Immediate effects after stochastic resonance whole-body vibration on physical performance on frail elderly for skilling-up training: a blind cross-over randomised pilot study.

Objective This pilot study examined the feasibility outcome recruitment, safety and compliance of the investigation for stochastic resonance whole-body vibration (SR-WBV) training. Another aim was to evaluate the effect size of one SR-WBV intervention session on Short Physical Performance Battery (SPPB), Expanded Timed Get Up-and-Go (ETGUG), isometric maximal voluntary contraction (IMVC) and rate of force development (IRFD) and chair rising (CR). Design Randomised double-blinded controlled cross-over pilot study. Method Feasibility outcomes included recruitment, safety and compliance. For secondary outcomes, SPPB, ETGUG, IMVC, IRFD and CR were measured before and 2-min after intervention. Nonparametric Rank-Order Tests of Puri and Sen L Statistics to Ranked Data were proposed. Wilcoxon signed-ranked tests were used to analyse the differences after SR-WBV intervention and sham intervention. Treatment effects between the interventions were compared by a Mann–Whitney U test. Results Among 24 eligible frail elderly, 12 agreed to participate and 3 drop out. The adherence was 15 of 24 intervention sessions. For secondary outcome, effect sizes (ES) for SR-WBV intervention on SPPB, ETGUG and CR were determined. Conclusion This pilot study indicate that the training protocol used in this form for frail elderly individuals is feasible but with modification due to the fact that not all defined feasibility outcomes target was met. SR-WBV with 6 Hz, noise level 4 shows benefit improvements on SPPB (ES 0.52), ETGUG (part sit-to-stand movement: ES 0.81; total time: ES 0.85) and CR (ES 0.66). Further research is desired to determine whether a new adapted training protocol is necessary for SR-WBV in the “skilling up” phase in frail elderly individuals. Keywords Feasibility Adherence Attrition Isometric maximal voluntary contraction Isometric rate of force developmen

A Swiss Health Care Professionals’ Perspective on the Meaning of Interprofessional Collaboration in Health Care of People with MS—A Focus Group Study

Multiple sclerosis (MS) is a chronic, inflammatory autoimmune disease of the central nervous system mainly of adults ranging from 20 to 45 years of age. The risk of developing MS is 50% higher in women than in men. Most people with MS (PwMS) experience a spectrum of symptoms such as spasticity, continence dysfunctions, fatigue, or neurobehavioral manifestations. Due to the complexity of MS and the variety of patient-centered needs, a comprehensive approach of interprofessional collaboration (IPC) of multiple health care professionals (HCP) is necessary. The aim of this qualitative study was to explore the meaning of IPC in the comprehensive care of PwMS from a HCP perspective. Focus groups (FG) with HCP were conducted, recorded, and transcribed verbatim. The sample contained HCP from three MS clinics in different phases of care and rehabilitation. Four main categories emerged: (a) experience with IPC, (b) relevant aspects for IPC in patients’ treatment, (c) differences in in- and outpatient settings, and (d) influence of patient perspective. IPC plays a crucial role in HCP perspective when treating PwMS, which can benefit from an IPC therapeutic approach because HCP work together in a patient-centered way. The inpatient setting of HCP strongly supports the implementation of IPC. This prerequisite does not exist in outpatient settings

Evaluation of a blended learning approach on stratified care for physiotherapy bachelor students

Stratified models of care are valuable for addressing psychosocial factors which influence the outcome of patients with musculoskeletal disorders. Introducing such models in the undergraduate training has the potential to propagate this knowledge with evidence and foster its implementation. The objective of this paper is to explore the perception and changes in the fear-avoidance beliefs of physiotherapy students participating in a developed blended learning course on stratified care. A mixed-methods with a convenient sample of two consecutive cohorts were given a blended learning course on stratified care for patients with low back pain. The blended learning course comprised scientific rudiments and application of stratified care in clinical practiceconceptualised using the KERN’ 6-step approach. The exam scores, perceptions, performance on self-reflection-tests and pre- and post-scores on The Tampa Scale for Kinesiophobia for Physiotherapists’ (TSK-PT) were obtained. After gaining clinical experience, participants were invited to discuss their clinical experiences and perceptions in workshops. The quantitative data was analysed explorative descriptively. The qualitative data was analysed following an inductive coding system with constant comparisons. Ninety-one participants consented to the evaluation (mean age=22.9±1.6 years), 66% were female. Exam scores correlated with time spent in training (r=0.30) and scores on self-reflection-tests 1 and 2 (r=0.40 and r=0.41). Participants in both cohorts described the learning resources as promoting their interest in the subject (72% and 94%), up-to-date (91% and 93%) and helpful (91% and 97%). The fear-avoidance scores for participants decreased from 53.5 (±9.96) to 40.1 (±12.4) with a large effect size (d=1.18). The regression model [F (2, 49)=1151.2, p<0.001] suggests that pre-TSK-PT and the interest of participants in the training predicted post-TSK-PT. The workshop participants (n=62) all worked in clinical practice. Emerging from the analysis were 4 categories (evolving to maturity in practice, perceiving determinants of stratified care, strategising for implementation and adopting an outlook for future practice). The quality of engagement in learning, training strategy and interest in the subject contributes immensely to learning outcomes. This blended learning course was successful in reducing kinesiophobia and influencing the participants’ attitude towards care with the potential of being translated into long-term practice

Effects of Stochastic Resonance Whole-Body Vibration in Individuals with Unilateral Brain Lesion: A Single-Blind Randomized Controlled Trial: Whole-Body Vibration and Neuromuscular Function

Introduction. Stochastic resonance whole-body vibration (SR-WBV) devices are promising sensorimotor interventions to address muscle weakness and to improve balance and mobility particularly in the elderly. However, it remains inconclusive whether individuals with stroke or traumatic brain injury (TBI) can profit from this method. The aim of this prospective single-blind randomized controlled trial was to investigate the effects of SR-WBV on muscle strength as well as gait and balance performance in this population. Methods. Forty-eight individuals with stroke or TBI were randomly allocated to an experimental and a sham group. Participants were exposed daily to 5 consecutives 1-minute SR-WBV sessions, whereas the experimental group trained in a standing position with 5 Hz and the sham group in a seated position with 1 Hz. Isometric muscle strength properties of the paretic knee extensor muscles as well as balance and gait performance were measured at baseline, after the first session and after two weeks of SR-WBV. Results. Both groups showed short- and long-term effects in gait performance. However, no between-group effects could be found at the three measurement points. Discussion. Complementary SR-WBV showed no beneficial effects immediately after the intervention and after two weeks of conventional rehabilitation therapy. Future research is needed to identify the potential efficacy of SR-WBV in individuals with stroke and TBI using shorter and less exhausting test procedures and a generally prolonged intervention time

Impact of guided self-study on learning success in undergraduate physiotherapy students in Switzerland – a feasibility study of a higher education intervention

Background Guided self-study (G-SS) can be used as a self-directed learning method or self-determined learning that fosters changes in knowledge and skills in a higher physiotherapy education setting. Until now, there has been no empirical evidence for the use of G-SS in higher physiotherapy education. This study aimed to investigate the feasibility to establish a G-SS program in a fulltime undergraduate physiotherapy degree course. In addition, the effectiveness of the G-SS was assessed on changes in knowledge and skills. Method Fifty-one first-semester physiotherapy students were randomly divided into a G-SS group or control group (CG). The G-SS group received six clinical cases. Each case was processed in an eight-day cycle. One week in advance, the clinical case were provided to the students electronically (day 1). The students prepared the cases in groups and were guided by the tutor during this preparation time (day 2 to 7). Group work results were presented and reflected on during a moderated plenum session at day 8. A priori criteria of success were defined based on empirical experience for the primary outcome parameters i) exposure, ii) responsiveness of students and iii) program differentiation. The secondary outcome was the total score in the objective structured clinical examination (OSCE) and written exams. Statistical analyses were conducted using SPSS. Results The responsiveness of students as willing to participate in the G-SS program was 23%, clearly below the a priori set 83%. No differences in program differentiation were found. G-SS as compared to the CG scored significantly better on OSCE (p = 0.003) and on the written exam (p = 0.004). Conclusion The results showed that this higher education G-SS program in its current form was not feasible. Slight modification of the study protocol (e.g. better time planning in the academic calendar) is needed to improve the student’s responsiveness. The adjustments to the timetable must allow the physiotherapy students to prepare the clinical cases under conditions of lower workload. G-SS has the potential to promote change in knowledge and skills in undergraduate physiotherapy students when students prepare and present the clinical case solutions and reflect upon their actions

Innovatives Studiendesign : Studierende lernen unter Supervision von Pensionierten

Physiotherapeutinnen und -therapeuten im Ruhestand begleiten Bachelor-Studierende beim Lernen. Welche Auswirkungen das Zusammentreffen der Generationen auf Lernerfolg und Alterbilder hat, untersucht die Berner Fachhochschule Gesundheit in der Pilotstudie "Retired PhysioTherapists' Tutor Supported Learning"

Planning and Implementation of Guided Self-study in an Undergraduate Physiotherapy Curriculum in Switzerland: A Feasibility Study

Background: Self-directed learning (andragogy) or self-determined learning (heutagogy) can be implemented in guided self-study (GSS) with the aim to foster changes in the knowledge and skills of physiotherapy students in a higher education setting. To date, there is a lack of evidence for the use of GSS in higher education for physiotherapy. Aim: This study aimed to evaluate the feasibility of developing and implementing GSS in an undergraduate physiotherapy educational program in Switzerland. In addition, the effectiveness of GSS in bringing changes in knowledge and skills was assessed. Method: Full-time undergraduate physiotherapy students (n = 49) from the third semester volunteered in this feasibility study. Students were randomly allocated into a GSS group or a control group (CG) in the period from October to November 2019. The GSS group prepared a total of 3 clinical cases. Each case was processed in an 8-day cycle. On day 1, the clinical case (ie, description of a patient and symptoms) and learning goals were provided to the students electronically. The students prepared the cases in groups from days 2 to 7. They were guided 2 times by the tutor (physical meeting and via Skype) during this preparation phase. The results of group work were presented and reflected on during a moderated plenum session (90 minutes) on day 8. The feasibility of this higher education study was operationalized as follows: exposure (“dose,” ie, the number of GSS sessions performed over 90 minutes, as well as the content of the cases and the learning objectives); students’ responsiveness, with an a priori set 100% willingness to participate on day 8; program differentiation, to illustrate differences between the content of GSS cases and the curriculum; and degree of acceptability. In addition, an assessment was made of the total scores in the objective structured clinical examination (OSCE) and written examinations, as well as the amount of GSS. Statistical analyses were conducted using an intention-to-treat approach. Results: All 3 GSS sessions on day 8 lasted the scheduled 90 minutes. The content of the presented cases was aligned with the learning objectives. The responsiveness of students willing to participate on day 8 was 42%. In program differentiation, no differences in content were found between the GSS presentation content and the usual curriculum content when compared with the learning aims. Objective structured clinical examination grades and written examination grades were similar for the GSS and CG. The analysis of the focus group interview showed a low degree of acceptability indicating that the students’ workload was high during the GSS period. Conclusions: This study showed that this GSS program for undergraduate physiotherapy students in its current form is “feasible with modification.” Modification of the study protocol (eg, better time planning in the academic calendar) is needed to improve the students’ responsiveness. Alternatively, classroom hours may be reduced to favor self-study time. Such adjustments to the timetable should allow the physiotherapy students to better prepare the clinical cases. The effectiveness of the GSS and normal curriculum on OSCE and written examination scores was similar, probably due to the observed low students’ acceptability Keywords education graduate, learning curve, physical therapist

Physical Activity, Nutritional Habits, and Sleeping Behavior in Students and Employees of a Swiss University During the COVID-19 Lockdown Period: Questionnaire Survey Study

Background: The new coronavirus SARS-CoV-2 led to the COVID-19 pandemic starting in January 2020. The Swiss Federal Council prescribed a lockdown of nonessential businesses. Students and employees of higher education institutions had to install home offices and participate in online lectures. Objective: The aim of this survey study was to evaluate lifestyle habits, such as physical activity (PA), sitting time, nutritional habits (expressed as median modified Mediterranean Diet Score mMDS), alcohol consumption habits, and sleeping behavior during a 2-month period of confinement and social distancing due to the COVID-19 pandemic. Survey participants were students and employees of a Swiss university of applied sciences. Methods: All students and employees from Bern University of Applied Sciences, Department of Health Professions (ie, nursing, nutrition and dietetics, midwifery, and physiotherapy divisions) were invited to complete an anonymous online survey during the COVID-19 confinement period. Information on the lifestyle dimensions of PA, sitting time, nutritional and alcohol consumption habits, and sleep behavior was gathered using adaptations of validated questionnaires. Frequency analyses and nonparametric statistical methods were used for data analysis. Significance was set at 5{\%} $\alpha$ level of error. Results: Prevalence of non-health-enhancing PA was 37.1{\%}, with participants of the division of physiotherapy showing the lowest prevalence. Prevalence of long sitting time (>8 hours/day) was 36.1{\%}. The median mMDS was 9, where the maximal score was 15, with participants of the division of nutrition and dietetics being more adherent to a Mediterranean diet as compared to the other groups. Prevalence of nonadherence to the Swiss alcohol consumption recommendations was 8.3{\%}. Prevalence of low sleeping quality was 44.7{\%}, while the median sleeping duration was 8 hours, which is considered healthy for adult populations. Conclusions: In the group analysis, differences in PA, sitting time, and mMDS were observed between different divisions of health professions as well as between Bachelor of Science students, Master of Science students, and employees. Therefore, public health messages regarding healthy lifestyle habits during home confinement should be more group specific. The results of this study may provide support for the implementation of group-specific health promotion interventions at universities in pandemic conditions. Trial Registration: ClinicalTrials.gov NCT04502108; https://www.clinicaltrials.gov/ct2/show/NCT0450210

Development and Evaluation of an Online Fall-Risk Questionnaire for Nonfrail Community-Dwelling Elderly Persons. A Pilot Study.

Falls are frequent in older adults and may have serious consequences but awareness of fall-risk is often low. A questionnaire might raise awareness of fall-risk; therefore we set out to construct and test such a questionnaire. Methods. Fall-risk factors and their odds ratios were extracted from meta-analyses and a questionnaire was devised to cover these risk factors. A formula to estimate the probability of future falls was set up using the extracted odds ratios. The understandability of the questionnaire and discrimination and calibration of the prediction formula were tested in a cohort study with a six-month follow-up. Community-dwelling persons over 60 years were recruited by an e-mail snowball-sampling method. Results and Discussion. We included 134 persons. Response rates for the monthly fall-related follow-up varied between the months and ranged from low 38% to high 90%. The proportion of present risk factors was low. Twenty-five participants reported falls. Discrimination was moderate (AUC: 0.67, 95% CI 0.54 to 0.81). The understandability, with the exception of five questions, was good. The wording of the questions needs to be improved and measures to increase the monthly response rates are needed before test-retest reliability and final predictive value can be assessed