Depression, Anxiety, Stress, and their Associated Factors among Iranian Physical Therapists during COVID-19 Pandemic: An Onlinebased Cross-sectional Survey

Background: Most physiotherapy treatments require direct contact with patients, which could predispose physical therapists to the transmission of infection. The present study aimed to investigate the depression, anxiety, and stress of physical therapists during the coronavirus disease 2019 (COVID-19) pandemic.Method: A cross-sectional, web-based survey was applied during the pandemic. The survey was completed by 135 physical therapists working in Iran. The depression-anxiety and stress scale 21 (DASS-21) was used to evaluate their depression, anxiety, and stress statuses. A multiple regression analysis was used to identify the demographic characteristics factors related to depression, anxiety, and stress.Results: The results showed that 43.7%, 43.8%, and 54.8% of physical therapists had severe and very severe levels of depression, anxiety, and stress, respectively. In addition, female physical therapists had higher levels of depression, anxiety, and stress. The level of anxiety was higher in physical therapists working in hospitals and those with more work experience.Conclusion: Our findings indicated that COVID-19 resulted in high levels of depression, anxiety, and stress in Iranian physical therapists. Therefore, the mental health of physical therapists should be regularly monitored, and the proper support and training in coping strategies should be provided for them

Impaired local dynamic stability during treadmill walking predicts future falls in patients with multiple sclerosis:A prospective cohort study

Background: Falling is a significant problem in patients with multiple sclerosis (MS) and the majority of falls occur during dynamic activities. Recently, there have been evidences focusing on falls and local stability of walking based on dynamic system theory in the elderly as well as patients with cerebral concussion. However, in patient with MS, this relationship has not been fully investigated. The aim of this study was to investigate local stability of walking as a risk factor for falling in patients with MS. Methods: Seventy patients were assessed while walking at their preferred speed on a treadmill under single and dual task conditions. A cognitive task (backward counting) was used to assess the importance of dual tasking to fall risk. Trunk kinematics were collected using a cluster marker over the level of T7 and a 7-camera motion capture system. To quantify local stability of walking, maximal finite-time Lyapunov exponent was calculated from a 12-dimensional state space reconstruction based on 3-dimensional trunk linear and angular velocity time series. Participants were classified as fallers (≥1) and non-fallers based on their prospective fall occurrence. Findings: 30 (43%) participants recorded ≥1 falls and were classified as fallers. The results of multiple logistic regression analysis revealed that short-term local dynamic stability in the single task condition (P < 0.05, odds ratio = 2.214 (1.037–4.726)) was the significant fall predictor. Interpretation: The results may indicate that the assessment of local stability of walking can identify patients who would benefit from gait retraining and fall prevention programs

Rehabilitation Educators′ Perceptions of Clinical Education Challenges in Iran: Is COVID-19 Having Redundant Effects?

Background: Clinical education is a core component of the curriculum of undergraduate rehabilitation students. Nevertheless, this field more than any other field of education has many shortcomings that should be addressed.Methods: The aim of this study was to explore the challenges of clinical education from the perspective of rehabilitation educators with particular focus on the new challenges created bythe COVID-19 outbreak. This qualitative study was conducted through purposeful sampling. Semi-structured interviews were conducted with 12 rehabilitation clinical educators of Ahvaz Jundishapur University of Medical Sciences, Iran. Data analysis was accomplished according to conventional content analysis. To prove the trustworthiness of the data, credibility, dependability, confirmability, and transferability were assessed.Results: Through data analysis, 240 initial codes were extracted in three main categories and nine sub-categories, indicating redundant challenges imposed by COVID-19 comprising restricted clinical resources (inadequate patient number and diversity, inadequate equipment, limited clinical space, inadequate manpower), an inefficient clinical education system (poor management of clinical education programs, insufficient clinical evaluation), and personal and professional characteristics of the students (lack of students’ practical knowledge, lack of motivation, fear).Conclusion: The results of this study provide deeper insight into the perceptions and experiences of rehabilitation educators regarding clinical education challenges. At present, an accidental and unexpected problematic event (COVID-19 pandemic) has inflicted detrimental effects on various aspects of clinical rehabilitation sciences. It is necessary to implement changes in future plans which include adaptations for COVID-19