Evidence for the use of Hyperbaric Oxygen Therapy (HBOT)

The purpose of this review was to assess the evidence for the use of HBOT to treat soft tissue injuries, including DOMS, and closed fractures. It was a report commissioned by City Football Services to help understand whether using HBOT was safe, effective, what parameters are required and what conditions could be treated using HBOT

Exploring the disclosure decisions made by physiotherapists with a specific learning difficulty

Objectives To explore the disclosure decisions made in the workplace by physiotherapy staff with a specific learning difficulty (SpLD). Design & Setting An exploratory qualitative design was used, which was informed by the social model of disability. The research was undertaken in North West England. It is presented according to the Consolidated Criteria for Reporting Qualitative Research. Participants A purposive sample of eight physiotherapists recognised as having a SpLD were recruited. All participants had studied on one of two programmes at a university in England between 2004-2012. Their NHS workplace experience was from across the UK. Data generation In-depth, semi-structured interviews were undertaken within the university setting or via telephone. Interviews lasted 40–70 minutes and were digitally recorded. An interview guide was used to direct the interview. Data analysis Interview data were transcribed verbatim and analysed using thematic analysis. Findings Four participants were female. The mean number of years qualified as a physiotherapist was 4.5 years (SD = 2.27). Three themes were identified: ‘Disclosing during the workplace application’; ‘Positive about disabled people scheme’; ‘Disclosing in the workplace’. Conclusions Disclosure of dyslexia is a selective process and is a central dilemma in the lives of individuals who have a concealable stigmatised identity. As a consequence, physiotherapy staff with dyslexia may choose to conceal their disability and not disclose to their employer. In order for staff with dyslexia to get the support they need in the workplace, disclosure is recommended. A number of recommendations have been made to facilitate the disclosure process

To disclose or not to disclose? Benchmarking disclosure of a SpLD in physiotherapy education and the NHS workplace.

Relevance: Firstly, w e report the incidence of disclosure of a specific learning difficulty (SpLD) by physiotherapy students in a Higher Education Institute (HEI), making it relevant to the congress theme, Education. Secondly, w e compare this to reports of disclosure in the NHS w orkplace, challenging managers to address the apparent discrepancy. This makes it relevant to the congress theme, Policy, Strategy and Influencing (in the w orkplace). Purpose: 1) To design an evidence-based data retrieval procedure from HEI databases to accurately report students disclosing a SpLD; 2) To identify characteristics of students w ho have disclosed a SpLD on an NHS commissioned physiotherapy programme and compare to NHS employer Equality and Diversity annual reports. Approach/Evaluation: This w as Phase 1 of a 3-phase evaluation. In order to extract data relevant to the reporting of SpLD, a literature search w as carried out to identify relevant factors. A repeatable procedure w as then designed to allow HEIs to retrieve and compare the data. We benchmarked three physiotherapy cohorts at a UK HEI and compared them to: 1) overall student data at the HEI; 2) the percentage of staff w ho disclosed a disability in the NHS. Outcomes: Students w ith a SpLD access higher education via both traditional and non-traditional routes. The most frequently disclosed SpLD w as dyslexia. On average, more physiotherapy students (11%) disclosed a SpLD than students in the university as a w hole (7%) or compared to NHS staff (3.5%). A smaller percentage of students w ith a SPLD did not proceed through the programme compared to those w ithout a SpLD. Students w ho disclosed their SpLD and in receipt of a Personal Learning Plan (PLP) generally achieved a better degree classification than those w ho disclosed but w ere not in receipt of a PLP. No students w ith a PLPobtained a Third Class Honours degree over the three cohorts studied. Discussion and conclusions: We have produced an evidence-based, repeatable data retrieval procedure to allow comparison across HEIs. In Physiotherapy, there is a higher incidence of disclosure of a SpLD compared to the general student body and in the NHS w orkplace. Phase 2 explored reasons for disclosure or non-disclosure w hilst as a student in University, on placement and in the w orkplace. Impact and Implications: By reporting the incidence of disclosure of a SpLD by physiotherapy students in higher education, and comparing this to reports of disclosure in the NHS w orkplace, w e challenge managers to address this apparent discrepancy. We anticipate this w ill improve support mechanisms for the employee and also facilitate the transition of physiotherapists w ith SpLD, from student to employee and back again. Funding Acknowledgement: Health Education Northw est (HENW

To disclose or not to disclose? Workplace experiences of healthcare professionals with specific learning difficulties: transition from education to employment.

Relevance: This survey investigated the experiences of nurses, physiotherapists and a variety of allied health professionals (AHP) employed by the National Health Service (NHS) related to specific learning difficulties (SpLD). Understanding issues faced by those w ith a SpLD in the context of the w orkplace and the impact on access to continuing professional development (CPD) has the potential to impact on practice and career progression making it relevant to Congress Theme 2. Purpose: To explore the experiences of nurses and AHPs w ith a SpLD in the NHS w orkplace. Methods/Analysis: This w as the final phase of a 3-phase evaluation. A questionnaire survey w as used to investigate the experiences of nurses and AHPs, w ith a SpLD, w orking in the NHS and their transitions from education to employment. Questions w ere developed from the qualitative findings of phase 2, w hich investigated these issues in physiotherapy. Participants w ere recruited using social media and email via NHS North West, Higher Education Institution (HEI) and other gatekeepers. Data w ere summarised using tables, histograms and pie charts. Open text comments w ere analysed using thematic analysis. Ethical approval w as gained from Manchester Metropolitan University. Results: As a student, more participants disclosed their SpLD to their HEI than did not disclose. How ever, on clinical placement and on application for an NHS post few er disclosed and there w as an even split betw een disclosure/non-disclosure. Once in employment, the trend w as tow ards disclosure. Non-disclosure w as related to fears of discrimination; of negative perceptions that might be held by others and that the use of assistive technology w ould lessen their w orth in the eyes of others. Participants did not report less favourable treatment compared to non-dyslexic peers, nor did they consider that less w as expected from them. Most had not experienced bullying and enjoyed supportive relationships w ith their co-w orkers. How ever, w hilst students in HEIs benefited from academic support on campus, the same adjustment w as not available on placement in NHS Trusts and once they had made transition to the w orkplace. Over a third of respondents felt their SpLD impacted on their ability to engage w ith CPD. Respondents felt that they had to ask for reasonable adjustment rather than have it provided automatically once the need w as recognised. Discussion and conclusions: Data from the survey suggests that disclosure of SpLD to HEI and to employers is likely, w hilst disclosure on placement and on application for employment is less likely. This seems to be related to fears of discrimination and negative perceptions that might be held by others. Non-disclosure is a barrier to the provision of reasonable adjustment. Impact and Implications: Lack of reasonable adjustment related to non-disclosure or failure to provide reasonable adjustment is a potential issue for those w ith SpLD. It may be that career progression/success in funded CPD opportunities is impeded because some w ith SpLD do not have access to reasonable adjustment/assistive technology. Funding Acknowledgement: Health Education North Wes

Sensory processing and anxiety in central sensitisation pain

Background: Patients with non-specific chronic low back pain (NSCLBP) and central sensitisation (CS) have been shown to exhibit sensory processing alterations, somatosensory hypersensitivity and differences in the brain's emotional networks. The concept that the extent of CS pain might be related to the patient's own trait sensory processing and anxiety characteristics has not yet been explored. This presentation will cover the background of CS pain, sensory processing, particularly trait sensory sensitivity and its relationship to trait anxiety. There are overlapping physiological mechanisms in sensory sensitivity and the individual behavioural responses to sensory stimuli in populations with CS, anxiety and abnormal sensory processing profiles. A pilot study designed to explore this topic will also be presented. Pilot Study Objectives: To establish concept plausibility by 1) exploring the range of CS in NSCLBP patients and 2) determining potential relationships between CS pain, trait anxiety and trait sensory processing profiles Study Design: Cross sectional observation study Methods: Questionnaires were administered to N=21 NSCLBP in physiotherapy outpatient clinics in New Zealand. Excluded were those with predominantly neuropathic or nociceptive pain. Outcome measures: Central Sensitisation Inventory (CSI), Adolescent/Adult Sensory Profile, State/Trait Anxiety Inventory (Trait section) and the Marlow Crown Sociable Desirability Questionnaire. Results: 76% (N=16/21) of respondents were classed as having CS pain, scoring ≥40 on the CSI. Of those with CS pain, higher CSI scores were associated with a) abnormal trait sensory processing profiles; b) higher trait anxiety sub-types and c) minimal low trait anxiety. Higher trait anxiety scores were associated with higher Sensory Sensitivity and Low Registration sensory profile scores and lower Sensation Seeking sensory profile scores

Experiences of attendance at a neuromuscular centre: perceptions of adults with neuromuscular disorders.

PURPOSE: The aim of this research is to gain an insight into adults with neuromuscular disorders' experiences of attendance at a specialised, voluntary sector, Neuromuscular Centre and explore its value to these adults who attend for treatment, education or employment. METHOD: This study was qualitative in design. In-depth interviews were conducted with nine self-selected participants, recruited from the population of adults with neuromuscular disorders who attended the Neuromuscular Centre. Interviews were transcribed verbatim and thematically analysed. Thematic networks were utilised to aid interpretation. RESULTS: Participants saw the benefit of specialist input to remain mobile and independent for longer. The Centre created a culture of understanding and empathy which facilitated mutual support and self-acceptance. Opportunities for employment and education offered a sense of purpose. Sharing experiences developed self-knowledge and the ability to self-manage their condition. CONCLUSION: Attendance at this voluntary sector Neuromuscular Centre provided physical, psychosocial and economic benefits. The Neuromuscular Centre through its holistic approach offers a unique model for rehabilitation of adults with neuromuscular disorders. As an enterprise, satellite centres adopting the ethos of the Centre could be created, which could potentially help to redress the inequalities in health care for adults with neuromuscular disorders