Description

The concept of the body which highlights the social and cultural aspects of life and an open concept of health, served as the theory for this study as well as the inspiration from two models of clinical practice. The data consist of observations of the practice of physiotherapy of seven hip arthroplasty patients, seven open semi structured interviews with the patients, followed by open semistructed interviews with the seven physiotherapists. The results showed that the physiotherapists only used their incidental knowledge of social/cultural aspects of the patients' lives to motivate the patients to comply with the physiotherapy regimen. The physiotherapists gave a much higher priority to the physical capability of the patients than to social/cultural aspects. As experts, the physiotherapists legitimised the dialogue with the patients. The physiotherapists were not able to perform clinical practice according to the above mentioned concepts of body and health since they did not have enough information about cultural/social aspects. The patients had little or no direct influence upon the contents of the physiotherapy regimen. Finally, the author discusses this rather paternalistic clinical practice.

Clinical Practice

A survey of undergraduate physiotherapy students at the Universities of Almeriá and Jaén in Spain found anatomy to be a “highly appropriate” inclusion in their course. By its very name, physiotherapy requires that its students and practitioners become well versed in the way in which the body moves in an optimally functional way. To achieve this goal, pre-clinical physiotherapy students have to know the musculoskeletal components of the human body in detail. They have to know how neuron-anatomy impacts on the functioning of these components and be able to discern whether, for example, a specific lobe of the lung is functioning optimally and direct their treatment accordingly. In many different ways, knowledge of human anatomy will play an integral role in the competency of a physiotherapist in future clinical practice. Systematic curriculum development addresses those to be taught, what the content will be, how it will be taught and the interaction between subject matter. Gross anatomy course designs have to consider clinically relevant, integrated systems and a learning outcomes-based approach in the development of a course curriculum. A number of authors have suggested that a gross anatomy curriculum for physiotherapy students should incorporate input from physiotherapists and be clinically relevant to physiotherapy practice. The different types of physiotherapy degree programs offered worldwide are designed to accommodate the needs that pertain to the specific physiotherapy practice in each of those countries. In South Africa, physiotherapists assume the role of first-line practitioners. These physiotherapists are permitted to have access to patients without having to have them referred to by another healthcare professional and can therefore work independently, can offer a diagnosis pertaining to the patient's illness within their scope of practice and can refer a patient to a specialist clinician if they feel that the condition is beyond their scope of practice. They can also write sick notes for patients and administer prescribed medicines. First-line physiotherapy practitioners are also found in Australia and in New Zealand but in many countries, including the United Kingdom, physiotherapists have not been given first-line status.

Neuromeningeal

Physiotherapy students often struggle to translate anatomical knowledge from textbooks into a dynamic understanding of the mechanics of body movements in real life patients. We present the Augmented Studio, an augmented reality system that uses body tracking to project anatomical structures and annotations over moving bodies for physiotherapy education. Through a user and learner cantered design approach, we established an understanding that through augmentation and annotation, augmented reality technology can enhance physiotherapy education. Augmented Studio enables augmentation through projection mapping to display anatomical information such as muscles and skeleton in real time on the body as it moves. We created a technique for annotation to create projected hand-drawing on the moving body, to enable explicit communication of the teacher's clinical reasoning strategies to the students. Findings from our pilot usability study demonstrate a more engaging learning and teaching experience and increased communication between teacher and students when using Augmented Studio. A detailed investigation of the anatomy of the lower cervical nerves and associated structures was undertaken, as these structures would most likely be affected by any stresses generated in the nerves of the brachial plexus during the upper limb tension test (ULTT). The investigation used dissection of three adult human spines and histological sections of three cervical spines. The results support the hypothesis that the lower cervical nerves have a specialised anatomical arrangement which may protect them from forces generated in the upper limb and cervical spine by the ULTT. The fifth, sixth and seventh cervical nerves are securely attached to many structures as they emerge from the spinal cord to form the brachial plexus. Furthermore, the posterior longitudinal ligament anchors the nerve roots to the vertebral bodies and intervertebral discs. The results suggest that innervated structures other than neuromeningeal tissue may also need to be considered when evaluating a patient's positive ULTT response.