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van Dijk M, Allegaert P, Locus M, Saenen L, Breuls S, Michiels D, Vermeulen L, Jannes S, Van Kerckhoven Y, Tournoy J, Verheyden G, Flamaing J. In-hospital rehabilitation with the Geriatric Activation Program Pellenberg improves functional performance in a heterogeneous geriatric population. Physiother Theory Pract 2024; 40:755-766. [PMID: 36576257 DOI: 10.1080/09593985.2022.2162356] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2022] [Revised: 12/19/2022] [Accepted: 12/19/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Regaining independent living can be challenging in patients undergoing inpatient geriatric rehabilitation. Given the paucity of evidence-based physiotherapy programs for this particular heterogeneous group, the Geriatric Activation Program Pellenberg (GAPP) was developed. PURPOSE Investigate the evolution of functional performance, and predict detectable changes throughout 4 weeks of GAPP. Methods: Participants in this observational study (2017-2019) followed GAPP as part of their rehabilitation program. Functional balance (Berg balance scale (BBS)) and independence (Katz scale) were the primary outcomes, with gait speed, elbow and knee extension strength, cognitive processing speed, and mood as secondary outcomes. All outcomes were assessed at baseline, 2 weeks and 4 weeks later. Prediction analysis was conducted using logistic regression modeling. Previously reported minimal detectable change with 95% confidence interval (MDC95) was used as detectable change. RESULTS We recruited 111 participants, with 83 completing 4 weeks of GAPP and all assessments. Over 4 weeks, all outcome measures showed a significant improvement (p ≤ .007). Detectable change was found for BBS (mean improvement of 12.8 points (95% CI: 10.9-14.8), MDC95 = 6.6) and gait speed (mean improvement of 0.24 m/s (95% CI: 0.19-0.29), MDC95 = 0.1 m/s). We found that baseline scores lower than 26 on the BBS (75% sensitivity, 65% specificity) and gait speed lower than 0.34 m/s (53% sensitivity, 81% specificity) were associated with participants achieving detectable change at 4 weeks on BBS and gait speed, respectively. CONCLUSION Functional performance of a heterogeneous group of geriatric inpatients improved notably after 4 weeks of GAPP. Baseline scores on BBS and gait speed can partially predict detectable changes in functional performance.
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Affiliation(s)
- Margaretha van Dijk
- Department of Physical Medicine and Rehabilitation, UZ Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Patsy Allegaert
- Department of Physical Medicine and Rehabilitation, UZ Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Marlies Locus
- Department of Physical Medicine and Rehabilitation, UZ Leuven, Campus Pellenberg, Pellenberg, Belgium
| | - Leen Saenen
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | - Sofie Breuls
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | - Demi Michiels
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | - Lien Vermeulen
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | - Stefanie Jannes
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | | | - Jos Tournoy
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
| | - Geert Verheyden
- Department of Physical Medicine and Rehabilitation, UZ Leuven, Campus Pellenberg, Pellenberg, Belgium
- Department of Rehabilitation Sciences, KU Leuven, Gymnasium, Leuven, Belgium
| | - Johan Flamaing
- Department of Public Health and Primary Care, KU Leuven, Leuven, Belgium
- Department of Geriatric Medicine, UZ Leuven, Leuven, Belgium
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Nepal GM, Acharya RS, Coppieters MW, Bimali I, Poudel S, Chaudhary B, Sharma S. The physiotherapy workforce in Nepal: A national survey. J Eval Clin Pract 2023; 29:69-82. [PMID: 35822869 PMCID: PMC10084353 DOI: 10.1111/jep.13729] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2022] [Revised: 06/05/2022] [Accepted: 06/09/2022] [Indexed: 01/18/2023]
Abstract
BACKGROUND Physiotherapy is a relatively young profession in Nepal. Education standards, and workforce organization and representation have improved in recent years, but there is no detailed workforce data to support decision-making and long-term planning. Therefore, this study aimed to describe the demographic characteristics, physiotherapy practice areas, settings and employment characteristics of physiotherapists in Nepal; and to document job satisfaction and the factors that influence it. METHODS In a cross-sectional survey, we asked Nepali physiotherapists about their sociodemographic characteristics, employment or physiotherapy practice area and settings, and job satisfaction. We assessed the associations between sociodemographic factors and job satisfaction among physiotherapists using univariable and multivariable logistic regressions. We invited all Nepali physiotherapists to participate via email, social media and visits to hospitals. RESULTS Of the 1120 physiotherapists who were contacted, 52% (female: 287; male: 293) completed the survey. The majority of the participants (75%) were less than 30 years old. The majority (73%) held a Bachelor of Physiotherapy degree. Eighty percent were employed at the time of data collection; 58% had 1-4 years of experience. The majority (77%) practiced in or near the capital Kathmandu. Most physiotherapist worked either in private hospitals (46%) or in private physiotherapy practices (26%), rehabilitation centres (19%) and 11% practiced in public hospitals. The most common areas of practice were musculoskeletal physiotherapy (90%) and adult neurology (67%). More than half of the physiotherapist (53%) felt that they were underpaid and 41% were not satisfied with their current job status. The majority of the physiotherapists (67%) reported that they participated in continuing professional development activities. Multivariable logistic regression showed that physiotherapists who had a higher remuneration were more likely to be satisfied with their job. CONCLUSIONS The majority of the physiotherapy workforce in Nepal is well-educated, young and at an early career stage. Most physiotherapists work in musculoskeletal and adult neurological physiotherapy, in private practices or private hospitals near Kathmandu. Job dissatisfaction was common and was related to low annual income. This first nationwide survey described the current physiotherapy workforce and provides comparison data for future physiotherapy workforce surveys.
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Affiliation(s)
| | | | - Michel W Coppieters
- Menzies Health Institute Queensland, Griffith University, Brisbane & Gold Coast, Australia.,Amsterdam Movement Sciences, Faculty of Behavioural and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, The Netherlands
| | - Inosha Bimali
- Kathmandu University School of Medical Sciences, Dhulikhel, Nepal
| | - Sajana Poudel
- Madan Bhandari Hospital and Trauma Center, Morang, Nepal
| | | | - Saurab Sharma
- Centre for Pain IMPACT, Neuroscience Research Australia, Sydney, New South Wales, Australia
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