Physiotherapy goal setting in anterior cruciate ligament rehabilitation : an exploration of training, practice and beliefs

Despite the growing interest into the role of physiotherapists providing psychological interventions within anterior cruciate ligament (ACL), literature surrounding goal setting practices within this field is minimal. The main purpose of this research was to explore physiotherapists’ approaches, training and beliefs into goal setting practices used within ACL rehabilitation. The thesis consisted of seven chapters, two of which were empirical studies. The empirical chapters aimed to gain further insight into physiotherapists understanding on the psychological aspects of patients following ACL surgery, theoretical knowledge of goal setting, experiences of implementing goals, training received on goal setting and future training needs. Study four involved a UK cross sectional online survey of one hundred and twenty four physiotherapists (N=124). The survey provided an insight of perceptions and goal setting approaches used within ACL rehabilitation. These findings were further explored in study five which involved a UK semi-structured interview study including twenty four physiotherapists (N=24), using an inductive approach. Study five provided a much deeper understanding in to physiotherapist’s goal setting practices, training and experiences within ACL rehabilitation and also revealed issues surrounding the initial consultation process. The research findings were conceptualised into a theoretical, innovative goal setting model. The goal of this model is to outline a multi-phase conceptual model of an appropriate ACL rehabilitation goal setting strategy for physiotherapists in an attempt to guide both practice, teaching and research

Goal setting for patients experiencing musculoskeletal pain: An evocative autoethnography

AbstractIntroduction: Musculoskeletal referrals within physiotherapy are continuing to rise and pain is a common symptom which patients typically present with. Patients reporting pain following injury, or who have developed chronic pain often experience a range of physical and psychological symptoms, therefore the need to treat patients within a bio-psychosocial model is of paramount importance. Self-management is a common approach when treating patients who experience musculoskeletal pain and goal setting is an essential, and indispensable component of this. Appropriate use of goal setting has been shown to be an effective tool in pain management by improving therapeutic alliance, self-efficacy and patient adherence.Aim: The primary aim of this paper is based on the principle researcher’s (Jenny) personal and professional experiences of goal setting to explore patient needs within contemporary physiotherapy practice.Design: This study is centred on an evocative auto-ethnography.Results: Two distinct themes emerged from the narrated experiences. A physiotherapy mandated approach with little regard of the patient concerned was evident and that goal setting practices appeared to lack any process, which may not give patients an appropriate platform to effectively self-manage.Conclusion: Establishing a therapeutic rapport is essential to improve the implementation of goal setting in pain management. Following a thorough process when setting goals ensures that all important aspects of the goal setting process are considered to enable patients to self-manage

A call for more psychological skills training: examining the views of qualified and student sports therapists in the United Kingdom

Context: Sports therapists can influence an athlete’s psychological response to injury. At present it is unclear whether sports therapists are sufficiency trained in psychology. Objectives: To understand the views both of practising clinicians and students regarding the extent to which sports therapy education addresses psychological factors in injury management. Design: Cross-sectional study. Setting: Online Questionnaire. Participants: Qualified sports therapists (n = 30) and sports therapy students, (n = 33). Interventions: Sports Therapist and Sport Psychology Questionnaire. Main Outcome Measures: The questionnaire included five subsets of questions (5-point Likert scale or multiple-choice). Internal consistency of each subset was rated via Cronbach’s alpha (α, 95% confidence interval) as good (questions 5 & 6; α 0.81, 0.68 to 0.88) or as excellent (scale questions 3-4; α 0.91, 0.85-0.95, question 8, α 0.97, 9.6 to 9.8, questions 7, 11 & 12; α 0.94, 0.91 – 0.96; and questions 9 & 10, α 0.96, 9.4 - 9.8). Results: Both groups recognised psychological components as either ‘important’ or ‘very important’ in rehabilitation. They reported a need for psychological skills in injury management, and more psychology training during education. While 80% of qualified therapists identified a duty to treat psychological components, only 45% of students concurred. Conclusions: Future sports therapy education should consider placing greater emphasis on the psychological components of injury management in order to sufficiently equip therapists with appropriate skills for practice

New graduate physiotherapists’ perceived preparedness for clinical practice. A cross-sectional survey

Objectives: The study aimed to explore new United Kingdom (UK) graduate physiotherapists’ perceived preparedness for clinical practice to provide valuable information to support curriculum development.Methods: 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 was 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. Results: 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.Conclusion: 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. <br/

A Physiotherapy Perspective of CrossFit: Guiding You Safely:Guiding You Safely

CrossFit is a constantly varied, high-intensity functional endurance and strength program that has seen a considerable growth in popularity. With more than 13,000 licensed CrossFit affiliates worldwide, physiotherapists should have a general knowledge of CrossFit exercise routines due to an increase in patient engagement in such activities. Research and scholarly activity focusing on the incidence and prevalence of both acute traumatic and chronic overuse injuries in CrossFit continues to rise. Considering physiotherapists play a key role in managing the sports performer, having a sound understanding of CrossFit is of paramount importance in positively shaping the athlete's rehabilitation outcomes and expectations.<br/

The Clinical Effectiveness of Using Kinesio Tape Following Wisdom Teeth Extraction

Surgical removal of third molars (3M) is a routine, low risk procedure. Common post-surgical symptoms are typically swelling, pain and trismus. Kinesiology Taping (KT) is a relatively new treatment option in musculoskeletal pathologies and some of the hypotheses of KT is that it reduces pain, oedema and increases blood flow; however current evidence does not support its use. Patient A underwent a routine removal of 3 third molars via general anaesthetic. A post-surgical lymphatic drainage KT application was applied to the patient’s lower mandible and masseter region. Results showed a significant reduction in pain, swelling and trismus was also reduced. The post op recovery time was decreased from the post op material of 10 days to 5 days; therefore suggesting that KT is potentially an effective treatment following surgical removal of wisdom teeth

Creación de una microempresa procesadora y comercializadora de mermeladas de piña con jengibre en el municipio de Belén departamento de Rivas, en el periodo 2021

El presente proyecto tiene como objetivo principal efectuar un estudio de factibilidad y rentabilidad para la creación e instalación de una pequeña micro empresa procesadora y comercializadora de mermeladas de piña con jengibre. Esta Mipyme se llamará Alimentos Cocibolca, estará ubicada en el municipio de Belén departamento de Rivas. Esta iniciativa surge del cómo aprovechar los recursos naturales, ya que el potencial productivo en Nicaragua se concentra en las actividades agrícolas, Cabe señalar que este potencial se está comercializando como materia prima, y no se están generando valores agregados a la misma, dando como resultado que el máximo beneficio económico está siendo desarrollado en otros sectores o países de la región. Lo que genera que los recursos, sus beneficios adicionales y la oportunidad de crear nuevas iniciativas empresariales se desaprovechen. Por lo que nos convertimos simplemente en productores de materia prima, y vendedores de mano de obra no calificada a grandes empresas externas o industrias

Comparison of the Thesslay Test and McMurray Test: A Systematic Review of Comparative Diagnostic Studies

The Thessaly test is a relatively recently developed meniscal test; therefore research compared to other meniscal tests is somewhat limited. In addition, a systematic review comparing the Thessaly’s test with a long standing test such as the McMurray test has not been previously conducted. Objectives: To systematically identify and appraise all empirical studies comparing the diagnostic accuracy of the Thessaly test and McMurray test. Procedure: Eligible studies were identified through a rigorous search of ScienceDirect, CINAHL Plus, Pubmed, PEDro, EMBASE and Cochrane Library from January 2004 until August 2014. Full English reports of studies investigating the accuracy of the Thessaly test and McMurray test. Quality Assessment of Studies of Diagnostic Accuracy (QUADAS) scores were completed on each selected article. Results: The Thessaly test reported to have higher diagnostic accuracy values (61-96%) compared to the McMurray test (56- 84%). Although McMurray test showed to have higher sensitivity in the detection of lateral meniscal tears, the Thessaly reported to more sensitive for medial and higher specificity values for both medial and lateral tears. Limitations: All the included studies have considerable limitations related to inclusion and exclusion criteria and recording of test outcomes. Conclusion: Higher strength of evidence studies are warranted to ensure a more robust data collection of information in addition to further investigate the diagnostic accuracy of such tests

The Effects of Unilateral versus Bilateral Motor Training on Upper Limb Function in Adults with Chronic Stroke: A Systematic Review

AbstractObjectives: Rehabilitation goals for chronic stroke patients are largely focused around regaining functional ability and independence, with particular focus on upper limb motor function. Unilateral and Bilateral motor training may help achieve this. Our objective was to evaluate and compare the effects of unilateral and bilateral motor training on upper limb motor function in chronic stroke patients. Materials and Methods: A comprehensive literature search was conducted until June 2020 through several electronic databases (CENTRAL, Medline, CINAHL, EBSCO, AMED and PEDro) to identify relevant studies. Studies that used the Fugl Meyer Assessment (FMA) as a minimum, to assess upper limb motor function following unilateral versus bilateral training in chronic stroke patients, qualified for inclusion within the review. Randomised controlled trial (RCT), cohort study and cross-sectional study designs were considered. The Cochrane risk of bias tool was used to assess Randomised Controlled Trials (RCTs). The findings were qualitatively synthesised. Results: From a total of 838 studies identified, 7 RCTs were included in this review. All except one of the studies included reported an unclear risk of bias, with one low risk of bias reported. Overall, the studies reported that unilateral and bilateral training improved upper limb function in chronic stroke patients. Improvements between interventions were equivocal. Bilateral upper limb training however may be more efficacious for increasing upper limb strength and quality of movement, with unilateral training more beneficial for recovering functional ability for activities of daily living. Conclusion: While the findings of the included studies support the use of unilateral and bilateral motor training post chronic stroke, the seven studies that were included methodologically all presented with limitations, hence strong conclusions cannot be drawn and further research is warranted. <br/