0000000000053915
AUTHOR
Ulla Talvitie
Validity of the Postural Control and Balance for Stroke test.
Background and Purpose. To determine the construct and predictive validity and sensitivity of the sub-scale items for postural changes, sitting balance and standing balance of the Postural Control and Balance for Stroke (PCBS) test over a 90-day follow-up. Method. In the initial phase of stroke the PCBS test scores were compared with values obtained for the Barthel Index (BI) and the four neuropsychological domains most widely studied in the literature: memory; language; visuo-spatial functions; and visual inattention. The ability of the PCBS test at an early stage to predict functional status, as measured by the BI, and tendency to falls at 90 days after stroke was studied. The sensitivity…
Physiotherapy under discussion: A discourse analytic study of physiotherapy students’ clinical education
Clinical education is asserted to be an important period in professional education, being an environment where deep conceptual understanding can develop. The aim of this study was to analyse the in...
Physiotherapists' accounts of their clients in geriatric inpatient rehabilitation.
This article aims to describe how physiotherapists working with frail older people talk about their clients. Semi-structured qualitative interviews with physiotherapists (n = 11) were audio recorded, transcribed and analysed using discourse analysis. Two accounts were identified: (i) older adults as recipients of a treatment intervention at the rehabilitation centre, with the dimensions 'a focus on physical impairments' and 'a focus on social needs' and (ii) older adults as partners in an exercise intervention to support their everyday living at home. Older adults' everyday living context was not considered in the approach where, in an isolated and objectified manner, the physiotherapists f…
Interaction between clients and physiotherapists in group exercise classes in geriatric rehabilitation
The aim of this paper is to explore how older people construct their interaction in group exercise classes in geriatric rehabilitation and what is their contribution to the interaction. Discourse analysis was employed and data, consisting of seven videotaped group-based exercise sessions, were collected from 52 older people (aged 66–93 years) and nine rehabilitation professionals in seven rehabilitation centres. Four discourse categories were found. In “taciturn exercising”, older people remained verbally silent but physically active. In “submissive disagreeing”, older people opposed the professionals’ agenda by displaying reluctant consent to proposals. In “resilient endeavouring”, older a…
Individualised home-based rehabilitation after stroke in eastern Finland – the client's perspective
Reintegration into society is one of the main purposes of post-stroke rehabilitation. The experiences of clients returning home after a stroke have been studied before. There is, however, little knowledge about activities carried out during home-based rehabilitation interventions and about the involvement of clients in the process. This study focused on clients' experiences of a 3-month individualised, home-based rehabilitation programme supervised by a multidisciplinary team. The data were collected in 2009-2010, and it was based on interviews with 14 clients (48-83 years of age) conducted approximately 7 months after stroke. In the thematic analysis, five main topics describing the goals …
The reliability, distribution, and responsiveness of the Postural Control and Balance for Stroke Test
Abstract Pyoria O, Talvitie U, Villberg J. The reliability, distribution, and responsiveness of the Postural Control and Balance for Stroke Test. Objectives To determine the inter- and intrarater reliability of the Postural Control and Balance for Stroke (PCBS) test and to assess its distribution and responsiveness to changes during 1-year follow-up. Design Intrarater reliability of the PCBS test was assessed by comparing the repeat ratings of videotaped test performances by each of the 5 raters. Interrater reliability was assessed by comparing the ratings of the videotaped test performances between the raters. Setting Hospital neurologic ward and outpatient department of physiotherapy as w…
Distribution of Working Time and Contents of Physiotherapy Activities in a Clinical Setting.
The purpose of the present study was to collect personnel utilization data in the physiotherapy department of a general hospital as a basis for improving the practice of physiotherapy. Over a four-week period in a process of continuous observation 12 physiotherapists recorded their activities under predefined task categories. The percentages of total time used in the observed activities were as follows: direct patient treatment 31%, other work (planning, recording, arranging walking aids and student guidance) 10%, and cooperation (consultation, meetings, arranging patients' affairs, counselling relatives and parents) 9%. The proportion of uncategorized work amounted to half of the total wor…
The effect of two physiotherapy approaches on physical and cognitive functions and independent coping at home in stroke rehabilitation. A preliminary follow-up study
Activating physiotherapy was used to support the principle of post stroke functional recovery as a learning process which requires both cognitive and physical actions. The purpose of the present preliminary study was to examine the influence of activating physiotherapy on stroke patients' cognitive and physical functions and independent living at home compared with traditional treatment over a 12-month follow-up.The 40 patients who received activating physiotherapy were compared with 40 patients receiving traditional therapy. Patients' physical functional capacity was measured one week and 12 months post stroke with the Barthel Index (BI), 10-m gait speed, the Postural Control and Balance f…
Construction of the client in physiotherapy student's practical learning sessions: a discourse analytic study
In recent years, there has been a tendency to stress the active role and equal partnership of clients in social and healthcare. Moreover, research in the role of clients has attracted growing interest. Clinical education has been seen as an excellent arena for learning the distinctiveness of the interaction between the client and the professional physiotherapist by giving students the chance to participate in actual healthcare encounters. This study focuses on examining the construction of various client roles through interactions between participants in practical learning sessions that physiotherapy students took part in. These sessions were real professional physiotherapy encounters. Qual…
Decreased neck muscle strength is highly associated with pain in cervical dystonia patients treated with botulinum toxin injections11No commercial party having a direct financial interest in the results of the research supporting this article has or will confer a benefit upon the author(s) or upon any organization with which the author(s) is/are associated.
Abstract Hakkinen A, Ylinen J, Rinta-Keturi M, Talvitie U, Kautiainen H, Rissanen A. Decreased neck muscle strength is highly associated with pain in cervical dystonia patients treated with botulinum toxin injections. Arch Phys Med Rehabil 2004;85:1684–8. Objectives To compare the isometric neck muscle strength of cervical dystonia patients treated with botulinum toxin injections with that of healthy control subjects and to evaluate the association between neck strength, neck pain, and disability in these patients. Design Clinical cross-sectional study. Setting Outpatient rehabilitation and neurology clinics in a Finnish hospital. Participants Twenty-three patients with cervical dystonia wi…
Client’s role and participation in stroke physiotherapy encounters: an observational study
AbstractClient participation is a basic principle in rehabilitation encounters. Coping at home after stroke requires self-confidence and autonomy, which can be enhanced by active collaboration and knowledge sharing. Earlier studies show, however, that clients are not always offered the role of an active participant in physiotherapy practice. A contradiction remains between official rhetoric and clinical practice. The purpose of this study was to investigate the interaction between the client and the physiotherapist in stroke rehabilitation sessions. Eight video-recorded treatment sessions were observed after an educational intervention that focused on client participation. Discourse analysi…
Kliinisestä harjoittelusta työssäoppimiseen ja yhteistyötiimeihin
Terveysalan työharjoittelun toteutumista on arvosteltu siitä, että oppilaitokset panostavat entistä vähemmän työharjoittelun ohjaukseen ja harjoittelupaikkojen kanssa tehtävään yhteistyöhön. Harjoittelussa perinteiset työtavat ja vallitseva työkulttuuri siirretään kritiikittömästi opiskelijoille. Koulun antamat tiedot ja harjoittelupaikan edellyttämät taidot eivät kohtaa. Artikkelissa luodaan näkymiä uudenlaiseen työssäoppimiseen tehostamalla koulun ja työpaikkojen välistä yhteistyötä.
The meanings older people give to their rehabilitation experience
Promoting older people's ability to manage at home is important both for themselves and for society, but few studies have explored whether geriatric rehabilitation actually meets the needs of this heterogeneous group. The purpose of this study was to investigate the meanings that older adults attribute to their geriatric rehabilitation experiences. A group of 27 older adults in inpatient rehabilitation were interviewed during the programme and after returning home. Semi-structured interviews were analysed using a qualitative method, which identified three categories of meaning. In the category ‘sense of confidence with everyday life’, rehabilitation was perceived as facilitating everyday li…
Construction of Group Exercise Sessions in Geriatric Inpatient Rehabilitation
There is little knowledge about the ways geriatric physiotherapy is being carried out in practice and about the situational construction of formal policies for promoting physical activity. This article examines how professional physiotherapists and frail community-dwelling older adults as their clients use talk and action to construct a group exercise session in an inpatient rehabilitation setting in Finland. The analysis of 7 group exercise sessions with a total of 52 clients and 9 professional physiotherapists revealed 3 different practitioner approaches, which served different functions in older adults' empowerment and lifestyle activity change. The highly structured approach favored tac…
Guidance strategies and motor modelling in physiotherapy
Patient education is an important aspect of physiotherapy. Supporting and developing patients' self-motivation and activity requires efficient education during the practice period. Physiotherapists use predominantly verbal instruction and demonstration in their teaching activities. The aim of this study was to investigate how physiotherapists organise their therapeutic interventions in order to facilitate patients' learning. This was done by studying the ways in which physiotherapists provide their patients with the mental and motoric imagery pertaining to the action to be performed using verbal, visual and manual guidance. The study was undertaken at three hospitals in southern Finland. Fi…
Clinical supervision as an interaction between the clinical educator and the student.
The interaction between clinical educators and students is regarded as the strongest element in developing expertise and in forming students' professional identity in clinical education. Although clinical education has been studied in physiotherapy, the natural interaction between clinical educators and students has remained unanalyzed. The aim of this study was to examine how supervised learning sessions during patient treatment were constructed. The focus was on the forms of interaction between clinical educators and students in natural contexts. By videotaping 12 natural patient treatment sessions, which simultaneously comprised part of the clinical education of physiotherapy students, a…
Discourse Analytic Study of Counseling Sessions in Stroke Physiotherapy
Studies on the interaction between physiotherapists and patients during treatment sessions have found low levels of communicative participation by patients and lack of direct influence by patients on the content of their treatment. This article reports the results of 7 counseling sessions in which physiotherapists and patients with stroke and their caregivers discussed the patients' postural control and balance, which had been tested and videotaped at different stages of the rehabilitation process. The physiotherapists' discourses relating to the videotaped test performances were either brief comments on the patient's performance or critical appraisals with references to difficulties encoun…
Relationships Between Standing Balance and Symmetry Measurements in Patients Following Recent Strokes (≤3 Weeks) or Older Strokes (≥6 Months)
Abstract Background and Purpose. The Functional Standing Balance (FSB) Scale was designed to obtain measurements of standing balance and to identify the problems typically faced by people with stroke. The purpose of this study was to investigate the validity of measurements obtained with the FSB Scale for use in the acute and chronic phases of stroke by comparing the measurements obtained with the FSB Scale with those obtained for postural sway and lateral symmetry by use of a force platform. Subjects and Methods. Measurements were obtained for 26 people with recent strokes (ie, strokes within 3 weeks of data collection) and for 28 people with long-standing strokes (ie, strokes of 6 months'…
Socio-affective characteristics and properties of extrinsic feedback in physiotherapy
Background and Purpose The usual approach in physiotherapy is to communicate the desired action by means of some combination of verbal instruction and explanation, visual demonstration and manual assistance. Patients' and physiotherapists' communication and acts express socio-affective elements which influence the atmosphere governing this interaction. The purpose of this study was to investigate the socio-affective characteristics of the verbal, visual and manual feedback given to their patients by physiotherapists in the performance of their duties. Method Data were collected by videotaping patient–physiotherapist interaction. Systematic observation was used to depict physiotherapists' an…