Elena Marqués-Sulé

Pilot randomized controlled trial to assess a physical therapy program on upper extremity function to counteract inactivity in chronic stroke

Background: In chronic stroke, feasible physical therapy (PT) programs are needed to promote function throughout life. Objective: This randomized controlled pilot trial investigated the feasibility and effect of a PT program composed of strengthening exercises with elastic bands and bimanual functional training, with clearly defined doses based on the rate of perceived exertion (Borg scale), to counteract inactivity in chronic stroke. Methods: Fifteen subjects > 6 month post-stroke were randomized to three-month of UE function training (UE group), or to lower extremity function training (LE group). At baseline (T0), post-intervention (T1) and three-month follow-up (T2) assessment included the Fugl-Meyer Assessment scale (FMA), Wolf Motor Function test (WMFT), grip strength, and muscle tone. Feasibility was also evaluated. Results: The mixed-model ANOVAs revealed a significant interaction between the time and group factors for FMA (p < .001) and WMFT (p = .009). The UE group improved upper extremity function and motor recovery significantly more than the LE group. There was no significant interaction between treatment group and change in grip strength over time (p = .217). No between-group differences (p > .05) were found in muscle tone. In the UE group, the attendance rate was ≥85% for 71.4% of subjects and 85.7% showed high satisfaction. No adverse events were recorded. After treatment, adherence to the program was higher in the UE group. Conclusions: The suggested PT program may be useful to improve the paretic UE function and motor recovery in chronic stroke. Moreover, it may be helpful to facilitate lifelong active involvement of stroke subjects in exercise.

Frequency of dicentrics and contamination levels in Ukrainian children and adolescents from areas near Chernobyl 20 years after the nuclear plant accident.

Abstract Purpose: To survey the possible presence of chromosomal damage and internal contamination in a group of Ukrainian children and adolescents, 20 years after the Chernobyl accident at the Nuclear Power Plant. Materials and methods: Cytogenetical procedures were performed according to dicentric assay in 55 Ukrainian children and adolescents (29 boys and 26 girls), living near Chernobyl. In addition, a whole body detector and urinalysis were used to detect internal contamination. Results: 36 dicentrics were found in a total of 53,477 metaphases scored in these children, which reflected a frequency of dicentrics below the background level. On the other hand, internal contamination was not detected in any subject studied. Conclusions: Since the estimated absorbed dose is below the detection limit, according to both biological and physical dosimetry, radiation overexposure during the last 3–5 years has not been detected in the considered subjects.

A blended-learning programme regarding professional ethics in physiotherapy students:

Background: In the university context, assessing students’ attitude, knowledge and opinions when applying an innovative methodological approach to teach professional ethics becomes fundamental to know if the used approach is enough motivating for students. Research objective: To assess the effect of a blended-learning model, based on professional ethics and related to clinical practices, on physiotherapy students’ attitude, knowledge and opinions towards learning professional ethics. Research design and participants: A simple-blind clinical trial was performed (NLM identifier NCT03241693) (control group, n = 64; experimental group, n = 65). Both groups followed clinical practices for 8 months. Control group performed a public exposition of a clinical case about professional ethics. By contrast, an 8-month blended-learning programme regarding professional ethics was worked out for experimental group. An online syllabus and online activities were elaborated, while face-to-face active participation techniques were performed to discuss ethical issues. Students’ attitudes, knowledge and opinions towards learning professional ethics were assessed. Ethical considerations: The study was approved by the University Ethic Committee of Human Research and followed the ethical principles according to the Declaration of Helsinki. Findings: After the programme, attitudes and knowledge towards learning professional ethics of experimental group students significantly improved, while no differences were observed in control group. Moreover, opinions reported an adequate extension of themes and temporization, importance of clinical practices and interest of topics. Case study method and role playing were considered as the most helpful techniques. Conclusion: The blended-learning programme proposed, based on professional ethics and related to clinical practices, improves physiotherapy students’ attitudes, knowledge and opinions towards learning professional ethics.

ENHANCING ONLINE LEARNING: THE USE OF OPEN COURSE WARE AS A TECHNOLOGICAL PLATFORM FOR THE STUDY OF COMMUNITY PHYSIOTHERAPY

Introduction: In the field of Higher Education, the modification of teaching-learning processes through the use of new teaching methodologies, is needed. To publish multimedia teaching materials (MTM) on technology platforms such as Open Course Ware (OCW) is currently possible. The aim of this study is to create on-line MTM for the subject Community Physiotherapy (CP) (University of Valencia, Spain) and present these materials in the OCW repository. Methodology: Eight presentations were created, reviewed and presented in the online repository OCW. These MTM included different types of resources, such as presentations, images, graphics, texts, tables and concept maps. In addition, we designed a hypertext structure, in which texts, images or videos referred to other web pages, as well as to additional information related to Community Physiotherapy. Results: This work presents the MTM that have been designed for the subject CP and are available in OCW. MTM have been differentiated by the type of teaching material. Thus, asynchronous study of the material is allowed. We expect students to improve their skills, increase their interest and have direct access to information. Educational Innovation Project funded by the University of Valencia. Conclusion: The proposed MTM can be considered a valid and useful resource for students, with the aim of achieving the learning objectives of the subject CP.

SATISFACTION OF PHYSIOTHERAPY STUDENTS TOWARDS A FORMATIVE EVALUATION PROGRAMME APPLIED TO CARDIOVASCULAR PHYSIOTHERAPY

Introduction. Nowadays, assessing students ́ opinions at the university is very important, in order to improve their interest and motivation towards the subject. Evaluation is considered as a systematic activity integrated in the teaching-learning process to optimize this process, readjusting the objectives, programmes, methods and resources. Thus, university teachers have to identify difficulties in the students` learning, to stimulate the effectivity of learning strategies and resources and assigning qualifications. In addition, it is an orientation for pupils, trying to improve their interest and motivation, both highly related to the students ́ satisfaction. The purpose of this study was to evaluate the satisfaction towards the materials used, the teaching methodology and the evaluation methodology of a programme based on formative evaluation. Methods. 185 Physiotherapy students (21±4,2 years, 48% women) were assigned to an experimental group (n=83) or to a control group (n=102). All participants signed an informed consent. A programme based on formative evaluation to teach Cardiovascular Physiotherapy was worked out for the students of the third course of the Physiotherapy Degree (University of Valencia, Spain). A special syllabus with multimedia materials was elaborated in the on-line institutional repository Roderic and was available for both groups. Experimental group followed the new methodology: formative evaluation, active group sessions and several on-line activities. On the other hand, control group performed the subject as usual with traditional lectures and final exams. Satisfaction towards the materials used, teaching methodology and evaluation methodology was assessed at the end of the programme. MannWhithney tests were used to compare between-group differences. Significance level was set at 0,05. Results. Regarding the satisfaction towards the teaching methodology, experimental group showed a significantly higher satisfaction when compared to the control group (25,50±3,56 vs. 24,0±3,59 respectively, p=0,022). Nevertheless, satisfaction towards the teaching materials used did not showed significant differences (14,50±3,08 vs.14,0±2,80 respectively, p=0,610). In addition, evaluation methodology was not significant different between both groups (16,0±2,10 vs. 16,0±2,87 respectively, p=0,329). In general, students were satisfied with the programme we used. Conclusions. The learning programme we present improves students ́ satisfaction toward the teaching methodology of a programme based on formative evaluation in order to learn Cardiovascular Physiotherapy.