The evidence and effectiveness of physiotherapy interventions in treatment of patients with confirmed or suspected coronavirus disease 2019 (COVID-19) is limited. Routinely used interventions in physiotherapy imply a very high risk for physiotherapists because the duration of direct contact with patients is quite long. Physiotherapy may need to be administered by weighing the benefit-risk ratio. Therefore, there is a critical and urgent need to adopt alternatives or modified forms of physiotherapy interventions. As the situation for management of COVID-19 in low-resource contexts could differ from that in high resource context, interventions need to be adapted to the available resources and technology in various settings. Tele-physiotherapy could be a viable option for patients who are in acute care in the hospital, in rehabilitation unit or under quarantine at home due to confirmed or suspected COVID-19. Modification in physiotherapy interventions and adjustment in intervention parameters may serve as an alternative strategy. This article describes alternatives to and/or modification of routinely used physiotherapy interventions for achieving maximum patients' benefits and minimising therapists' exposure in treatment of individuals with confirmed or suspected COVID-19.
Purpose: To investigate 1)how older women who are living alone perceive chronic musculoskeletal pain,Activities of Daily Living (ADL), physical activity, affective distress,pain-related beliefs, pain management, and rate pain-related disability andmorale, 2) the relationships betweendemographic variables, ADL, physical activity, affective distress, pain-relatedbeliefs, and pain management with pain-related disability and morale.Method: The study had across-sectional and correlational design. Sixty women, living alone with chronicpain and community support aged ≥65 years were included.Results: The women were on average 81 years old and had lived with pain forabout 21.5 years. They reported low scores of affective distress,catastrophizing thoughts and self-efficacy, high scores of fear of movement,low degrees of pain-related disability, and low levels of morale. The multiple regression analysisshowed that only catastrophizing thoughts significantlyexplained the variation in pain-related disability, and both affective distress and catastrophizing thoughtssignificantly explained the variation in morale. Conclusion: These older women livingalone with chronic pain reported similar prevalence ofchronic pain and pain-related disability but lower morale when comparingthe results with similar studies about older people in the same age group orolder people who are in need of help to manage their daily life. The only variable that was independely associated to bothpain-related disability and morale was catastrophizing. Further researchshould focus on identifying catastrophizing thougts,and also on developing a rehabilitation program based on a biopsychosocialperspective with the goal to decrease catastrophizing, pain-relateddisability, and increase morale for this target group
Objectives: To explore users’ experiences of a tailored, interactive web application that supports behaviour change in stress management and to identify if and in that case what in the web-based programme that needed further development or adjustment to be feasible in a randomised controlled trial.
Method: The design of this study was explorative with a qualitative approach. Nine individuals were recruited among the staff at a university. Semi-structured individual interviews were conducted and analysed using qualitative content analysis, after the participants had completed the web-based stress management programme.
Results: One theme was identified, Struggling with what I need when stress management is about me, describing the paradox in having a programme that is perceived as supporting stress management while also being perceived as extensive and time consuming. The theme was divided in two categories: Defining the needs, where the users expressed what they needed from the programme and their everyday environment, to be able to use the programme, and It is about me, where the programme was described as helping the users understand their own stress.
Conclusion: The participants expressed acceptance of using a web-based programme for stress related problems. The perceived extensiveness of the programme must be considered in further development.
Purpose
To explore how stroke survivors experience and prefer to participate in clinical reasoning processes in the subacute phase of stroke rehabilitation.
Methods
An explorative qualitative design was used. Individual interviews were conducted with 10 stroke survivors (4 women and 6 men, mean age 68 years) 4 weeks after their stroke, and follow-up interviews were conducted with 6 of them after 10 weeks. The interview settings were the patient’s home during their home rehabilitation, an inpatient and an outpatient rehabilitation unit. A reflexive thematic analysis was performed.
Results
Four themes were identified: discharge as a critical point for participation, describing a stressful time with varying involvement; supportive actions and context as crucial for participation, describing collaboration with the stroke team, the team’s consideration of the stroke survivor’s resources and needs, and a supportive home environment; the importance of goals and follow-up, describing goals as motivational and an unstructured use of goals; and difficulties in participation, describing a lack of dialogue with the stroke team and undetected resources and needs.
Conclusions
The stroke survivors experienced changes in their participation in the clinical reasoning process as their rehabilitation progressed. They moved from perceiving themselves as passengers at the time of their hospital discharge to gradually seeing themselves as the driver of their rehabilitation process. Some person-centered attributes, such as respectful relationships and a health focus, were incorporated into the clinical reasoning, while others, such as a holistic view and shared goal-setting, required further emphasis for improved person-centeredness in stroke rehabilitation.
Background: Impaired mobility in people with severe dementia is well known. Physical therapists play a key role in guiding professional caregivers on how to handle mobility and transfer-related problems; however, it is unknown how to handle the complexity of dementia-related impaired endurance, joint dysfunction, balance, and gait dysfunction and at the same time, take into consideration the person's decreased cognition, communication deficits, and behaviour problems.
Aims and methods: The aim was to explore the effectiveness and efficiency of functional behaviour analysis (FBA) guided interventions of dyadic transfer-related behaviour in dementia care dyads. An experimental single-case research design was used. Two care dyads participated. Different methods of assessment were performed to gather the dyadic transfer-related behavioural problems. Transfers were recorded by video uptakes and to generate a hypothesis about dyadic transfer-related behavioural problems, the Dyadic Interaction in Dementia Transfer Assessment Scale (DIDTAS) was used.
Results: The problematic transfer-related behaviour in care dyad 1 changed positively, as reflected by a decrease in discomfort verbally expressed by the person with dementia. A trend towards increased cooperation was observed among caregivers assisting in the transfer situation. In care dyad 2, a trend towards increased caregiver self-efficacy (SE) was observed between the baseline and completed intervention phases. The decreased resistiveness to care (RTC) exhibited by the person with dementia paralleled the increase in caregiver SE.
Conclusion: Considering the findings of this explorative study, physical therapists could consider the development of tailored interventions guided by an FBA for complex dyadic transfer-related behavioural problems in dementia care dyads.
The aim of this study was to investigate the validity and measurement agreement of a smartphone pedometer application and a traditional pedometer, both compared to manual step count, in six environments. The study also examined the relative reliability of two positions of the smartphone pedometer application in the six environments. Twenty participants carried two smartphones (iPhone 4S) with the same pedometer application (Pedometer FREE GPSþ) in two device positions together with a traditional pedometer (Yamax LS2000) while walking in six environments. The pedometer application in the chest position (app chest) differed significantly from the manual step count when walking uphill (p¼0.003), the application in the trouser (pants) position (app pants) differed for downhill (p¼0.001) and the traditional pedometer (trad ped) differed upstairs (p¼0.007). The measurement agreement was high for app pants uphill, app chest downhill and trad ped downstairs. The relative reliability was fair for app chest, but poor for app pants. In conclusion, the pedometer application and traditional pedometer were valid for step self-monitoring in some environments, and the measurement agreement compared to manual step count was mainly medium to high. The relative reliability for the smartphone pedometer application was partly acceptable. Smartphones could be useful in some environments for physical activity self-monitoring.