Posts Tagged physiotherapist

[WEB SITE] Mental Health is Important. What You Can Do as a Physiotherapist

 

I understand that mental health is an important topic, but what can I do as a physiotherapist?

As health care professionals we are dedicated to improving a person’s well-being. As physiotherapists, we are comfortable within the realm of physical signs and symptoms, while sometimes neglecting the intimate connection between the physical and mental bodily spheres. It is undeniable that the two are mutually influenced, but how proficient are we as clinicians in recognizing and addressing this importance within a clinical setting?

Do you know what outcome measures are available to you for quantifying suspected mental health disturbances? Are you confident with who you should be referring your patients to, for the appropriate type of care? How equipped do you feel as a physiotherapist, with addressing a suspected underlying mental health imbalance with your patient? If you felt uncertain with any of your answers to these questions, you are certainly not alone.

October 10th is World Mental Health Day, which is the perfect opportunity for you to become more familiar with your role as a physiotherapist within a multi-disciplinary team, addressing this complex and often stigmatized subject.

Physiopedia and its content crew have been working diligently within the past month to promote mental health awareness and offer practical resources to physiotherapists.

Physiopedia has helpful pages on specific mental health disorders such as alcoholismattention deficit disordersbipolar disorderchronic pain and post-traumatic stress disorder (to name a few).  There are also several pages outlining the challenges and considerations when addressing a specific population such as the elite athlete, an individual affected by  a generalized anxiety disorderamputees, or a homeless population, for example.

Physiopedia is dedicated to helping physiotherapists feeling more confident and competent with their roles as health care providers when confronted with mental health factors. As such, Physiopedia offers supportive resources for identifying red flags, how to self-identify clinical burnout symptoms, and offer guidelines for clinically friendly mental health outcome measures. There are also online courses offered to members addressing Clinical Reflective Frameworks and mindfulness.

Lastly, there are numerous clinically applicable pages highlighting the benefits of exercise and physical activity with respect to promoting a strong mental and physical life balance. Notwithstanding that we all recognize the importance of movement for health, I encourage you all to take a look at the following pages as a reminder of the specific benefits for sound mental health:

I would like to take this opportunity to congratulate the Physiopedia team for their efforts in bringing mental health to the forefront of our practice this month. This is an impressive collection of resources that will only continue to grow over time. If you would like to contribute to this specialized topic, consider becoming a Physiopedia volunteer. If there are important topics or issues you would like to see on Physiopedia, feel free to let me know and contact me.

~Calm mind, calm body~

 

via Mental Health is Important. What You Can Do as a Physiotherapist – Physiospot – Physiotherapy and Physical Therapy in the Spotlight

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[ARTICLE] Automatic Control of Wrist Rehabilitation Therapy (WRist-T) device for Post-Ischemic Stroke Patient – Full Text PDF

Abstract

Since a decade, the wrist rehabilitation services in Malaysia has been operated by the physiotherapist (PT). Throughout the rehabilitative procedure, PT commonly used a conventional method which later triggered some problems related to the effectiveness of the rehab services. Timeconsuming, long-waiting time, lack of human power and all those leading to exhaustion, both for the patient and the provider. Patients could not commit to the therapy session due to logistic and domestic problems. This problem can be greatly solved with rehabilitation robot, but the current product in the market is expensive and not affordable especially for lowincome earners family. In this paper, an automatic control of wrist rehabilitation therapy; called WRist-T device has been developed. There are based on three different modes of exercises that can be carried out by the device which is the flexion/extension, radial/ulnar deviation and pronation/supination. By using this device, the patient can easily receive physiotherapy session with minor supervision from the physiotherapist at the hospital or rehabilitation centre and also can be conducted at patient home.

Full Text: PDF

 

References

N. Bayona,“The role of task-specific training in rehabilitation therapies,”Topics in Stroke Rehabilitation, vol. 12, 2005,pp. 58–65.

R. Bonita, R. Beaglehole, “Recovery of motor function after stroke,”Stroke, 1988,pp. 19.

S. Cramer, J. Riley, “Neuroplasticity and brain repair after stroke,”Current Opinion in Neurology,vol. 21, 2008,pp. 76–82.

D.J. Reinkensmeyer, J. Emken, S. Cramer, “Robotics, motor learning, and neurologic recovery,”Annual Review of Biomedical Engineering, vol. 6, 2004, pp. 497-525.

M. Takaiwa, “Wrist rehabilitation training simulator for P.T. using pneumatic parallel manipulator,”IEEE International Conference on Advanced Intelligent Mechatronics (AIM), 2016, pp. 276-281.

H. Al-Fahaam, S. Davis, S. Nefti-Meziani, “Wrist Rehabilitation exoskeleton robot based on pneumatic soft actuators,”International Conference for Students of Applied Engineering (ICSAE), 2016, pp. 491-496.

D. Dauria, F. Persia, B. Siciliano,“Human-Computer Interaction in Healthcare: How to Support Patients during their Wrist Rehabilitation,”IEEE Tenth International Conference on Semantic Computing (ICSC), 2016, pp. 325-328.

W.M. Hsieh, Y.S. Hwang, S.C. Chen, S.Y. Tan,C.C. Chen, and Y.L. Chen, “Application of the Blobo Bluetooth ball in wrist rehabilitation training,”Journal of Physical Therapy Science, vol. 28, 2016, pp. 27- 32.

A. Hacıoğlu, O.F. Özdemir, A,K, Şahin, Y.S. Akgül, “Augmented reality based wrist rehabilitation system,”Signal Processing and Communication Application Conference (SIU), 2016. pp. 1869-1872.

Z.J. Lu, L.C.B. Wang, L.H. Duan, Q.Q. Lui, H.Q. Sun, Z.I. Chen, “Development of a robot MKW-II for hand and Wrist Rehabilitation Training,”The Annual IEEE International Conference on Cyber Technology in Automation, Control and Intelligent Systems, 2016, pp. 302-307.

 

via Automatic Control of Wrist Rehabilitation Therapy (WRist-T) device for Post-Ischemic Stroke Patient | Mohd Adib | Journal of Telecommunication, Electronic and Computer Engineering (JTEC)

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[Abstract] Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool

Purpose: To assess the inter-rater reliability and concurrent validity of the Communication Evaluation in Rehabilitation Tool, which aims to externally assess physiotherapists competency in using Self-Determination Theory-based communication strategies in practice.

Materials and methods: Audio recordings of initial consultations between 24 physiotherapists and 24 patients with chronic low back pain in four hospitals in Ireland were obtained as part of a larger randomised controlled trial. Three raters, all of whom had Ph.Ds in psychology and expertise in motivation and physical activity, independently listened to the 24 audio recordings and completed the 18-item Communication Evaluation in Rehabilitation Tool. Inter-rater reliability between all three raters was assessed using intraclass correlation coefficients. Concurrent validity was assessed using Pearson’s r correlations with a reference standard, the Health Care Climate Questionnaire.

Results: The total score for the Communication Evaluation in Rehabilitation Tool is an average of all 18 items. Total scores demonstrated good inter-rater reliability (Intraclass Correlation Coefficient (ICC) = 0.8) and concurrent validity with the Health Care Climate Questionnaire total score (range: r = 0.7–0.88). Item-level scores of the Communication Evaluation in Rehabilitation Tool identified five items that need improvement.

Conclusion: Results provide preliminary evidence to support future use and testing of the Communication Evaluation in Rehabilitation Tool.

  • Implications for Rehabilitation
  • Promoting patient autonomy is a learned skill and while interventions exist to train clinicians in these skills there are no tools to assess how well clinicians use these skills when interacting with a patient. The lack of robust assessment has severe implications regarding both the fidelity of clinician training packages and resulting outcomes for promoting patient autonomy.

  • This study has developed a novel measurement tool Communication Evaluation in Rehabilitation Tool and a comprehensive user manual to assess how well health care providers use autonomy-supportive communication strategies in real world-clinical settings.

  • This tool has demonstrated good inter-rater reliability and concurrent validity in its initial testing phase.

  • The Communication Evaluation in Rehabilitation Tool can be used in future studies to assess autonomy-supportive communication and undergo further measurement property testing as per our recommendations.

via Assessing physiotherapists’ communication skills for promoting patient autonomy for self-management: reliability and validity of the communication evaluation in rehabilitation tool: Disability and Rehabilitation: Vol 0, No 0

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[ARTICLE] Therapists’ Perspective on Virtual Reality Training in Patients after Stroke: A Qualitative Study Reporting Focus Group Results from Three Hospitals – Full Text

Abstract

Background. During the past decade, virtual reality (VR) has become a new component in the treatment of patients after stroke. Therefore aims of the study were (a) to get an insight into experiences and expectations of physiotherapists and occupational therapists in using a VR training system and (b) to investigate relevant facilitators, barriers, and risks for implementing VR training in clinical practice.

Methods. Three focus groups were conducted with occupational therapists and physiotherapists, specialised in rehabilitation of patients after stroke. All data were audio-recorded and transcribed verbatim. The study was analysed based on a phenomenological approach using qualitative content analysis.

Results. After code refinements, a total number of 1289 codes emerged out of 1626 statements. Intercoder reliability increased from 53% to 91% until the last focus group. The final coding scheme included categories on a four-level hierarchy: first-level categories are (a) therapists and VR, (b) VR device, (c) patients and VR, and (d) future prospects and potential of VR developments.

Conclusions. Results indicate that interprofessional collaboration is needed to develop future VR technology and to devise VR implementation strategies in clinical practice. In principal, VR technology devices were seen as supportive for a general health service model.

1. Background

Stroke is a frequent cause of livelong disability in adulthood and is one of the most expensive diseases regarding patient-centred care [1]. To reduce the burden of upper limb limitations and to improve patients’ outcomes and independence, new treatment concepts have to be developed and effectiveness of patient outcomes has to be investigated, respectively [2]. Virtual reality (VR) is a novel computer technology that was adapted for rehabilitation over the past decade [3]. It is a computer technology that simulates real-life learning while providing augmented feedback and a high intensity of massed practiced tasks [4]. VR can be differentiated into immersive and nonimmersive gaming systems. Immersive systems enable players to move an avatar in a simulated environment. Nonimmersive systems often focus on arm or leg movements in simulated 3D environments [5]. VR provides a safe environment for patients to explore functional capability without interference from their physical or cognitive limitations [6]. As an example of a therapeutic VR system, YouGrabber (YG, YouRehab© Ltd.) will be explored in this study: it is a training system for upper limb training in stroke rehabilitation (Figure 1). It provides training of bimanual reaching and grasping in combination with different game options on a computer or television screen. Patients’ movements are captured by two size-adjustable data gloves and infrared arm tracking [7]. As Saposnik and Levin reported in their meta-analysis, there are beneficial effects for upper limb rehabilitation using VR in combination with conventional treatment approaches [8]. Analysed studies evaluated different aspects of VR including number of repetitions and exercise intensity. While rehabilitation targets are functional skills, most of VR implementation is working with simulations that are playful but not directly relevant to patients’ daily life [4]. To maximise benefits, the therapeutic application of VR should be compatible with the therapeutic goal setting [9]. Moreover, patients’ motivation and attention are important factors stimulating motor relearning after stroke [10].

Continue —> Therapists’ Perspective on Virtual Reality Training in Patients after Stroke: A Qualitative Study Reporting Focus Group Results from Three Hospitals

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[WEB SITE] Novel robotic walker helps patients regain natural gait

Survivors of stroke or other neurological conditions such as spinal cord injuries, traumatic brain injuries and Parkinson’s disease often struggle with mobility. To regain their motor functions, these patients are required to undergo physical therapy sessions. A team of researchers from the National University of Singapore’s (NUS) Faculty of Engineering has invented a novel robotic walker that helps patients carry out therapy sessions to regain their leg movements and natural gait. The system also increases productivity of physiotherapists and improves the quality of rehabilitation sessions.

Designed by a team of researchers led by Assistant Professor Yu Haoyong from the NUS Department of Biomedical Engineering, the robotic walker is capable of supporting a patient’s weight while providing the right amount of force at the pelvis of the patient to help the patient walk with a natural gait. In addition, quantitative data can be collected during the therapy sessions so that doctors and physiotherapists can monitor the progress of the patient’s rehabilitation.

Improving therapy outcomes with robotic aid

The robotic walker comprises six modules: an omni-directional mobile platform; an active body weight support unit; a pelvic and trunk motion support unit; a suite of body sensors; a functional electrical stimulation unit; and an intuitive user control interface.

The suite of body sensors measure the gait of the patient so that the walker can provide the right amount of support to help the patient walk with a natural gait. The electrical stimulation unit can deliver targeted electrical current to stimulate the correct muscle at the correct timing to facilitate joint movement. The walker can also provide assistive force, resistive force, and disturbance force depending on the training requirements set by the therapists. In this way, patients can go through different training schemes that are often difficult to achieve manually. The patient interacts with the walker through a force sensor which detects the user intent. The intelligent control system uses this information as well as the gait information provided by the body sensors to control the movement of the walker. Another unique feature of this walker is that it allows the patient to practice gait movements by walking over ground instead of on a treadmill. Such features enable the gait training to be conducted in a natural and intuitive way for the patients.

Asst Prof Yu explained, “This robotic walker allows patients to practice their gait movements continuously to optimise their therapy. When patients repeat the movements in a natural setting, the routine can be imprinted into their brains which gradually learn to correct from the damage resulting from their medical conditions.”

In addition, the robotic walker is capable of collecting data on the gait kinematics and muscle activation pattern of the patient. Such information is useful for doctors and therapists to monitor the progress of the patients’ recovery.

A robotic helper for physiotherapists

Besides improving the quality of rehabilitation sessions, the robotic walker will also relieve physiotherapists from the physical strain of assisting patients with the exercises.

Currently, gait training requires one or two physiotherapists to support the patient’s body weight and trunk, and an additional physiotherapist may be needed to move the paretic leg. Such therapy sessions are labour intensive, and they are also ergonomically unfavourable for the physiotherapists as they often suffer from back injuries. This limits the quality, duration and frequency of rehabilitation sessions.

With the robotic walker, manual therapy can be taken over by the robotic system, while physiotherapists can focus on providing better assessment and training guidance for patients. The device also reduces the number of physiotherapists needed to conduct each rehabilitation session, thereby increasing productivity and reducing the cost of care.

Clinical studies and commericalisation

Asst Prof Yu is collaborating with homegrown company Hope Technik to fine-tune the robotic walker. He is also planning to conduct clinical studies to validate the training effects on patients and to develop novel therapy regimes together with clinicians at the National University Hospital. There are also plans to commercialise the device with Hope Technik.

“Our vision is for the robotic walker to be installed at outpatient clinics and rehabilitation centres to benefit patients who need therapy sessions. There is also a possibility that patients can perform exercises in the comfort of their own homes,” said Asst Prof Yu.

via Novel robotic walker helps patients regain natural gait.

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[PRESS RELEASE] Novel robotic walker invented by NUS researchers helps patients regain natural gait and increases productivity of physiotherapists

Survivors of stroke or other neurological conditions such as spinal cord injuries, traumatic brain injuries and Parkinson’s disease often struggle with mobility. To regain their motor functions, these patients are required to undergo physical therapy sessions. A team of researchers from the National University of Singapore’s (NUS) Faculty of Engineering has invented a novel robotic walker that helps patients carry out therapy sessions to regain their leg movements and natural gait. The system also increases productivity of physiotherapists and improves the quality of rehabilitation sessions.

Designed by a team of researchers led by Assistant Professor Yu Haoyong from the NUS Department of Biomedical Engineering, the robotic walker is capable of supporting a patient’s weight while providing the right amount of force at the pelvis of the patient to help the patient walk with a natural gait. In addition, quantitative data can be collected during the therapy sessions so that doctors and physiotherapists can monitor the progress of the patient’s rehabilitation…

more–> Novel robotic walker invented by NUS researchers helps patients regain natural gait and increases productivity of physiotherapists.

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