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BACKGROUND: In physical therapy practice patients and therapists exchange their perspectives on musculoskeletal health problems and their meaning for both of them. However, literature indicates that physical therapists find it difficult to enquire about the patients' values during clinical encounters. OBJECTIVES: The aim of this study was to gain deeper insight into the perspectives of physical therapists about patient values. DESIGN: Explorative qualitative focus group study. METHOD: Twenty-three physical therapists were interviewed in the Netherlands from March to May 2021. Two researchers analyzed the interviews and derived relevant codes. After an iterative process of comparing, analyzing, conceptualizing and discussing the codes, themes were identified through a thematic framework, illustrated with meaningful quotes. RESULTS: Three major themes were identified: Humane, Tacit, and Responsive. It appeared that patient values play unconsciously a major role in daily practice and are associated with humanity, not technical or procedural aspects of the encounter. Responsive denotes that all values require interaction in which aligning with the individual patient forms the basis of treatment. Barriers for being responsive are identified as subthemes: Choices, Trust, Diverseness, and Boundaries. CONCLUSION: The concept of patient values appeared to be implicit. The professional intuitively attunes as a fellow human being to values and expectations of the individual patient. This study contributes to finding a balance and mutual reinforcement of implicit and explicit knowledge. With all found experiences and insights the concept of patient values became more explicit in physical therapy to create a framework for education and research in the future.

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Este guia se propõe orientar profissionais fisioterapeutas na atenção ao paciente com câncer avançado e dor. Será feita uma explanação, aprofundando conteúdos científicos sobre sua avaliação e tratamento fisioterapêutico, e essas informações têm como objetivo promover melhor assistência ao paciente com limitações provenientes desse sintoma

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A prematuridade pode causar déficits de desenvolvimento motor nos lactentes apresentando assim a necessidade de intervenção precoce, neste sentido o objetivo deste trabalho foi comparar o desenvolvimento motor de lactentes prematuros na aquisição da habilidade do sentar independente após um programa de intervenção motora e de orientação de pais para estímulos domiciliares. Estudo longitudinal e avaliativo sobre o marco motor sentar em 11 lactentes, de ambos os sexos, com diagnóstico de prematuridade e idade cronológica de 6 a 8 meses. Os participantes foram divididos em dois grupos, o grupo intervenção que recebeu tratamento fisioterapêutico três vezes por semana durante seis semanas; e o grupo orientação, com encontros semanais durante o mesmo período com a fisioterapeuta que disponibilizou uma cartilha estruturada de exercícios a serem realizados pelos cuidadores durante a semana, sendo ambos os grupos com foco no sentar independente e avaliados com a escala AIMS. Foram encontradas diferenças significativas entre os resultados antes e após intervenção (t: -6.8571; p: 0,0012) assim como antes e após orientação (t: - 4.5995; p: 0.0029), sendo que ao analisar a porcentagem do ganho na dimensão sentar pela AIMS, o grupo intervenção teve maior ganho. Conclui-se que a intervenção fisioterapêutica apresentou melhores resultados para a aquisição do marco motor sentar. Apesar disso, a estimulação feita pelos pais após orientação profissional também apresentou valores positivos.

Prematurity can cause motor development deficits in infants, thus presenting the need for early intervention, in this sense the objective of this study was compare the motor development of preterm infants in the acquisition of the ability to sit independently after a motor intervention program and of orientation of parents for home stimuli. A longitudinal and evaluative study on the motor frame sit in 11 infants, of both sexes, with diagnosis of prematurity and chronological age of 6 to 8 months. Participants were divided into two groups, the intervention group that received physiotherapeutic treatment three times a week for six weeks; and the orientation group, with weekly meetings during the same period with the physiotherapist who provided a structured workbook of exercises to be performed by the caregivers during the week, both groups being focused on independent sitting and evaluated with the AIMS scale. There were significant differences between the results before and after intervention (t: -6.8571; p: 0.0012) as well as before and after orientation (t: -4.5995; p: 0.0029); when analyzing the percentage of gain in dimension by the AIMS, the intervention group had greater gain. It was concluded that the physiotherapeutic intervention presented better results for the acquisition of the motor frame sit. Despite this, the stimulation done by the parents after professional orientation also presented positive values.

La prematuridad puede causar déficits de desarrollo motor en los bebés, por lo que se requiere una intervención temprana. El objetivo de este estudio fue comparar el desarrollo motor de los bebés prematuros en la adquisición de la capacidad de sentarse de forma independiente después de un programa de intervención motora y la orientación de los padres para la estimulación en el hogar. Se trata de un estudio longitudinal y evaluativo del hito motor de la sedestación en 11 bebés de ambos sexos, diagnosticados como prematuros y con una edad cronológica que oscila entre los 6 y los 8 meses. Los participantes se dividieron en dos grupos, el grupo de intervención que recibió tratamiento fisioterapéutico tres veces por semana durante seis semanas; y el grupo de orientación, con reuniones semanales durante el mismo periodo con el fisioterapeuta que proporcionó un folleto estructurado de ejercicios que debían realizar los cuidadores durante la semana, ambos grupos centrados en la sedestación independiente y evaluados con la escala AIMS. Se encontraron diferencias significativas entre los resultados antes y después de la intervención (t: -6,8571; p: 0,0012), así como antes y después de la orientación (t: -4,5995; p: 0,0029), y al analizar el porcentaje de ganancia en la dimensión de sentarse por el AIMS, el grupo de intervención tuvo mayor ganancia. Concluimos que la intervención fisioterapéutica presentó mejores resultados para la adquisición del hito motor sentado. Sin embargo, la estimulación realizada por los padres tras la orientación profesional también mostró valores positivos.

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O objetivo deste estudo é compreender o significado da experiência do estágio curricular de Fisioterapia em cenários de prática da Atenção Primária à Saúde (APS). Foi realizada uma pesquisa qualitativa (estudo de caso) a partir de entrevistas semiestruturadas com estudantes de Fisioterapia, supervisores, profissionais da saúde e usuários (n = 20). O material textual foi interpretado pela análise de conteúdo. O estágio na APS mostrou-se um importante componente curricular da graduação em Fisioterapia, oportunizando o conhecimento/problematização da singularidade da vida nos territórios e estabelecendo relações de vínculo do estudante aos usuários-famílias; e fortalecendo a identidade profissional do fisioterapeuta pelo reconhecimento da equipe e usuários sobre o papel da Fisioterapia na APS. Barreiras foram percebidas pela ausência do fisioterapeuta na equipe de APS e pela interação com a equipe, que foi restrita a determinados profissionais, limitando a análise da experiência do estágio na sua perspectiva interprofissional.(AU)

El objetivo de este estudio es comprender el significado de la experiencia de la pasantía curricular de Fisioterapia en escenarios de práctica de la Atención Primaria de la Salud (APS). Se realizó investigación cualitativa (estudio de caso) a partir de entrevistas semiestructuradas con estudiantes de Fisioterapia, supervisores, profesionales de la salud y usuarios (n=20). El material textual se interpretó por el análisis de contenido. La pasantía en la APS mostró ser un importante componente curricular de la graduación en Fisioterapia. Hizo oportuno el conocimiento/problematización de la singularidad de la vida en los territorios, estableciendo relaciones de vínculo del estudiante con los usuarios-familias. Fortaleció la identidad profesional del fisioterapeuta por el reconocimiento del equipo y usuarios sobre el papel de la fisioterapia en la APS. Se percibieron barreras por la ausencia del fisioterapeuta en el equipo de APS y por la interacción con el equipo que se restringió a determinados profesionales, limitando el análisis de la experiencia de la pasantía desde su perspectiva interprofesional.(AU)

This study aimed to understand the meaning of the experience of the Physiotherapy curricular internship in Primary Health Care (PHC) practice settings. A qualitative research (case study) was carried out based on semi-structured interviews with Physiotherapy students, supervisors, health professionals and users (n=20). The textual material was interpreted by content analysis. The internship in PHC proved to be an important curricular component of the Physiotherapy undergraduate course. It provided opportunities for knowing and problematizing the uniqueness of life in the territories and established bonds between students and users-families. It strengthened the professional identity of the physiotherapist through the team's and users' recognition of the role played by physiotherapy in PHC. Barriers were perceived due to the absence of the physiotherapist in the PHC team and to the fact that interaction with the team was restricted to certain professionals, limiting the analysis of the internship experience in its interprofessional perspective.(AU)

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BACKGROUND: The history of physiotherapy in Latin America has received little attention thus far in the English-speaking literature. In this paper, we draw on narratives from activists, educators, and professional leaders who have been instrumental in shaping the development of physiotherapy in Argentina, Colombia, and Ecuador. Physiotherapists in the Latin American countries faced many similar challenges, including developing physiotherapy in the shadow of medicine, overcoming conservative attitudes toward women professionals, and frequent social upheaval. AIMS: The paper explores the disputed story of physiotherapy's origins in the polio epidemics, the influence of Swedish remedial gymnastics, and the educational colonialism of North American and European educators. We examine some of the effects of social unrest and trauma, military rule, and economic instability on the professions attempts to establish itself in the face of competition from other professions allied to medicine. And we consider the efforts taken to establish the profession's autonomy and its shifting relationship with the state. METHODS: We employed two different methods for data collection to explore aspects of physiotherapy's history in Latin America from a political and socio-cultural context: 1) A reconstruction of memories from activist physiotherapists in Colombia, Ecuador, and Argentina, who have seen, lived, and promoted the development of physiotherapy in their own countries, gleaned from in-depth interviews; and 2) Analysis of secondary sources. Data were analyzed following the method described by Maynes, Pierce, and Laslett (2008), exploring personal narratives. Textual data were analyzed using documentary research (Prior, 2003) using thematic analysis, to inductively discover, and describe relevant themes about the two main guiding study questions. A constant comparative method as outlined by Boeije (2002) was used to form categories, establish boundaries, and discerning conceptual similarities between participants' narrative. RESULTS: Five physiotherapists were interviewed. One from Colombia, two from Argentina and two from Ecuador. Three main themes were identified: 'A Female Profession?', 'training and education', and 'Present Day in Argentina, Ecuador, and Colombia'. Tensions between the interests of the State, professionals, patients, cultures, urban and rural services, and practices are prevalent throughout physiotherapy in Argentina, Colombia, and Ecuador. Operating within these tensions is very much the reality for physiotherapists in Latin America today. CONCLUSION: Multiple histories emerge from the research, opening up a space for a more nuanced, polyphonic reading of physiotherapy in Colombia, Ecuador, and Argentina than has been heard to date.

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OBJECTIVE: The purpose of this case report was to describe the role of physical therapists in a neurosurgical center that was converted into a COVID-19 center for critically ill patients. METHODS (CASE DESCRIPTION): On March 16, 2020, the state government of Rio de Janeiro, Brazil, determined that a neurosurgical center with 44 ICU beds equipped with mechanical ventilators should immediately transfer all patients with neurological conditions to other institutions and prepare for patients who were critically ill with COVID-19. The staff, including physical therapists, were trained to handle patients with COVID-19, many of whom were developing acute respiratory distress syndrome (ARDS) with complex and multifactorial ventilatory support needs. Adjustments were made to the physical therapy routine and protocols. Following the stabilization of patients' respiratory condition, physical therapist interventions focused on restoring physical function. RESULTS: A total of 116 confirmed COVID-19 cases were treated from March 17 to May 17, 2020. Sixty percent were men (70) and 40% were women (46), with a median age of 59 years. Eighty-nine percent (103) underwent mechanical ventilation during hospitalization, of which 11% (11) were successfully extubated. Thirty percent (31) of patients underwent tracheostomy, and 26% of those (8) were successfully decannulated. Of the total patients, 57 patients died (mortality rate of 49%), 4 (3%) were transferred to another institution, 23 (20%) were discharged home, and 32 (28%) continued to be hospitalized. CONCLUSION: Physical therapists in the ICU can facilitate care for critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training. IMPACT: The coronavirus pandemic has highlighted the importance of physical therapists, specifically in the care of patients who are critically ill with COVID-19. The availability and expertise of physical therapists in the ICU are important for managing critical events such as intubation, patient positioning, ventilatory adjustments, extubation, and functional training.

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BACKGROUND: In Brazil, the number of physical therapy education programs and, consequently, of professionals has been growing for the past 20 years. OBJECTIVES: The objective of the study was to describe the evolution and distribution of physical therapist education programs in Brazil and to analyze the impact of workforce growth on the labor market for these professionals. DESIGN: This was a descriptive, exploratory, quantitative study. METHODS: Secondary data collected from official sources in Brazil were used. RESULTS: The first physical therapist education program was created in 1958, and, after significant growth, 536 programs were active in 2014. The historical series (1996-2014) shows a corresponding increase in the number of admissions by higher educational institutions. This expansion resulted in an increase in the number of professionals, with an impact on the labor market. The workforce in physical therapy is predominantly female, and women increased their participation in this labor market from 59% in 1996 to 81% in 2014. An increase in nominal monthly salaries was observed over the years from US $797.00 in 1996 to US $1056.00 in 2014. Nevertheless, the real average salaries, that is, salaries adjusted to inflation, have followed a trend of devaluation. LIMITATIONS: Results of this study must be interpreted in terms of overall trends rather than as precise absolute numbers due to the inherent nature of the varied secondary data sources. CONCLUSIONS: These data can support further discussion on training and the labor market in the field of physical therapy.

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OBJECTIVE: The aim of the study was to determine if evidence-based physiotherapy (EBP) was being applied in the public physiotherapy and physical rehabilitation departments in Ecuador, Zone 3. METHODS: A cross-sectional study was developed applying the "Evidence-Based Practice: Beliefs, Attitudes, Knowledge, and Behaviors of Physical Therapists" questionnaire, designed by Jette et al. and validated in Spanish by Guerra et al. to 67 physiotherapists working in the public service in the provinces of Chimborazo, Cotopaxi, Pastaza, and Tungurahua. RESULTS: Of the physiotherapists, 65.67% fully agree in being necessary to implement EBP in their clinical setting; however, 44.78% identified EBP as highly time demanding. Insufficient time (95.52%), lack of information resources (53.73%), and absence of support among co-workers (50.75%) were reported as the main barriers that prevent physiotherapists from practicing EBP. CONCLUSIONS: Physiotherapists showed a positive attitude and interest towards EBP, although there is unawareness on how to accomplish EBP on daily basis in addition to little specific training during preprofessional studies in relation to scientific research.

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