Survey of Attitudes, Knowledge, and Barriers to Evidence-Based Practice Among Thai Physical Therapists

Purpose: Healthcare professionals are encouraged to use evidence-based practice (EBP) to improve the quality of care and the patient’s quality of life. Knowledge and skill set specific to EBP, critical resources such as time and accessibility to databases, and clinician’s attitude toward EBP are needed for successful implementation of EBP. However, little is currently known about these factors among Thai Physical Therapists (PTs). This study aimed to explore the patterns of attitudes, perceived knowledge, and barriers toward EBP in Thai PTs. Method: An online questionnaire was used to obtain information regarding attitudes, knowledge, and barriers from Thai PTs. Descriptive statistics were used to describe the responses. Multiple logistic regression was used to determine the association between personal and work characteristics and the responses related to attitude, knowledge, and barriers. Results: A total of 719 Thai PTs responded to the questionnaire. Based on this sample, Thai PTs had positive attitudes and perceived themselves as having sufficient background EBP education and skills. They were confident in performing a literature search, critically appraisal, and applying research in their practice. However, the frequencies of searching and reading of literature were relatively low. Less than half of respondents understood terms related to EBP asked in the survey instrument. The barriers to EBP were insufficient time and limited research and statistical skills. PTs who were younger and having higher education were more likely to have better attitudes and knowledge. Conclusions: Despite the positive attitude and perceived knowledge of EBP, time allocation, formal training of EBP skills during academic preparation, and continuing education are required to overcome the barriers toward EBP. The discrepancy between the perception and practice of EBP observed calls for further investigation of actual skills and the barriers to the implementation of EBP

Survey Of Preferred Delivery Methods For Training Related To Inclusive Education For Teacher In Vientiane Capital Lao P.D.R

Investigation teachers‟ preferred delivery methods regarding inclusion of children with special needs in Vientiane capital Lao P.D.R. Teachers (n=152) from different levels of teaching (elementary school, junior-high school, high school and university) were included in this study. This survey was conducted by questionnaire, which developed from “Teacher Attitude towards Inclusive Education Questionnaire” by Evangeline Kern in 2006. The survey questionnaire was consisted of open-ended responses related to the type of training that should be the most benefit for them in effectively applying inclusive education. Participants responded on a seven points scale from 1 (most beneficial) to 7 (least beneficial). Ranking of preferred delivery methods for receiving training about inclusion were arranged and calculated. The study revealed that coursework at the college/university as the most beneficial for delivery method for them. District level in-service training and out of district training being were the following sequence, respectively. In addition, they also needed training regarding how to be accessible data toward inclusive education, how to applying and adapting equipment for teaching students with disabilities. Interesting enough, they preferred the consistence training twice per year to improve their performance in inclusive education teaching

ผลของกระแสไฟฟ้าที่ใช้ในการรักษาทางกายภาพบำบัดต่อการซึมผ่านของยาโซเดียมไดโคลฟิแนค Effects of Physical Therapy Electrotherapeutic Modalities on Sodium Diclofenac Permeation

Objective: The aim of this study was to compare the effect of usingelectrotherapeutic modalities, galvanic current (GC) and high voltagepulsed current (HVPC) on sodium diclofenac permeation through shedsnake skin. Methods: Franz diffusion cell was used as a model ofpermeation study in four different conditions: 1) passive diffusion, 2) GC at1 mA, 3) HVPC at 150 volts and 4) HVPC at 500 volts. All conditions wereinvestigated at two different time points, 5 and 10 minutes.Spectrophotometry was used to determine the concentration of drugs. The1 mg/ml sodium diclofenac was used. Results: The results of this studyrevealed that using HVPC at 500 volts exhibited highest enhancement ofsodium diclofenac permeation, 10.41 and 22.19 g/cm2 at 5 and 10minutes, respectively. High voltage pulsed current at 150 volts was showncomparable result to GC condition. In addition, fold increment of thepermeation GC, HVPC at 150 volts and HVPC at 500 volts when comparewith passive diffusion was 3, 4, 12 at 10 minutes and 2, 3, 8 at 5 minute,respectively. Conclusion: High voltage pulsed current exhibited betterpermeation of sodium diclofenac than GC. Further studies are required toevaluate the compliance of this electrical stimulation to obtain thoroughlyinformation prior transfer to clinical application.Keywords: electroporation, iontophoresis, high voltage pulsed current,Franz diffusion cell, electrical stimulatio

อุบัติการณ์การบาดเจ็บของทีมนักกีฬารักบี้ประเภทผู้เล่น 15 คน มหาวิทยาลัยศรีนครินทรวิโรฒ ในกีฬามหาวิทยาลัยแห่งประเทศไทยครั้งที่ 37 (INCIDENCE OF INJURY IN AMATEUR RUGBY FIFTEEN PLAYERS OF SRINAKHARINWIROT UNIVERSITY TEAM IN THE 37TH UNIVERSITY GAME IN THAI)

วัตถุประสงค์ของการศึกษาในครั้งนี้เพื่อศึกษาถึงอุบัติการณ์ ตำแหน่ง และกลไกการบาดเจ็บของทีมนักกีฬารักบี้ประเภท 15 คน ของมหาวิทยาลัยศรีนครินทรวิโรฒ ในกีฬามหาวิทยาลัยแห่งประเทศไทยครั้งที่ 37 ณ มหาวิทยาลัยธรรมศาสตร์ วิทยาเขตรังสิต จังหวัดปทุมธานี โดยจำนวนนักกีฬาในทีมที่เข้าร่วมการฝึกซ้อม และแข่งขันทั้งสิ้น 30 คน เก็บข้อมูลโดยนักกายภาพบำบัด และผู้ฝึกสอนด้วยแบบสอบถามการบาดเจ็บของนักรักบี้จาก Gabbett TJ (2003) ข้อมูลที่ได้จะทำการเก็บข้อมูลจากช่วงระยะเวลาการฝึกซ้อมและการแข่งขัน และคำนวณเปรียบเทียบ 1,000 ชั่วโมงการเล่น ผลการศึกษาพบว่า อุบัติการณ์การบาดเจ็บที่พบในช่วงการแข่งขันเท่ากับ 119.017 ต่อ 1,000 ชั่วโมงการเล่น (Playing hours) (67.45%) และในช่วงฝึกซ้อมเท่ากับ 1.233 ต่อ 1,000 ชั่วโมงการเล่น ตำแหน่งของร่างกายที่ได้รับบาดเจ็บที่พบได้มากที่สุดในการศึกษานี้ ได้แก่ ข้อเท้า และเท้า โดยพบว่า เป็นการบาดเจ็บของกล้ามเนื้อและเอ็นยึดข้อต่อเป็นหลักในทีมผู้เล่นนี้ นอกจากนี้การบาดเจ็บที่พบจะมีมากในช่วงการแข่งขัน การศึกษานี้พบว่า ปัจจัยที่มีผลต่อการบาดเจ็บได้แก่การเกิดการล้า การเกิดการบาดเจ็บซ้ำ  ด้านอุณหภูมิ สภาพสนามแข่งขัน หรือสนามฝึกซ้อม ประสบการณ์ของผู้เล่น และจำนวนนักกีฬา ต่างมีผลต่ออุบัติการณ์การบาดเจ็บในการแข่งขัน และการฝึกซ้อม ซึ่งข้อมูลที่ได้นี้สามารถนำไปประยุกต์ใช้ในการให้การดูแลป้องกันการบาดเจ็บของทีมนักกีฬารักบี้ต่อไปคำสำคัญ: กายภาพบำบัด การปะทะ ระบาดวิทยา การฝึกซ้อมIt was the purpose of this study to investigate the incidence, site, and mechanism of injuries in fifteen amateur rugby players of Srinakharinwirot University team in the 37th University game at Thammasat University, Rangsit Campus, Pathum Thani, Thailand. A total of 30 players from rugby team, Srinakharinwirot University, joined in this game. The data were collected by physical therapists and the head coach by using checklist from Gabbett TJ (2003). All injured data during practice and competition match were recorded. The incidence in competition of injury was 119.017 per 1,000 playing hours (64.45%) and during training was 1.233 per 1,000 playing hours (35.55%). The most common site of injuries was the area of ankle and foot. The sprain and overuse injury were commonly found in this study. The results show that muscular injuries and injuries of the ankle and foot were the most common injury in fifteen rugby players. Furthermore, injuries were found mostly in competition period. These finding suggest that fatigue microtrauma, temperature, athletic experience, number of players and surface of the field may contribute to the injuries of fifteen rugby players of Srinakharinwirot University team. The professional health care and team can apply this data for prevention of rugby players.Keywords: Physical therapy, Collision, Epidemiology, Trainin

The effect of a modified elastic band orthosis on gait and balance in stroke survivors

Introduction: Gait is crucial for independent living for stroke survivors and assistive devices have been developed to support gait performance. Ankle foot orthoses (AFOs) are commonly provided to stroke survivors to prevent foot drop during walking. However, previous studies have reported limitations of AFOs including them being too heavy, creating skin irritation, and being a stigma of disability. The purpose was to compare the gait and balance improvement between elastic band orthoses (EBOs) and AFOs. Materials and Methods: The AFOs and EBOs were provided to 17 stroke survivors, and changes in gait and balance were assessed compared to barefoot (control). Gait spatiotemporal parameters were measured using the zebris-FDM-Rehawalk® system, and balance ability was evaluated using the timed up and go test (TUG). Satisfaction with the EBOs was determined using the Quebec user evaluation of satisfaction with assistive technology (QUEST2.0) questionnaire. Results: The EBO showed significant differences in; gait speed, cadence, stride length, stride time, step length unaffected side, stance phase and swing phase on the affected side, and pre-swing on the unaffected side, and balance performance (TUG) (p<0.05) when compared to the AFO and control conditions. The participants were quite satisfied with the EBOs with QUEST2.0 scores greater than 4 out of 5. Conclusions: EBOs could be provided to stroke survivors given their acceptability and properties to improve gait and balance. The EBO used in this study offered clinically important improvements in gait and balance when compare to AFO and control conditions, and could mitigate against some of the limitations reported in the use of AFOs in stroke survivors

Individuals with impaired lumbopelvic control demonstrate lumbar multifidus muscle activation deficit using ultrasound imaging in conjunction with electrical stimulation: A cross-sectional study.

Objective: To determine lumbar multifidus muscle (LM) activation deficits in individuals with impaired lumbopelvic control (iLPC) based on musculoskeletal ultrasound (MSKUS) in conjunction with electrical stimulation approach, and the correlation between back extension force and LM activation. Design: A cross-sectional study design. Setting: A university laboratory. Participants: Fifty participants (25 iLPC and 25 NoLBP) were recruited from the university physical therapy clinic and surrounding areas. Main Outcome Measures: The MSKUS was used to measure LM thickness at rest, maximum voluntary isometric contraction (MVIC), and electrical stimulation combined with MVIC, while a hand-held dynamometer was used to record force during MVIC and electrical stimulation combined with MVIC. These data were used to derive LM activation (LMACT) and percentage force generation (ForceGEN). Results: The iLPC group had significantly lower LMACT (17%) than the NoLBP group (P0.05). No significant correlation was seen between LMACT and ForceGEN (P>0.05). Conclusion: The findings support the utility of our protocol to determine LM activation deficits. The lower LM activation in iLPC group suggests that individuals with iLPC were unable to fully recruit the motor units available in LM. Force generation measurements may not be an appropriate approach to determine such deficits in LM

Proof-of Concept that an Acute Trophic Factors Intervention After Spinal Cord Injury Provides an Adequate Niche for Neuroprotection, Recruitment of Nestin-Expressing Progenitors and Regeneration.

Trophic factor treatment has been shown to improve the recovery of brain and spinal cord injury (SCI). In this study, we examined the effects of TSC1 (a combination of insulin-like growth factor 1 and transferrin) 4 and 8 h after SCI at the thoracic segment level (T12) in nestin-GFP transgenic mice. TSC1 treatment for 4 and 8 h increased the number of nestin-expressing cells around the lesion site and prevented Wallerian degeneration. Treatment with TSC1 for 4 h significantly increased heat shock protein (HSP)-32 and HSP-70 expression 1 and 2 mm from lesion site (both, caudal and rostral). Conversely, the number of HSP-32 positive cells decreased after an 8-h TSC1 treatment, although it was still higher than in both, non-treated SCI and intact spinal cord animals. Furthermore, TSC1 increased NG2 expressing cell numbers and preserved most axons intact, facilitating remyelination and repair. These results support our hypothesis that TSC1 is an effective treatment for cell and tissue neuroprotection after SCI. An early intervention is crucial to prevent secondary damage of the injured SC and, in particular, to prevent Wallerian degeneration

Proof-of Concept that an Acute Trophic Factors Intervention After Spinal Cord Injury Provides an Adequate Niche for Neuroprotection, Recruitment of Nestin-Expressing Progenitors and Regeneration

Trophic factor treatment has been shown to improve the recovery of brain and spinal cord injury (SCI). In this study, we examined the effects of TSC1 (a combination of insulin-like growth factor 1 and transferrin) 4 and 8 h after SCI at the thoracic segment level (T12) in nestin-GFP transgenic mice. TSC1 treatment for 4 and 8 h increased the number of nestin-expressing cells around the lesion site and prevented Wallerian degeneration. Treatment with TSC1 for 4 h significantly increased heat shock protein (HSP)-32 and HSP-70 expression 1 and 2 mm from lesion site (both, caudal and rostral). Conversely, the number of HSP-32 positive cells decreased after an 8-h TSC1 treatment, although it was still higher than in both, non-treated SCI and intact spinal cord animals. Furthermore, TSC1 increased NG2 expressing cell numbers and preserved most axons intact, facilitating remyelination and repair. These results support our hypothesis that TSC1 is an effective treatment for cell and tissue neuroprotection after SCI. An early intervention is crucial to prevent secondary damage of the injured SC and, in particular, to prevent Wallerian degeneration