scholarly journals Physical Therapists' Use of Functional Electrical Stimulation for Clients With Stroke: Frequency, Barriers, and Facilitators

2016 ◽  
Vol 96 (7) ◽  
pp. 995-1005 ◽  
Author(s):  
Nolan Auchstaetter ◽  
Juliana Luc ◽  
Stacey Lukye ◽  
Kaylea Lynd ◽  
Shelby Schemenauer ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Stroke Rehabilitation ◽  
Online Survey ◽  
Physical Therapists ◽  
Barriers And Facilitators ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Access To Resources ◽  
Therapeutic Goals

Abstract Background Best practice guidelines for stroke rehabilitation recommend functional electrical stimulation (FES) to improve gait and upper extremity function. Whether these guidelines have been implemented in practice is unknown. Objective The purposes of this study were: (1) to determine the frequency with which physical therapists use FES to address common therapeutic goals poststroke and (2) to identify the barriers to and facilitators of FES use. Design This was a cross-sectional, survey study. Methods A valid and reliable online survey was sent to Canadian physical therapists. Questions about demographic characteristics, FES use, knowledge of FES literature, and barriers and facilitators were posed. Closed-ended questions were analyzed with descriptive statistics and index scoring to produce summary scores. Pearson or point-biserial correlation coefficients correlated FES use with demographic variables. Open-ended questions about barriers and facilitators were analyzed by 3 researchers using a conventional content analysis. Results Two hundred ninety-eight physical therapists responded. Use of FES for clients with stroke was low for all therapeutic goals queried (improve walking, arm function, muscle strength and endurance, and sensation; prevent shoulder subluxation; and decrease spasticity). However, 52.6% of the respondents stated that they would like to increase their use of FES. More than 40% of the respondents were unsure of the strength of the evidence supporting FES for stroke care. Physical therapists with postgraduate FES training were more likely to use FES (r=.471, P<.001). A lack of access to resources, such as time, equipment, and training, was the most frequently cited barrier to FES use. Limitations As an observational study, cause-and-effect relationships for FES use cannot be identified. Conclusions Functional electrical stimulation is not widely used by physical therapists in stroke rehabilitation. Improving access to resources—in particular, continuing education—may facilitate the implementation of FES into clinical practice.

Psychological Impacts of COVID-19 During the First Nationwide Lockdown in Vietnam: Web-Based, Cross-Sectional Survey Study (Preprint)

2020 ◽  
Author(s):  
Khanh Ngoc Cong Duong ◽  
Tien Nguyen Le Bao ◽  
Phuong Thi Lan Nguyen ◽  
Thanh Vo Van ◽  
Toi Phung Lam ◽  
...  
Keyword(s):  
Psychological Distress ◽  
General Population ◽  
Psychological Health ◽  
Online Survey ◽  
Survey Study ◽  
Limited Information ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Event Scale ◽  
The Impact

BACKGROUND The first nationwide lockdown due to the COVID-19 pandemic was implemented in Vietnam from April 1 to 15, 2020. Nevertheless, there has been limited information on the impact of COVID-19 on the psychological health of the public. OBJECTIVE This study aimed to estimate the prevalence of psychological issues and identify the factors associated with the psychological impact of COVID-19 during the first nationwide lockdown among the general population in Vietnam. METHODS We employed a cross-sectional study design with convenience sampling. A self-administered, online survey was used to collect data and assess psychological distress, depression, anxiety, and stress of participants from April 10 to 15, 2020. The Impact of Event Scale-Revised (IES-R) and the Depression, Anxiety, and Stress Scale-21 (DASS-21) were utilized to assess psychological distress, depression, anxiety, and stress of participants during social distancing due to COVID-19. Associations across factors were explored using regression analysis. RESULTS A total of 1385 respondents completed the survey. Of this, 35.9% (n=497) experienced psychological distress, as well as depression (n=325, 23.5%), anxiety (n=195, 14.1%), and stress (n=309, 22.3%). Respondents who evaluated their physical health as average had a higher IES-R score (beta coefficient [B]=9.16, 95% CI 6.43 to 11.89), as well as higher depression (B=5.85, 95% CI 4.49 to 7.21), anxiety (B=3.64, 95% CI 2.64 to 4.63), and stress (B=5.19, 95% CI 3.83 to 6.56) scores for DASS-21 than those who rated their health as good or very good. Those who self-reported their health as bad or very bad experienced more severe depression (B=9.57, 95% CI 4.54 to 14.59), anxiety (B=7.24, 95% CI 3.55 to 10.9), and stress (B=10.60, 95% CI 5.56 to 15.65). Unemployment was more likely to be associated with depression (B=3.34, 95% CI 1.68 to 5.01) and stress (B=2.34, 95% CI 0.84 to 3.85). Regarding worries about COVID-19, more than half (n=755, 54.5%) expressed concern for their children aged <18 years, which increased their IES-R score (B=7.81, 95% CI 4.98 to 10.64) and DASS-21 stress score (B=1.75, 95% CI 0.27 to 3.24). The majority of respondents (n=1335, 96.4%) were confident about their doctor’s expertise in terms of COVID-19 diagnosis and treatment, which was positively associated with less distress caused by the outbreak (B=–7.84, 95% CI –14.58 to –1.11). CONCLUSIONS The findings highlight the effect of COVID-19 on mental health during the nationwide lockdown among the general population in Vietnam. The study provides useful evidence for policy decision makers to develop and implement interventions to mitigate these impacts. CLINICALTRIAL

scholarly journals Evaluation of Individualized Functional Electrical Stimulation-Induced Acute Changes during Walking: A Case Series in Children with Cerebral Palsy

Sensors ◽  
2021 ◽  
Vol 21 (13) ◽  
pp. 4452
Author(s):  
Nicole Zahradka ◽  
Ahad Behboodi ◽  
Ashwini Sansare ◽  
Samuel C. K. Lee
Keyword(s):  
Cerebral Palsy ◽  
Electrical Stimulation ◽  
Functional Electrical Stimulation ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Case Series ◽  
Phase Detection ◽  
Lower Extremity Muscle ◽  
Children With Cerebral Palsy ◽  
Muscle Groups

Functional electrical stimulation (FES) walking interventions have demonstrated improvements to gait parameters; however, studies were often confined to stimulation of one or two muscle groups. Increased options such as number of muscle groups targeted, timing of stimulation delivery, and level of stimulation are needed to address subject-specific gait deviations. We aimed to demonstrate the feasibility of using a FES system with increased stimulation options during walking in children with cerebral palsy (CP). Three physical therapists designed individualized stimulation programs for six children with CP to target participant-specific gait deviations. Stimulation settings (pulse duration and current) were tuned to each participant. Participants donned our custom FES system that utilized gait phase detection to control stimulation to lower extremity muscle groups and walked on a treadmill at a self-selected speed. Motion capture data were collected during walking with and without the individualized stimulation program. Eight gait metrics and associated timing were compared between walking conditions. The prescribed participant-specific stimulation programs induced significant change towards typical gait in at least one metric for each participant with one iteration of FES-walking. FES systems with increased stimulation options have the potential to allow the physical therapist to better target the individual’s gait deviations than a one size fits all device.

scholarly journals sEMG Bias-Driven Functional Electrical Stimulation System for Upper-Limb Stroke Rehabilitation

2018 ◽  
Vol 18 (16) ◽  
pp. 6812-6821 ◽  
Author(s):  
Yu Zhou ◽  
Yinfeng Fang ◽  
Kai Gui ◽  
Kairu Li ◽  
Dingguo Zhang ◽  
...  
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Stroke Rehabilitation ◽  
Stimulation System

scholarly journals Doctors’ perception of support and the processes involved in complaints investigations and how these relate to welfare and defensive practice: a cross-sectional survey of the UK physicians

BMJ Open ◽  
2017 ◽  
Vol 7 (11) ◽  
pp. e017856 ◽  
Author(s):  
Tom Bourne ◽  
Bavo De Cock ◽  
Laure Wynants ◽  
Mike Peters ◽  
Chantal Van Audenhove ◽  
...  
Keyword(s):  
Online Survey ◽  
Well Being ◽  
Adverse Outcomes ◽  
Perceived Support ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Final Sample ◽  
Perception Of Support ◽  
The Uk

ObjectiveHow adverse outcomes and complaints are managed may significantly impact on physician well-being and practice. We aimed to investigate how depression, anxiety and defensive medical practice are associated with doctors actual and perceived support, behaviour of colleagues and process issues regarding how complaints investigations are carried out.DesignA survey study. Respondents were classified into three groups: no complaint, recent/current complaint (within 6 months) or past complaint. Each group completed specific surveys.SettingBritish Medical Association (BMA) members were invited to complete an online survey.Participants95 636 members of the BMA were asked to participate. 7926 (8.3%) completed the survey, of whom 1780 (22.5%) had no complaint, 3889 (49.1%) had a past complaint and 2257 (28.5%) had a recent/current complaint. We excluded those with no complaints leaving 6144 in the final sample.Primary outcomes measuresWe measured anxiety and depression using the Generalised Anxiety Disorder Scale 7 and Physical Health Questionnaire 9. Defensive practice was assessed using a new measure for avoidance and hedging.ResultsMost felt supported by colleagues (61%), only 31% felt supported by management. Not following process (56%), protracted timescales (78%), vexatious complaints (49%), feeling bullied (39%) or victimised for whistleblowing (20%), and using complaints to undermine (31%) were reported. Perceived support by management (relative risk (RR) depression: 0.77, 95% CI 0.71 to 0.83; RR anxiety: 0.80, 95% CI 0.74 to 0.87), speaking to colleagues (RR depression: 0.64, 95% CI 0.48 to 0.84 and RR anxiety: 0.69, 95% CI 0.51 to 0.94, respectively), fair/accurate documentation (RR depression: 0.80, 95% CI 0.75 to 0.86; RR anxiety: 0.81, 95% CI 0.75 to 0.87), and being informed about rights (RR depression 0.96 (0.89 to 1.03) and anxiety 0.94 (0.87 to 1.02), correlated positively with well-being and reduced defensive practice. Doctors worried most about professional humiliation following a complaint investigation (80%).ConclusionPoor process, prolonged timescales and vexatious use of complaints systems are associated with decreased psychological welfare and increased defensive practice. In contrast, perceived support from colleagues and management is associated with a reduction in these effects.

scholarly journals A survey of clinical opinions and preferences on the non-surgical management of intermittent exotropia in China

2021 ◽  
Author(s):  
Yidong Wu ◽  
Tingting Peng ◽  
Jinjing Zhou ◽  
Meiping Xu ◽  
Yi Gao ◽  
...  
Keyword(s):  
Surgical Management ◽  
Online Survey ◽  
Randomized Clinical Trials ◽  
Treatment Guidelines ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Intermittent Exotropia ◽  
Cross Sectional ◽  
Surgical Interventions ◽  
Surgical Options

Purpose: Intermittent exotropia (IXT) is the most common form of childhood exotropia. Currently, controversies exist regarding its management and non-surgical options in particular. This study reports clinical opinions and preferences on the non-surgical management among practitioners in China. The opinions within and between ophthalmologists and optometrists were also compared. Design: Cross-sectional survey study. Methods: An online survey was developed and distributed through professional bodies. The study was conducted from July 25th to August 3rd, 2019. A total of 300 ophthalmologists and 188 optometrists responded. Results: Of 488 participants, 257 (53%) considered fusion defects as the main cause of IXT, and 299 (61%) took IXT as a progressive disorder. Two hundred and seventy-one (56%) participants considered orthoptic exercises as the most effective non-surgical intervention for IXT. Likewise, 245 (50%) participants reported that orthoptic exercises was their most frequent non-surgical option, followed by observation (178, 37%). There are discrepancies between ophthalmologists and optometrists. A greater proportion of ophthalmologists (201, 67%) shared the view that IXT worsens over time compared with optometrists (98, 52%) (p = 0.001). Additionally, ophthalmologists (121, 40%) tended to prefer observation compared with optometrists (57, 30%) (p = 0.021). Conclusions: This study shows that there is no general consensus on the non-surgical management of IXT in China. Given the lack of robust evidence, the findings from this study not only show the current clinical opinions but also highlight the need for future randomized clinical trials to validate the effectiveness of non-surgical interventions, orthoptic exercises in particular, and to establish treatment guidelines accordingly.

Hybrid Exoskeletons for Upper Limb Stroke Rehabilitation

2018 ◽  
pp. 76-98
Author(s):  
Ashley M. Stewart ◽  
Christopher G. Pretty ◽  
Mark Adams ◽  
XiaoQi Chen
Keyword(s):  
Electrical Stimulation ◽  
Upper Limb ◽  
Functional Electrical Stimulation ◽  
Stroke Rehabilitation ◽  
Potential Benefit ◽  
Patient Monitoring ◽  
State Of The Art ◽  
Early Stage ◽  
Control Methods ◽  
Stage Of Development

Hybrid exoskeletons are a recent development, combining electrically controlled actuation with functional electrical stimulation, which potentially offers great benefits for muscular rehabilitation. This chapter presents a review on the state of the art of upper-limb hybrid exoskeletons with a particular focus on stroke rehabilitation. The current needs of the stroke rehabilitation field are discussed and the ability of hybrid exoskeletons to provide a solution to some of the gaps in this field is explored. Due to the early stage of development which most hybrid exoskeletons are in, little research has yet been done in control methods used for them. In particular, more investigation is needed with regards to the potential benefit of hybrid exoskeletons as a patient-monitoring and rehabilitation assist-as-need tool.

The characteristics of Queensland private physiotherapy practitioners’ interprofessional interactions: a cross-sectional survey study

2020 ◽  
Vol 26 (6) ◽  
pp. 500
Author(s):  
Jack A. Seaton ◽  
Anne L. Jones ◽  
Catherine L. Johnston ◽  
Karen L. Francis
Keyword(s):  
Private Practice ◽  
Online Survey ◽  
Interprofessional Collaboration ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Face To Face ◽  
Level Of Satisfaction ◽  
Cost Efficient ◽  
High Level

Effective interprofessional collaboration (IPC) contributes to superior patient outcomes, facilitates cost-efficient health care, and increases patient and practitioner satisfaction. However, there is concern that IPC may be difficult to implement in clinical settings that do not conform to formal team-based processes, such as mono-professional physiotherapy private practice facilities. The aim of this study was to describe the characteristics of private physiotherapy practitioners’ interprofessional interactions, including their experiences and perceptions regarding IPC. A custom developed cross-sectional online survey instrument was used to collect data from physiotherapists employed in private practice facilities in Queensland, Australia. In all, 49 (20% response rate) physiotherapists completed the survey. Only a small proportion (14%) indicated that their interprofessional interactions were a daily occurrence, and less than one-third of all respondents (31%) participated in formal, multi-professional face-to-face planned meetings. Most participants (76%) reported a moderate-to-high level of satisfaction regarding their interprofessional interactions. Despite low self-reported levels of interprofessional activity and other data indicating that IPC is necessary for holistic patient care, this study shows that physiotherapists were predominately satisfied when interacting with health practitioners from various professional backgrounds. Further research is required to inform the implementation of robust strategies that will support sustainable models of IPC in physiotherapy private practice.

scholarly journals Association of Colours and Mood Tones That Could Define Stress among International School Students in Bangkok

2021 ◽  
Vol 04 (03) ◽  
Author(s):  
Jiraporn Jensuriyarkun ◽  
Keyword(s):  
Online Survey ◽  
International School ◽  
Situational Factors ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
School Students ◽  
Cross Sectional ◽  
Daily Lives ◽  
Stress Levels ◽  
Different Cultures

Have you ever wondered how colours perceiving through the lens of our eyes influence our emotions or why some objects in different colours dissimilarly affect the mood we experience in our daily lives? The purpose of this study is to determine the correlation between colours and stress levels of international school teenagers. The rationale behind this topic is from theGoethe’s Theory of Colours. To test whether two variables correlate, we conducted a cross-sectional survey study. Our questionnaire contains 28 questions, all of which have been approved by 4 experts. Data were collected from Mahidol University International Demonstration School (MUIDS) students who aged between 15 and 18 years old using an online survey, Google Forms. A total of 245 students participated in the study and completed the survey. To determine the correlation between colours and stress levels, we used Statistical Product and Service Solutions version 27.0 (SPSS) for data analysis. Pearson’s correlation test revealed that there is no significant correlation between colours and stress levels. Although we did not find any correlation, we suspected that there might be other possible factors such as cultures, personality and situational factors that play a significant role in developing stress. Moreover, colours also have different meanings in different cultures. Therefore, more scientific research is required to gain a better understanding of colour psychology.

scholarly journals Predictors of nurses’ caring practice for critically ill patients in critical technological environments: A cross-sectional survey study

2021 ◽  
Author(s):  
Yinglan Li ◽  
Waraporn Kongsuwan
Keyword(s):  
Critically Ill ◽  
Critically Ill Patients ◽  
Online Survey ◽  
Demographic Data ◽  
Linear Regression Analysis ◽  
Guizhou Province ◽  
Survey Study ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
Professional Value

Background: Caring practice for critically ill patients refers to the actions/behaviors/performance of nurses while caring for critically ill adult patients in the intensive care unit (ICU). Although the caring practice is vital in ICUs and complex due to the multitude of availabletechnologies, research on ICU nurses’ caring practice and its predictive factors are lacking. Objective: This study aimed to explore the level of nurses’ caring practice for critically ill patients in critical technological environments in China and its predictors. Methods: This was a cross-sectional online survey study with 218 ICU nurses in 29 tertiary hospitals of Guizhou province, China, from 1st to 30th April 2020. Data were collected by using e-questionnaires made in the Questionnaire Star program, including the Demographic Data Questionnaire (DDQ), Practice of Technological Competency as Caring in Nursing Instrument (P-TCCNI), Influence of Technology Questionnaire (ITQ), and Nurses’ Professional Value Scale (NPVS). The questionnaires were content validated by three experts. Cronbach’s alpha coefficient was 0.96 for the P-TCCNI, 0.70 for the ITQ, and 0.95 for the NPVS. Links to the questionnaires were distributed by research assistants to WeChat groups including target participants. Statistical Package for the Social Science (SPSS) program version 26 (IBM Corporation, Armonk, NY, USA) was used for data analysis. Descriptive and inferential statistics were used to analyze the data. Multiple linear regression analysis using stepwise solution analysis was performed to identify unique predictors of nurses’ caring practice. Results: The level of nurses’ caring practice for critically ill patients was high (mean = 87.30, standard deviation = 13.73). The professional value was a significant predictor of nurses’ caring practice (β = 0.41, p = 0.00). Conclusion: ICU nurses exhibited a high level of caring practice. Professional value was a significant predictor of ICU nurses’ caring practice. Nursing administrators should understand the current situation of caring practice in critical technological environments and design strategies to maintain and improve ICU nurses’ professional value to increase the level of caring practice. Funding: This study was financially supported by a thesis grant from Thailand’s Education Hub for Southern Region of ASEAN Countries (TEH-AC) Scholarship through Prince of Songkla University, Thailand.

scholarly journals Australian podiatrists scheduled medicine prescribing practices and barriers and facilitators to endorsement: a cross-sectional survey

2021 ◽  
Author(s):  
kristin graham ◽  
Lisa Matricciani ◽  
Helen Banwell ◽  
Saravana Kumar ◽  
Ryan Causby ◽  
...  
Keyword(s):  
Health System ◽  
Online Survey ◽  
Demographic Data ◽  
Public Funding ◽  
Local Anaesthetics ◽  
Cross Sectional Study ◽  
Barriers And Facilitators ◽  
Prescribing Practices ◽  
Cross Sectional Survey ◽  
Cross Sectional

Abstract BackgroundNon-medical prescribing is one healthcare reform strategy that has the potential to create savings in the health system as well as offer equitable and timely access to scheduled medicines. Currently there is a lack of information about prescribing practices of Australian podiatrists, making it difficult to assess if endorsement for scheduled medicines (endorsement) for podiatrists provides health system efficiencies or improved patient access and outcomes. Further, the uptake for endorsement remains low among Australian podiatrists. The aim of this research was to investigate the prescribing practices among Australian podiatrists as well as to explore barriers and facilitators that influence participation in endorsement. MethodsParticipants in this quantitative, cross-sectional study were registered and practicing Australian podiatrists and podiatric surgeons who were recruited through a combination of professional networks, social media, and personal contacts. Respondents were invited to complete a customised self-reported online survey. The survey was developed using previously published research, research team’s expertise and piloted with podiatrists. The survey contained three sections: demographic data including clinical experience, questions pertaining to prescribing practices, and barriers and facilitators of the endorsement pathway. ResultsRespondents (n = 225) were predominantly female, aged 25-45, working in the private sector. Approximately one quarter were endorsed (15%) or in training to become endorsed (11%). Of the 168 non-endorsed respondents, 66% reported that they would like to undertake training to become an endorsed prescriber. The medications most frequently prescribed include local anaesthetics, antimycotics, antibacterial agents, and analgesia. The most common indications reported for prescribing these medications include nail surgery (71%), foot infections and ulcerations (88%), post-operative pain (67%), and mycosis (95%). The most prescribed Schedule 2 medications were ibuprofen, paracetamol, and topical terbinafine. The most prescribed Schedule 4 medicines among endorsed podiatrists included lignocaine (84%), Cephalexin (68%), Flucloxacillin (68%), and Amoxicillin with Clavulanic acid (61%). ConclusionWhile podiatrists predominantly prescribe to assist pain, inflammatory, or infectious conditions, lack of public funding and pathology testing access limit podiatrists’ ability to maximise prescribing opportunities. Many barriers exist in the current endorsement for podiatrists, particularly related to training processes, including mentor access and supervised practice opportunities, requiring targeted enabling strategies.

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