Dissertations / Theses on the topic 'Physiotherapy'
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1
Conocimiento, Dirección de Gestión del. "Access Physiotherapy." McGraw-Hill, 2004. http://hdl.handle.net/10757/655258.
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McVeigh, Joseph G. "Fibromyalgia syndrome : physiotherapy management." Thesis, University of Ulster, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.436779.
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Awunor-Renner, Rita. "Physiotherapy as a profession." Thesis, Cranfield University, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.260405.
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Yeowell, Gillian. "Culture and the Physiotherapy Profession." Thesis, Manchester Metropolitan University, 2010. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.523147.
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Schoeb, Mezzanotte Veronika. ""What do you expect from physiotherapy?" : a conversation analytic approach to goal setting in physiotherapy." Thesis, University of Nottingham, 2014. http://eprints.nottingham.ac.uk/14210/.
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Professional practice guidelines direct health care professionals to include patients in the decision-making process and to establish collaboration for therapeutic goal setting. Currently, little is known about the interaction between patients and professionals during this process. The aim of this study is to shed light on goal setting practices in physiotherapy. Twenty-eight consenting patients seeking physiotherapy for their musculoskeletal problems and their therapists were videotaped during three consecutive sessions. Sequences related to goal setting were selected, and Conversation Analysis was chosen to analyse patient-therapist interactions. The data comprise fifteen episodes in which therapists enquire explicitly about goals. Findings show that two assumptions underlie these enquiries: a) that patients have a goal in mind, and b) that they are able to articulate it. My data indicate that this is not straightforwardly the case in practice. Patients orient in their responses to epistemic dimensions related to issues of whether they have access to this knowledge, and whether they treat themselves as entitled to know about goals. When patients respond to therapists’ enquiries, they use a variety of interactional resources to convey their epistemic orientation. I further found that therapists use different strategies for following-up patients’ responses: these have different implications for patients’ continued talk. My analysis also shows that a goal can only be treated as acceptable by therapists when it is amenable to improvement by physiotherapy. My study indicates that the process of goal setting is not as straightforward as policy documents suggest. In actual practice it requires addressing and managing underlying assumptions and epistemic dimensions. A better comprehension of the interaction between physiotherapists and patients will contribute to better understand the limitations of current goal setting theory, and how and why current policies on goal setting may not have the desired effect.
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Kuisma, Raija. "Domiciliary physiotherapy in Hong Kong: studyof the outcomes of domiciliary physiotherapy for patients withfractured proximal femur." Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2000. http://hub.hku.hk/bib/B31240409.
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Bower, Eva. "Physiotherapy for children with cerebral palsy." Thesis, University of Southampton, 1996. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.242574.
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Lowe, Anna. "Physical activity and physiotherapy : moving forwards." Thesis, Sheffield Hallam University, 2018. http://shura.shu.ac.uk/23229/.
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Background: Physical inactivity affects every system in the body and is associated with many chronic diseases. This impacts on the lives of individuals and has substantial social and economic implications. A large proportion of the UK population is insufficiently active and system-wide approaches to promoting physical activity are required. There are over 55,000 physiotherapists in the United Kingdom, yet little is known about physical activity promotion in this domain of healthcare. The overarching research aim is to explore physical activity promotion in physiotherapy practice and to understand the factors that influence current practice. Method: This programme of research is underpinned by a philosophical position of pragmatism. Within this methodological framework, a systematic scoping review was first undertaken to assess the state of the existing global evidence. Following this, a mixed methods study, was completed using a sequential explanatory design. Phase 1 involved a national, cross-sectional survey of UK physiotherapists. Phase 2 involved a qualitative, explanatory follow-up which aimed to further explain the quantitative findings. Findings: Thirty-one studies were included in the systematic scoping review. Findings from Phase 1 of the mixed methods study indicated that respondents (n=514) initiate conversations with patients about physical activity but lack a systematic approach. Physical activity status was not routinely assessed, signposting to other services was inconsistent, and knowledge of the physical activity guidelines was poor. These findings were further explained in Phase 2; participants (n=12) highlighted a lack of understanding of key concepts which underpinned the inconsistent approach to physical activity promotion. Phase 2 also identified that physiotherapists focus on short-term restoration of function over longer-term promotion of health. Conclusion: Physical inactivity is a major public health issue, and physiotherapists have the potential to contribute to tackling inactivity. However, the current approaches identified within this programme of research were inconsistent and unsystematic. Changes in demography necessitate holistic physiotherapy approaches that promote long-term health and wellbeing. Recommendations are made to improve physiotherapy practice in line with the aspiration of orientating healthcare toward prevention.
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Conocimiento, Dirección de Gestión del. "Guía de acceso para Access Physiotherapy." McGraw-Hill, 2021. http://hdl.handle.net/10757/655258.
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Trede, Franziska Veronika. "A Critical Practice Model For Physiotherapy." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1430.
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A perspective in critical social science is concerned with knowledge, power and critique. This thesis explores the question: What would physiotherapy practice look like if it were informed by critical social science? This question originated from four observations: (1) physiotherapists work with constantly changing health care demands, (2) traditional practice approaches underpinned by rational objectivity widen the gap between theory and practice, (3) professional judgments are based on more than objective, rational thinking, and (4) concluding from the first three observations clinical physiotherapists rely more and more on thinking for themselves. If physiotherapists were to adopt a critical social science perspective they would question their practice, identify taken-for-granted, unreflected assumptions and unnecessary system constraints and liberate themselves, their practice and patients, thereby enhancing both the quality of patient care and the practitioner’s professional work experience. Following the hermeneutic tradition I constructed texts from pertinent literature as well as transcripts from participants’ interviews, action plans and field notes. I developed an integrative design to interpret these texts drawing from philosophical and critical hermeneutics as well as action research. The question and answer dialogue methodology consisted of four cycles including deep, critical and transformative dimensions. These I labelled critical transformative dialogues. The first dialogue was with the critical social science literature and with the Gadamer-Habermas and Foucault- Habermas debates in particular. These debates addressed issues of rationality, knowledge and power. Further, I reviewed relevant education, nursing and health promotion literature that addressed these critical social science themes. This first dialogue crystallised my identification of key CSS dimensions relevant to physiotherapy practice. The second dialogue comprised physiotherapy literature that related to these identified critical social science dimensions, as well as transcripts from physiotherapists’ interviews. This dialogue critically interpreted current practice models in their historical, educational and practice contexts. It highlighted the finding that physiotherapy practice is currently dominated by instrumental thinking rather than critical thinking, and that there is a lack of engagement of physiotherapy practice with CSS. The third dialogue was with physiotherapists trialling CSS in practice. Physiotherapists of this trialling group designed action learning “contracts” where they set out to change their practice in the sense of adopting CSS principles and activities in their practice. I explored with these participants how CSS could work or fit in their practice and practice contexts and how this would be experienced. Through this action learning project of endeavouring to transform their practice towards a CSS model I explored participants’ capacity to learn about posing problems concerning their practice, recognise practice contradictions, experience practice challenges and recognise their motivations and interests. This exploration illuminated the viability of CSS in their practice. The fourth dialogue was with physiotherapists who operationalised CSS values or who could visualise a CSS framework for their practice whether they used this terminology or not. This dialogue brought critical understanding of the advantages and potential limitations of realising a CSS-centred physiotherapy practice. I conclude the thesis with twelve propositions arising from these four critical transformative dialogues. Based on the trialling, transforming and visioning of CSS as a model for physiotherapy practice, the relevance of these propositions for critical physiotherapy practice is asserted and implications for education and further research are discussed. The contribution that CSS can make to physiotherapy practice is to add critical transformative dialogues as a strategy to advance practice that is patient-centred and multidisciplinary in approach, inclusive of sociopolitical environments, mindful of professional power and open about professional values.
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Trede, Franziska Veronika. "A Critical Practice Model For Physiotherapy." University of Sydney, 2006. http://hdl.handle.net/2123/1430.
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Doctor of PhilosophyA perspective in critical social science is concerned with knowledge, power and critique. This thesis explores the question: What would physiotherapy practice look like if it were informed by critical social science? This question originated from four observations: (1) physiotherapists work with constantly changing health care demands, (2) traditional practice approaches underpinned by rational objectivity widen the gap between theory and practice, (3) professional judgments are based on more than objective, rational thinking, and (4) concluding from the first three observations clinical physiotherapists rely more and more on thinking for themselves. If physiotherapists were to adopt a critical social science perspective they would question their practice, identify taken-for-granted, unreflected assumptions and unnecessary system constraints and liberate themselves, their practice and patients, thereby enhancing both the quality of patient care and the practitioner’s professional work experience. Following the hermeneutic tradition I constructed texts from pertinent literature as well as transcripts from participants’ interviews, action plans and field notes. I developed an integrative design to interpret these texts drawing from philosophical and critical hermeneutics as well as action research. The question and answer dialogue methodology consisted of four cycles including deep, critical and transformative dimensions. These I labelled critical transformative dialogues. The first dialogue was with the critical social science literature and with the Gadamer-Habermas and Foucault- Habermas debates in particular. These debates addressed issues of rationality, knowledge and power. Further, I reviewed relevant education, nursing and health promotion literature that addressed these critical social science themes. This first dialogue crystallised my identification of key CSS dimensions relevant to physiotherapy practice. The second dialogue comprised physiotherapy literature that related to these identified critical social science dimensions, as well as transcripts from physiotherapists’ interviews. This dialogue critically interpreted current practice models in their historical, educational and practice contexts. It highlighted the finding that physiotherapy practice is currently dominated by instrumental thinking rather than critical thinking, and that there is a lack of engagement of physiotherapy practice with CSS. The third dialogue was with physiotherapists trialling CSS in practice. Physiotherapists of this trialling group designed action learning “contracts” where they set out to change their practice in the sense of adopting CSS principles and activities in their practice. I explored with these participants how CSS could work or fit in their practice and practice contexts and how this would be experienced. Through this action learning project of endeavouring to transform their practice towards a CSS model I explored participants’ capacity to learn about posing problems concerning their practice, recognise practice contradictions, experience practice challenges and recognise their motivations and interests. This exploration illuminated the viability of CSS in their practice. The fourth dialogue was with physiotherapists who operationalised CSS values or who could visualise a CSS framework for their practice whether they used this terminology or not. This dialogue brought critical understanding of the advantages and potential limitations of realising a CSS-centred physiotherapy practice. I conclude the thesis with twelve propositions arising from these four critical transformative dialogues. Based on the trialling, transforming and visioning of CSS as a model for physiotherapy practice, the relevance of these propositions for critical physiotherapy practice is asserted and implications for education and further research are discussed. The contribution that CSS can make to physiotherapy practice is to add critical transformative dialogues as a strategy to advance practice that is patient-centred and multidisciplinary in approach, inclusive of sociopolitical environments, mindful of professional power and open about professional values.
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Richardson, Robert C. "Actuation and control for robotic physiotherapy." Thesis, University of Leeds, 2001. http://etheses.whiterose.ac.uk/1534/.
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Over the last few years researchers have developed prototype robots that are capable of administering physiotherapy, however, these devices tend to be complex and expensive. The use of modem pneumatic servo systems as actuators would make such devices simpler and cheaper. This thesis assesses the feasibility of a pneumatically actuated robotic physiotherapy device through the implementation of force and position control strategies. Traditional pneumatic servo systems consist of a pneumatic cylinder prone to stiction effects and a single spool valve. Here the performance of modem pneumatic servo system, consisting of a low friction pneumatic cylinder and two electropneumatic proportional valves has been evaluated. The increased linearity of the modem pneumatic system enabled a self-tuning pole-placement controller to be implemented that would be unsuitable for conventional pneumatic systems. The selftuning pole-placement controller enabled consistent and accurate position control. Other researchers have achieved force control of pneumatic systems, however their force models are not applicable on this modem configuration. Accurate control of the servo system force output, while the position of the cylinder piston is fixed, has been achieved through an open-loop force controller, however applications for fixed position force control are limited. The servo system force output, during motion, has been found to be a function of the piston velocity and input control signal. A pneumatic robot has been designed and fabricated with a position workspace that enables the average male to perform upper limb reach and retrieve exercises when attached to the robot. The pneumatically actuated robot, combined with a simple three degree-of-freedom force sensor, form a device capable of administering upper-limb robotic physiotherapy. Impedance control has been identified as the most suitable force and position control strategy for implementing physiotherapy. Applying the impedance control strategy, to a single link of the robot, resulted in accurate implementation of the desired force and position relationship. Extending the controller to two and three degrees of freedom has resulted in degradation of the controller performance due to limitations of the three degree-offreedom force sensor. The controller performance is also found to be dependent upon selection of the impedance characteristics. Low stiffness and high damping, along with high stiffness and high damping have been identified as particular low points in controller performance due to the requirement for the system to provide large forces with little resulting motion. It was concluded that the pneumatic robot and impedance control strategy have the potential to administer physiotherapy. However, further work incorporating a force sensor with greater accuracy that is robust to torque inputs and a rigorous stability analysis would be required before the device could be clinically evaluated.
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Kunstler, Breanne. "Physical activity promotion in physiotherapy practice." Thesis, Federation University Australia, 2018. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/165585.
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Australian physiotherapists promote non-treatment physical activity, which is physical activity used to improve or maintain general health, to patients with musculoskeletal conditions. However, it is unclear how physiotherapists promote non-treatment physical activity and the behaviour change techniques they use to do this. This thesis used four studies to: (i) review the efficacy of physiotherapist-led physical activity interventions; (ii) investigate the factors that influence physiotherapists’ choice to promote non-treatment physical activity; and (iii) identify the behaviour change techniques that private practice and outpatient physiotherapists use to promote non-treatment physical activity. Two systematic reviews identified that physiotherapist-led physical activity interventions are efficacious. However, effects were small and not maintained. Additionally, physiotherapists only used a small number of behaviour change techniques when promoting physical activity. National survey and interview studies were used to identify the factors that influence physiotherapists’ choice to promote non-treatment physical activity. The survey found that having poor knowledge of how to promote non-treatment physical activity, prioritising other patient problems before non-treatment physical activity and using promotion methods that were not compatible with daily practice significantly and independently reduced the odds of physiotherapists promoting non-treatment physical activity. Interpretative phenomenological analysis was used to design interviews that showed that having a perceived inability to motivate an unmotivated patient and believing that patients expect hands-on therapy instead of non-treatment physical activity promotion complicated treatment choices. The behaviour change techniques Australian physiotherapists used to promote non-treatment physical activity were compared to those used to encourage adherence to rehabilitation exercises in the survey too. The survey found that physiotherapists used similar behaviour change techniques to promote non-treatment physical activity and encourage adherence to rehabilitation exercises. This thesis provides clinicians and researchers with an understanding of the factors that influence Australian physiotherapists’ decision to promote non-treatment physical activity and the behaviour change techniques they use.Doctor of Philosophy
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Kuisma, Raija. "Domiciliary physiotherapy in Hong Kong : study of the outcomes of domiciliary physiotherapy for patients with fractured proximal femur /." Hong Kong : University of Hong Kong, 2000. http://sunzi.lib.hku.hk/hkuto/record.jsp?B21734628.
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Leiserson, Sara. "Caring in physiotherapy work, an ethnographic study." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1997. http://www.collectionscanada.ca/obj/s4/f2/dsk3/ftp05/nq22894.pdf.
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Žukauskienė, Milda. "Curriculum modelling of the physiotherapy professional education." Doctoral thesis, Lithuanian Academic Libraries Network (LABT), 2011. http://vddb.laba.lt/obj/LT-eLABa-0001:E.02~2011~D_20110325_133315-52749.
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Due to the changing personal and public demands as regards health care new requirements for the health care service providers have presently arisen; consequently, the whole health care system, especially rehabilitation, has been facing new challenges. The scientific research on the physiotherapy practice, as the main providers of the previously mentioned health service, stand far behind from being developed in Lithuania. Thus, this work, which analyses physiotherapy professional education with regard to systemic view, aims at developing theoretically and empirically validated curriculum model of physiotherapy education. The development of the model includes the conception of physiotherapy, its historical evolution, defines the peculiarities of physiotherapy practice and education in foreign countries and in Lithuania, and finally, it introduces a hypothetical model of the interaction between physiotherapy practice and their competences. The empirical research with reference to holistic view precondition scientific validation of the physiotherapy education parameters and curriculum modelling. The curriculum model developed on the basis of the research results and the discussion in this dissertation reflect the tendencies of physiotherapy education in the world and presuppose further research in the field of physiotherapy practice and education.Kintant asmens ir visuomenės poreikiams, susijusiems su sveikatos priežiūra, keliami nauji reikalavimai sveikatos priežiūros paslaugų teikėjams, o tai yra iššūkis visai sveikatos priežiūros, o ypač reabilitacijos, sistemai. Kineziterapeutų, kaip pagrindinių šias paslaugas teikiančių specialistų, veiklos ir profesinio rengimo tyrimai Lietuvoje nėra plėtojami. Todėl šio darbo, kuriame profesinis kineziterapeutų rengimas analizuojamas sisteminiu požiūriu, tikslas – sukurti teoriškai ir empiriškai pagrįstą kineziterapeutų profesinio rengimo turinio modelį. Jį kuriant aptariama kineziterapijos samprata, jos istorinė kaita, aprašomi kineziterapeutų veiklos ir jų profesinio rengimo ypatumai užsienio šalyse ir Lietuvoje, pristatomas hipotetinis kineziterapeutų profesinės veiklos ir kompetencijų sąveikos modelis. Empiriniai tyrimai, atlikti remiantis holistiniu požiūriu, sudaro prielaidas moksliškai pagrįsti kineziterapeutų profesinio rengimo turinio parametrus, modeliuoti turinį, sudaro prielaidas apibrėžti kineziterapeutų kvalifikacijos lygmenis, nustatyti jiems keliamus reikalavimus ir parengti naujas studijų programas. Tyrimo rezultatų pagrindu sukurtas ir disertacijoje aprašytas modelis atspindi pasaulines kineziterapeutų profesinio rengimo tendencijas ir suponuoja tolimesnius kineziterapeutų veiklos ir jų profesinio rengimo tyrimus.
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Nankervis, Kathryn Jane. "Physiology and biomechanics relating to equine physiotherapy." Thesis, University of the West of England, Bristol, 2013. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.601226.
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This commentary provides evidence of my fulfilment of the requirements for a DPhil via the presentation of publications resulting from my research activity. The overarching theme of the publications is 'Physiology and biomechanics relating to equine physiotherapy'. The portfolio of evidence consists of eight peer-reviewed publications which combine to provide evidence for normal back function in the horse, and the use of manual therapy as a precursor to rehabilitation in order to develop and enhance optimal back function in the horse. Specifically, the papers conside~ 1. suitable periods for physiological and biomechanical acclimation to water treadmill exercise 2. the physiological and biomechanical responses of horses to water treadmill exercise 3. the muH~functional role of the longissimus dorsi muscle in the horse (which has relevence to LD activity in other species) and methods of influencing LD tone and activity 4. the nature of physiological and biomechanical responses of horses to exercise on gradients 5. the safety of treadmill exercise in horses. The commentary is divided into three chapters. Chapter 1 provides an analysis of the contribution of my selected publications to the current knowledge within the field of equine physiology and biomechanics. Chapter 2 describes the application of current knowledge to rehabilitation in practice and Chapter 3 provides a critical review of the study designs and measurement techniques employed in my research. Wrthin this chapter, evidence of my ability to design and implement appropriate empirical methods to test hypotheses and answer research questions is given. The aim of the commentary is to provide evidence as to my ability to generate new knowledge at the forefront of equine physiotherapy via expertise in research methods.
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Webster, Valerie Sneddon. "A study of open access physiotherapy practice." Thesis, Glasgow Caledonian University, 1997. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.387853.
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McNeill, Sheelagh C. "Acupuncture : clinical practice and effectiveness in physiotherapy." Thesis, University of Ulster, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.288826.
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Barnard, Irene Susan. "Exploring the older patient/physiotherapy clinician relationship." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.401751.
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Bazilo, K. V., and V. V. Medianyk. "Research of Piezoelectric Adders for Vibroacoustic Physiotherapy." Thesis, Sumy State University, 2015. http://essuir.sumdu.edu.ua/handle/123456789/41385.
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Vibroacoustic physiotherapy – the one of types of vibrotherapy, at which, for the therapeutic and prophylactic purposes a contact effect of microvibration with sound frequency (20 Hz – 20 kHz) is used. Most
frequently the piezoelectric transducers are used as the projectors.
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Talberg, Heather. "Investigating professional identity in undergraduate physiotherapy education." Master's thesis, University of Cape Town, 2012. http://hdl.handle.net/11427/12016.
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Includes abstract.Includes bibliographical references.
Clinical practice remains an integral part of the training of physiotherapy students. It is seen as an effective way of socialising students into the profession. By placing students in a clinical setting where under the guidance of clinicians and clinical educators, they are able to put their classroom taught procedures into practice it is believed that they then start to develop an understanding of what being a physiotherapist entails. Drawing on Lave and Wenger's model of situated learning, this research sets out to understand how final year physiotherapy students begin to develop their identity as physiotherapists. The research looks at the positioning of students within specific communities of practice and the nature of the learning that occurs within these communities.
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Pillay, Savondarie Govindaswami. "The role of physiotherapy in inclusive education." University of the Western Cape, 2011. http://hdl.handle.net/11394/5308.
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Magister Scientiae (Physiotherapy) - MSc(Physio)The education system in South Africa has been on a path of change since 1994, in an effort to correct the injustices and inequalities of our apartheid past. In 2001 Education White Paper Six and the inclusive education policy was introduced. This policy is based on creating an environment where special needs education is seen as a non-racial and integrated part of the education system and envisages the role of special schools changing in order to facilitate this process. Special schools will continue to provide services to the severely disabled and high needs learner. However staff at special schools will be encouraged to make their expertise and resources available to the ordinary schools in the community. This study is focused on the role of the physiotherapist in special schools. The introduction of the new policy required physiotherapists to serve the needs of learners at special schools as well as provide indirect support to ordinary schools in the community. However physiotherapists have not been trained to provide indirect support and feel that they have not had adequate assistance to improve their skills and knowledge in this area. This study therefore looked at how the knowledge, skills and attitudes of physiotherapists can be enhanced and developed in order to meet the need of successfully implementing inclusive education. The aim of the study was to design, implement and evaluate an intervention aimed at improving the knowledge, skills and attitudes of physiotherapists in providing indirect support in the education system. In order to do so, it was necessary to meet the following objectives. Firstly to determine how physiotherapists perceive indirect support and their role in the district based support team; and secondly to determine the barriers experienced by physiotherapists in providing indirect support as well as their needs to provide appropriate support within the inclusive education framework. A qualitative study was conducted using the action research method. This study involved five special schools in the Western Cape and a total of nine participating physiotherapists. Focus group discussions were used to collect data. The first focus group discussion involved participants identifying their perceptions of indirect support, their role in the district based support team, barriers to indirect support and their needs in order to provide appropriate support in the inclusive education framework. The data collected were analyzed using content analysis. The findings revealed that many of the physiotherapists are experiencing difficulties in making the shift from direct to indirect support, due to not having been provided with the necessary support, resources and training to facilitate the transition to inclusive education practices. A second round of focus group discussions were held for the physiotherapists to prioritise a need that the intervention would be based on. Thereafter a training workshop was held, based on the prioritised need, to improve the provision of indirect support by physiotherapists. This research has shown that physiotherapists have begun to engage with the change process by questioning the implications of the inclusive education policy and looking at how their role in special schools needs to change. The physiotherapists require assistance in the facilitation of a transition from providing mainly direct support in special schools, to also providing indirect support in an inclusive education setting. They require the assistance of the school management and the Department of Education to provide the necessary support, resources and training to facilitate the transition to inclusive education practices.
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Cruz, Eduardo José Brazete Carvalho. "Clinical reasoning in musculoskeletal physiotherapy in Portugal." Thesis, University of Brighton, 2010. https://research.brighton.ac.uk/en/studentTheses/5d5210fe-b5d1-4bc6-be38-aa29f91a1178.
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Clinical reasoning refers to the process in which practitioners, interacting with their patients, structure meaning, goals, and health management strategies based on clinical data, patient/client choices, and professional judgment and knowledge (Higgs & Jones, 2000, p. 11). Recent literature in physiotherapy and other allied health professions describes clinical reasoning as moving between cognitive and decision-making processes required to optimally diagnose and manage impairment and physical disabilities (hypothetic-deductive), and those required to understand and engage with patients' experience of disabilities and impairments (narrative reasoning). Clinical reasoning has been described as a universal process, common to all clinicians, in particular in the musculoskeletal area. However, clinical reasoning models emerged from research developed in specific and well-developed health care and professional cultures, such as Australia and United States, but there has been little discussion of their relevance and applicability to other cultural groups. Since research literature concerning physiotherapy in Portugal is almost non-existent, the aims of this study were twofold. The first aim was to explore clinical reasoning processes in a sample of Portuguese expert physiotherapists and secondly, to identify the current perspective of clinical reasoning held by educators and students, and how it is promoted in the undergraduate curriculum. The focus of the study was musculoskeletal physiotherapy. The research was influenced by the interpretative/constructivist paradigm of inquiry. The study consisted of three parts. In part one, the clinical reasoning approach of a sample of Portuguese expert therapists in musculoskeletal physiotherapy was investigated. The study focused on Portuguese clinicians' interaction with their patients in order to define and manage clinical problems. Data was collected through non-participant observation, semi-structured interviews, memos and field notes, and analysed thematically to identify and compare the practice and reasoning approach used. In part two, the generic aspects of undergraduate physiotherapy curricula in Portugal were analysed to provide a first insight of how educational programmes are organized and delivered in Portugal. Then, current musculoskeletal physiotherapy curricula in Portuguese entry-level physiotherapy programs were analysed by a questionnaire survey and documentary analysis. The specific aim was to capture the educational process and actions underlying current educational practice across undergraduate courses. In part three (Study 3 and 4), a sample of musculoskeletal lecturers and a sample of near graduate students were selected against criteria relating to the diversity of institutions that offer undergraduate physiotherapy courses (private versus public institutions) and length of time as a Physiotherapy education provider. Each course was examined from lecturer and student perspectives (through individual interviews and focus groups) to see what kind of clinical reasoning approach were most emphasised in relation to physiotherapy intervention in musculoskeletal conditions. Data were transcribed and subjected to thematic analysis. Findings showed some similar characteristics in the reasoning process of this group of Portuguese expert physiotherapists in the study when compared with other studies in the musculoskeletal physiotherapy field. However, findings also highlighted that Portuguese physiotherapists were more likely to use and value an instrumental approach to clinical practice. There was little evidence of patients sharing their perspectives about their problems or participating in clinical decisions made. An instrumental approach to reasoning and practice was also dominant in current Portuguese musculoskeletal programs as well in educators' and students' perspectives. The focus was on diagnostic and procedural strategies of reasoning with little emphasis on promoting student competences to involve patients in the decision making process. In this sense, the practice and reasoning of this sample could be seen as more instrumental than communicative. Perspectives on clinical reasoning differ between cultures and contexts of practice and this has implications for the quality of health care education and service delivery. This research has identified the current model of clinical reasoning in Portuguese Physiotherapy practice. The findings have significant implications for clinical practice in musculoskeletal physiotherapy, curriculum development, and wider education and health service policy.
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Campbell, Evan. "Physiotherapy for people with progressive multiple sclerosis." Thesis, University of Glasgow, 2018. http://theses.gla.ac.uk/30597/.
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Progressive Multiple Sclerosis (MS) is a degenerative neurological disease with no known cure. The overall aim of the research within this thesis was to investigate physiotherapy, an important part of the care, for people with progressive MS. This was done in three studies. A systematic review of the current literature for the effectiveness of physiotherapy for the rehabilitation of people with progressive MS; an online survey of people with progressive MS assessing levels of access to, and use of, clinical services across the United Kingdom; and a feasibility study of High Intensity Interval Training (HIIT) for people with progressive MS. The systematic search returned 15 studies, 482 participants in total, which investigated eight different interventions: exercise therapy, multi-disciplinary rehabilitation, functional electrical stimulation, botulinum toxin type A injections and manual stretches, inspiratory muscle training, therapeutic standing, acupuncture and body weight supported treadmill training. All studies, apart from one, produced a positive result, however, only one study was adequately powered. In conclusion, the review found that the evidence was positive for using physiotherapy for rehabilitation in people with progressive MS, but further adequately powered research, is required to strengthen this. In total 1298 people with progressive MS from across the United Kingdom completed the online survey in August to October 2015. Participants were asked regarding access and use of clinical services, delivery and opinion of physiotherapy, and use of complementary and alternative therapies. Access to MS Specialists was high (95%), as was access to a physiotherapist (87%). Seventy seven percent of physiotherapy was delivered by the National Health Service and 32% were currently receiving physiotherapy for their MS. Physiotherapy was very well perceived by people with progressive MS and the most common interventions received were independent (83%) and supervised exercise (71%). Five percent of respondents were currently using disease modifying therapies and 23% had previously taken them. Almost three quarters (74%) received a regular review but 37% received this review less than annually. It was recommended that service providers make steps to address this gap in service provision. Finally, eight weeks of twice weekly HIIT sessions were compared to twice weekly sessions of continuous moderate intensity training. Ten out of twelve participants completed the trial. The HIIT intervention was well tolerated with 93% adherence, 100% compliance with protocol and no adverse events. There were three adverse events in the continuous training group and compliance was 79%. In addition, those who received HIIT improved their maximal heart rate and mental processing speed while no changes were found in the continuous training group. A larger, fully powered trial is required to confirm these results. Overall the studies within this thesis demonstrate that physiotherapy has the potential to be beneficial in the rehabilitation of people with progressive MS, that people with progressive MS are engaging with physiotherapy, and that interventions such as HIIT may provide new avenues for eliciting health benefits from this patient group. However, despite these positive findings, more work is required to strengthen the evidence base and gaps in service provision should be addressed.
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Zetterberg, Lena. "Multidimensional Aspects of Dystonia : Description and Physiotherapy Management." Doctoral thesis, Uppsala universitet, Institutionen för neurovetenskap, 2008. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-9417.
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Aims: The overall aim of this research was to increase the knowledge about dystonia by identifying factors that influence self-reported quality of life and health in this disorder and to determine what factors predict disability. A further aim was to develop an objective outcome measure for quantifying the movement dysfunction in cervical dystonia (CD) and evaluate effects of physiotherapy. Methods: A descriptive correlative design was adopted for study I (n=351), with a questionnaire covering physical activity, satisfaction with treatment, physiotherapy or not, and quality of life and health measured with the Craniocervical Dystonia Questionnaire (CDQ-24) and the Cervical Dystonia Impact Profile, respectively. In study II a CD group (n=6) was compared with a control group (n=6). Head movements were measured with a motion capture system, and a Movement Energy Index (MEI) was calculated. In study III an experimental single-case design (n=6) was used, with continuous assessments during pre-treatment, intervention and follow-up. Quality of life, measured with CDQ-24, was the primary outcome measure. A prospective correlative design was applied in study IV (n=179), where data from questionnaires were collected on inclusion and 2 months later. Independent variables were: duration of dystonia, severity of dystonia, pain intensity, catastrophizing, self-efficacy, fatigue, kinesiophobia, depression, anxiety and physical activity; and the dependent variables were the Neck Disability Index and the Functional Disability Questionnaire. Results: Study I indicated that physical activity and satisfaction with treatment were associated with quality of life and health in dystonia. In study II the groups differed significantly concerning MEI in all movement directions. Mean MEI was significantly higher in patients than in controls. Positive treatment outcomes were reported by all patients in study III, mainly with reduced pain and reduced CD severity during the treatment period. Five of the six patients reported increased quality of life at the 6-month follow-up. Perceived self-efficacy, fatigue, pain intensity and anxiety contributed significantly to disability prediction in study IV. Conclusion: These investigations have increased the knowledge of dystonia from a multidimensional perspective and the results could be valuable in developing new treatment strategies.
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Waterfield, Jacqueline. "Post-registration learning in physiotherapy : practice and policy." Thesis, Keele University, 2006. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.435153.
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The profession of physiotherapy is evolving in an era of evidence-based health C
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Belchamber, Caroline Anne. "Physiotherapy palliative cancer care : a case study approach." Thesis, Bournemouth University, 2016. http://eprints.bournemouth.ac.uk/24774/.
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There is evidence to suggest that the role of the allied health professional continues to evolve in the delivery of palliative cancer care services. Whilst it appears that there is an increasing need for physiotherapists, there is a lack of understanding about the nature of their role, their educational needs and their place within the rehabilitation team. The aim of my work was to explore a local palliative cancer care physiotherapy service provision in the light of best practice recommendations, using both my own practice development and a research study. For my research a qualitative approach using a single case study design was chosen as it provided a framework to facilitate the inclusion of multiple perspectives in a complex context within an area of healthcare where little research has been undertaken. Multiple methods of data collection were used from numerous perspectives, which included four data sets: interviews (healthcare professionals [10]); interviews (service users [10]); observations (physiotherapists [2] treating service users [5]); and policy document collection (NICE guidelines; white papers [12]). Detailed data analysis was then carried out using a thematic approach within a framework, comparing and contrasting patterns within and across the four data sets. Emergent themes highlighted a number of important aspects relating to physiotherapists including: new ways of working, shift in mindset and treatment planning, emotional adjustment and integration of professional boundaries. My primary research and practice development project combined to evidence the metamorphosis of both the physiotherapist profession and service provision where competencies around mentorship, entrepreneurship, leadership, policy championship, integrated teamwork, humanisation and self-reflection embodied within the psycho-social-cultural-spiritual model of healthcare enabled them to meet key policy recommendations of service quality and innovation. A debate is necessary around the need for profession specific or service specific outcomes in this area, and how physiotherapists ‘prove their worth’ now that they are an integral part of palliative cancer care provision.
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Dawson, Valerie Lesley. "Cultural implications for physiotherapy education : the Bethlehem experience." Thesis, Loughborough University, 1997. https://dspace.lboro.ac.uk/2134/31867.
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This study investigates the cultural context of physiotherapy education. Research questions addressed are in relation to innovative physiotherapy curricula, the possibility of such a curriculum being introduced into the Middle East and the effects of the curriculum on graduates' forward looking attitudes.
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Mummery, Christine C. "Efficacy of physiotherapy treatment for female urinary incontinence." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape9/PQDD_0020/MQ47075.pdf.
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Conroy, Sherrill. "Moral inclinations of medical, nursing and physiotherapy students." Thesis, University of Oxford, 2001. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.367447.
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Dawson, Pam. "An evaluation of a new domiciliary physiotherapy service." Thesis, Northumbria University, 2000. http://nrl.northumbria.ac.uk/1882/.
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The aim of this research was to undertake an evaluation of domiciliary physiotherapy, by assessing the cost effectiveness of a new Domiciliary Physiotherapy Service (DPS) and by analysing the process of domiciliary physiotherapy practice. The main element of the work was a randomised controlled trial of the DPS, in which an experimental group receiving domiciliary physiotherapy assessment and intervention was compared with a control group receiving conventional care. Hypotheses that domiciliary physiotherapy would improve clients' independence in activities of daily living (ADL) and health status, and reduce clients' use of other services, were tested. The null hypotheses related to ADL and health status could not be rejected, possibly because of a smaller than intended sample size, and/or the masking of real effects by sample attrition, or lack of sensitivity of the outcome measures. There was evidence to suggest that the DPS may have significantly increased, rather than decreased, the proportion of clients with at least one contact with another health or social service. The analysis of the process of domiciliary physiotherapy developed as the RCT progressed. An interpretive account of domiciliary physiotherapy practice, framed within the author's own experiential knowledge, was constructed using quantitative and qualitative data from DPS treatment records, GP referral forms, and interviews with clients, carers and experienced community-based therapists. The interpretive analysis has underpinned a new `reciprocal learning' model of domiciliary physiotherapy, which may assist practitioners working in the field. The way forward for domiciliary physiotherapy practice may be to acknowledge that measurable clinical outcomes cannot easily be determined, and that criteria for assessing the value of domiciliary physiotherapy should be based on client and carer perspectives.
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Allgar, Victoria. "Physiotherapy from admission to discharge : an exploratory study." Thesis, University of Newcastle Upon Tyne, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.289094.
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Jenkins, Susan Carol. "Effect of post-operative physiotherapy on lung function." Thesis, King's College London (University of London), 1989. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.328236.
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Xerri, de Caro John. "The Bologna Process and physiotherapy education across Europe." Thesis, Sheffield Hallam University, 2014. http://shura.shu.ac.uk/20708/.
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This study sought to understand the influences of the Bologna Process on physiotherapy education by looking at the extent of the adoption of the objectives of the Bologna Process and interpreting the impact on organisational governance. The aim was to draw out the influence that the Bologna Process may have had on physiotherapy in higher education across Europe. It was decided that the appropriate research methodology to address this aim would be Case Study Methodology and a Type 1 single-case holistic design was employed. The case is defined as the influence of the Bologna Process on physiotherapy in higher education. Two independent groups were purposefully chosen to investigate the case as they met the criteria for information-oriented and context-dependent participants: the Heads of Departments of physiotherapy schools across Europe and the Country Coordinators of the European Network of Physiotherapy in Higher Education (Enphe). A multiple method approach, using both quantitative and qualitative data collection methods, was adopted. A survey method was employed to gather data from both groups and the findings were analysed using SPSS and reported as descriptive statistics. A semistructured interview method was employed to collect narrative data from twelve participants who were purposefully selected from the Enphe group. The interview transcripts were reviewed analytically and reported in a narrative manner by following the Framework Approach. The participation rate to the survey method involving Heads of Departments from 26 countries was 45.3% (91/201); and that involving the Enphe country coordinators was 82.1% (23/28).The Bologna Process was identified to have had an influence on the organisational governance of physiotherapy in higher education across Europe. Three key findings that emerged from this study show that these influences were on the degree structure and duration of programmes (including ECTS); Mobility and Quality. Issues of harmonisation & diversity were identified in relation to understanding the social factors that have determined and shaped any influences of the Bologna Process on physiotherapy in higher education. The implications of the findings from this study are that they lay down a foundation for further study into the conceptual and strategic organisational designs for future physiotherapy education.
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Bennett, Rosalie. "Maintaining the quality of clinical education in physiotherapy." Thesis, University of Birmingham, 2008. http://etheses.bham.ac.uk//id/eprint/204/.
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Government demands to increase the number of physiotherapy students have led to problems in acquiring extra placements in which these students can experience their clinical education. This problem has been accentuated by difficulties with recruitment and retention of physiotherapy staff that might take on the role of clinical educator. This study uses empirical data to explore how further placements could be found without compromising the quality of the learning experiences. Action research is used to identify current practice and areas where change may be advantageous. Perceptions are drawn from professionals and students - physiotherapy managers, clinical educators and physiotherapy students. Data collecting techniques include interviews (13 physiotherapy managers) and five questionnaires – with clinical educators (n=67 and 42) and students (n= 73, 76 and 62) as samples. All data are triangulated to justify the study findings. The findings are framed around concepts of management and learning within clinical education. Evidence that emerged during the action research process led to two main changes. Firstly more junior grades of physiotherapy staff were included within the pool of clinical educators. Secondly a new ‘model’ of facilitating learning was established through the creation of ‘learning teams’ where both students and clinical educators worked together to share and develop knowledge. Changes meant that increased student numbers were accommodated without compromising quality. This was demonstrated through positive student evaluation of clinical placements at the end of their degree course. The impact of accommodating students within physiotherapy settings is discussed in relation to departmental, personal and professional management. Priority could be given to improving how student learning might influence not only personal but also professional development.
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Brocki, Barbara C. "Physiotherapy interventions and outcomes following lung cancer surgery." Doctoral thesis, Örebro universitet, Institutionen för hälsovetenskap och medicin, 2015. http://urn.kb.se/resolve?urn=urn:nbn:se:oru:diva-45728.
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The aim of this thesis was to evaluate the effect of exercise training and inspiratory muscle training and to describe pulmonary function, respiratory muscle strength, physical performance and health-related quality of life (HRQoL) following lung cancer surgery. Study I was a randomised controlled trial including 78 patients radically operated for lung cancer. The intervention group received 10 sessions of supervised exercise training in addition to home-based exercise; the control group was instructed on home-exercise alone. Supervised compared to non-supervised exercise training did not result in differences between groups in HRQoL, except for the SF-36 bodily pain domain four months after the surgery. No effects of supervised training were found for any outcome after one year. Study II was descriptive and was based on the study I sample. We evaluated the course of recovery of HRQoL and physical performance up to one year following surgery. All patients improved HRQoL and physical performance one year after the surgery, reaching values comparable to a reference healthy population. The walked distance was positively associated with the SF-36 domain for physical functioning. Study III was descriptive, included 81 patients and evaluated the influence of surgery on respiratory muscle strength, lung function and physical performance two weeks and six months after surgery. We found that respiratory muscle strength was not affected after the second postoperative week and that muscle-sparring thoracotomy did not deteriorate respiratory muscle strength, compared to video-assisted thoracic surgery. Compared to preoperative values, physical performance was recovered, whereas lung function remained reduced six months postoperatively. Study IV was a randomised controlled trial including 68 patients at high risk of developing postoperative pulmonary complications (PPC). This study evaluated the effects of two weeks of postoperative inspiratory muscle training in addition to breathing exercises and early mobilisation on respiratory muscle strength and the incidence of PPC. Additional inspiratory muscle training did not increase respiratory muscle strength, but improved postoperative oxygenation. Respiratory muscle strength was recovered in both groups two weeks postoperatively.
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Goldby, Lucy. "The physiotherapy management of chronic low back disorder." Thesis, University of Brighton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.251746.
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Musculoskeletal physiotherapy is the most common intervention for chronic low back disorder. Any observation on clinical practice or investigation into the clinical and scientific literature indicates that musculoskeletal physiotherapy encompasses a plethora of treatment modalities and approaches. The aim of the present investigation was to determine the most common intervention(s) that comprise musculoskeletal physiotherapy and to critically explore their empirical therapeutic basis. Two components were highlighted as the most frequently employed interventions; namely manually applied therapy (manual therapy) and exercise(s) to rehabilitate the lumbar spine's stabilising system. In the course of an extensive literature search, work was uncovered that suggested that the mechanisms required for spinal stability could be better facilitated using methods other than those in current clinical use. These discoveries culminated in the creation of a ten-week rehabilitation programme which was primarily developed to facilitate rehabilitation of spinal stabilisation but also permitted an empirical analysis of this component of musculoskeletal physiotherapy. The efficacy of the regime was then assessed in comparison to manual therapy and to a control (an education booklet) in a randomised controlled trial. Following a series of pilot studies, 300 patients with chronic low back disorder were randomly assigned to groups and completed their respective management programmes. Data were collected on pain, disability, handicap, impairment and quality of life prior to entry and at three, six, twelve and twenty-four months post intervention. The results indicated a consistent trend for greater improvement in the spinal stabilisation group in the pain, handicap, impairment, disability, dysfunction and medication variables. These trends reached statistical significance at the three-month follow-up stage as evidenced by quality of life (P = 0.025), at the six-month follow-up stage in pain (P = 0.009) and dysfunction (P = 0.042) and at the one-year follow-up stage in medication (P = 0.007), dysfunction (P = 0.048), disability (P = 0.0098) and quality of life (P = 0.003). It was therefore concluded that the spinal stabilisation programme was a more effective component of musculoskeletal physiotherapy (when analysed in isolation) than manually applied therapy or an education booklet in the management of chronic low back disorder. Various sub-analyses of the data were conducted. Subjects who entered the study with high levels of low back pain (greater than 50 numerical rating scale) demonstrated a statistically Significant reduction in pain levels (P = 0.04) in both the manual therapy group and the spinal stabilisation group in comparison to the education control group at the three-month follow-up stage. These data provide empirical evidence towards the efficacy of these two musculoskeletal physiotherapy management regimes as being effective in pain reduction in comparison to an active control intervention. This has not hitherto been demonstrated on patients with chronic low back disorder.
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Roberts, Penelope Anne. "The practice of physiotherapy : theoretical and contextual reflections." Thesis, Sheffield Hallam University, 2000. http://shura.shu.ac.uk/20795/.
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This thesis is an examination of the practice of physiotherapy, an exploration of the context within which the profession of physiotherapy developed and an identification of the theoretical frameworks within which it is practised. The experiences of physiotherapists and nurses working in particular settings at a specific point in the development of the profession provided a starting point for the study. Physiotherapy, a profession openly dependent for a significant part of its history on medicine for its practice and knowledge base, is contextualised with reference to the development of a medical hegemony, the changing role of women in society, and the development of specialisms within physiotherapy. A methodological framework was developed through the use of a naturalistic design which places the researcher within the study and legitimises personal perspectives. Knowledge of the field prior to the study, fieldwork observations, and findings from two sets of interviews generated the data which provided the framework for an exploration of the theoretical base for the practice of physiotherapy. The thesis concludes by examining the components of context and theory which are fundamental to the practice of theory, and places them within a new framework. This new framework or paradigm is based on a re-evaluation of the concept of holism and goes back to the origins of this model which developed amidst the chaos of post-Boer was South Africa. The meaning of holism has been changed to make it nearer the concept of summative dualism which fits well with key concepts of balance, harmony and homeostasis. True holism is about movement and change and this is proposed as an appropriate model on which to base a paradigm for physiotherapy.
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Sacco, Mark. "Modernising the Maltese physiotherapy curriculum : an empirical study." Thesis, Sheffield Hallam University, 2008. http://shura.shu.ac.uk/20801/.
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Following a poliomyelitis epidemic, physiotherapy was introduced to Malta in 1943 based on the curriculum of the English Chartered Society of Physiotherapy and has remained the core of Maltese physiotherapy courses. However, health services in Malta are undergoing major changes in policy and resources cumulating with the development of a new teaching hospital. The need was felt both from the clinical and academic perspectives that the inherited curriculum needed review to ensure it meets the current requirements of local stakeholders including those of overseas authorities. Various research methodologies were examined and a qualitative approach using an 'Action Research' paradigm was identified as the most appropriate. Seven cycles of planning, action and evaluation using documentary research and interviews with: educators, students, practitioners, patients, management as well as the professional body were undertaken. 'Thematic Analysis' was used to interpret and analyse the data. To triangulate the data collected during the previous cycles, Q Methodology was applied as a means to offer an empirical explanation to the qualitative data collected previously. During the early stages of the study the data indicated that both students and academia were not content with the curriculum and expressed scepticism that the study will result in change. As the study developed their interest increased, becoming actively involved in the research process resulting in the empowerment of the primary stakeholders to ameliorate their curriculum, work and working environment. Throughout the study changes to the course design, content, teaching and assessment methods of the curriculum have occurred, encouraging students to become critical and reflective practitioners. The study resulted in two curricula being designed; a workable curriculum acceptable to the University which would satisfy the needs of both local and foreign requirements and an 'ideal' curriculum for future implementation. Importantly this study offers a model and methodology for designing professional curricula that could be utilised by other professions, both locally and abroad. Finally, suggestions for further and future considerations are presented.
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Frank, Denise M. "Reporting of ethical requirements in published physiotherapy research." Master's thesis, University of Cape Town, 2004. http://hdl.handle.net/11427/2688.
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Banda, Faith. "Physiotherapy management of spina bifida in Lusaka, Zambia." University of the Western Cape, 2016. http://hdl.handle.net/11394/5073.
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Magister Artium - MABackground: Spina Bifida (SB) is one of the leading causes of disability in children globally. Its management in Sub-Saharan countries is quite challenging and has shown to be an expensive public health problem. A recent study on SB has shown that physiotherapy is poorly utilised in Zambia. Although it is very cardinal in the rehabilitation of children right from birth, very little is known on the role of physiotherapy in the management of children with SB. Aim: To investigate the role of physiotherapy in the management of SB patients both at the University Teaching Hospital (UTH) and Beit Cure International Hospital (BCIH) during the period: January 2010 to December 2014. Study design: A sequential explanatory mixed study design was used for this study. An adapted validated data extraction form was used to capture quantitative data from hospital records, while an interview guide was used in in-depth interviews and Focus Group Discussion (FGDs) with specialist physiotherapists. Data analysis: Quantitative data was analysed using SPSS version 23 and descriptive statistics represented on graphs, charts and tables in form of percentages and frequency distributions. Qualitative data was audiotaped during the focus group discussion and in-depth interviews, transcribed verbatim and thematic analysis was used. Results: A total number of 207 children with SB were managed during the period under review at the two hospitals with the most prevalent type of SB being myelomeningocele and hydrocephalus at 69.4%, commonly located in the lumbar region 53.3%, prone in female patients 55.6%. A total of 38% had an increased tone while 2% had low tone indicating the need for physiotherapy. Through purposive sampling, a total of eight physiotherapists took part in the qualitative study. Results showed that there are poor referral systems for physiotherapy at the two hospitals making follow up quite difficult at times. Information on physiotherapy sessions was not included in patient files but only indicated in the physiotherapy departmental registers. Some physiotherapists felt that their role in the rehabilitation process was not known amongst team members such as surgeons. However, the availability of assistive devices at the hospitals helped provide better services which in turn promoted improvement in patients and also contributed to motivation. Conclusion: Having undergone some training as rehabilitation team members, all the physiotherapists noted that training helped to empower them, gain experience and changed attitudes of some rehabilitation team towards them. It is therefore recommended that the referral system and documentation be improved upon in order to effectively work together as a rehabilitation team with common goals.
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Nel, Corne. "Establishing a peer mentorship program for physiotherapy students." Diss., Pretoria : [s.n.], 2008. http://upetd.up.ac.za/thesis/available/etd-06022009-174733.
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Leung, Joan Wai King. "Physiotherapy management of contractures after acquired brain injury." Thesis, The University of Sydney, 2014. http://hdl.handle.net/2123/12547.
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The first part of the thesis investigates treatments for contracture management. The hypothesis is that passive stretch is effective when a high intensity is used and when it is combined with treatments that target the underlying causes of contractures. To support this hypothesis, a case report was presented which described a resolution of severe knee contractures following an intensive program of passive stretch administered in conjunction with motor control training. Two randomised controlled trials were conducted to assess if electrical stimulation was an effective adjunct treatment to address spasticity and muscle weakness, factors believed to contribute to contractures. The findings of both studies demonstrate that electrical stimulation administered in conjunction with passive stretch is not more useful than passive stretch alone for people with severe motor and cognitive impairments. This result highlights a need to consider other treatment options in future research. The second part of the thesis investigates the impact of ankle contractures on the knee joint. An observational study establishes the link between ankle contractures and increased knee extension, and identifies the two gait patterns that are associated with simulated ankle contractures. This information contributes to the understanding of gait deviations that are secondary to ankle contractures.
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Ajjawi, Rola. "Learning to communicate clinical reasoning in physiotherapy practice." Thesis, The University of Sydney, 2006. http://hdl.handle.net/2123/1556.
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Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.
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Ajjawi, Rola. "Learning to communicate clinical reasoning in physiotherapy practice." University of Sydney, 2006. http://hdl.handle.net/2123/1556.
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Doctor of Philosophy (PhD)Effective clinical reasoning and its communication are essential to health professional practice, especially in the current health care climate. Increasing litigation leading to legal requirements for comprehensive, relevant and appropriate information exchange between health professionals and patients (including their caregivers) and the drive for active consumer involvement are two key factors that underline the importance of clear communication and collaborative decision making. Health professionals are accountable for their decisions and service provision to various stakeholders, including patients, health sector managers, policy-makers and colleagues. An important aspect of this accountability is the ability to clearly articulate and justify management decisions. Considerable research across the health disciplines has investigated the nature of clinical reasoning and its relationship with knowledge and expertise. However, physiotherapy research literature to date has not specifically addressed the interaction between communication and clinical reasoning in practice, neither has it explored modes and patterns of learning that facilitate the acquisition of this complex skill. The purpose of this research was to contribute to the profession’s knowledge base a greater understanding of how experienced physiotherapists having learned to reason, then learn to communicate their clinical reasoning with patients and with novice physiotherapists. Informed by the interpretive paradigm, a hermeneutic phenomenological research study was conducted using multiple methods of data collection including observation, written reflective exercises and repeated semi-structured interviews. Data were analysed using phenomenological and hermeneutic strategies involving in-depth, iterative reading and interpretation to identify themes in the data. Twelve physiotherapists with clinical and supervisory experience were recruited from the areas of cardiopulmonary, musculoskeletal and neurological physiotherapy to participate in this study. Participants’ learning journeys were diverse, although certain factors and episodes of learning were common or similar. Participation with colleagues, peers and students, where the participants felt supported and guided in their learning, was a powerful way to learn to reason and to communicate reasoning. Experiential learning strategies, such as guidance, observation, discussion and feedback were found to be effective in enhancing learning of clinical reasoning and its communication. The cultural and environmental context created and supported by the practice community (which includes health professionals, patients and caregivers) was found to influence the participants’ learning of clinical reasoning and its communication. Participants reported various incidents that raised their awareness of their reasoning and communication abilities, such as teaching students on clinical placements, and informal discussions with peers about patients; these were linked with periods of steep learning of both abilities. Findings from this research present learning to reason and to communicate reasoning as journeys of professional socialisation that evolve through higher education and in the workplace. A key finding that supports this view is that clinical reasoning and its communication are embedded in the context of professional practice and therefore are best learned in this context of becoming, and developing as, a member of the profession. Communication of clinical reasoning was found to be both an inherent part of reasoning and an essential and complementary skill necessary for sound reasoning, that was embedded in the contextual demands of the task and situation. In this way clinical reasoning and its communication are intertwined and should be learned concurrently. The learning and teaching of clinical reasoning and its communication should be synergistic and integrated; contextual, meaningful and reflexive.
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Sexton, Mary. "Patient-centredness : a conceptual framework for musculoskeletal physiotherapy." Thesis, University of Brighton, 2011. https://research.brighton.ac.uk/en/studentTheses/7b5f1fd2-cfdd-47ba-b05f-f5d4d12d96e1.
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Introduction The centrality of the patient to health care has been increasingly recognised both politically and professionally. Patient-centred care has become synonymous with high-quality care and a number of studies have reinforced patient's desire for, and the positive impact of the approach. Although the concept emerged over 30 years ago, it is still not clear what it is, upon what theories it is based, or how to measure it. Whilst the concept has been explored within medicine, nursing and other allied health professions, within physiotherapy there has only been minimal discussion. The aim of this research was to explore the meaning of patient-centred care in relation to low back pain, from the perspective of musculoskeletal physiotherapists. Methods Purposive sampling was initially used to select participants. Subsequently theoretical sampling was adopted whereby analysis of the data informed the sample selection. Nine musculoskeletal physiotherapists agreed to participate in the study. They ranged in experience from five to 25 years. Individual semi- structured interviews were adopted as the method of data collection. The interviews were audio taped and then transcribed verbatim. Analysis broadly followed the Grounded Theory approach outlined by Strauss and Corbin (1990). It consisted of a process of open, axial and selective coding. Constant comparative analysis resulted in the identification with a core category and three inter-related sub-categories and the development of a substantive theory of patient-centred care.
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Klepper, Karin. "Family-centred physiotherapy for children with developmental coordination disorder /." [St. Lucia, Qld.], 2005. http://www.library.uq.edu.au/pdfserve.php?image=thesisabs/absthe19188.pdf.
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Elliot, Michael. "Happiness in the private physiotherapy sector of South Africa." Thesis, Nelson Mandela Metropolitan University, 2017. http://hdl.handle.net/10948/15171.
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There is limited research pertaining to assessing the happiness levels of various disciplines within the healthcare industry. Furthermore, happiness and physiotherapy studies are two research areas that are not necessarily associated with one another on a global perspective. Hence, the happiness levels have not been adequately established for private physiotherapists. This treatise is the first attempt to evaluate the happiness levels of private physiotherapists in South Africa. A thorough literature review was conducted to determine the current climate of happiness studies pertaining to the business industry, with focus on private physiotherapy businesses in the healthcare sector. The literature review enabled the development of a hypothesised model, which was tested with quantitative techniques consisting of a questionnaire, data collection and statistical analysis. The research confirmed that influence, social relations, life balance, optimism, work and leisure are all positively associated with the happiness levels of private physiotherapists in South Africa. These variables are recommended as key focus areas for physiotherapy business owners to address, in order to positively affect happiness levels in the workplace and thereby create favourable bottom line results. In accordance with the reviewed literature and the findings of this treatise, by adequately addressing these variables the business owners of physiotherapy practices will generate a workforce that are more productive, demonstrate greater collaboration with colleagues and customers, produce happier customers, are more positively energised and are less absent and more loyal to the business. It is recommended that the proposed model is tested to provide further benefit to the industry by constructing evidence-based retention and recruitment strategies for high performing private physiotherapy staff.
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Sommerfeld, Disa. "Body function and activity after acute stroke : physiotherapy perspectives /." Stockholm, 2004. http://diss.kib.ki.se/2004/91-7349-828-9/.
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