<p> Home health care is heavily utilized to assist homebound clientele with a variety of medical needs. Home health services greatest population is the baby boomers. This population has multiple chronic medical problems that requires surgical intervention, disabilities that limit mobility, many suffer from a loss of mental capacities, or they suffer from depression which affects their physical and mental well-being. Because this population will continue to grow over the next several years, there will continue to be a growing need for home health care. RTK Home Health Services proposes to improve the home care delivered to this population by introducing a new psychological concept that is currently helpful in Psychiatry. The goal is to introduce this service during therapy sessions to decrease the emotional perception of pain by meditating. The full name of this service is Mindfulness Based Stress Reduction Techniques. It is accomplished by instituting meditation prior to therapy to convince the client to control and manipulate their perception to pain during therapy.</p><p>

Despite the education, autonomy, and high demand for physical therapists both nationally and in Florida, recent graduates have seen steadily rising education costs with disproportionate changes in income once they have graduated and entered the workforce. The growing debt burden of physical therapists entering the workforce, coupled with the growth in projected need and stagnant wages, raises concern about where and how entry-level physical therapists will practice and if these choices will be affected by their debt burden. The purpose of this quantitative, cross-sectional survey study was to identify the debt profile of entry-level physical therapists and explore the relationship between the student debt and clinical practice choices of entry-level physical therapists. The results of this study provide important findings and additional questions to be considered with these growing concerns surrounding student debt in physical therapy. The results of this study suggest that practice setting choice may be affected by physical therapists’ student debt and that student debt may be a barrier overall to career choices in physical therapy. Additional research and support for innovative models that reduce debt burden in academic physical therapy should be considered.

Patients with lower limbs problems are an increasing population in the US and many of them require surgery and its subsequent post-op Physical Therapy (PT). For all these patients, tracking their progress and evolution towards full recovery is very important. To assess the patients and track their progress, patients are usually required to perform very specific tests administered by a physical therapist. These tests either require very expensive equipment or rather require the subjective experience of the physical therapist who administer them. One of these tests is the Functional Gait Assessment (FGA) test, perhaps the most widely adopted one for gait assessment. This thesis presents a system for Clinical Gait Assessment using exclusively the sensors embedded in today’s smartphones. The system processes the raw sensor data to perform the FGA test and calculate additional metrics, capable of identifying problems in the human gait. The system is therefore objective, as it is based on measurements; cheap, as it only requires a smartphone; mobile, as it can be used pretty much anywhere; and self-care, as it does not need the presence of a physical therapist. The system was designed and tested on the Android OS with the phone attached to the back of the user using a belt or elastic band. It includes a new step detection algorithm with a mean absolute error of ±1 and algorithms to detect the deviation from a straight path with an accuracy of 90%, 80%, 35%, and 30% for each of the required deviation levels of the FGA test. Additionally, the system includes autocorrelation and DTW metrics, which provide additional information to detect different impediments of the user gait.

Magister Scientiae (Physiotherapy) - MSc(Physio) / There has recently been an increased pressure in all-healthcare disciplines to provide interventions that are scientific, safe, efficient and cost-effective. Evidence-based practice is said to be the current best approach to address these attributes. All healthcare professionals including physiotherapists need to adopt it. Numerous physiotherapy studies have been carried out to ascertain the attitudes towards, knowledge of, engagement in as well as the barriers of evidence-based practice. These studies were mostly carried out in the developed countries and almost none in the devloping African countries. By means of an exploratory cross-sectional study, deploying both quantitative and qualitative methods, this study investigated the Tanzanian physiotherapists attitudes towards the concept of evidence-absed practice. The study also examined the knowledge that they possess, that could enable them engage in evidence-based related activities. In addition, this study explored the barriers they experience while practicing evidence-based practice. / South Africa

Magister Scientiae (Physiotherapy) - MSc(Physio) / The aim of the current study was to determine the relationship between low back pain and physical activity levels among nurses in Kanombe Military Hospital (KMH), as well as other confounding factors leading to low back pain. A quantitative, cross-sectional and descriptive design was used to conduct the study. The study population and sample included all clinical nurses in all the departments/wards at KMH (excluding three nurses doing administrative work only and the four who participated in the pilot study). A total of 133 nurses participated in the study and data was collected using three self administered questionnaires. The first one requested socio-demographic data, followed by the International Physical Activity Questionnaire (IPAQ) which examined the physical activity levels of nurses, and lastly the Nordic Musculoskeletal Disorder Questionnaire which examined low back pain prevalence. A response rate of 122 (92%) was obtained. / South Africa

Little research has explored the dilemmas of practice experienced by practitioners working with rehabilitation clients who are assimilating disabilities, resulting from injury or chronic conditions, into their lives. Consequently, there is limited literature to support educational initiatives or clinicians' decision-making in these settings. Accordingly, this qualitative study was designed to explore 'expert' physical therapists' perceptions of dilemmas of practice in rehabilitation settings. Using an ethnographic design, multiple interviews were conducted over a period of six months with each of ten participants. The researcher's theoretical background and 'insider' role were thoroughly explicated. Interpretive analysis was grounded in three overarching themes that emerged from the participants' accounts and compared with relevant theoretical constructs and research in physical therapy and other health professions. In the first theme the 'authority' of the concept of evidence-based practice as it is currently promoted within physical therapy was questioned. A need was identified to develop rigorous alternative sources of 'evidence' to support current practice that are more congruent with the multifactorial and client-centred nature of rehabilitation service provision. A second theme explored situations interpreted as causing moral distress in which the participants found themselves prevented from acting effectively on behalf of the clients, as a result of admission and discharge decisions and perceived misuse of rehabilitation resources within the organization and health system. The third theme related to the advantages and disadvantages of being involved with the interdisciplinary team. A lack of understanding of different professional philosophies of practice was perceived as a contributing factor to conflict and miscommunication. These themes are related to issues of professional accountability and suggest that physical therapy needs to develop a clearly articulated philosophy and conceptual models, including the concept of client-centred practice, that would reflect practice, serve to guide research and promote interdisciplinary collaboration. Alternative sources of 'best' evidence need to be developed that more realistically reflect complex 'practice' knowledge. In addition, the profession needs to commit to developing a comprehensive ethics curriculum offered in education programs and through interdisciplinary learning opportunities, by which physical therapists will be better prepared for the moral deliberations inherent in their professional role. / Education, Faculty of / Educational Studies (EDST), Department of / Graduate

Orientador: Mauro Gonçalves / Banca: Camila Coelho Greco / Banca: Ulysses Fernandes Ervilha / Resumo: O processo de envelhecimento é acompanhado de diversas alterações no sistema neuromuscular as quais interferem em atividades motoras tais como a marcha. Essas alterações tornam o padrão de movimento menos eficiente, propicia que o indivíduo atinja mais rapidamente a fadiga e aumenta o risco de quedas na população idosa. O objetivo do presente estudo foi analisar o efeito da fadiga em variáveis biomecânicas durante a marcha em velocidade de preferência em idosas. Participaram do estudo 22 voluntárias do gênero feminino, na faixa etária de 60 a 85 anos, não institucionalizadas. A coleta de dados foi realizada em dois dias. No primeiro dia foi feita a anamnese, aplicação da escala de equilíbrio de Berg e o Mini Exame do Estado Mental, e realizado o protocolo para determinação da velocidade de preferência de marcha em esteira e familiarização das voluntárias aos procedimentos de coleta. No segundo dia foi realizada a avaliação da marcha, a qual inicialmente foi realizada em solo, seguida do protocolo incremental de fadiga na esteira ergométrica e, posteriormente, a reavaliação em solo... / Abstract: The aging process is accompanied by several changes in the neuromuscular system, which interferes with motor activities such as walking. These changes make the movement pattern less efficient, leading the individual to a faster fatigue onset and increasing the risk of falls in the elderly population. The aim of the present study was to analyze the effect of an incremental protocol fatigue on biomechanical gait variables during preference gait speed in elderly. The study included 22 female volunteers, aged 60-85 years, not institutionalized. Data collection was done in two days. On the first day volunteers were questioned about their fall history and use of drugs, Berg Balance Scale, Mini -Mental State Examination, protocol of preference gait speed determination and familiarization were performed. On the second day volunteers did the gait assessment, which was initially made in ground, followed by the incremental fatigue protocol on the treadmill and then the reassessing gait performance in ground. The gait assessment consisted in acquisition of EMG, kinematic and kinetic data during gait in preferred speed... / Mestre

Orientador: Márcia Rodrigues Franco Zambelli / Banca: Diego Giulliano Destro Christofaro / Banca: Bruno Tirotti Saragiotto / Resumo: Introdução: Apesar dos benefícios, a participação em níveis suficientes de atividade física (AF) entre as pessoas com 65 anos ou mais é a menor quando comparado com qualquer faixa etária. Embora os níveis de atividade física possam ser medidos por meio de métodos objetivos ou autorrelatados, o último tem maior risco de viés, principalmente entre pessoas mais velhas. Medidas objetivas de atividade física, no entanto, são usadas para aumentar a precisão, eliminando possíveis vieses nas respostas. Revisões sistemáticas publicadas anteriormente que investigam a eficácia de intervenções que promovem atividade física compilaram dados de medidas subjetivas e objetivas de atividade e, até onde sabemos, não há revisões sistemáticas que avaliem o impacto dessas intervenções apenas nos desfechos objetivos. Objetivo: Avaliar o efeito de intervenções que promovem a atividade física em níveis de atividade física mensurados objetivamente em idosos residentes na comunidade. Realizamos uma revisão sistemática buscando cinco bases de dados internacionais eletrônicas e os principais registros de ensaios clínicos. Foram considerados elegíveis ensaios clínicos randomizados controlados com o efeito de intervenções de atividade física em níveis de atividade física objetivamente medidos (por exemplo, usando acelerômetros ou pedômetros) em pessoas idosas da comunidade em comparação com nenhuma ou mínima intervenção. Os estudos foram agrupados e calculado o efeito usando a diferença média padronizada.... (Resumo completo, clicar acesso eletrônico abaixo) / Abstract: Background: Despite these benefits, participation in sufficient levels of physical activity 0(PA) among people aged 65 years and older is the lowest of any age group. Although physical activity levels can be measured through objective or self-reported methods, the latter is prone to recall bias, particularly among older people. Objective physical activity measures, however, are used to increase accuracy, eliminating possible biases in responses. Previously published systematic reviews investigating the efficacy of interventions that promote physical activity have compiled data from subjective and objective measures of activity and, to our knowledge, there are no systematic reviews that evaluate the impact of these interventions on objective outcomes alone. Purpose: To evaluate the effect of interventions aiming to promote physical activity on objectively measured physical activity levels among older adults living in the community. We performed a systematic review searching five electronic international databases and the main clinical trial registries. Randomized controlled trials investigating the effect of physical activity interventions on objectively measured physical activity levels (e.g, using accelerometers or pedometers) in community-dwelling older people compared to none / minimal intervention were considered eligible.. Pooled effects were calculated using the standardized mean difference (SMD) and the Grading of Recommendations Assessment, Development and Evaluation ... (Complete abstract click electronic access below) / Mestre

Background:  Earthquakes and other natural disasters have increased over recent years, more people around the world are living with disabilities. The physical therapists have an important role to increase function and restore quality of life. Although it is stated that early rehabilitation intervention is an essential part of the health response there is limited information about the work and the experiences from physical therapists.  Aim: The aim of this study is to examine physical therapists’ experiences after the earthquakes in Nepal 2015.  Design: This study had a qualitative exploratory design, based on five individual semi-structured interviews using the communication platform zoom. The data was analysed by a qualitative content analysis and had an inductive approach.   Result: The physical therapists’ describes a chaotic situation, the psychological vulnerability in patients made it challenging to motivate and keep the patients focused on their rehabilitation. The huge influx of patients made it hard for the physical therapists to manage their time and led to compromised treatments and the need of early discharge of patients. The physical therapists had dual experiences about their role in the healthcare teams. There was a clear system on how to prioritize the patients based on severity of injuries. Conclusion: This study showed that physical therapists in Nepal had an important role from acute care to follow-up after the earthquakes. The study provides an insight from physical therapists in disaster settings and may contribute to identify barriers in performing their work tasks in future disaster settings. / Bakgrund: Jordbävningar och andra naturkatastrofer har ökat de senaste åren, fler människor runt om i världen lever med kvarstående funktionshinder. Fysioterapeuterna har en viktig roll genom att öka funktionen och återställa livskvaliteten hos dessa patienter. Även om det tydligt anges att en tidig rehabiliteringsinsats är en väsentlig del av arbetet finns det begränsad information om erfarenheterna från fysioterapeuter. Syfte: Syftet med denna studie är att undersöka fysioterapeuters erfarenheter efter jordbävningarna i Nepal 2015. Metod: Denna studie hade en kvalitativ utforskande design, baserad på fem individuella semistrukturerade intervjuer med hjälp av kommunikationsplattformen zoom. Data analyserades med kvalitativ innehållsanalys och hade en induktiv ansats. Resultatsammanfattning: Fysioterapeuterna beskriver en kaotisk situation, den psykologiska sårbarheten hos patienter gjorde det svårt att motivera och hålla patienterna fokuserade på deras rehabilitering. En stor tillströmning av patienter gjorde det svårt för fysioterapeuterna att hantera sin tid och detta ledde till att behandlingar behövde kompromissas och ökade behovet av tidig utskrivning av patienter. Fysioterapeuterna hade tvetydiga erfarenheter av sin roll i vårdteamet. Det fanns ett tydligt system för hur man skulle prioritera patienterna baserat på svårighetsgraden av skador. Slutsats: Denna studie visar att fysioterapeuter i Nepal hade en viktig roll för patienten efter jordbävningarna, en roll som sträcker sig från akutvården till uppföljning. Studien ger tydlig insikt i hur fysioterapeuterna upplevde sitt jobb vilket skulle kunna bidra till identifiering av hinder för fysioterapeuter i utförandet sina uppgifter vid framtida katastrofsituationer.

Serving infants and toddlers and their families is the core of Part C under IDEA. Early motor delays have an increased risk for developmental delays in visual motor perception, social-emotional, and cognitive domains. Physical therapists in early intervention can assist families understanding of their child’s strengths and abilities so that families help their children develop and learn. The Division for Early Childhood (DEC) have recommended practice areas and special monograph series that guide practitioners in working with families. These document support promotion of the active participation of families in decision-making related to their child and development of a service plan for achieving the goals they hold for their child. In this interactive session, participants will learn about tools to help engage families to focus on intervention strategies in their natural enviornment. The session will challenge providers to think about their interactions with the child's family and how those interactions strengthen a family’s ability to support learning. Family-centered practices, family capacity-building practices and family and professional collaboration will be discussed with case examples. Participants will walk away with resources and tools to build capacity and tailor practice with families in their natural environment for best practice under IDEA.