Carmen Suárez Serrano

Attitudes of European physiotherapy students towards their chosen career in the context of different educational systems and legal regulations pertaining to the practice of physiotherapy: implications for university curricula

OBJECTIVES Differences in the organisation of educational systems and regulations pertaining to the practice of a profession can influence the attitudes of students towards their chosen career and their perceptions of employment possibilities. The aim of this paper was to discuss the different educational systems and legal regulations pertaining to the practice of physiotherapy in selected countries of the European Union (EU), and to present some conclusions regarding the influence of these differences on the perceptions of first-year physiotherapy students on their chosen career. DESIGN Quantitative questionnaire-based study. SETTING Twenty-one university-level schools in the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. PARTICIPANTS Six hundred and sixty-seven first-year physiotherapy students. RESULTS The mean response rate was 74%. Most students (79%) reported that a personal interest was the main reason why they had decided to study physiotherapy (79%). Most students from Spain and the Czech Republic reported that, on completion of their studies, they would like to work as physiotherapists (61/120, 51% Czech Republic; 140/250, 56% Spain), compared with only 4% of Polish students (P<0.001). Most students from Poland and Spain were not familiar with employment opportunities in their respective countries (202/250, 81% Spain; 212/250, 85% Poland), and claimed that it is difficult to find employment as a physiotherapist in their country. Most students from the Czech Republic, Latvia, Malta, Poland, Spain and the U.K. claimed that it is easy to find a job in other EU countries. CONCLUSION Most physiotherapy students chose their course because of an interest in physiotherapy. They were not familiar with employment possibilities for graduates, and believed that it is easier to find work in other EU countries. Both factors may further aggravate the problem of unemployment among physiotherapists.

The efficacy of capacitive radio-frequency diathermy in reducing buttock and posterior thigh cellulite measured through the cellulite severity scale

AbstractBackground: Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. Objectives: To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. Methods: Design: Experimental clinical study consists of two parallel groups. Sample: Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patients two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. Variables: Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. Results: A significance of p ...Abstract Background: Cellulite, despite its high prevalence in women, has been subjected to very little research, while the majority has been carried out using unvalidated evaluation tools. Objectives: To determine the efficacy of capacitive radio-frequency diathermy (CRFD) in reducing buttock and posterior thigh cellulite and to verify its relationship with the reduction of body weight. Methods: Design: Experimental clinical study consists of two parallel groups. Sample: Totally 54 lower limbs of 27 women (26.41 ± 6.16 years) were considered with each patients two limbs being assigned one to each group via simple random distribution. First group received local application of CRFD (30 min) and the second received the same treatment followed by a supplementary whole-segment application of CRFD (20 min). Each limb received 20 sessions, twice a week. Variables: Cellulite Severity Scale dimensions score, weight and Body Mass Index (BMI) were taken for the evaluation of the study. Results: A significance of p less than 0.01 was observed for all the variables in both groups, thereby demonstrating the effectiveness of both the treatments; no significant differences were observed between groups (p > 0.05). Conclusions: Monopolar static application of CRFD is effective in reducing buttock and posterior thigh cellulite. It appears that there is not necessarily any relationship between weight loss, decreased BMI and reduction in cellulite.

Evaluation of levator ani muscle throughout the different stages of labor by transperineal 3D ultrasound.

Description and assessment by 3‐D transperineal ultrasound of modifications suffered by pelvic floor muscles during the passage of the fetal head through the birth canal during the second stage of labor, as well as the identification of the precise moment in which levator ani muscle avulsion takes place.

Spanish Version of the Broome Pelvic Muscle Self-Efficacy Scale: Validity and Reliability

Background Self-efficacy appears to be an important predictor of functional recovery for women with urinary incontinence, but no specific Spanish-language questionnaires for measuring pelvic-floor exercise self-efficacy exist. Objective The aim of this study was to design a valid and reliable Spanish version of the Broome Pelvic Muscle Self-Efficacy Scale to measure self-efficacy, as perceived by women with urinary incontinence, in performing pelvic-floor exercises. Design This was an observational validation study. Methods Translation-back translation was used to design the survey, and then the survey was validated with a sample of 119 women who were incontinent and had undergone a pelvic-floor exercise training program. The reliability and construct validity of the questionnaire were assessed. Descriptive statistics were used to score the questionnaire. Internal consistency was evaluated with the Cronbach alpha coefficient and the Pearson correlation coefficient. Exploratory factor analysis with both the principal components extraction method and the varimax rotation method was used to assess construct validity. Results The reliability coefficient (Cronbach alpha=.91) and the correlations among items were high. The factor analysis revealed that 6 main factors accounted for 75.8% of the variance. Limitations Conclusions regarding the validity of the questionnaire should be drawn with caution because of the inability to assess criterion-related validity. Conclusions The Spanish version of the Broome questionnaire for self-efficacy appears to be useful as a measuring tool for a psychometrically accurate, clinically relevant estimation of womens self-efficacy in performing pelvic-floor exercises.

Discriminating power of CPPQ‐Mohedo: a new questionnaire for chronic pelvic pain

OBJECTIVES In the absence of a gold-standard tool to measure chronic pelvic pain (CPP), most studies on the prevalence of CPP use the NIH-chronic prostatitis symptom index (CPSI) questionnaire. However, its suitability and relevance for use in both sexes have not yet been evaluated, and generalized interpretation of the results is therefore questionable. Accordingly, we designed a questionnaire that discriminates between patients with and without symptoms of CPP. METHODS We undertook a study to test the discriminating capacity for chronic pelvic pain questionnaire (CPPQ)-Mohedo test for CPP among healthy and unhealthy individuals, and if this discrimination was similar for men and women. We did a matched study - 40 unhealthy men were matched by age with 40 unhealthy women - and each of those was matched with six healthy controls by age and sex (480 in total). To elaborate the questionnaire (CPPQ-Mohedo), we started with the NIH-CPSI, adapting the items referring to anatomic areas for women, changing the type of response and including various items on pelvic pain not previously recorded. RESULTS The NIH-CPSI questionnaire [area under the receiver operating characteristic (ROC curve), 0.946] was very similar to that of the CPPQ-Mohedo questionnaire (area under the ROC curve, 0.968), but the first required more items. CPPQ-Mohedo showed similar discriminant capacity between men and women. The dimensions involved (pain and quality of life) showed internal consistency (Cronbachs alpha: 0.75). CONCLUSIONS The CPPQ-Mohedo questionnaire presented discriminating power in men and women with symptoms of CPP. This questionnaire may be used as a screening tool to identify patients and include them in treatment programmes, as an outcome assessment tool for treatment and clinical trials, or as a tool to assess the prevalence of CPP in epidemiologic studies.

Eficacia ante el dolor y la discapacidad cervical de un programa de fisioterapia individual frente a uno colectivo en la cervicalgia mecánica aguda y subaguda

OBJECTIVE To compare the efficacy in reducing neck pain and disability in an individualised physiotherapy treatment with group treatment in acute and subacute mechanical neck pain. DESIGN Randomised clinical trial. LOCATION Health Area of University Hospital Virgen del Rocío, Seville, Spain. PARTICIPANTS A total of 90 patients diagnosed with mechanical neck pain of up to one month onset, distributed randomly into two groups: (i)individualised treatment; (ii)group treatment. INTERVENTION The treatment consisted of 15 sessions of about 60minutes for both groups. Individual treatment consisted of 15minutes of infrared heat therapy, 17minutes of massage, and analytical passive stretching of the trapezius muscles and angle of the scapula. The group treatment consisted of a program of active mobilisation, isometric contractions, self-stretching, and postural recommendations. MAIN MEASURES Pain was measured at the beginning and end of treatment pain using a Visual Analogue Scale (VAS) and an algometer applied on the trapezius muscles and angle of the scapula, and neck disability using the Neck Disability Index. RESULTS Both treatments were statistically significant (P<.001) in improving all variables. Statistically significant differences (P<.001) were found for all of them in favour of individualised treatment compared to group treatment. CONCLUSIONS Patients with acute or subacute mechanical neck pain experienced an improvement in pain and neck disability after receiving either of the physiotherapy treatments used in our study, with the individual treatment being more effective than collective.Resumen Objetivo Comparar la eficacia en la disminución del dolor y la discapacidad cervical del tratamiento fisioterapéutico individualizado frente al colectivo en las cervicalgias mecánicas agudas y subagudas. Diseño Ensayo clínico aleatorizado. Emplazamiento . Área sanitaria del Hospital Universitario Virgen del Rocío, Sevilla. Participantes Noventa sujetos diagnosticados de cervicalgia mecánica de menos de un mes de evolución distribuidos aleatoriamente en 2 grupos: a) tratamiento individualizado, y b) tratamiento colectivo. Intervención Se realizaron 15 sesiones de aproximadamente 60 min en ambos grupos. El tratamiento individual consistió en 15 min de termoterapia infrarroja, 17 de masaje, y estiramientos analíticos pasivos de los músculos trapecio y angular de la escápula. El colectivo constó de un programa de movilizaciones activas, contracciones isométricas, autoestiramientos y recomendaciones posturales. Mediciones principales Al inicio y al final del tratamiento se midió el dolor mediante la escala visual analógica y el algómetro aplicado sobre los músculos trapecio y angular de la escápula, así como la discapacidad cervical mediante el índice de discapacidad cervical. Resultados Ambos tratamientos se mostraron estadísticamente significativos (p < 0,001) en la mejora de todas las variables. Se observaron diferencias estadísticamente significativas (p < 0,001) para todas ellas a favor del tratamiento individualizado frente al colectivo. Conclusiones Los pacientes con cervicalgia mecánica en estado agudo o subagudo experimentan una mejora estadísticamente significativa del dolor y de la discapacidad cervical tras recibir ambas modalidades de tratamiento de fisioterapia empleadas en nuestro estudio, mostrándose la modalidad de tratamiento individual más eficaz que la colectiva.

Discriminating power of CPPQ-Mohedo: a new questionnaire for chronic pelvic pain: Discriminating power of CPPQ-Mohedo

OBJECTIVES In the absence of a gold-standard tool to measure chronic pelvic pain (CPP), most studies on the prevalence of CPP use the NIH-chronic prostatitis symptom index (CPSI) questionnaire. However, its suitability and relevance for use in both sexes have not yet been evaluated, and generalized interpretation of the results is therefore questionable. Accordingly, we designed a questionnaire that discriminates between patients with and without symptoms of CPP. METHODS We undertook a study to test the discriminating capacity for chronic pelvic pain questionnaire (CPPQ)-Mohedo test for CPP among healthy and unhealthy individuals, and if this discrimination was similar for men and women. We did a matched study - 40 unhealthy men were matched by age with 40 unhealthy women - and each of those was matched with six healthy controls by age and sex (480 in total). To elaborate the questionnaire (CPPQ-Mohedo), we started with the NIH-CPSI, adapting the items referring to anatomic areas for women, changing the type of response and including various items on pelvic pain not previously recorded. RESULTS The NIH-CPSI questionnaire [area under the receiver operating characteristic (ROC curve), 0.946] was very similar to that of the CPPQ-Mohedo questionnaire (area under the ROC curve, 0.968), but the first required more items. CPPQ-Mohedo showed similar discriminant capacity between men and women. The dimensions involved (pain and quality of life) showed internal consistency (Cronbachs alpha: 0.75). CONCLUSIONS The CPPQ-Mohedo questionnaire presented discriminating power in men and women with symptoms of CPP. This questionnaire may be used as a screening tool to identify patients and include them in treatment programmes, as an outcome assessment tool for treatment and clinical trials, or as a tool to assess the prevalence of CPP in epidemiologic studies.