Dirección de Gestión del Conocimiento
05 April 2021
Proporciona los pasos y procedimientos para acceder al recurso Access Physiotherapy.
16 August 2007
Pastaruoju metu daug diskutuojama paslaugų (ypatingai medicinos srityje) kokybės tema. Kadangi tema Lietuvoje aktuali, o mokslinių darbų atlikta labai nedaug, šis darbas turėtų tapti savotišku įnašu į sveikatos apsaugos paslaugų kokybės gerinimą. Dažnai iškyla klausimas ar teisingai suprantama kineziterapijos sąvoka ir kineziterapeuto kaip reabilitacijos specialisto atliekamas darbas. Todėl mūsų tyrimas leis geriau suprasti kokiame lygmenyje šiuo metu yra kineziterapijos specialistas, kokia vieta Lietuvos sveikatos apsaugos sistemoje ir įstatymų bazėje yra skiriama kineziterapeutui. Atliekamas tyrimas leis atlikti gilesnę analizę tarp pacientų ir medikų supratimo apie kineziterapeuto funkcijas, tikslus, uždavinius ir reabilitacinės komandos nario veiklą Tyrimo tikslas – nustatyti kineziterapijos paslaugų kokybę ir įvertinti asmens sveikatos priežiūros įstaigų vadovų bei pacientų požiūrį į kineziterapiją. Buvo atlikta anketinė apklausa, kurioje dalyvavo Kauno asmens sveikatos priežiūros įstaigų vadovai ir pacientai. Tyrimui pasirinkta 400 pacientų ir 40 įstaigų vadovų, tyrimo imtis – 440 respondentų. Tiriamųjų amžius – nuo 30 iki 70 metų, 67% moterų ir 33% vyrų. Tyrimo dalyvių atranka buvo vykdoma tipiniu metodu. Gauti rezultatai parodė, kad daugiau nei pusė visų asmens sveikatos priežiūros įstaigų vadovų nežino kas yra kineziterapija ir kas penktas neatskiria kineziterapijos nuo elektroterapijos. Net 56,2 proc. vadovų kineziterapijos nepriskiria prie būtinos pagalbos... [toliau žr. visą tekstą] / Lately the topic of service quality (especially in the medicine area) is widely discussed. As this topic is very relevant in Lithuania, and there are little works performed in the area, this study should become a partial contribution to the improvement of the service quality in the health service area. It is being often questioned if the concept of physiotherapy and the work of physiotherapist as specialist are understood correctly. Thus, our study will allow understanding in what level the specialist of physiotherapy is currently located, and what place is dedicated to the physiotherapist in the health service system and legislation of Lithuania. The study performed allows deeper analysis of the understanding of patients and medical staff about the functions, aims, goals and the activity of physiotherapist as member of the rehabilitation team. Aim of study: Determine the quality of physiotherapy services and evaluate the approach of the management of medical institutions and of patients to the physiotherapy. The questionnaire survey was performed where the patients and the management of the medical institutions of Kaunas participated. There were selected 400 patients and 40 managers of institutions; the sample of study is 440 respondents. The age of participants was from 30 to 70 years; 67% of women and 33% of men. The participants were selected using typical method. The obtained results revealed that more than half of the managers of medical institutions are in ignorance... [to full text]
No description available.
10 August 2007
Wheelchair rugby originated in 1977 in Canada, as a sport for athletes with tetraplegia (quadriplegia).The game has grown into an intense physical team sport for both female and male with a variety of disabilities involving all four limbs. Athletes are systematically grouped into sport classes according to their ability to move and perform basic functional skills in their specific sport. This allows for fairness. Cerebral palsy (CP) players joined the wheelchair rugby. Because the CPâs disability lies on a total different level, classifiers find it difficult to classify them correctly. The aim of the study as to explore whether the present classification system disadvantages the CP wheelchair rugby players. An explorative descriptive research design was used. Data was gathered by the use of the nominal group technique. The research took place at the 2005 International Wheelchair Amputee Sport championships in Brazil. Seven specialists in the field of wheelchair rugby participated in the study. The findings of the study and the conclusion reached indicated that there is a definite need for a different and more functional approach to bench testing cerebral palsy wheelchair rugby players. A new bench test format should be developed and could then be suggested to the International Wheelchair Rugby Federation for possible future inclusion in the classification manual.
PREVELANCE OF NEURODEVELOPMENTAL SEQUELAE IN INFANTS WHO SUFFERED MODERATE TO SEVERE NEONATAL ASPHYXIASmith, Robyn 07 December 2006 (has links)
Globally four to nine million cases of newborn asphyxia occur each year. Despite major advances in monitoring technology, obstetric care and knowledge of fetal and neonatal pathologies, asphyxia remains a serious condition causing significant mortality and longterm morbidity. More than a million newborns that survive asphyxia at birth develop longlasting problems such as cerebral palsy, speaking, hearing and visual disabilities. The role of the physiotherapist in the follow up, assessment and early intervention of at risk infants is poorly researched and subject to much debate. The aims of the study were two-fold. The primary aim was to determine the proportion of neurodevelopmental sequelae in infants who suffered moderate to severe neonatal asphyxia. The secondary aim was to describe the population regarding maternal, neonatal and referral risk factors associated with asphyxia. This retrospective descriptive study included a study population of all infants diagnosed with grade II or III neonatal asphyxia admitted to the Pelonomi Hospital neonatal unit. All subjects had to have had a physiotherapy neurodevelopmental assessment between the ages of six weeks and twelve months of age. A total of 40 subjects were included in the study. Five subjects were lost to follow up and five did not meet the inclusion criteria. Information contained in the subjectsâ medical record and physiotherapy file were used to complete a data form. The Data form contained the neurodevelopmental assessment score (NDS), which served as the objective measure for neurodevelopmental outcome. The NDS for the grade II and grade III subjects showed no statistical difference, whilst there was a tendency towards the grade IIIâs having a higher score indicating poorer developmental performance. The results indicated that 32% of the subjects presented with neurodevelopmental sequelae following moderate to severe birth asphyxia. In terms of risk factors this study found that hypertensive disease of pregnancy and intrauterine growth restriction were the most prevalent maternal risk factors. Neonatal risks indicated the majority of subjects had low (< 7) Apgar scores at both five and ten minutes of life. Five infants required mechanical ventilation following initial resuscitation. In 41% of the subjects, mothers resided outside of Bloemfontein at the time of the birth, and 37% of the deliveries occurred at a primary health care facility. Of the subjects 62% were delivered vaginally and 38% via caesarian section. In conclusion the study indicates that developmental sequelae are common in this study population. In some cases developmental delays were observed as early as six weeks of age. Neurological impairments however were only observed from nine months of age. It would therefore be suggested that all moderate to severely asphyxiated infants be followed up routinely and assessed by a physiotherapist for developmental problems from six weeks of age and on. A routine assessment by an occupational and speech therapist is also advised.
Myofascial pain syndrome is characterized by sensory, motor and autonomic symptoms, and a myofascial trigger point (MTrP) is considered the principal clinical feature. Clinicians recognise myofascial pain syndrome as an important clinical entity but many basic and clinical issues need further research. Electrophysiological studies indicate that abnormal electrical activity is detectable near MTrPs. This phenomenon has been described as endplate noise and it has been purported to be associated MTrP pathophysiology. Authors also suggest that MTrPs are located in the innervation zone (IZ) of muscles. The aim of this thesis was to describe both the location of MTrP and the IZ’ locations in the upper trapezius muscle. The hypothesis was that distance between the IZ and the MTrP in upper trapezius muscle is equal to zero. This thesis includes two preliminary studies. The first one address the reliability of surface electromyography (EMG) in locating the IZ in upper trapezius muscle, and the second one address the reliability of a manual palpation protocol in locating the MTrP in upper trapezius muscle. The intrarater reliability of surface EMG in locating the IZ was almost perfect; with Kappa = 0.90 for operator A and Kappa = 0.92 for operator B. Also the interrater reliability showed an almost perfect agreement, with Kappa = 0.82. Both the operators conducted 900 estimations of IZ’ location through visual analysis of the EMG signals. The reliability of an experienced physiotherapist using a manual palpation protocol in locating the MTrP in the upper trapezius was established. An anatomical landmark system was defined and MTrP’ location established using X and Y values. The ICC values were 0.62 for X and 0.81 for Y. Twenty-four subjects with MTrP in upper trapezius were enrolled for this latter study. MTrP’ and IZ’ locations were described in 48 subjects. MTrPs were located in well-defined areas of the upper trapezius, showing a typical location with a mean distance from the IZ of 10.4 ± 5.8 mm. MTrPs in the upper trapezius are proximally located to the IZ but not overlapped by it (p = 0.6). These results extend the body of knowledge regarding the phenomenon of MTrP iperalgesia.
The effects of a pragmatic community exercise programme in adolescents and young adults with cerebral palsyZanudin, Asfarina January 2017 (has links)
Evidence suggests that the walking ability of people with cerebral palsy (CP) often deteriorates in early adulthood. This is especially problematic as the health care for young people with disabilities changes considerably over the course of the transition from paediatric to adult health care services. This suggests the importance of providing young people with the appropriate tools for managing their disability on a largely independent basis if they hope to reduce or delay this physical decline. One such strategy is the introduction of young people to an exercise programme which may be carried out independently of the health care system. Therefore, the main aim of this thesis was to investigate the feasibility and effectiveness of an 18-week pragmatic community exercise programme in adolescents and young adults with CP. Acknowledging the importance of assessing the effects of exercise studies using outcome measures (OMs) which are reliable, valid and responsive to change, a secondary aim of this thesis was to synthesise the psychometric evidence for the measures of gait quality and walking performance currently used for adolescents and young people with CP through a systematic review. Additional psychometric evidence for measures commonly used to assess the efficacy of exercise interventions was provided by a test-retest reliability study as part of this thesis. A standardised quality checklist (COSMIN) was used in the systematic review (Study 1) to measure methodological quality. The strength of the evidence was rated using standardised guidelines. The synthesis of best evidence was scored according to the Cochrane criteria, which indicated that the reliability (inter-rater) of the Functional Mobility Scale was characterised by a ‘strong’ level of evidence. The evidence for the responsiveness for all OMs included in this review was rated as ‘unknown’. Only one study reported on measurement error when reporting on reliability. In Study 2, test-retest reliability (Intraclass Correlation Coefficient (ICC) and Minimal Detectable Change) was calculated for physical function, habitual physical activity (HPA), quality of life (QoL) and self-esteem measures in a group of adolescents and young adults with CP (n=8) and their age-matched peers (n=14). The ICCs for physical function and HPA OMs ranged from moderate to good but were poor for the measures of QoL and self-esteem. The RCT (Study 3) showed no statistically significant improvement following the exercise programme in any of the OMs at 6 weeks (experimental n=9, control n=7). A small effect size (d=0.54) in favour of the experimental group was found for the Canadian Occupational Performance Measure (COPM). Considering the experimental group only, a statistically significant improvement was found for the COPM at 12 weeks (n=7, p=0.02) compared to the baseline. Feasibility issues were also identified. This study was limited by its small sample size. This thesis contributes to the evidence base on pragmatic community exercise programmes for adolescents and young adults with CP and confirms the test-retest reliability (consistency) of physical function and HPA OMs commonly used to assess the efficacy of exercise interventions in CP.
An explorative study of factors influencing health-related quality of life in patients with femoral fracturesSiebritz, Ruth January 2013 (has links)
Includes abstract. Includes bibliographical references.
The effect of the Nintendo Wii Fit on the balance control and gross motor function of children with spastic hemiplegic cerebral palsyPronk, Marieke Daniela January 2010 (has links)
Includes bibliographical references (p.181-200). / Background: Balance and postural control are an integral part of gross motor function in activities of daily living. Studies have shown that children with hemiplegic cerebral palsy have poor directional specificity as well as problems with the temporal and spatial modulation of appropriate muscle action in response to balance perturbations. Children with hemiplegia have also been shown to develop direction-specific postural control at a slower pace than typically developing children. Apart from their postural muscle coordination problems, these children have difficulties with sensory integration which contributes to increased reaction time. Research on balance training in children with cerebral palsy has demonstrated that improved balance translates into more effective gross motor function. It appears that postural control mechanisms are still modifiable for children with cerebral palsy even in elementary to middle school ages. Physiotherapy treatment for children with cerebral palsy should therefore involve balance training as a focus of intervention. Literature on balance control and virtual reality rehabilitation justifies investigating the use of a commercially ~vailable gaming system, such as the Nintendo Wii Fit, as a rehabilitation tool to improve balance control and therefore gross motor function in children with cerebral palsy. Objective: To determine the effect of an intervention with the Nintendo Wii Fit on the balance control and gross motor function of children with spastic hemiplegic cerebral palsy.
Background: Respiratory problems, both acute and chronic, remain an important cause of disease burden for children worldwide. Airway clearance techniques, as part of the management of these conditions, might influence the course of the disease thereby reducing this burden. Objective: This PhD thesis aimed to explore the epidemiology and management of children with acute respiratory diseases admitted to a paediatric hospital in Cape Town, South Africa; and to determine the usefulness and safety of assisted autogenic drainage in children with an acute (pneumonia) or chronic (cystic fibrosis) respiratory disease. In order to do this, several linked studies were undertaken including a retrospective folder review, two systematic reviews and two pragmatic randomised controlled trials.
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