Physiotherapy Practice and Research - Volume 41, issue 2

Authors: Flahive, Mary | Broderick, Julie

Article Type: Research Article

Abstract: BACKGROUND: The relationship between physical function and the development of complications in people after abdominal surgery is not well known. The objective of this study was to prospectively examine the relationship between simple physical functioning tests and complications following abdominal surgery. METHODS: Participants were recruited from an elective surgery waiting list. The following variables were measured pre-surgery; functional capacity (Six Minute Walk Test, 30 Second Sit to Stand Test), grip strength (hand dynamometer), self-report physical activity [International Physical Activity Questionnaire, (IPAQ)]. At 30 and 60 days post-operatively IPAQ and self-reported recovery were collected by telephone. Data related to …complications and length of stay was extracted from the medical chart. RESULTS: Forty-nine participants (25M/18F) were recruited with a mean (SD) age of 59.5 (14.7) years. The complication rate was 41.9% (n  = 18). Factors which differed between the complications and no complications groups were; longer operating time (p  = 0.05),>2 co-morbidities (p  = 0.033), body mass index >30 (p  = 0.005), lower activity levels (p  = 0.02), VO2 Peak (p  = 0.017) and 6-minute walk distance (p  = 0.019). There was an increased length of stay (p  < 0.001) and sedentary time (p  = 0.007) in the complications group. Activity levels reduced in the whole group (p  < 0.001) even though self-report physical activity and recovery were high. CONCLUSION: A number of potentially modifiable physical functioning factors differed in the complication versus no complication groups. Future studies should evaluate whether optimizing physical functioning pre-operatively could alter complication rates and recovery in patients undergoing abdominal surgery. Show more

Keywords: Physical function, abdominal surgery, complications

DOI: 10.3233/PPR-190390

Citation: Physiotherapy Practice and Research, vol. 41, no. 2, pp. 177-185, 2020

Authors: Omranipour, Ramesh | Alipour, Sadaf | Eslami, Bita

Article Type: Case Report

Abstract: BACKGROUND: Late occurrence of solitary soft tissue upper extremity metastasis of breast cancer is very rare. We hereby present a case of metastasis to the biceps muscle of the ipsilateral arm, detected by a physiotherapist six years after mastectomy. The aim of this report is to highlight the rarity of this presentation, to emphasize the role of the physiotherapist as a member of the multidisciplinary treatment team and the possibility of curative treatment despite the poor prognosis. CASE DESCRIPTION: A 2 * 3 cm well-defined isolated metastasis of breast cancer was diagnosed in the left arm of …a 31-year-old woman 6 years after successful treatment of her primary tumor. Tumor characteristics, diagnostic plan, and treatment options are discussed. CONCLUSION: Due to its scarcity, there is a lack of knowledge about the frequency, interval, characteristics, best diagnostic modality, adequate treatment, and prognosis of isolated breast cancer metastasis to the soft tissue, and these can be found out by proper reporting. As an important member of the multidisciplinary team in the care and treatment of breast cancer patients, physiotherapists should be aware of this type of rare presentation. Show more

Keywords: Breast cancer, metastasis, soft tissue

DOI: 10.3233/PPR-200402

Citation: Physiotherapy Practice and Research, vol. 41, no. 2, pp. 187-191, 2020

Authors: O’Connor, Anne | McCurtin, Arlene

Article Type: Research Article

Abstract: BACKGROUND: Limited evidence exists regarding practice educators’ and practice tutors’ experience of, and training in, student supervision in the physiotherapy workplace. This knowledge would inform universities of their learning needs and help to enhance the practice-based experience for physiotherapy students. OBJECTIVE: The aim of this study was to create a profile of physiotherapy practice educators’ and practice tutors’ student supervision experience, university support available to them during practice placement and training undertaken by them. This study was undertaken in the Republic of Ireland. METHODS: An online survey was designed and circulated via the Irish Society of …Chartered Physiotherapists’ database of physiotherapy members. RESULTS: One hundred and ninety-two practice educators and 71 practice tutors participated. Findings indicate that the 1:1 model of practice education is the predominant model of practice education employed in the Republic of Ireland. 70% of practice educators currently receive support from a practice tutor. Fifty-five percent of practice educators undertake student supervision 2-3 times per year. However, 56% of practice educators and 48% of practice tutors had not undertaken training in student supervision in the year prior to the study. A decline was also noted in the uptake of student supervision among clinicians with 16–25 years clinical experience. CONCLUSION: This study provides an insightful profile of physiotherapy practice education in the Republic of Ireland. Findings are encouraging, with data highlighting that most practice educators are supported by practice tutors. Recommendations include the need for further investigation of the apparent decline in student supervision among experienced clinicians. Consideration of the learning needs of practice educators and practice tutors is encouraged as well as a review of the accessibility and flexibility of training resources provided. Show more

Keywords: Physiotherapy, practice education, practice educator, practice tutor, supervision

DOI: 10.3233/PPR-200427

Citation: Physiotherapy Practice and Research, vol. 41, no. 2, pp. 193-199, 2020

Authors: Whelehan, Dale F. | Baily-Scanlan, Maria | Ridgway, Paul F.

Article Type: Research Article

Abstract: INTRODUCTION: Health professionals have been subject to increased levels fatigue when compared to population norms. It remains unknown if physiotherapists report high levels of sleep deprivation. This paper explores levels of sleep deprivation, and its potential impact on professional performance. METHODS: A survey was distributed through the Irish Society of Chartered Physiotherapists. The survey explored work characteristics, sleep quality using the Pittsburgh Sleep Quality Index, daytime sleepiness using the Epworth Sleepiness Scale, and the professional and non-professional causes of sleep deprivation in the profession. Pearson correlation and independent t -tests were used on SPSS to explore relationship between …variables. RESULTS: There was a total of 559 valid respondents. Females accounted for 82% and public sector employees accounted for 63% of respondents. Over half (50.1%) of respondents said they felt sleep deprivation impacted on their practice. Most physiotherapists (63.3%) of respondents said they did not feel that their practice impacted sleep. The PSQI global score was 5.6 indicating “poor” quality of sleep. The ESS global score was 6.0 indicating ‘higher normal daytime sleepiness’. Potential causes of sleep deprivation included professional issues relating to burnout and work-life balance, and non-professional reasons such as parenthood. DISCUSSION AND CONCLUSION: A mismatch exists between self-reported sleep deprivation and validated measurements of sleep indicating poor self-awareness of the impact of sleep in optimising professional performance. A work-life balance is needed to facilitate a safe and efficient workforce. Individual and organizational efforts should be made to improve sleep quantity and quality to reduce personnel fatigue and enhance physiotherapists professional performance. Show more

Keywords: Sleep deprivation, performance, fatigue, performance management

DOI: 10.3233/PPR-200400

Citation: Physiotherapy Practice and Research, vol. 41, no. 2, pp. 201-211, 2020

Authors: Ross, Michael | Purrington, Benjamin | Zuniga, Colleen | Farnand, Brian | Pattacciato, Florianna

Article Type: Research Article

Abstract: PURPOSE: It is estimated that up to 80% of patients referred to outpatient physical therapy have diabetes, prediabetes, or diabetes risk factors; thus, physical therapists are in an optimal position to intervene as members of a multidisciplinary team working to effectively manage and reduce the diabetes epidemic. The purpose of this study is to assess the knowledge, practices, attitudes and beliefs of private practice physical therapists toward patients with prediabetes. METHODS: One thousand members of the Private Practice section of the American Physical Therapy Association were randomly selected through a random number generator to participate. Participants completed a …paper based survey that was specifically designed for this study. RESULTS: Sixty-three physical therapists (34 males, 29 females; mean age: 52.8±11.5 years; mean number of years of clinical practice: 25.7±12.3 years) agreed to participate. The majority of participants (79%) agreed that identifying prediabetes in their patients is important; only 3% identified all of the risk factors that should prompt prediabetes screening. Seventy three percent of participants identified the correct laboratory test to screen for diabetes;<10% could identify the correct laboratory parameters for diagnosing prediabetes and diabetes. Only 2% and 22% of participants could identify correct weight loss and physical activity recommendations, respectively. CONCLUSION: A number of gaps in the knowledge of private practice physical therapists were noted in this study. These results may have important implications for the education of private practice physical therapists, especially those providing care for patients without a referral who are at risk for diabetes. Show more

Keywords: Physical therapy, prediabetes, screening, management

DOI: 10.3233/PPR-190384

Citation: Physiotherapy Practice and Research, vol. 41, no. 2, pp. 213-223, 2020