Cancer Rehabilitation, Diabetes, Haemodialysis: AB No: 23: Development, Validation and Establishing Internal Consistency of Knowledge, Attitude, and Barriers towards Tele Physiotherapy Questionnaire

Background: During unprecedented times of COVID- 19, continuing Physiotherapy through conventional mode is tough and limited to certain extent. To overcome the current situation, WCPT has strongly suggested the implementation of Tele-physiotherapy. Many studies have proven efficiency of Tele-rehabilitation in delivering rehabilitative services;still its use is limited in India may be due to knowledge and attitude of physiotherapists. Currently, no valid tool is available for assessing the attitude, knowledge and barrier of tele physiotherapy among Indian physiotherapist. Thus, the aim of the current study is to develop, validate and establish internal consistency of the questionnaire for the same. Participants: 60 physiotherapists with minimum of 1 year of and those who were willing to participate were included. Non-Practicing Physiotherapist were excluded from the study. Method: Questionnaire was drafted on the basis of previous studies under 4 domains: Demographics, Knowledge, Attitude and Barrier. A panel of 5 experts was formulated. A Delphi process was carried out to validate the developed questionnaire. The content validity ratio (CVR) was calculated. The questionnaire was sent to physiotherapists electronically/ physically and data of 60 Physiotherapist was analysed for Cronbach alpha coefficient using SPSS version 20. Results: The content validity ratio for the complete questionnaire was 0.98. 66.7 % of our sample was between the age of 25–35 years with 82.2% Physiotherapists were postgraduate and 26.2% being experienced for more than 10 years. The Cronbach alpha coefficient for internal Consistency of the questionnaire was good (0.77). Conclusion: The questionnaire is as an effective valid and reliable tool to assess knowledge, Attitude, and Barrier towards Tele physiotherapy. Implications: Developing and validating Questionnaire will help us measure the knowledge, Attitude and Barriers towards Tele- Physiotherapy amongst Physiotherapists across India in a comprehensive way. This in turn will help policymakers and Authorities to make new policies/ modify existing ones for effective use of Tele- Physiotherapy.

COVID-19 pandemic and physiotherapy practice: the efficacy of a telephone-based therapeutic program for people with knee osteoarthritis.

BACKGROUND: Knee osteoarthritis (OA) is one of the leading causes of pain and disability among adults worldwide. For many individuals with knee OA, accessing proper physiotherapy services is difficult, especially with the current COVID-19 pandemic. OBJECTIVE: The purpose of the current study is to investigate the feasibility and efficacy of a telephone-based physiotherapy (PT) care program for people with knee OA. METHODS: This was a pilot feasibility study, with a cross-over design and repeated measures. Two groups with knee OA were recruited, an immediate therapy group (IG) and a delayed therapy group (DG). The therapeutic program involved a telephone call from a physiotherapist to the participants 3/week for 8 weeks. Physiotherapist delivered to participants educational information on knee OA, followed-up on adhering to daily therapeutic exercises and coached participants regarding exercises while using a behavioral-change framework to ensure proper therapy. Following the 8-weeks program, the IG group were advised to continue exercises and the DG group were provided with the same telephone-based PT program. RESULTS: Forty participants were enrolled in the study (IG = 20; DG = 20). There were no significant differences between groups at baseline. The results of our study showed that the telephone-based PT program led to improvements across all outcome measures. Participants reported that they had less pain, less stiffness, and an overall improvement in physical function. CONCLUSIONS: A telephone-based PT program appears to be feasible and effective in yielding significant benefits among individuals with knee OA.

Pandemic decrease of in-person physiotherapy as a factor in parent perceived decline in function in children with neuromuscular disorders.

PURPOSE: Restrictions related to the COVID-19 pandemic can negatively affect patients who require physiotherapy. This study aimed to analyze the consequences of limited physiotherapy on the functional state of children with neuromuscular diseases (NMD). In addition, the caregivers' well-being and caregiver opinions on physiotherapy were analyzed. METHODS: A questionnaire was shared with parents of children with NMD immediately after the COVID-19 lockdown. The survey included questions regarding the physical and mental condition of children and parents before the pandemic and during lockdown as well as their views on physiotherapy and telephysiotherapy. Statistical analysis was performed using the Wilcoxon Matched-Pairs Signed Ranks test, Spearman's Rank Correlation test, McNemar test, and Chi-square test. RESULTS: Parents of 235 children participated in the study. Results indicated that children devoted more time to physiotherapy before the pandemic than during the lockdown period, which was true for those living in cities and the countryside. The functional state of 50.2% of the children deteriorated during the lockdown, in the opinion of their parents. Significant correlations were found between limited physiotherapy time and the deterioration of children's functional condition, ability to maintain a standing position, and increased anxiety. The majority of parents reported increased levels of fear and anxiety (72.8%), fatigue (67.7%), and pain (53.2%). In-person physiotherapy was rated significantly higher than telephysiotherapy by parents. CONCLUSIONS: Limited access to physiotherapy and shorter therapy times may lead to functional deterioration in children with NMD, but this assumption needs to be objectively confirmed. According to the parents' opinions, telephysiotherapy is less beneficial than direct physiotherapy but may support therapy conducted directly by a physiotherapist. Results based on subjective parental opinions may be helpful in planning future projects.

Tele-Physiotherapy in Iran: Perceived Challenges by Physiotherapists to Its Implementation in COVID19 Outbreak.

Background: COVID-19 pandemic has brought new and fundamental challenges to the healthcare system. Physiotherapists, like other rehabilitation professionals, have been involved in this crisis. One way to protect both the clients and physiotherapists from getting infected and provide physiotherapy services effectively is tele-physiotherapy (TPT). This study investigated the physiotherapists' perception of TPT and the barriers to its practical application during the COVID-19 outbreak. Methods: This cross-sectional, descriptive study was adopted in December 2020, using a newly designed checklist. The checklist had four sections, consisting of physiotherapists' knowledge and awareness, satisfaction, attitude, and also barriers to the use of TPT during the COVID-19 outbreak. The checklist was uploaded to social physiotherapy networks across Iran, and the descriptive data were analyzed statistically. Results: In this study, 192 physiotherapists participated as follows. Before the COVID-19 outbreak, 48.96% of the participants used TPT, while this rate grew to 64.06% during the outbreak. The majority of the participants (65.1%) believed that the use of TPT would improve the relationship among the physiotherapists and their patients. They also had the lowest level of knowledge (27.08%) about one item in the checklist, i.e., "how to consult with TPT". Based on the participants' views, lack of proper familiarity with the use of this method (87.5%), a lack of high-speed internet access (86.45 %), and a lack of awareness of this method and its benefits (84.37%) had the highest frequencies compared to other barriers. Conclusion: The results indicate that during the COVID-19 pandemic in Iran, a significant increase in the use of TPT has developed. The overall physiotherapists' attitude towards TPT was positive, but it was necessary to minimize or eliminate the barriers to applying this effective method. Major recommendations from the participants were: continue to seek physiotherapists' and patients' perspectives, introduce proper educational programs for new students enrolled in professional associations and universities, and support the infrastructures, such as telecommunication and financial assistance from insurance companies.