Effects of stochastic resonance whole-body vibration on sensorimotor function in elderly individuals - A systematic review

Introduction: Due to demographic changes, falls are increasingly becoming a focus of health care. It is known that within six months after a fall, two thirds of fallers will fall again. Therefore, therapeutic procedures to improve balance that are simple and can be performed in a short time are needed. Stochastic resonance whole-body vibration (SR-WBV) may be such a procedure. Method: An electronic search to assess the effectiveness of SR-WBV on balance in the elderly was conducted using databases that included CINAHL Cochrane, PEDro, and PubMed. Included studies were assessed using the Collaboration Risk of Bias Tool by two independent reviewers. Results: Nine studies showing moderate methodological quality were included. Treatment parameters were heterogeneous. Vibration frequency ranged from 1 to 12 Hz. Six studies found statistically significant improvements of balance from baseline to post measurement after SR-WBV interventions. One article found clinical relevance of the improvement in total time of the "Expanded Time to Get Up and Go Test". Discussion: Physiological adaptations after balance training are specific and may explain some of the observed heterogeneity. Two out of nine studies assessed reactive balance and both indicated statistically significant improvements after SR-WBV. Therefore, SR-WBV represents a reactive balance training

Guided self-study in preclinical physiotherapy students: A feasibility study

Background: Literature describing the impact of guided self-study (G-SS) in knowledge changes and skills improvements in undergraduate students is scarce. Objectives: The aims of our study were to evaluate the feasibility of a G-SS programme in a full-time undergraduate physiotherapy degree course and to assess the effectiveness of the G-SS on changes in knowledge and development of skills (hands-on). Method: Fifty-three first-semester undergraduate physiotherapy students were randomly divided into a G-SS group and a control group (CG). The G-SS group received six clinical cases and prepared each case during an 8-day cycle. The control group received self-study learning units of the original curriculum content. Primary outcome parameters were (1) time of task, (2) responsiveness of students and (3) programme differentiation. Knowledge changes and skills changes were tested using a multiple-choice questionnaire and the objective structured clinical examination (OSCE). Results: Students’ responsiveness was 32%. This was below the a priori set 83%. No differences in programme differentiation were found. The OSCE grade was significantly higher in the G-SS compared to CG (p = 0.003). Conclusion: The G-SS programme in its current form was not feasible regarding students’ responsiveness. Therefore, a slight modification of our study protocol (e.g., better time planning in the academic calendar) is needed to improve students’ willingness to participate in the G-SS programme. Clinical implications: Adaptation of the school timetable should allow undergraduate physiotherapy students to prepare clinical cases under conditions of lower workload. Guided self-study as compared to CG is superior in knowledge change and (hands-on) skills improvement

The impact of guided self-study on knowledge and skills in Swiss pre-clinical physiotherapy students - a feasibility study protocol

Physiotherapy education in Europe must incorporate self-study units in the curriculum due to the bologna reform. Studies investigating the impact of guided self-study (G-SS) on knowledge and skills in pre-clinical Swiss physiotherapy students are scarce. This study protocol describes a prospective randomized feasibility education study that will primarily examine the feasibility of establishing G-SS using retired physiotherapists as tutors in undergraduate physiotherapy students at the Bern University of Applied Sciences, School of Health Professions. Secondary objective will be to evaluate the effectiveness of six G-SS cycles with retired physiotherapists as tutors on knowledge and skills of pre-clinical undergraduate physiotherapy students. Students of the physiotherapy degree course will be allocated into a G-SS group or control group (CG). G-SS consists of an 8-day cycle. Feasibility outcome are the fidelity of implementation that include exposure dosage and students' responsiveness, and the degree of acceptability. Success criteria of feasibility are (1) exposure dosage calculated as the number of 90-min presentations that are conducted, and the content of cases and competences and (2) students' responsiveness, with at least a 83% willingness to participate. Acceptability of intervention from the undergraduate students' perspective will be evaluated by a questionnaire with open, semi-structured questions (post intervention). This study will provide new information regarding the feasibility of embedding G-SS in the curriculum and about the students' responsiveness and their acceptability for G-SS. Study protocol version 1 Trial registration: German Register of Clinical Studies (DKRS: DRKS00015518)

The Use of Self-Study in Health Professional Higher Education and Medical Education - A Mixed-Method Systematic Review

Purpose: Health profession education and medical education should implement primarily active learning units in the curriculum. Self-study/guided self-study is such a tool that promotes active learning, a method that involves students in their learning process. The implementation of active learning is intended to develop or consolidate practical skills (hands-on). This mixed-method systematic review evaluated the of self-study/guided self-study in the university landscape for health professions education and medical education. Another goal was to foster awareness of the method self-study/guided self-study. Method: A systematic literature search in CINAHL, Embase, ERIC, PubMed and Web of Science was performed. Additionally, a manual search was conducted. This article included qualitative, quantitative, or mixed-method study designs. Included articles were appraised using the JBI Critical Appraisal Tool for qualitative and quantitative research. Abductive thematic analysis was used to synthesize evidence. Random-effects meta-analysis was performed to determine the effects of self-study that develop or consolidate practical skills (hands-on) in health professional or medical students compared to traditional teaching. Results: Fifteen articles were included totaling 3949 students volunteering in the studies. Critical appraisal of the studies ranged from average to good. Seven studies reported the use of individual self-study. The overall weighted effect favored self-study compared to traditional teaching (SDM 0.30, 95%CI: 0.13-0.48, p = 0.003). Discussion: The synthesized findings suggested that self-study/guided self-study was used as individual self-study. Self-study/guided self-study could develop or consolidate practical skill (hands-on) in health professional and medical students. The self-study/guided self-study should be structured in such a way that individual learning, dyad and group learning are possible

Effects of stochastic resonance whole-body vibration on sensorimotor function in elderly individuals—A systematic review

IntroductionDue to demographic changes, falls are increasingly becoming a focus of health care. It is known that within six months after a fall, two thirds of fallers will fall again. Therefore, therapeutic procedures to improve balance that are simple and can be performed in a short time are needed. Stochastic resonance whole-body vibration (SR-WBV) may be such a procedure.MethodAn electronic search to assess the effectiveness of SR-WBV on balance in the elderly was conducted using databases that included CINAHL Cochrane, PEDro, and PubMed. Included studies were assessed using the Collaboration Risk of Bias Tool by two independent reviewers.ResultsNine studies showing moderate methodological quality were included. Treatment parameters were heterogeneous. Vibration frequency ranged from 1 to 12 Hz. Six studies found statistically significant improvements of balance from baseline to post measurement after SR-WBV interventions. One article found clinical relevance of the improvement in total time of the “Expanded Time to Get Up and Go Test”.DiscussionPhysiological adaptations after balance training are specific and may explain some of the observed heterogeneity. Two out of nine studies assessed reactive balance and both indicated statistically significant improvements after SR-WBV. Therefore, SR-WBV represents a reactive balance training

Determinants of inpatient rehabilitation length of stay and discharge modality after hip and knee replacement surgery in Switzerland : a retrospective observational study

QUESTIONS UNDER STUDY / PRINCIPLES: The aims of this study were to identify the determinants influencing the inpatient rehabilitation length of stay (LoS) and discharge modality (DisMod) after hip or knee replacement surgery. METHODS: Data were retrieved for 306 patients (185 females, 121 males) who were admitted to a Swiss orthopaedic rehabilitation facility between 2007 and 2008 after hip or knee replacement surgery. LoS and DisMod were extracted from the medical files along with an additional seven binary and six continuous variables (including scores of timed-get-up-and-go [TUG], walking distance [WDT] and stair climbing tests [FIM_St]). Nonparametric procedures were used to detect differences between the gender groups. For the analysis of the LoS determinants, a linear regression model was used. The nonmotor performance test determinants of DisMod were analysed using a logistic regression model, whereas the motor performance test determinants were examined using binary classification. For both regression models, a backward procedure was used. RESULTS: Unlike DisMod, LoS calculations were conducted after stratification for gender. The simplified regression models explained 22% (females) and 31% (males) of the LoS variance and 20% (both genders) of the DisMod variance. TUG, WDT and FIM_St were all important predictors for LoS, whereas DisMod could be best predicted by WDT. CONCLUSIONS: Patients with good motor ability at admission were discharged earlier and more frequently to home. These findings might be of importance for preoperative physiotherapeutic care and might help to improve care planning as well as more accurately predict the access to inpatients beds and the allocation of resources

Prognostic Factors for Quality of Life After Interdisciplinary Pain Rehabilitation in Patients with Chronic Pain: a Systematic Review

Background. Health-related quality of life (hrQoL) is a core outcome in evaluating interdisciplinary pain rehabilitation (IPR). This systematic review aimed to identify prognostic factors for hrQoL at least six months after IPR in chronic pain patients. Methods. A systematic search was conducted in MEDLINE, PsycINFO, EMBASE, CINAHL, Web of Science and Cochrane CENTRAL until September 2020. Included were prognostic studies on the outcome hrQoL in adults aged 18 to 67 years with chronic pain (excluding malignancies, systemic-, inflammatory or degenerative joint diseases) who had undergone IPR. Studies were assessed with The Quality in Prognostic Studies-tool. Potential prognostic factors at baseline for the domains pain, psychological and physical functioning were qualitatively synthesized for hrQoL. Grading of Recommendations Assessment, Development and Evaluation was used to evaluate the level of evidence. Results. Fourteen studies on 6,668 participants (mean age 37.4–52.8 y), with musculoskeletal pain/fibromyalgia and a pain duration ranging between 13.1 and 177.4 months were considered eligible. With a very low certainty of evidence, pain intensity, emotional distress, and physical functioning at baseline were inconsistent for prediction of hrQoL and pain duration was not predictive. With low certainty of evidence, fewer pain sites, lower levels of negative cognitive behavioral factors, and higher levels of positive cognitive behavioral factors predicted a better outcome. Conclusions. The overall certainty of evidence was low to very low, making it difficult to reach definitive conclusions at present. Future studies with a predefined core set of predictors investigating hrQoL in patientswith chronic pain after IPR are needed

Ownership and attitudes towards technology use in physiotherapy students from seven countries

PURPOSE: To assess differences in prerequisites to blended learning such as technology use and Internet access in an international sample of physiotherapy students from Bangladesh, Belgium, Brazil, Luxembourg, Sudan, Switzerland and South Africa. RESULTS: Students' digital technology experiences were generally low. They primarily used a smartphone and a laptop to connect to the Internet. However, there was a significant difference between institutions in owning a laptop and access to Internet. Most students preferred learning in environments that included some online components but had never used Twitter or written a blog post and wanted less social media in their learning environments. CONCLUSION: Physiotherapy students would prefer an increase in the use of digital tools in their learning. However, differences in technology use and access highlight the challenges inherent to offering international online courses. Therefore decisions around online and blended course design in health professions education must be made with caution.Michael Rowe receives funding from the South African National Research Foundation

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"

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