http://www.indianjournals.com/ijor.aspx?target=ijor:ijpot&volume=10&issue=1&article=011
*Corresponding
author: Dr. Gajanan Bhalerao (PT) Head of Department of Physiotherapy
in Neurosciences Sancheti Institute College of Physiotherapy. Head of
Department of Physiohterapy and Rehabilitation Sancheti Hospital, Pune,
Email: gajanan_bhalerao@yahoo.com
Abstract
Background
There
are various neurophysiological approaches like Proprioceptive
neuromuscular facilitation technique i.e. PNF, Bobath's
neurodevelopmental approach i.e. NDT, Brunnstrom's technique and Rood's
approach. But there is a lot of variation of use of these approaches
depending on the therapists. We wanted to find the what approach is used
the most, what was the reason behind the selection, and were the
physiotherapists trained in it.
Material and Method
It
is questionnaire based survey, validated by 3 clinical experts, created
using Google docs and was emailed to more than 2000 therapists across
India. Out of which 412 therapists willingly participated in the survey.
Ten incomplete questionnaires were excluded. Final sample size was 402.
The questionnaire was based on the neuro therapeutic approaches.
Physiotherapists holding BPTh and MPTh degrees were included in the
study. After the reception of responses the data was analyzed through
descriptive analysis.
Results
Out
of all the respondents, 15% of them were on-going masters students
while rest all of them were clinicians. This included 39% from south and
west region each and 13% from north and 9% from east region of India.
The study shows that 96% therapist show good awareness about the
approaches, despite this 73% faced difficulty practicing it. Although
PNF, sensory integration, CIMT, MRP are found to be most commonly taught
at graduation level followed by Rood, NDT/Bobath and Brunnstorm, PNF
and CIMT are most commonly preferred and practiced approaches, followed
by NDT/Bobath and Brunnstorm. The least preferred and practiced
approaches were found to be Roods and Motor Relearning Program. It was
found that the therapists misunderstood sensory integration with sensory
re-education. PNF and CIMT were more preferred because they are easy to
learn and practice and are also evidence based. Only 13% of therapists
were found to have received training in some approaches. Surprisingly,
90% of them were found to be interested in attending additional training
in these approaches.
Conclusion
96%
of therapists are well aware of neuro approaches, but face difficulty
practicing them. PNF and CIMT are most commonly preferred and practiced
approaches, followed by NDT and Brunnstorm and Roods and MRP. There is a
mix pattern of practice of traditional approaches such as PNF,
Brunnstorm and NDT and the task specific training such as CIMT. This
study suggests that the physiotherapists are still practicing more of
traditional approaches than task specific approaches such as CIMT and
MRP. The study further shows that majority of the therapists i.e.87%
have not had any additional training and that 90% are keen on acquiring
additional knowledge about these approaches through some workshop or a
seminar.
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