Factors affecting physiotherapy clinical education: Perceptions of students and clinical educator

Senthilnathan Ramakrishnan, Kalyana Chakravarthy Bairapareddy


Senthilnathan Ramakrishnan, Kalyana Chakravarthy Bairapareddy – Factors affecting physiotherapy clinical education: Perceptions of students and clinical educator. Fizjoterapia Polska 2022; 22(4); 92-100

DOI: https://doi.org/10.56984/8ZG1A6z0J

Abstract
Introduction. Clinical education is the cornerstone of physiotherapy education. Clinical educators play a pivotal role in shaping students’ attitude towards their future role as physiotherapist. But the implementation of physiotherapy clinical education varies significantly between institutions. Research has shown several factors influencing the clinical education.
Aim. To explore the factors affecting physiotherapy clinical education.
Methods. This research used mixed-methods approach and recruited participants through purposive and convenience sampling. Data was collected through a survey using questionnaire and face-to-face interviews. Thirty-four physiotherapy students completed a questionnaire after attending 12 weeks of clinical placements. Twenty-six clinical educators and 9 students participated in the interview. Descriptive statistics including frequency percentage, median and percentiles were used for quantitative data analysis. Thematic analysis method was used for qualitative data analysis.
Results. Quantitative study found greater student satisfaction in clinical education. But the qualitative study identified several factors affecting clinical education in the context of this study. These factors include student interest, learning style, culture, and ability to cope with challenges. In addition, clinical educator workload, teaching strategies, curriculum knowledge, academic-clinical partnership, peer learning, placement model and expectations were the other factors that influenced physiotherapy clinical education.
Conclusions. The findings of this study are useful to physiotherapy clinical educators, students, and faculty. It provides insight into various factors affecting physiotherapy clinical education. Furthermore, it recommends evidence-based strategies to neutralize those factors influencing clinical education.

Keywords
clinical placements, clinical education, physiotherapy

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Within the National Health Fund (NFZ) or privately? Use of health services provided by physiotherapists

Józefa Dąbek, Oskar Sierka, Joanna Frąckiewicz, Barbara Hebenstreit, Oliwia Kabalak, Monika Janowska, Halina Kulik


Józefa Dąbek, Oskar Sierka, Joanna Frąckiewicz, Barbara Hebenstreit, Oliwia Kabalak, Monika Janowska, Halina Kulik – Within the National Health Fund (NFZ) or privately? Use of health services provided by physiotherapists. Fizjoterapia Polska 2022; 22(4); 80-91

DOI: https://doi.org/10.56984/8ZG1A6xlA

Abstract
Aim of the study. The profession of a physiotherapist is still at the stage of shaping and strengthening its position, both in the group of medical professions and in social awareness. The study aimed to assess the scope of use and satisfaction with physiotherapy services provided as part of public and private health care.
Matherials and methods. The study covered a total of 606 people (100%). The vast majority were women (506; 83.5%). The research tool was an original questionnaire made available via a Google form. The survey consisted of 35 questions, 5 of which concerned some socio-demographic characteristics.
Results. Most of the respondents used commercial services financed from their own budget (258; 78.2%). The most frequently indicated criterion for selecting a public institution was the distance from the place of residence (97; 16,1%), and a private one – the opinion of friends (159; 26,24%). The largest number of respondents using physiotherapeutic services would choose commercial services if they had to be used again (224; 67.9%).
Conclusions. More than half of the surveyed people used the services provided by a physiotherapist, moreover vast majority of respondents used commercial services, financed from their resources. Criteria for selecting public and private institutions were varied and the assessed satisfaction with commercial physiotherapeutic services was higher than public.

Key words:
physiotherapy, public health care, private health care, use, satisfaction

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Efficacy of ultrasound in diagnosis and treatment of the shoulder – A systematic review

Dawid Lukoszek, Dominik Sieroń, Izabella Jabłońska, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk


Dawid Lukoszek, Dominik Sieroń, Izabella Jabłońska, Jan Szczegielniak, Rafał Trąbka, Karol Szyluk – Efficacy of ultrasound in diagnosis and treatment of the shoulder – A systematic review. Fizjoterapia Polska 2022; 22(4); 56-73

DOI: https://doi.org/10.56984/8ZG1A6k5q

Abstract
Objectives. The aim of this study was to provide an overview of the scientific evidence base on the use of ultrasonography in physiotherapy and rehabilitation of the shoulder.
Methods. The PubMed / Medline database was reviewed using the following keywords: shoulder ultrasonography AND rehabilitation; shoulder ultrasound imaging AND physiotherapy; shoulder ultrasound imaging AND rehabilitation; Rehabilitative Ultrasound Imaging AND Shoulder. Only full-text, open-access studies in English published before 15 May 2022 were included in the analysis.
Results. 51 articles (out of 748 identified) were included in the analysis. Of all the studies, 3 studies were randomized, 5 were not randomized, the rest were cross-sectional or case studies. The most common study group were patients with hemiplegia (in 13 out of 51 reviewed works). 12 papers out of 51 concerned orthopedic conditions of the shoulder with varying diagnoses. Ultrasound imaging was used mainly to assess echogenicity and measure structures of the shoulder.
Conclusion. There are many studies demonstrating the utility of ultrasound in various aspects of the physiotherapist’s practice, including but not limited to diagnostic purposes, assessment of treatment effectiveness, monitoring treatment progress, and referring the patient to another specialist.

Key words:
ultrasonography, ultrasound, imaging, ultrasonography, rehabilitation, physical therapy, physiotherapy, diagnosis, shoulder, pain, treatment

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Ethical and psychological issues of oncological physiotherapy

Damian Durlak


Damian Durlak – Kwestie etyczne i psychologiczne fizjoterapii onkologicznej. Fizjoterapia Polska 2022; 22(4); 44-46

DOI: https://doi.org/10.56984/8ZG1A6Sbq

Abstract
Every year, canceris diagnosed in an increasing number of patients. Any diagnosis that confirms cancer causes enormous stress and trauma to the patient. Poor mental state may result in a lack of willingness to cooperate with a physiotherapist, and, as a result, hinder the overall treatment process. Physiotherapists should pay special attention to the principles of ethics in the profession and the possibilities of psychological support of patients during therapy. Reducing stress in patients and gaining their trust might help them recover faster.

Key words:
physiotherapy, oncology, ethics, psychological support

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Incidence of back pain in people practicing amateur horse riding

Ewa Puszczałowska-Lizis, Dominik Szymański, Piotr Pietrzak, Marcin Wilczyński


Ewa Puszczałowska-Lizis, Dominik Szymański, Piotr Pietrzak, Marcin Wilczyński – Incidence of back pain in people practicing amateur horse riding. Fizjoterapia Polska 2022; 22(4); 6-15

DOI: https://doi.org/10.56984/8ZG1A68mY

Abstract
Introduction. While riding a horse, proper seat requires the trunk positioning so that the rider’s centre of gravity overlaps with the horse’s centre of gravity. Seat errors can lead to repeated and cumulative spinal overloads. The aim of the study was to analyse the incidence of back pain in people who practice amateur horse riding.
Material and methods. The study involved 88 people aged 40-45 years, associated in equestrian centers. The research tool was the author’s questionnaire, Neck Disability Index (NDI) and Oswestry Distability Index (ODI). The collected research results were analysed with the use of Chi-square test and Mann-Whitney U test.
Results. Statistically significant relationships were found between the incidence of pain location and gender (p = 0.001), and also between between the gender and the opinion on the need to use physiotherapy in case of back problems (p = 0.049).
Conclusions. Women report pain in the lumbar and thoracic spine more frequently, while men report pain in the cervical section and entire spine. Women in a greater percentage than men believe that people who practice horse riding as an amateur should attend physiotherapy in case of pain.

Key words:
horse riding, spine, pain, physiotherapy

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Post-COVID-19 rehabilitation in the post-hospitalization period – case study

Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka


Michał Polawski, Wiktor Obręcki, Magdalena Kościelniak, Rafał Trąbka – Post-COVID-19 rehabilitation in the post-hospitalization period – case study. Fizjoterapia Polska 2022; 22(3); 102-115

Abstract
Aim of the research work. The main goal of the research work was to show an author’s plan of physiotherapeutic intervention for people suffering of COVID-19 in the post-acute stage. The therapeutic procedure highlighted pulmonary rehabilitation, aerobic and resistance training and patient’s education.
Case study. The research work was performed on a 62-year old woman, who was diagnosed with infection by SARS-CoV-2 virus. The patient was admitted to ICU with acute ARDS in a heavily severe condition. The medical history showed obesity, chronic ischemic heart disease, arterial hypertension and cardiac arrest (2011). The patient was admitted to the rehabilitation unit in the post-acute stage of infection, and was using passive oxygen therapy with oxygen flow set to 4 l/min. During the qualification for therapy the patient was tested using a questionnaire which consisted of clinical tests such as 6MWT, MRC, 30CST and FIM scale. Furthermore, the lungs were examined using spirometry. Identical measurements were being used every 2 weeks of the therapy process. After 8 weeks of physiotherapeutic procedure there was a significant increase of score in 6-MWT which upgraded by 750%. Systematic improvement was also visible in dyspnoea and fatigue, which completely surceased after finishing the therapeutic process. Functional state of the patient improved considerably which is shown by 30CST score, improved by 380%. Spirometry score analysis shows FVC, FEV1 and Tiffeneau-Pinelli index improve respectively by 40%, 53% and 9.6%.
Summary. The therapeutic program based on pulmonary rehabilitation, aerobic and resistance training and patient’s education looks very promising. Implemented procedure contributed to the patient’s relatively quick recovery to a pre-COVID-19 state. Patient’s physical and pulmonary efficiency were noticed, exertional tolerance increased, dyspnoea and fatigue gave way which all combined led to improved functional efficiency. Pulmonary system function was also enhanced which was demonstrated by spirometry.

Key words:
SARS-CoV-2, COVID-19, physiotherapy, rehabilitation

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Labour law for physiotherapists in Poland

Damian Durlak


Damian Durlak – Prawo pracy dla fizjoterapeutów w Polsce. Fizjoterapia Polska 2022; 22(3); 30-36

Abstract
Every employee is responsible for their basic knowledge of labour law. Getting acquainted with relevant laws and regulations may save an unaware employee from being sued by the employer or provide grounds for pursuing their claims when the employer violates the employee’s interest. This is particularly important in the case of medical professionals. Physiotherapists, as employees of one of the medical professions, are covered by different regulations regarding, for example, working hours or remuneration for work outside working hours. The prevailing COVID-19 pandemic additionally contributed to the introduction of new regulations that would change the way medical employees perform work. The objective of this study is to present the most important information about labour law from the point of view of a physiotherapist.

Key words:
physiotherapy, labour law, COVID-19, medical professions

Article only in Polish language

Successful public procurement of physiotherapeutic equipment

Damian Durlak


Damian Durlak – Skuteczne zamówienia publiczne na sprzęt fizjoterapeutyczny. Fizjoterapia Polska 2022; 22(2); 54-58

Abstract
Medical facilities purchasing medical equipment under the public procurement procedure are obliged to comply with the regulations specified in legal acts. Due preparation of the specification of the subject of the contract, selection of the appropriate team responsible for the process, and above all, understanding the needs and opinions of physiotherapists who will be using the equipment in the future can significantly affect the success of the entire process. Physiotherapists should be aware of the basics in the field of public procurement in order to be able to support other employees in the adequate preparation of tenders and in the selection of contractors.
Proper cooperation will ensure physiotherapists’ satisfaction working on the suitable equipment, and safe physiotherapeutic conditions for patients.
Key words:
Physiotherapy, public procurement, physiotherapy equipment
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Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients

Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon


Meenakshi Jharbade, Sivakumar Ramachandran, Shankar V, John M Solomon – Development of a functional training protocol to improve lower limb motor recovery in early sub-acute stroke patients. Fizjoterapia Polska 2022; 22(1); 234-239

Streszczenie
Abstract
Background. Functional training is a common intervention practiced in stroke rehabilitation. The efficacy of lower limb functional training to improve functions has been widely tested in patients with chronic stroke. Improvement in function generally does not reflect changes in motor recovery. The effect of this training on motor recovery has been less explored. Moreover, a standard protocol for lower limb functional training is elusive in literature.
Aim. To develop an intervention protocol of functional training for lower extremity to improve motor recovery and functions in acute and early subacute stroke patients.
Methods. Study was conducted in two phases. First phase involved literature review to identify the components for functional training for lower extremity in patients with stroke. Second phase involved two rounds of Delphi survey to design an intervention protocol. First round of Delphi survey was conducted to identify the functions of lower extremity that can be used as components of training and second round was conducted to receive the consensus on activities of lower extremity which can be practiced in acute and early subacute stroke patients.
Results. Functions of lower extremity and exercises of functional training which received consensus of atleast 70% and above in Delphi survey are selected to design the protocol. Weight-bearing, postural control, sit to stand, stepping, walking, standing, manipulation function was selected to design activities for functional training.
Conclusion. A Functional training protocol was developed with activities for weight bearing, postural control, manipulation and walking function.
Key words:
stroke, physiotherapy, functional training, rehabilitation, task oriented exercise
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Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland

Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry


Zbigniew Tytko, Dominik Dziurda, Dorota Mańkowska, Agata Bąk, Katarzyna Leoszkiewicz, Katarzyna Kędzior, Piotr Bednarski, Roman Topór-Mądry – Index assessment of outpatient physiotherapy financed from public funds at the disposal of the National Health Fund provided in 2017–2019 in Poland. Fizjoterapia Polska 2022; 22(1); 152-158

Abstract
Introduction. Our study aims to present the state of Polish outpatient physiotherapy covered by the National Health Fund (NHF) based on a set of original indices to parametrise the structure of services and the physiotherapy process.
Materials and methods. The study used the NHF reporting data on outpatient physiotherapy collected between January 2017 and October 2019. The analysis used a set of originally developed indices.
Results. Of all outpatient physiotherapy cycles, generally provided on consecutive working days, 70% lasted 10 days and 84% were provided to patients without a formal confirmation of severe disability. From the patient’s perspective, 41% of the time of services is provided in a one-on-one basis (index of the structure of services), while the kinesiotherapy accounted for 30% of total time of services. The dominant group of services, about 70% in quantitative terms, is physical therapy.
Conclusions. To satisfy the health needs of patients by publicly funded outpatient physiotherapy is still a challenge and creates a perspective to develop a new way of organising and financing outpatient physiotherapy. The proposed indices of service structure and process enable an accurate diagnosis of the current situation, development of optimal system solutions and monitoring their implementation.
Key words:
physiotherapy, index, population-based, real world data
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