Disability and rehabilitation
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To determine the reliability and validity of the Chinese version of Expanded and Revised Gross Motor Function Classification System (GMFCS-ER) for cerebral palsy (CP) and to explore if there existed differences between parents and the other raters. ⋯ The Chinese version of the GMFCS-ER is a valid measure of functional ability in school children with CP and reliable enough for use by Chinese healthcare providers and parents. Effects of environmental and personal factors should be considered when practicing GMFCS-ER assessment. Implications for Rehabilitation Cerebral palsy. Research about GMFCS-ER is needed to promote a more extensive use of GMFCS-ER in China for school children with CP. The Chinese version of the GMFCS-ER is a valid measure of functional ability in school children with CP and reliable enough for use by Chinese healthcare providers. Effects of environmental and personal factors should be considered when performing the GMFCS-ER assessment.
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Health care practice guidelines require physiotherapists to include patients in goal-setting. However, not much is known about how this process is accomplished in practice. The purpose of this study is to analyse patient-physiotherapist consultations and to identify how physiotherapists enquire about goals and how patients respond to these enquiries. ⋯ Goal-setting is not a straightforward process. Practices that entail asking patients to state their goals neither take into consideration the fact that patients may not know what an achievable goal is nor do they consider so-called social reasons for patients not to make claims to their physiotherapist about what the goals should be. Implications for Rehabilitation Patients respond to explicit goal enquiries using an open question with delayed responses indicating some communication problem. Goal-setting should not be treated as a predetermined process, but as negotiated in consultations. Goal-setting is a complex interaction in which participants manage knowledge about goals.
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The recent introduction of master's level curricula for Occupational Therapy (OT) and Physiotherapy (PT) training programs in Canada raises both challenges and opportunities to address ethical issues during professional training. This study evaluated the inclusion of ethics content in course descriptions and course calendars in order to develop a preliminary understanding of how rehabilitation ethics is taught in Canadian universities. ⋯ With the growing recognition and status of OT and PT in the healthcare system, and corresponding shifts in how professionals are being trained, it is crucial to assess and reflect upon the place accorded to and manner of teaching ethics. Implications for Rehabilitation Ethics training in rehabilitation programs With the evolving recognition of OT and PT professions within the healthcare system, and corresponding shifts in how future professionals are trained, it is crucial to assess the place accorded to teaching ethics. In Canadian OT and PT programs, ethics content is most commonly included in broad courses related to standards of practice and not in specific ethics courses. Careful attention is needed to ensure that OT and PT students receive sufficient ethics training that is well aligned with their future practice context to support them to competently address the ethical issues that they will encounter in clinical practice. In addition, OT and PT professionals would benefit from the development of continuing education activities that target ethical issues relevant to their practice.
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Comparative Study
Physical activity and low back pain: the role of subgroups based on the avoidance-endurance model.
This study examines the relationship between low back pain, disability and fatigue and overt physical activity with respect to fear-avoidance and endurance-related subgroups. ⋯ The results indicate different pathways to chronic pain and disability with physical underuse in FAR patients and overuse/overload in endurance patients suggesting the need for individually targeted cognitive-behavioral treatments in the maladaptive groups. Implications for Rehabilitation Improving the return to a normal physical activity level is an important goal for the rehabilitation of patients after lumbar disc surgery. Different pathways to chronic pain and disability with physical underuse in fear-avoidance patients and overuse in endurance patients should be considered. Different pain-related pain response pattern, based on the avoidance-endurance model, indicate the need for individual targeting of rehabilitation programs.
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Goal setting and patient-centredness are considered fundamental concepts in rehabilitation. However, the best way to involve patients in setting goals remains unclear. The purpose of this study was to explore patient experiences of goal setting in post-acute stroke rehabilitation to further understanding of its application to practice. ⋯ Stroke patients think about goals very differently from health professionals. Individual patients have diverse ideas about goals within the context of the uncertainty of stroke, their life as a whole and recovery after formal rehabilitation is completed. To meet these diverse needs, health professionals need to communicate fully with patients to gain an understanding of their experiences of stroke and wider views on goals.