists in Cameroon, by assessing knowledge, practice, and barriers to its implementation. METHODS A cross-sectional survey was conducted online among French- and English-speaking physiotherapists in Cameroon over a period of six months from April to July 2023, using the EBP2 questionnaire. This enabled us to collect socio-demographic data from participants and information on their knowledge, understanding and practice of EBP and possible barriers to EBP according to 5 domains (Confidence, Relevance, Terminology, Practice, Compatibility) scored out of 100. Data were analysed using IBM SPSS 25.0 software and Pearson correlations (95% CI) and significance (p < 0.05). RESULTS A total of 110 physiotherapists practising in the 10 regions of Cameroon participated in the study. The majority were male (54.5%), the median age was 34 years (age range 20 to 50), the median year of graduation was 2019 (range 2004 to max 2022) with 72.7% never having knowledge or training in EBP. Participants scored below 50/100 for 3 domains (confidence, relevance, and compatibility) showing poor general knowledge and understanding of EBP, although they generally had a positive attitude towards EBP. The use of EBP in practice was low (26.3/100 SD. 6.5), despite that they appeared to have a good understanding of research terminology (55.4 SD. 17.2). Level of study of participants did not appear to significantly influence domain scores (P > 0.05). The main barriers to practice were lack of time (75.1%), workload (66%), cost of access to information resources like databases for seek informations about recent support protocols (60%), ease of access to computers (49%), and lack of resources or skills (49%). CONCLUSION Physiotherapists in Cameroon have a poor knowledge of EBP and a low level of practice of EBP, despite an overall positive attitude towards it. These results could inform stakeholders of higher education on the need to improve training of physiotherapy students in the domain of EBP in Physiotherapy. Also, it will help in raising the level of scientific research and promoting the implementation of EBP in Cameroon.
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Affiliation(s)
- Dilane Landry Nsangou Muntessu
- Physiotherapy Unit, Protestant Hospital of Bafoussam, Bafoussam, Cameroon.
- Department of Physiotherapy, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.
| | - Hyacinte Trésor Ghassi
- Department of Physiotherapy, University and Strategic Institute of the Estuary, (IUEs/Insam), Bafoussam, Cameroon
- Department of Physiotherapy, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
| | - Franklin Chu Buh
- Department of Physiotherapy, Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon
- Department Animal Biology, University of BUEA, Buea, Cameroon
| | | | - Julio Rostan Siewe
- Department of Physiotherapy, University and Strategic Institute of the Estuary, (IUEs/Insam), Bafoussam, Cameroon
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Merletti R. Metrology in sEMG and movement analysis: the need for training new figures in clinical rehabilitation. FRONTIERS IN REHABILITATION SCIENCES 2024; 5:1353374. [PMID: 38348456 PMCID: PMC10859507 DOI: 10.3389/fresc.2024.1353374] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 12/10/2023] [Accepted: 01/12/2024] [Indexed: 02/15/2024]
Abstract
A new educational curriculum for the next generation of physical and occupational therapists is urgent in order to manage the recent fast advances in sensors, measurement technologies and related instrumentation. This is required by the growing role of STEM in rehabilitation, kinesiology, and sport sciences. Surface EMG technology is used in this work as a representative example of similar problems present in movement analysis, exoskeletons, and many other fields. A review of the most relevant articles and international projects in the field of interfacing physical therapy with measurement technology for quantitative assessment of outcome is presented. It is concluded that a new generation of educators is needed as well as a Ph.D. and/or a clinical doctorate degree in physical therapy, still lacking in many countries. It is urgent to consider knowledge translation since it will take many years before any recommended change in teaching will be accepted and show some effect. A call for a "white paper" on rehabilitation metrology is highly auspicable.
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Affiliation(s)
- Roberto Merletti
- LISiN, Department of Electronicsand Telecommunications, Politecnico di Torino, Italy
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Aldajah S, Etoom M, Mysore SB, Alawneh A, Hadoush H, Al Jarrah M, Abdullahi A. Evidence- based physiotherapy practice in Jordan: Evaluation and identification of implementation factors. Physiother Theory Pract 2023; 39:2723-2739. [PMID: 35833380 DOI: 10.1080/09593985.2022.2098212] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2021] [Revised: 06/27/2022] [Accepted: 06/30/2022] [Indexed: 10/17/2022]
Abstract
BACKGROUND Evidence-based physiotherapy practice (EBPTP) is becoming increasingly important to improve patient outcomes and clinical decision-making in the physiotherapy profession. OBJECTIVE To evaluate the EBPTP in Jordan and identify the barriers to its implementation in clinical practice. METHOD The study used a cross-sectional survey of licensed physiotherapists working in Jordan using EBPTP self-reported questionnaire. Frequencies, percentages, and one sample Wilcoxon rank test were used to evaluate the EBPTP level. The EBPTP implementation was evaluated by demographic variations of participants, Spearman's correlation, and stepwise multiple linear regression analyses at 95% confidence interval. RESULTS A total of 210 participants completed the survey. All EBPTP questionnaire elements showed significant positive levels (p = .00) except facility support reflecting non-significant negative level (p = .08). The EBPTP implementation was at a significantly lower level of uptake (p = .00). Clinical decision-making was based mainly on personal experience. The EBPTP implementation was significantly correlated with elements of the EBPTP questionnaire and differed by personal/organizational characteristics. There were four significant predictors of EBPTP implementation: understanding of EBPTP terminologies, facility support, formal training in EBPTP, and being a clinical instructor. CONCLUSION The findings confirm a clear gap in EBPTP implementation among physiotherapists in Jordan. The EBPTP implementation factors were mainly based on education sectors and work facilities. Engagement of stakeholders and education sectors in EBPTP implementation is required to strengthen the standing of the physiotherapy profession in Jordan.
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Affiliation(s)
| | - Mohammad Etoom
- Division of Physical Therapy, Allied Medical Sciences Department, Aqaba University of Technology, Aqaba, Jordan
| | - Sunitha Bhagavathi Mysore
- Department of Physiotherapy, Fatima College of Health Sciences, Near Al Mafraq Hospital, Abu Dhabi, UAE
| | - Anoud Alawneh
- Division of Physical Therapy, Allied Medical Sciences Department, Aqaba University of Technology, Aqaba, Jordan
| | - Hikmat Hadoush
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Muhammed Al Jarrah
- Department of Physiotherapy, Fatima College of Health Sciences, Near Al Mafraq Hospital, Abu Dhabi, UAE
- Department of Rehabilitation Sciences, Jordan University of Science and Technology, Irbid, Jordan
| | - Auwal Abdullahi
- Department of Physiotherapy, Bayero University Kano, Kano, Nigeria
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Shousha T, Javed A, Bekhet A, Jahan AM, Alayat M, Alshehri M, Moustafa I. Investigating behavior, attitudes, knowledge, awareness and barriers to the implementation of evidence-based practice by physiotherapists in Egypt: A cross sectional study. Heliyon 2023; 9:e22951. [PMID: 38144339 PMCID: PMC10746425 DOI: 10.1016/j.heliyon.2023.e22951] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2022] [Revised: 11/02/2023] [Accepted: 11/22/2023] [Indexed: 12/26/2023] Open
Abstract
Few studies exist regarding the attitudes and behaviours of Egyptian physiotherapists in relation to the use of evidence in practice (EBP). The purpose of this study was to describe the beliefs, attitudes, knowledge, and behaviours of Egyptian physical therapists as they relate to evidence-based practice. It also explores their perception of possible barriers to implement EBP. Four hundred and seventy Egyptian therapists responded to our questionnaire with results revealing participants' awareness towards EBP was quite diverse. Only terms of systematic review and randomized controlled trial were well understood while remaining terms showed various level of comprehension which were rather low. Results also revealed significant correlations between attitudes towards EBP and overall awareness as well as attitudes and knowledge (r = 0.270 and 0.107) respectively. In addition, a significant relationship was also found between EBP awareness and knowledge with (r = 0.219). With regards to the barriers, insufficient teaching in previous education was identified as the primary barrier (34.4 %), followed by lack of funding and resources (31.1 %), while lack of time (10.2 %) was reported as the least. These barriers highlight the need to enhance implementation of EBP within Egyptian Physiotherapists. Findings of this study can be used as a foundation for the implementation of EBP in various clinical settings by understanding the limitations and barriers reported. Our study concluded that despite Egyptian physiotherapists declare their awareness of EBP, nevertheless, knowledge is restricted to a small number of terms. More focus is required to enhance the knowledge and practice of EBP. Focusing on adjustable factors, including increasing the awareness of value of research would help reduce time and resource demands for physiotherapists when implementing EBP.
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Affiliation(s)
- Tamer Shousha
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS – Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
| | - Asma Javed
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
| | - Amira Bekhet
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
| | - Alhadi M. Jahan
- School of Rehabilitation Sciences, University of Ottawa, Canada
- Physiotherapy Department, College of Medical Technology, Misrata, Libya
| | - Mohamed Alayat
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
| | - Mansour Alshehri
- Physical Therapy Department, Faculty of Applied Medical Sciences, Umm Al-Qura University, Mecca, Saudi Arabia
- NHMRC Centre of Clinical Research Excellence in Spinal Pain, Injury& Health, School of Health and Rehabilitation Sciences, University of Queensland, Australia
| | - Ibrahim Moustafa
- Department of Physiotherapy, College of Health sciences, University of Sharjah, United Arab Emirates
- Faculty of Physical Therapy, Cairo University, Cairo, Egypt
- Neuromusculoskeletal Rehabilitation Research Group, RIMHS – Research Institute of Medical and Health Sciences, University of Sharjah, P.O. Box: 27272, Sharjah, United Arab Emirates
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Piano L, Chiarotto A, Mascarello M, Turolla A, Cecchetto S, Gianola S, Castellini G. Teaching evidence-based practice to physiotherapy students in Italy: a cross sectional study. Arch Physiother 2023; 13:19. [PMID: 37779190 PMCID: PMC10544500 DOI: 10.1186/s40945-023-00174-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Accepted: 09/14/2023] [Indexed: 10/03/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is being rapidly adopted by the Italian physiotherapy community, although a knowledge gap persists at clinical level with consequent lack of integration of EBP into ground roots practice. Teaching of EBP during the Bachelor of Science (BSc) undergraduate course in physiotherapy likely has a vital role to play in the spread of knowledge, providing a grounding in the fundamental concepts of EBP. The aim of the present study was to investigate the prevalence of EBP educational content in Italian BSc courses in physiotherapy. METHODS This is a cross-sectional study during which characteristics of EBP teaching in BSc degree courses of physiotherapy in Italy were collected from institutional websites during the period May to September 2021 with an update in August 2022. We used the STrengthening the Reporting of Observational studies in Epidemiology (STROBE) guidelines for our manuscript. RESULTS Forty-two physiotherapy BSc degree programs were retrieved, accounting for all the BSc delivered in the 2021-2022 academic year. Fourteen of these (33.3%) did not report EBP content. Northern universities provided EBP content in 16 out of 18 (88%) degree courses. Central Italian universities provided EBP content in 6 out of 9 (66.6%) degree courses. Southern universities delivered EBP content in 3 out of 9 (33.3%) degree courses. The universities of Sicily and Sardinia provided EBP content in 2 out of 5 (40%) degree courses. The degree courses taught in public universities were more likely to contain EBP material (25 out of 37, 67.4%), compared to those taught within the private system (3 out of 5, 60%). CONCLUSIONS The prevalence of EBP content within physiotherapy BSc degree programs in Italy can be considered suboptimal, with both regional differences and according to the system (public vs private). The results of this study could be used as a stimulus for increasing investment in the teaching of EBP in Italian physiotherapy degree courses, thereby improving educational standards.
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Affiliation(s)
- Leonardo Piano
- Unit of Rehabilitation and Functional Recovery, Fondazione Dei Santi Lorenzo E Teobaldo, 12050, Rodello, Italy.
- Department of Human Neurosciences, Sapienza University of Rome, Rome, Italy.
| | - Alessandro Chiarotto
- Department of General Practice, Erasmus University Medical Center, Rotterdam, The Netherlands
- Department of Health Sciences, Faculty of Science, Amsterdam Movement Sciences, VU University Amsterdam, Amsterdam, The Netherlands
| | - Marco Mascarello
- Department of Neuroscience and Rehabilitation, University of Ferrara, Ferrara, Italy
| | - Andrea Turolla
- Department of Biomedical and Neuromotor Sciences-DIBINEM, Alma Mater Studiorum, Università Di Bologna, 40138, Bologna, Italy
- Unit of Occupational Medicine, IRCCS Azienda Ospedaliero-Universitaria Di Bologna, 40138, Bologna, Italy
| | | | - Silvia Gianola
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Lombardia, Italy
| | - Greta Castellini
- Unit of Clinical Epidemiology, IRCCS Istituto Ortopedico Galeazzi, Milan, Lombardia, Italy
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Balzer J, Jung A, Gerhard J, Reinecke S, Mijic M, Fichtmüller A, Jahjah A, Eggert M, Koch M, Ernst K, Haring R. Psychometric properties of questionnaires to assess evidence-based practice among occupational, physical and speech therapists: A systematic review. ZEITSCHRIFT FUR EVIDENZ, FORTBILDUNG UND QUALITAT IM GESUNDHEITSWESEN 2023; 176:1-11. [PMID: 36702639 DOI: 10.1016/j.zefq.2022.11.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 10/27/2022] [Accepted: 11/11/2022] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Evidence-based practice (EBP) is an important aspect of healthcare work, but the clinical implementation is complex. To be able to facilitate EBP implementation, valid measurement of the "EBP status quo" is essential. Therefore, we aimed to identify valid tools for EBP status assessment among occupational, physical and speech therapists in Germany. METHODS The databases PubMed, Cochrane Library, PsycINFO, and CINAHL were systematically searched from August 2011 until July 2022. Methodological quality and evidence level were scored by two independent raters via: i) the COnsensus-based Standards for the selection of health Measurement INstruments (COSMIN) checklist, ii) updated criteria for good measurement properties, and iii) modified GRADE criteria. RESULTS Overall, 57 reports describing the development or validation of 31 EBP questionnaires were included. Six questionnaires showed "sufficient" evidence for content validity, three questionnaires showed "sufficient" evidence for reliability, two questionnaires showed "sufficient" evidence for structural validity as well as internal consistency, and nine questionnaires showed "sufficient" evidence for construct validity. Most questionnaires demonstrated moderate or low-quality evidence for the psychometric properties tested. DISCUSSION Overall, the present review found a lack of sufficient evidence on the psychometric properties of most questionnaires. The Evidence-Based Practice Inventory (EBPI), the Evidence-based Practice Confidence (EPIC) scale and the Health Sciences-Evidence-Based Practice (HS-EBP) questionnaire were the only questionnaires with "sufficient" content validity and, in addition, "sufficient" reliability or "sufficient" internal consistency. CONCLUSION Although a lack of high-quality psychometric properties of EBP tools became apparent, the EBPI, the EPIC scale and the HS-EBP questionnaire currently appear to be the best validated tools to assess EBP behavior/attitude and implementation in occupational, physical and speech therapists.
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Affiliation(s)
- Julia Balzer
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Andrés Jung
- Universität zu Lübeck, Institute of Health Sciences, Department of Physiotherapy, Pain and Exercise Research Luebeck (P.E.R.L), Lübeck, Germany.
| | - Janina Gerhard
- Gesellschaft für psychosoziale Einrichtungen gGmbH, Mainz, Germany
| | - Sarah Reinecke
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Marko Mijic
- Ludwig-Maximilians-Universität München, Friedrich-Baur-Institut / Neurologische Klinik und Poliklinik, LMU Klinikum, Munich, Germany
| | - Andrea Fichtmüller
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | | | - Marieke Eggert
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Maren Koch
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Kathrin Ernst
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
| | - Robin Haring
- European University of Applied Sciences, Faculty of Applied Public Health, Rostock, Germany
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Bonnechère B, Timmermans A, Michiels S. Current Technology Developments Can Improve the Quality of Research and Level of Evidence for Rehabilitation Interventions: A Narrative Review. SENSORS (BASEL, SWITZERLAND) 2023; 23:s23020875. [PMID: 36679672 PMCID: PMC9866361 DOI: 10.3390/s23020875] [Citation(s) in RCA: 9] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/29/2022] [Revised: 12/19/2022] [Accepted: 01/05/2023] [Indexed: 06/01/2023]
Abstract
The current important limitations to the implementation of Evidence-Based Practice (EBP) in the rehabilitation field are related to the validation process of interventions. Indeed, most of the strict guidelines that have been developed for the validation of new drugs (i.e., double or triple blinded, strict control of the doses and intensity) cannot-or can only partially-be applied in rehabilitation. Well-powered, high-quality randomized controlled trials are more difficult to organize in rehabilitation (e.g., longer duration of the intervention in rehabilitation, more difficult to standardize the intervention compared to drug validation studies, limited funding since not sponsored by big pharma companies), which reduces the possibility of conducting systematic reviews and meta-analyses, as currently high levels of evidence are sparse. The current limitations of EBP in rehabilitation are presented in this narrative review, and innovative solutions are suggested, such as technology-supported rehabilitation systems, continuous assessment, pragmatic trials, rehabilitation treatment specification systems, and advanced statistical methods, to tackle the current limitations. The development and implementation of new technologies can increase the quality of research and the level of evidence supporting rehabilitation, provided some adaptations are made to our research methodology.
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Affiliation(s)
- Bruno Bonnechère
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Technology-Supported and Data-Driven Rehabilitation, Data Science Institute, Hasselt University, 3590 Diepenbeek, Belgium
| | - Annick Timmermans
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
| | - Sarah Michiels
- REVAL Rehabilitation Research Center, Faculty of Rehabilitation Sciences, Hasselt University, 3590 Diepenbeek, Belgium
- Department of Otorhinolaryngology, Antwerp University Hospital, 2650 Edegem, Belgium
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Caffini G, Battista S, Raschi A, Testa M. Physiotherapists' knowledge of and adherence to evidence-based practice guidelines and recommendations for ankle sprains management: a cross-sectional study. BMC Musculoskelet Disord 2022; 23:975. [PMID: 36368960 PMCID: PMC9650827 DOI: 10.1186/s12891-022-05914-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Accepted: 10/26/2022] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Lateral ankle sprain (LAS) is a common and burdensome injury. However, the quality of its management is scant. Nowadays, physiotherapy management of musculoskeletal diseases seems to be generally not based on research evidence. Studies that investigated the knowledge-to-practice gap in LAS management are yet to be carried out. Therefore, this research investigated physiotherapists' knowledge of and adherence to LAS Clinical Practice Guidelines (CPGs) and recommendations. METHODS A cross-sectional study based on an online survey structured in three sections. The first section collected demographic data. The second section showed two clinical cases (with positive and negative Ottawa Ankle Rules (OAR), respectively). The participants indicated which treatments they would adopt to manage them. Participants were classified as 'following', 'partially following', 'partially not following' and 'not following' the CPGs and recommendations. In the third section, participants expressed their agreement with different CPG and recommendation statements through a 1-5 Likert scale. RESULTS In total, 483 physiotherapists (age: 34 ± 10; female 38%, male 61.5%, other 0.5%) answered the survey: 85% completed the first two sections, 76% completed all three sections. In a case of acute LAS with negative OAR, 4% of the participants were considered as 'following' recommended treatments, 68% as 'partially following', 23% as 'partially not following', and 5% as 'not following'. In a case of acute LAS with positive OAR, 37% were considered 'following' recommended treatments, 35% as 'partially following', and 28% as 'not following'. In the third section, the consensus was achieved for 73% of the statements. CONCLUSION This study showed that although there is a good knowledge about first-line recommended treatments, a better use of CPGs and recommendations should be fostered among physiotherapists. Our results identify an evidence-to-practice gap in LAS management, which may lead to non-evidence-based practice behaviors.
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Affiliation(s)
- Giulia Caffini
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, via Magliotto 2 -, 17100, Savona, Italy
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, via Magliotto 2 -, 17100, Savona, Italy
| | - Andrea Raschi
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, via Magliotto 2 -, 17100, Savona, Italy
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, via Magliotto 2 -, 17100, Savona, Italy.
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12
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Spiegl C, Schiefermeier-Mach N, Schifferegger E, Wiederin C, Scheiber B. Physiotherapeutic evaluation of patients with post COVID-19 condition: current use of measuring instruments by physiotherapists working in Austria and South Tyrol. Arch Physiother 2022; 12:21. [PMID: 36104802 PMCID: PMC9473730 DOI: 10.1186/s40945-022-00147-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Accepted: 07/17/2022] [Indexed: 11/29/2022] Open
Abstract
Background The implementation of standardized assessments in physiotherapeutic practice strongly supports diagnostic and treatment plans. Previous studies reported insufficient usage of standardized assessments due to lack of time, lack of knowledge, lack of resources and other barriers. Physiotherapy in outpatient settings became essential for the rehabilitation of patients with post COVID-19 condition but it remains unknown to what extent assessments are implemented into the evaluation of these patients. In this study, we explored the current use and barriers regarding the implementation of physiotherapeutic assessments to evaluate patients with post COVID-19 condition. Methods A cross-sectional online survey was carried out among 180 physiotherapists working in outpatient settings in Austria and South Tyrol. Results The majority of physiotherapists (88%) indicated that standardized assessments are useful, though less than a fifth of participants actually implement assessments in practice. Among implementation barriers, “insufficient experience” (41.8%) and “lack of knowledge” (36.6%) were mentioned most often. Concerning specific post COVID-19 assessments, the evaluation of “physical and respiratory function”, “quality of life” and “activities of daily living” were stated to be of particular relevance. Conclusions Our study revealed a low implementation rate and identified the main barriers regarding the non-usage of standardized assessments for post COVID-19 patients. Trial registration The Private University for Health Sciences and Health Technology (UMIT TIROL), and the Research Committee for Scientific Ethical Questions granted approval for the survey (RCSEQ, Hall in Tirol, Austria, Number 2834). Supplementary Information The online version contains supplementary material available at 10.1186/s40945-022-00147-0.
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Bruchard A, Laurent X, Raul P, Saniel G, Visery G, Fontanier V, Lemeunier N. Evidence-based-practice profile among physiotherapists: a cross-sectional survey in France. EUROPEAN JOURNAL OF PHYSIOTHERAPY 2022. [DOI: 10.1080/21679169.2022.2057587] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Arnaud Bruchard
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
| | - Xavier Laurent
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
| | - Pauline Raul
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
| | - Germain Saniel
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
| | - Grégory Visery
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
| | | | - Nadège Lemeunier
- Département Recherche, KINESPORT, Pôle scientifique, Paris, France
- Center for Epidemiology and Research in POPulation health (CERPOP), Université de Toulouse, Inserm, Université Paul Sabatier, Toulouse, France
- Faculty of Health Sciences, Ontario Tech University, Oshawa, Canada
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14
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Płaszewski M, Krzepkowska W, Grantham W, Wroński Z, Makaruk H, Trębska J. Knowledge, behaviours and attitudes towards Evidence-Based Practice amongst physiotherapists in Poland. A nationwide cross-sectional survey and focus group study protocol. PLoS One 2022; 17:e0264531. [PMID: 35231040 PMCID: PMC8887773 DOI: 10.1371/journal.pone.0264531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 02/11/2022] [Indexed: 11/18/2022] Open
Abstract
Objectives
Evidence-Based Practice, EBP, is recognised, along with team work and patient-centred care, as a core competency in contemporary healthcare. However, dissemination and implementation of EBP remains problematic and is dependent on various external and internal factors, from personal through institutional to systemic, factors, with specific characteristics for different professions, contexts and settings. Knowledge, behaviours, attitudes, as well as facilitators and barriers towards EBP amongst physiotherapists, have been widely explored worldwide, but never in Poland. This study is part of a nationwide project, including dissemination actions addressing EBP in physiotherapists registered in Poland. Our purpose is to explore the issues of knowledge, behaviours, experiences, and attitudes of physiotherapists in Poland towards EBP. Descriptive research studies are warranted before analytical investigations and dissemination activities are conducted.
Methods
We plan to conduct a quantitative, cross-sectional study–an online survey amongst the total population of physiotherapists registered in Poland to assess knowledge, behaviours and use of EBP (Study 1), and a qualitative study to allow physiotherapists to voice their opinions and to explore their experiences and attitudes towards EBP (Study 2). The EBP2 questionnaire, Polish validated translation, will be used for Study 1, in a web-based survey. A focus group approach will be applied for Study 2, with purposive sampling to achieve a representative picture of physiotherapists with respect to setting, specialty, seniority, educational degrees, and age. We will follow an inductive approach, using topics rather than questions.
Results
We will present the results of the studies separately, as typically presented in relevant study types: Study 1 will be reported addressing the domains and items of the EBP2, in relation to the independent variables, and Study 2 will be discussed using the themes and illustrative quotes analyses.
Discussion
We are aware that significant non-response, spin and Hawthorne effect may potentially bias our findings.
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Affiliation(s)
- Maciej Płaszewski
- Department of Rehabilitation, Faculty of Physical Education and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, Warsaw, Poland
- * E-mail:
| | - Weronika Krzepkowska
- Department of International Cooperation, The Polish Chamber of Physiotherapists, Warsaw, Poland
| | - Weronika Grantham
- Faculty of Physical Education and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Zbigniew Wroński
- Department of Rehabilitation, Warsaw Medical University, Warsaw, Poland
| | - Hubert Makaruk
- Faculty of Physical Education and Health in Biała Podlaska, The Józef Piłsudski University of Physical Education, Warsaw, Poland
| | - Joanna Trębska
- Institute of Econometrics, University of Łódź, Łódź, Poland
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15
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Leach MJ. Implementation science in New Zealand naturopathic practice: a cross-sectional study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:781-790. [PMID: 35092655 DOI: 10.1515/jcim-2021-0508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Understanding and addressing the barriers to evidence-based practice (EBP) falls within the realm of implementation science. To date, disciplines such as naturopathy have paid little attention to implementation science, meaning the obstacles to delivering best practice care have largely been ignored. This study addresses this knowledge gap by examining the determinants of evidence implementation in New Zealand naturopathic practice. METHODS This cross-sectional study was open to all New Zealand naturopaths who had Internet access, and were fluent in the English language. Participants were invited to complete the 84-item Evidence-Based practice Attitude and utilization Survey (EBASE) online between February and July 2020. RESULTS The survey was completed in full by 104 naturopaths (86% female; 55% aged 40-59 years). While attitudes toward EBP were generally favourable, engagement in EBP activities was reported at a moderate-low level. Factors potentially contributing to the modest uptake of EBP were the moderate level of self-reported EBP-related skill, lack of clinical evidence in naturopathy and lack of time. Enablers of EBP uptake that were supported by the majority of participants were access to the Internet, online databases, EBP education materials, and full-text journal articles. CONCLUSIONS This study has provided much-needed insight into the level of EBP engagement among New Zealand naturopaths, as well as the various factors impacting evidence implementation. Attitude did not pose a major barrier to evidence implementation; rather, the barriers were largely structural, cognitive and cultural. This suggests that the barriers to EBP uptake in naturopathy are not unsurmountable.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Military Road, Lismore, NSW 2480, Australia
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16
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Ahmad T, Khan M, Haroon , Dhama K, Jin H, Baig M. Characteristic Features of 100 Most Influential Studies in Evidence-Based Medicine: A Worldwide Bibliometric Analysis. ELECTRONIC JOURNAL OF GENERAL MEDICINE 2021. [DOI: 10.29333/ejgm/11321] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
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17
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Evidence based physiotherapy practice in cardiopulmonary subdiscipline: A survey in United Arab Emirates. Heliyon 2021; 7:e08098. [PMID: 34632155 PMCID: PMC8488807 DOI: 10.1016/j.heliyon.2021.e08098] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2021] [Revised: 08/04/2021] [Accepted: 09/27/2021] [Indexed: 11/23/2022] Open
Abstract
Background Evidence based practice (EBP) is widely used by cardiopulmonary physical therapists worldwide. Therefore, it is important to identify whether the therapists have the required knowledge, skills and resources in order to deliver the best evidence-based practice. Objectives The main objective of this cross-sectional study is to analyse the self-reported characteristics of behaviour, knowledge, skills and resources, opinion and barriers related to evidence-based practice among cardiopulmonary physical therapists of United Arab Emirates (UAE). Methods An electronic questionnaire was circulated among 60 licensed cardiopulmonary physical therapists, of either gender, practicing in UAE with a minimum experience of 1 year via e-mail. The response was further subjected to descriptive analysis. Results The rate of response was 55% (33/60). The physical therapists of cardiopulmonary disciple reported that they understand the term Evidence Based Practice and frequently update themselves through scientific papers obtained via accessing various databases. Respondents also believe that the exposure in undergraduate or postgraduate course was not sufficient. However, they were also satisfied with amount of discussions taking place regarding EBP at their work place. The barriers commonly reported were difficulty in obtaining full-text papers, lack of time and lack of evidence-based training. Conclusion Thus, concluding that physical therapists from UAE who practiced in cardiopulmonary subdiscipline believe that they have knowledge and skills to use evidence-based practice. Although, they have favourable opinions regarding its application and they still encounter difficulties in implementing it successfully.
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Cutolo R, Battista S, Testa M. Actual and Perceived Level of Scientific English across Italian Physiotherapy Courses: A Cross-Sectional Study. Healthcare (Basel) 2021; 9:healthcare9091135. [PMID: 34574909 PMCID: PMC8465386 DOI: 10.3390/healthcare9091135] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2021] [Revised: 08/26/2021] [Accepted: 08/28/2021] [Indexed: 01/31/2023] Open
Abstract
The knowledge of the English language is fundamental for the application of evidence-based practice. Hence, this study explores, through an online survey, the (1) perceived and (2) actual level of Scientific English among Italian undergraduate (UGs) and postgraduate (PGs) physiotherapists. As for (1), the participants expressed their agreement with 10 statements regarding the attitude towards Scientific English through a 1–4 Likert-type scale, with consensus set at ≥70%. As for (2), an ad-hoc 10-point questionnaire was developed through a Delphi procedure, with a pass score set at ≥60%. The survey was completed by 421 participants (UG: 47%; PG: 53%). As for (1), consensus was achieved in both groups in 4 out of 10 statements, specifically the ones addressing the capability to fully understand a scientific paper and physiotherapy-specific language in English. As for (2), the mean score reached by both groups was below 60%. The participants who had studied or were studying at a university in southern Italy presented 2.56 [1.54; 4.24] times higher odds to fail the test. New strategies to bridge the gap in the knowledge of Scientific English in Italy should be developed, through the creation of a unique syllabus tailored to the needs of future physiotherapists.
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Affiliation(s)
- Raffaele Cutolo
- School of Medicine and Surgery, University of Verona, 37135 Verona, Italy;
| | - Simone Battista
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, 17100 Savona, Italy;
| | - Marco Testa
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Campus of Savona, 17100 Savona, Italy;
- Correspondence: ; Tel.: +39-019-860250
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19
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Brindisino F, De Santis A, Rossettini G, Pellicciari L, Filipponi M, Rollo G, Gibson J. Post-surgery rehabilitation following rotator cuff repair. A survey of current (2020) Italian clinical practice. Disabil Rehabil 2021; 44:4689-4699. [PMID: 33945358 DOI: 10.1080/09638288.2021.1916628] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
AIMS To analyse the clinical practice of Italian physiotherapists within the framework of postoperative rehabilitation of rotator cuff (RC) surgery patients, and to compare it with similar studies carried out in other countries. METHODS A web-based, voluntary, cross-sectional survey with 27 closed multiple-choice questions was developed and submitted to Italian-based physiotherapists in order to assess their clinical practice. RESULTS Data from 1160 questionnaires were then analysed. Thirty-five percent of respondents (n = 413/1160) reported that they commence passive range of motion from the first postoperative week, while 49.2% (n = 571/1160) start during the second or third week. The majority of respondents (n = 603/1160, 52.0%) introduce active mobilisation between the fourth and the sixth week after surgery and 41.1% (n = 477/1160) introduce overhead movements between the fourth and the sixth week after surgery. DISCUSSION AND CONCLUSIONS When managing the postoperative rehabilitation of RC surgery patients, Italian physiotherapists' practice is congruent with the guidelines published by American Society of Shoulder and Elbow Therapists (ASSET) and also with other UK surveys. However, while Italian physiotherapists manage immobilisation periods, active and passive mobilisation and the return to sport activities, according to evidence-based best practice guidelines, there is less consistency with respect to physical exercise, patient follow-up and referral.IMPLICATIONS FOR REHABILITATIONItalian physiotherapists' practice with patients following rotator cuff (RC) repair complies with evidence-based practice guidelines regarding immobilisation periods, passive and active mobilisation, and return to sport activities.There is less consistency between reported/declared practice and available evidence concerning physical exercise, patient follow-up, and referral.Physiotherapist with Orthopaedic Manipulative Physical Therapy (OMPT) training is more aligned with the current literature compared to physiotherapists without specific training, in terms of managing rehabilitation programmes, period of immobilisation and therapeutic exercise.More careful adherence to the international guidelines is recommended, in order to manage patients following RC repair in accordance with the evidence and to achieve the best possible outcomes.
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Affiliation(s)
- Fabrizio Brindisino
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Department of Clinical Sciences and Translational Medicine, Tor Vergata University of Rome, Rome, Italy
| | - Andrea De Santis
- Department of Medicine and Health Science "Vincenzo Tiberio", University of Molise, Campobasso, Italy.,Poliambulatorio Physiofit, Borgo Podgora, Italy
| | - Giacomo Rossettini
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy.,School of Physiotherapy, University of Verona, Verona, Italy
| | | | - Marco Filipponi
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy
| | - Giuseppe Rollo
- Department of Orthopedics and Traumatology, Vito Fazzi Hospital, Lecce, Italy
| | - Jo Gibson
- Department of Physiotherapy, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK.,The School of Health Sciences, University of Liverpool, Liverpool, UK
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Manca A, Cereatti A, Bar-On L, Botter A, Della Croce U, Knaflitz M, Maffiuletti NA, Mazzoli D, Merlo A, Roatta S, Turolla A, Deriu F. A Survey on the Use and Barriers of Surface Electromyography in Neurorehabilitation. Front Neurol 2020; 11:573616. [PMID: 33123079 PMCID: PMC7566898 DOI: 10.3389/fneur.2020.573616] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Accepted: 08/25/2020] [Indexed: 11/13/2022] Open
Abstract
Historical, educational, and technical barriers have been reported to limit the use of surface electromyography (sEMG) in clinical neurorehabilitation settings. In an attempt to identify, review, rank, and interpret potential factors that may play a role in this scenario, we gathered information on (1) current use of sEMG and its clinical potential; (2) professional figures primarily dealing with sEMG; (3) educational aspects, and (4) possible barriers and reasons for its apparently limited use in neurorehabilitation. To this aim, an online 30-question survey was sent to 52 experts on sEMG from diverse standpoints, backgrounds, and countries. Participants were asked to respond to each question on a 5-point Likert scale or by ranking items. A cut-off of 75% agreement was chosen as the consensus threshold. Thirty-five invitees (67%) completed the electronic survey. Consensus was reached for 77% of the proposed questions encompassing current trends in sEMG use in neurorehabilitation, educational, technical, and methodological features as well as its translational utility for clinicians and patients. Data evidenced the clinical utility of sEMG for patient assessment, to define the intervention plan, and to complement/optimize other methods used to quantify muscle and physical function. The aggregate opinion of the interviewed experts confirmed that sEMG is more frequently employed in technical/methodological than clinical research. Moreover, the slow dissemination of research findings and the lack of education on sEMG seem to prevent prompt transfer into practice. The findings of the present survey may contribute to the ongoing debate on the appropriateness and value of sEMG for neurorehabilitation professionals and its potential translation into clinical settings.
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Affiliation(s)
- Andrea Manca
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Andrea Cereatti
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Lynn Bar-On
- Department of Rehabilitation Sciences, KU Leuven, Leuven, Belgium.,Department of Rehabilitation Medicine, Amsterdam UMC, Amsterdam Movement Sciences, Amsterdam, Netherlands
| | - Alberto Botter
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | - Ugo Della Croce
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
| | - Marco Knaflitz
- Department of Electronics and Telecommunications, Politecnico di Torino, Turin, Italy
| | | | - Davide Mazzoli
- Gait and Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
| | - Andrea Merlo
- Gait and Motion Analysis Laboratory, Sol et Salus Hospital, Rimini, Italy
| | | | - Andrea Turolla
- Laboratory of Rehabilitation Technologies, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) San Camillo Hospital, Venice, Italy
| | - Franca Deriu
- Department of Biomedical Sciences, University of Sassari, Sassari, Italy
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