28 research outputs found

    “Learning is about being active, but the digital is not really active”: physiotherapy teachers’ attitudes toward and experiences with digital education

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    This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.Background: Digital education is expected to transform higher education teaching and learning. Despite high expectations, higher education teachers have been slow to implement active digital learning. Objective: The aim of this study was to investigate physiotherapy teachers’ attitudes toward and experiences with digital education and what the teachers’ considered prerequisites to a digital transformation of teaching and learning in physiotherapy. Methods: Qualitative in-depth interviews were conducted with 12 teachers in physiotherapy education. The interviews were analyzed using inductive thematic analysis. Findings: The findings illuminate teachers’ attitudes toward and experiences with digital education and their views on prerequisites to a digital transformation of teaching and learning in physiother-apy education, presented as four themes: 1) skepticism toward digital education; 2) digital technol-ogy as a tool to support the established teaching practice; 3) longing for teacher collaboration; and 4) calling for time to plan and learn, and significant academic leadership. Conclusion: This study shows how physiotherapy teachers are skeptical about digital education, primarily viewing it as a threat to established teaching practices. Taken together, the findings demonstrate a potential for digital transformation in physiotherapy education, which can be released by informing the current teaching practices with evidence from research showing how use of digital technology can improve teaching and learning in physiotherapy education.publishedVersio

    Reliability and validity of the Norwegian version of the disabilities of the arm, shoulder and hand questionnaire in patients with shoulder impingement syndrome

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    Background: Patient-rated outcome measures (PROMs) are an important part of clinical decision-making in rehabilitation of patients with shoulder pain. The Disabilities of Arm, Shoulder and Hand (DASH) questionnaire was designed to measure physical disability and symptoms in patients with musculoskeletal disorders of the upper extremity and is one the most commonly used outcome measures for patients with shoulder pain. The purpose of this study was to investigate the reliability and validity of the Norwegian version of the DASH in patients with shoulder impingement syndrome. Methods: Sixty-three patients diagnosed with shoulder impingement syndrome at an orthopaedic outpatient clinic were included in the study. Internal consistency of the DASH was evaluated by the Cronbach’s alpha and item-to-total correlations. Test-retest reliability was analyzed by the intraclass correlation coefficient (ICC) and limits of agreement (LoA) according to the Bland Altman method. Standard error of measurement (SEM) and minimally detectable change (MDC) were calculated for the total DASH score. Construct validity was evaluated by testing six a priori hypotheses for the Pearson’s correlation coefficient between the DASH and the Shoulder Pain and Disability Index (SPADI), the 36-item Short Form Health Survey (SF-36) and a Numeric Pain Rating Scale (NPRS). Results: Reliability: Cronbach’s alpha of the DASH was 0.93 and item-to-total correlations ranged from 0.36 to 0.81. ICC was 0.89. The 95 percent LoA was calculated to be between −11.9 and 14.1. SEM was 4.7 and MDC 13.1. Construct validity: Eighty-three percent of the a priori hypotheses of correlation were confirmed. The DASH showed a high positive correlation of 0.75 with the SPADI, a negative moderate correlation of −0.48 to −0.62 with physical functioning, bodily pain and physical component summary of the SF-36 and a moderate positive correlation of 0.58 with the NPRS. DASH correlated higher with the physical component summary than with the mental component summary of the SF-36. Conclusions: The Norwegian version of the DASH is a reliable and valid outcome measure for patients with shoulder impingement syndrom

    Development and Reliability of a Clinician-rated Instrument to Evaluate Function in Individuals with Shoulder Pain: A Preliminary Study

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    Background and Purpose Subacromial impingement syndrome (SIS) is a common and disabling condition in the population. Interventions are often evaluated with patient-rated outcome measures. The purpose of this study was to develop a simple clinician-rated measure to detect difficulties in the execution of movement-related tasks among patients with subacromial impingement syndrome. Method The steps in the scale development included a review of the clinical literature of shoulder pain to identify condition-specific questionnaires, pilot testing, clinical testing and scale construction. Twenty-one eligible items from thirteen questionnaires were extracted and included in a pilot test. All items were scored on a five-point ordinal scale ranging from 1 (no difficulty) to 5 (cannot perform). Fourteen items were excluded after pilot testing because of difficulties in standardization or other practical considerations. The remaining seven items were included in a clinical test-retest study with outpatients at a hospital. Of these, four were excluded because of psychometric reasons. From the remaining three items, a measure named Shoulder Activity Scale (summed score ranging from 3 to 15) was developed. Results A total of 33 men and 30 women were included in the clinical study; age range 27–80 years. The intraclass correlation coefficient results for inter-rater reliability and test-retest reliability were 0.80 (95% CI = 0.51–0.90) and 0.74 (95% CI = 0.58–0.84), respectively. The standard error of measurement and minimal detectable change were 1.19 and 3.32, respectively. The scale was linked to the International Classification of Functioning, Disability and Health second level categories lifting and carrying objects (d430), dressing (d540), hand and arm use (d445) and control of voluntary movement (b760). Conclusion The Shoulder Activity Scale showed acceptable reliability in a sample of outpatients at a hospital, rated by clinicians experienced in shoulder rehabilitation. The validity of the scale should be investigated in future studies before application to common practice. © 2013 The Authors. Physiotherapy Research International published by John Wiley & Sons Ltd

    Learning with technology in physiotherapy education: Design, implementation and evaluation of a flipped classroom teaching approach

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    The purpose of the study was to describe the design, implementation and evaluation of a flipped classroom teaching approach in physiotherapy education. The flipped classroom is a blended learning approach in which students receive digital lectures as homework, while active learning activities are used in the classroom. Flipped classroom teaching enables a learning environment that aims to develop higher-order cognitive skills. The study design was a historically controlled, prospective, cohort study. An eight week theoretical course on musculoskeletal disorders was redesigned, moving from a conventional approach to a flipped classroom model. Pre-class learning material consisted of about 12 h of video lectures and other digital learning resources that were split up over the duration of the course. In-class activities consisted of seven full-day seminars where students worked in groups in order to solve problem-based assignments. The assignments were designed to reflect authentic clinical problems and required critical thinking and reasoning. Outcomes were measured with coursegrades and compared with historical controls of conventional teaching, using descriptive statistics. Self-perceived learning outcomes and students’ experiences were also collected in a survey

    MĂĽlinger av funksjon og Verdens Helseorganisasjons Internasjonale klassifikasjon av funksjon

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    :"Målinger av funksjon og Verdens Helseorganisasjons Internasjonale klassifikasjon av funksjon, funksjonshemming og helse (ICF). Et arbeidshefte for fysioterapeuter og andre helseprofesjonsutøvere." Utgivelsesdata Tittel:Målinger av funksjon og Verdens Helseorganisasjons Internasjonale klassifikasjon av funksjonForfatter(e):Yngve RøeSerie:HiO notatIssn:0807-1047Nr:2009 nr 4 Utgiver:HiOAvdeling/fakultet:HFSider:91Pris:95,– ISBN-print:978-82-579-4686-

    Shoulder pain within the ICF framework; patient experiences of functioning and assessment methods

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    Introduction: Shoulder pain is a common, persistent and disabling disease. The restoration of abnormal movement-patterns is often an important goal in the treatment of patients with shoulder pain. The International Classification of Functioning, Disability and Health (ICF) is a conceptual framework and classification that has been developed by the World Health Organisation. The ICF is a common, multi-disciplinary language that allows identification of condition-specific codes (ICF categories), comparison between patient-experiences of functioning and assessment tools and development of new measures. Aims: The aims of this thesis are to identify the ICF categories that reflect the concepts used in assessment of shoulder pain and identify the ICF categories that reflect problems related to functioning and interactions with the environment in patients with shoulder pain. As an extension of this aim, whether patient experiences of functioning are captured by the present assessment tools is also investigated. Moreover, the ICF categories that reflect the patientexperiences of functioning and the content of the assessment tools are used to create a preliminary list of ICF categories for shoulder pain. Finally, a clinician-rated activity measure to capture abnormal movement patterns in the upper extremities is developed and tested. Methods: The present work is based on three studies: a literature review of measures, a cross-sectional study with patient interviews and a test-retest study. In addition, the datasets from the literature review of measures and the cross-sectional study with patient interviews constitute the material used for the comparison of the patient-experiences of functioning and the content of measures, and for the development of a preliminary list of ICF categories for shoulder pain. In the literature review, articles that were written in English, published in peerreviewed journals and based on clinical studies that included patients with shoulder pain aged 18 years and older were included. Studies on patients with fractures, joint replacement, complete dislocation, malignant condition, rheumatic diagnosis and stroke were excluded. The measures extracted from the articles were linked to ICF categories according to standardised rules. The frequency of the identified ICF categories was calculated and reported for categories with a frequency of at least 1%. In the cross-sectional study, patients in the outpatient clinic at the Department of Physical Medicine and Rehabilitation, Ullevaal University Hospital, were included. The inclusion and exclusion criteria were similar to those in the literature review. The patients were interviewed with a condition-adapted ICF checklist that contained 154 categories. The presence of a functional problem or environmental factor according to these ICF categories was registered. The ICF categories that were registered with a frequency of at least 5% were reported. The correspondence between these two datasets was investigated using the following criteria: (1) categories included in both datasets with similar rankings, (2) categories included in both datasets with different rankings, and (3) categories included in only one of the datasets. In addition, the match between high frequent patient-derived ICF categories (reported by = 50 %) and the content of frequently cited condition-specific measures (identified with = 10 citations) was investigated. The preliminary list of ICF categories for shoulder pain was constituted from all the ICF categories that were reported in the cross-sectional study with patient interviews and the literature review of measures. Finally, a simple, clinician-rated activity measure was developed and reliability tested. The development process was based on identification of eligible items in the literature, pilot-testing and statistical analyses. The test-retest study was conducted at the Department of Physiotherapy at Martina Hansens Hospital, Baerum. Patients aged 18 years and older with a main diagnosis of subacromial impingement syndrome were included. The exclusion criteria were similar to those from the literature review and the cross-sectional study. Item-reduction was based on item-to-sum correlations. In the further testing of the final scale, inter- and intra-rater reliability were calculated with the Interclass Correlation Coefficient (ICC) and a 95% Confidence Interval (CI). The minimal detectable change was calculated from the standard error. The content of the scale was linked to ICF categories according to the established rules. Results: In the literature review, 40 ICF categories were identified in 475 measures. Of these, 28 belonged to activities and participation, 11 to body functions and structures and 1 to environmental factors. In the cross-sectional study with patient interviews, 165 patients with a mean age of 46.5 years (SD = 12.5) were included. A total of 61 ICF categories were identified. Of these, 19 covered body functions and structures, 34 activities and participation, and 8 environmental factors. The correspondence between the two datasets was high for activities and participation, and lower for body functions and structures and environmental factors. In particular, patient-derived mental- and muscle body functions and environmental social support were not present in the measures. Moreover, 6 high frequent patient-derived categories are not matched by the content of any of the most frequently selected conditionspecific scales. The American Shoulder and Elbow Surgeons Standardized Form for Assessment of the Shoulder (ASES) and the Disability of the Arm, Shoulder and Hand (DASH) scale match the highest number of high frequent patient-derived categories. The preliminary list of ICF categories for shoulder pain contains a total of 68 second-level ICF categories. Of these more than half belong to activities and participation. In the test-retest study, a total of 63 patients, aged 53.3 (SD = 12.9) and diagnosed with subacromial impingement syndrome, were included. A clinician-rated activity measure, the Shoulder Activity Scale, with 3 items and a summed score ranging from 3 to 15 was developed. The inter-rater reliability and test-retest reliability were ICC = 0.80 (95% CI = 0.51 - 0.90) and ICC = 0.74 (95% CI = 0.58 - 0.84), respectively. The minimal detectable change of the scale was calculated as 3.32. The scale covers the ICF categories lifting and carrying objects (d430), dressing (d540), hand and arm use (d445) and control of voluntary movement (b760). Conclusions: The patient experiences of shoulder pain are multi-faceted, covering the ICF body functions sensation of pain, movement-related functions and mental functions and the activity and participation functions mobility, self-care, domestic life, interpersonal interactions and relationships, work and leisure activities. Except for social support from immediate family and friends, environmental factors were scarcely represented. The assessments of patients with shoulder pain only partially capture the patient experiences of functioning and there is large variation in the content of condition-specific measures. These findings have implications for clinicians and researchers in the selection of measures. The Shoulder Activity Scale is a simple and reliable measure that fills a gap in the assessment of patients with shoulder pain. Before it is applied in clinical settings, it needs to be validated. For the first time, a preliminary list of ICF categories for shoulder pain is presented. The preliminary list should be further developed with contributions from qualitative patient interviews, an expert survey and a formalised decision process

    Emotional distress was associated withpersistent shoulder pain afterphysiotherapy: a prospective cohort study

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    Background: There is a paucity of research on the association between psychological factors and persistent shoulder pain. The aim of this study was to investigate whether emotional distress was associated with pain intensity and self-reported disability after physiotherapy treatment in patients with shoulder pain. Methods: Data from 145 patients treated at physiotherapy outpatient clinics aged ≥18 years with self-reported pain in the shoulder or arm, and movement activity problems related to the upper-extremity, were included. Outcome measures were pain intensity measured by Numeric Pain Rating Scale and disability measured by Patient Specific Functional Scale. Demographic and clinical characteristics, including emotional distress measured by Hopkins Symptom Checklist – 25, were obtained at study onset. Association between characteristics at study onset and pain and disability after physiotherapy treatment were analysed using multiple linear regression and a backward manual elimination method. The final models were adjusted for age and sex. Results: Higher emotional distress at study onset (B 1.06, 95% CI 0.44 to 1.68) was associated with higher pain intensity after the physiotherapy treatment (P=0.001). Emotional distress was not associated with self-reported disability after the physiotherapy treatment. Conclusion: This study found that emotional distress at study onset was associated with shoulder pain intensity after physiotherapy treatment, but not with disability. The findings indicate that emotional distress should be included in the initial physiotherapy examination of shoulder pain

    The Digital Transformation of Higher Education Teaching: Four Pedagogical Prescriptions to Move Active Learning Pedagogy Forward

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    Digital learning technologies are expected to reform higher education: The recent Digital Education Action Plan (2021–2027) of the European Commission (EC) states that digital education should facilitate more personalised, flexible, and student-centred teaching (European Commission, 2021). This places great demands on university teachers, whose technological skills have long been considered the most formidable barrier to the digital transformation of higher education (Børte et al., 2020). Meanwhile, the COVID-19 pandemic has resulted in a steep technological learning curve among higher education teachers. Overnight, university teachers were forced to adapt their teaching to a digital, online format to meet the needs of more than 1.5 billion students across the globe who have been affected by COVID-19 restrictions (UNESCO, 2021). Despite a great willingness to change, over a year into the pandemic, the frustration among (university) teachers has become apparent. A United Kingdom survey found that higher education teachers thought that their pedagogical practis had been “reduced to the fulfilment of rudimentary technical functions” and that they played more of a transmissionist pedagogical role (Watermeyer et al., 2020). Taking the perspective of the students, recent survey data from Norwegian higher education shows that, during the pandemic, lack of motivation and sense of loneliness have been an increasing problem among students (NOKUT the Norwegian Agency for Quality Assurance in Education, 2020). From this we learn that a fully digital approach in higher education has limitations both when it comes to pedagogical practices and students’ well-being

    Flipping the classroom in physiotherapy education: experiences, opportunities and challenges

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    In higher education, resistance to shifting educational methods presents a challenge in fulfilling the opportunities offered by new methods. The purpose of the present study is to document the experiences of a flipped classroom intervention in a Norwegian physiotherapy programme, from the perspectives of the students and the teachers. The findings demonstrate that the students’ attitudes were mainly positive. In particular, the students evaluated autonomous group work and unlimited access to digital material as positive. The academic outcomes from the final exam were similar to previous years. Interviews with the teachers showed that the learning environment associated with the group work in the flipped classroom was a different and highly appreciated experience. In conclusion, the present study indicates that there is potential in implementing digital approaches in physiotherapy programmes

    Hvordan behandle frossen skulder

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    Innledning: Denne artikkelen er en sammenfatning av versjon 1.0 av den kunnskapsbaserte fagprosedyren Fysioterapi ved frossen skulder. Fagprosedyren er laget etter metoden beskrevet pü Helsebiblioteket.no. Hensikten med fagprosedyren er ü gi rüd og anbefalinger om behandling av personer med frossen skulder. Hoveddel: Frossen skulder er en tilstand som gir smerter og stivhet i skulderen. Leddkapselen blir tykkere og strammere. Skulderen für begrenset büde aktiv og passiv bevegelighet. De fleste für frossen skulder uten at man kan peke pü en bakenforliggende ürsak. Sykdomsforløpet kan deles inn i smertefasen og stivhetsfasen. Behandling av personer med frossen skulder bør inneholde opplÌring om hva frossen skulder er, sykdomsforløpet, hva pasienten kan gjøre selv og behandlingsalternativer. Aktivitetstilpasning kan vÌre nødvendig. Smertedempende medisiner som paracetamol og/eller ikke-steroide antiinflammatoriske medisiner (NSAIDs) kan brukes etter behov. Injeksjon av kortikosteroider kan vurderes ved sterke smerter. Øvelser for bevegelighet, muskulÌr kontroll, styrke og utholdenhet med hensyn til smerter kan vÌre aktuelt i begge faser av frossen skulder. Øvelser og tøying uten hensyn til smerter anbefales ikke. Avslutning: Hovedpunktene for behandling av personer med frossen skulder er pasientopplÌring, farmakologisk behandling etter behov og øvelser som ikke gir økte smerter
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