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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
the experienced raters was found to be 0.48 with a novice rater ICC of 0.48 as well. The ICC between all the raters was 0.33. Conclusion(s): This constitutes poor reliability. The poor reliability of the technique testing the length of LD was identified and addressed in order for adequate usage thereof, in research and in practice. Recommendations of a new technique to test the length of LD were provided by the researcher. A suggestion was made regarding a manner of testing its reliability. Implications: A reliable technique for assessing the length of the Latissimus Dorsi muscle will add to objectivity and consistency in the assessment as well as the management of human movement related musculo-skelatal conditions. Keywords: M Latissimus Dorsi; Muscle length test; Dysfunction; Reliability; Reproducibility; Glenoh Funding acknowledgements: The University of Pretoria. Ethics approval: The ethics referral number for the protocol of this study is 464/2013. The Research Ethics Office: 012 354 1677 [email protected]. http://dx.doi.org/10.1016/j.physio.2015.03.3667 Research Report Platform Presentation Number: RR-PL-3732 Monday 4 May 2015 15:02 Room 334–335 MUSCULOSKELETAL PAIN IN MELANCHOLIC AND ATYPICAL DEPRESSION K. Korniloff 1 , S. Kotiaho 2 , M. Vanhala 3,4 , H. Kautiainen 5 , H. Koponen 6 , P. Mäntyselkä 4 1 University
of Jyväskylä, Department of Health Sciences, Jyväskylä, Finland; 2 Saarikka Primary Care Public Utility, Saarijärvi, Finland; 3 Primary Health Care Unit, Central Finland Central Hospital, Jyväskylä, Finland; 4 Unit of Primary Health Care, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; 5 Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Unit of Primary Health Care, Helsinki University Central Hospital and Department of General Practice, University of Helsinki, Helsinki, Finland; 6 University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, Finland Background: Pain and depressive disorders often present together. On average, 65% of patients with depression are identified as simultaneously having pain, and the prevalence of pain symptoms is as high as 69% in primary care patients with depression. Comorbidity of chronic pain and depression has been consistently associated with a poorer prognosis and greater disability in patients when compared with those suffering from each illness alone. Depression can be dichotomized into subgroups with mainly melancholic and
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atypical depression based on differential in the biological correlates and symptoms presentation of these subtypes, which may also affect the experience of pain to some extent. Purpose: The aim of this study was to evaluate the possible differences in the prevalence of pain between participants in melancholic and atypical depression subgroups. Methods: The data of this study was enrolled between 2008 and 2011 in the area of hospital district of Central Finland. Participants were 35-75 years old. Depressive symptoms were determined with Beck Depression Inventory (BDI-21) and depression diagnosis was confirmed with Mini-International Neuropsychiatric Interview (M.I.N.I.). Participants were dichotomized into subgroups with melancholic depression (n = 269), atypical depression (n = 144) and controls (n = 401). Musculoskeletal pain was identified if pain occurred frequently or continuously in the joints, back, neck or was multisite. Also fasting blood samples and oral glucose tolerance test were drawn. Results: The prevalence of participants with musculoskeletal pain was 37% in controls, 57% in atypical depression, and 71% in melancholic depression (p < 0.001, after adjusting for sex and age). A logistic regression model showed that the odds ratio of pain after adjusting with demographic, lifestyle, and biological factors was 2.35 (1.56 to 3.56) with atypical depression compared with controls (p < 0.001) and 4.38 (3.03 to 6.33) with melancholic depression compared with atypical depression (p = 0.006). BDI scores were higher for those with melancholic depression than for those with atypical depression (p < 0.001), and the fasting glucose and glucose tolerance were higher for those with atypical depression compared with controls (p = 0.029 and p = 0.028, respectively). Conclusion(s): This article shows that melancholic depression is associated with a higher prevalence of musculoskeletal pain in comparison with atypical depression. This study highlights the need for further studies about the mechanisms behind the association between pain and depression, and particularly the association with melancholic depression, and biological differences between melancholic and atypical depression found in this study as well. Implications: The presence of pain may negatively affect recognition and treatment of depression, as most often physical causes of pain are assessed instead of examining the broader biopsychosocial context. Primary care providers should recognize that depression and musculoskeletal pain often coexists and further, should be aware of the depression subtype as they may respond a distinct treatment and rehabilitation. Patients with melancholic depression may require more detailed and effective treatment of depression, and those with atypical depression may also benefit from lifestyle counseling. Keywords: Musculoskeletal pain; Depressive disorder; Melancholia Funding acknowledgements: Study was supported by financing from the Hospital District of Central Finland and Yrjö Jahnsson Foundation.
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
Ethics approval: Ethical permission for the study was granted by the Hospital District of Central Finland Ethics Committee. http://dx.doi.org/10.1016/j.physio.2015.03.3668 Special Interest Report Poster Presentation Number: SI-PO-08-21-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 PROBLEM-BASED LEARNING IN PHYSIOTHERAPY STUDENTS’ DEVELOPMENT FOR EXPERTS H. Korpi, A. Piirainen, L. Peltokallio University of Jyväskylä, Faculty of Sport and Health Sciences, Department of Health Sciences, Jyväskylä, Finland Background: Problem-based learning (PBL) has become a significant approach in vocational education since 1980’s. Nowadays PBL is used in 5 out of 15 physiotherapy education units in Finland. The study brings new information about continuous learning for developing physiotherapy education and its curricula. European Qualification Framework (EQF) defines the key competences of the education, but it does not define those individual study paths, which help the students to reach their goals. Purpose: The aim of the study is to investigate physiotherapy students’ development for experts in Finnish university of applied sciences, which uses problem-based learning as their approach. Methods: The study had a qualitative, narrative approach to describe and understand the physiotherapy students’ stories as narratives. Longitudinal data written by eleven voluntary students (mean age 24.5 years) was collected during 3.5 years from a university of applied sciences in Finland. The data consists of 802 typewritten A4 pages of learning experiences of the students. This data tells about them as learners and their development process. Students wrote their portfolios every 6 months, in which they described their learning experiences and feelings. Students were given guidance in making a portfolio. The lengths of the stories varied from 25 to 286 pages; on average they wrote 73 pages. The writing was free narration from the students. Finally, the portfolio consisted of a single report of their study time. Results: The use of PBL method in teaching “stops” all students at the beginning of their studies. The new way of learning creates enthusiasm in a part of the students, but at the same time it brings fear about not learning everything essential. Information seeking skills and ability to work in a group are experienced as needed when using the PBL method. Critical and analytical relation to learning is seen in the students’ stories already in the beginning of studies. The students also think about problems they face in real working life. In
addition to tutorials students see multiple teaching methods as important. Professional identity starts developing when students face a real patient in instructed practical training. The main episodes of professional development are: earlier studies, new way of learning, understanding the physiotherapy and turning to be professional in physiotherapy. Three story models based on the students’ stories were formed: the story of the development of an autonomous learner, the story of becoming a physiotherapy community member and the story of the development of critical developer. Conclusion(s): The results of the study help to understand the entirety of professional development and professional development when using PBL method in learning. The critical stages of learning become clear in the four-level transition -steps of the physiotherapy students’ professional development. Especially seeing the turning points of the story models help to recognize when the different kinds of learners need guidance the most. Implications: The knowledge is useful to create new curricula for physiotherapy students’ programmes. It is important to take into account the stories of how to become a physiotherapist and the critical turning points in students’ learning process. Keywords: Problem-based learning; Physiotherapy student; Narrative research Funding acknowledgements: The work was unfunded. Ethics approval: The University of Jyväskylä Ethical Committee 2012. http://dx.doi.org/10.1016/j.physio.2015.03.3669 Research Report Poster Presentation Number: RR-PO-15-18-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 DEVELOPMENT OF THE TOILET ASSISTANCE CHART AND EXAMINATION OF ITS VALIDITY IN A CONVALESCENT REHABILITATION WARD M. Kota 1 , J. Ushirogochi 1 , K. Kobayashi 1 , H. Sunahori 1 , H. Hirayama 1 , H. Kudo 1 , A. Shirai 2 1 Hiroshima
City Rehabilitation Hospital, Department of Rehabilitation, Hiroshima City, Japan; 2 Hiroshima City Rehabilitation Hospital, Department of Nurse, Hiroshima City, Japan Background: Convalescent rehabilitation wards in Japan house many patients who need assistance with toilet-related activities. The independence level of toilet-related activities is usually assessed using the Functional Independence Measure (FIM). The FIM includes some toilet-related items such as dressing the lower body, toileting, transfers, and locomotion.
the experienced raters was found to be 0.48 with a novice rater ICC of 0.48 as well. The ICC between all the raters was 0.33. Conclusion(s): This constitutes poor reliability. The poor reliability of the technique testing the length of LD was identified and addressed in order for adequate usage thereof, in research and in practice. Recommendations of a new technique to test the length of LD were provided by the researcher. A suggestion was made regarding a manner of testing its reliability. Implications: A reliable technique for assessing the length of the Latissimus Dorsi muscle will add to objectivity and consistency in the assessment as well as the management of human movement related musculo-skelatal conditions. Keywords: M Latissimus Dorsi; Muscle length test; Dysfunction; Reliability; Reproducibility; Glenoh Funding acknowledgements: The University of Pretoria. Ethics approval: The ethics referral number for the protocol of this study is 464/2013. The Research Ethics Office: 012 354 1677 [email protected]. http://dx.doi.org/10.1016/j.physio.2015.03.3667 Research Report Platform Presentation Number: RR-PL-3732 Monday 4 May 2015 15:02 Room 334–335 MUSCULOSKELETAL PAIN IN MELANCHOLIC AND ATYPICAL DEPRESSION K. Korniloff 1 , S. Kotiaho 2 , M. Vanhala 3,4 , H. Kautiainen 5 , H. Koponen 6 , P. Mäntyselkä 4 1 University
of Jyväskylä, Department of Health Sciences, Jyväskylä, Finland; 2 Saarikka Primary Care Public Utility, Saarijärvi, Finland; 3 Primary Health Care Unit, Central Finland Central Hospital, Jyväskylä, Finland; 4 Unit of Primary Health Care, University of Eastern Finland and Kuopio University Hospital, Kuopio, Finland; 5 Unit of Primary Health Care, Kuopio University Hospital, Kuopio, Unit of Primary Health Care, Helsinki University Central Hospital and Department of General Practice, University of Helsinki, Helsinki, Finland; 6 University of Helsinki and Helsinki University Hospital, Psychiatry, Helsinki, Finland Background: Pain and depressive disorders often present together. On average, 65% of patients with depression are identified as simultaneously having pain, and the prevalence of pain symptoms is as high as 69% in primary care patients with depression. Comorbidity of chronic pain and depression has been consistently associated with a poorer prognosis and greater disability in patients when compared with those suffering from each illness alone. Depression can be dichotomized into subgroups with mainly melancholic and
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atypical depression based on differential in the biological correlates and symptoms presentation of these subtypes, which may also affect the experience of pain to some extent. Purpose: The aim of this study was to evaluate the possible differences in the prevalence of pain between participants in melancholic and atypical depression subgroups. Methods: The data of this study was enrolled between 2008 and 2011 in the area of hospital district of Central Finland. Participants were 35-75 years old. Depressive symptoms were determined with Beck Depression Inventory (BDI-21) and depression diagnosis was confirmed with Mini-International Neuropsychiatric Interview (M.I.N.I.). Participants were dichotomized into subgroups with melancholic depression (n = 269), atypical depression (n = 144) and controls (n = 401). Musculoskeletal pain was identified if pain occurred frequently or continuously in the joints, back, neck or was multisite. Also fasting blood samples and oral glucose tolerance test were drawn. Results: The prevalence of participants with musculoskeletal pain was 37% in controls, 57% in atypical depression, and 71% in melancholic depression (p < 0.001, after adjusting for sex and age). A logistic regression model showed that the odds ratio of pain after adjusting with demographic, lifestyle, and biological factors was 2.35 (1.56 to 3.56) with atypical depression compared with controls (p < 0.001) and 4.38 (3.03 to 6.33) with melancholic depression compared with atypical depression (p = 0.006). BDI scores were higher for those with melancholic depression than for those with atypical depression (p < 0.001), and the fasting glucose and glucose tolerance were higher for those with atypical depression compared with controls (p = 0.029 and p = 0.028, respectively). Conclusion(s): This article shows that melancholic depression is associated with a higher prevalence of musculoskeletal pain in comparison with atypical depression. This study highlights the need for further studies about the mechanisms behind the association between pain and depression, and particularly the association with melancholic depression, and biological differences between melancholic and atypical depression found in this study as well. Implications: The presence of pain may negatively affect recognition and treatment of depression, as most often physical causes of pain are assessed instead of examining the broader biopsychosocial context. Primary care providers should recognize that depression and musculoskeletal pain often coexists and further, should be aware of the depression subtype as they may respond a distinct treatment and rehabilitation. Patients with melancholic depression may require more detailed and effective treatment of depression, and those with atypical depression may also benefit from lifestyle counseling. Keywords: Musculoskeletal pain; Depressive disorder; Melancholia Funding acknowledgements: Study was supported by financing from the Hospital District of Central Finland and Yrjö Jahnsson Foundation.
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WCPT Congress 2015 / Physiotherapy 2015; Volume 101, Supplement 1 eS633–eS832
Ethics approval: Ethical permission for the study was granted by the Hospital District of Central Finland Ethics Committee. http://dx.doi.org/10.1016/j.physio.2015.03.3668 Special Interest Report Poster Presentation Number: SI-PO-08-21-Mon Monday 4 May 2015 12:15 Exhibit halls 401–403 PROBLEM-BASED LEARNING IN PHYSIOTHERAPY STUDENTS’ DEVELOPMENT FOR EXPERTS H. Korpi, A. Piirainen, L. Peltokallio University of Jyväskylä, Faculty of Sport and Health Sciences, Department of Health Sciences, Jyväskylä, Finland Background: Problem-based learning (PBL) has become a significant approach in vocational education since 1980’s. Nowadays PBL is used in 5 out of 15 physiotherapy education units in Finland. The study brings new information about continuous learning for developing physiotherapy education and its curricula. European Qualification Framework (EQF) defines the key competences of the education, but it does not define those individual study paths, which help the students to reach their goals. Purpose: The aim of the study is to investigate physiotherapy students’ development for experts in Finnish university of applied sciences, which uses problem-based learning as their approach. Methods: The study had a qualitative, narrative approach to describe and understand the physiotherapy students’ stories as narratives. Longitudinal data written by eleven voluntary students (mean age 24.5 years) was collected during 3.5 years from a university of applied sciences in Finland. The data consists of 802 typewritten A4 pages of learning experiences of the students. This data tells about them as learners and their development process. Students wrote their portfolios every 6 months, in which they described their learning experiences and feelings. Students were given guidance in making a portfolio. The lengths of the stories varied from 25 to 286 pages; on average they wrote 73 pages. The writing was free narration from the students. Finally, the portfolio consisted of a single report of their study time. Results: The use of PBL method in teaching “stops” all students at the beginning of their studies. The new way of learning creates enthusiasm in a part of the students, but at the same time it brings fear about not learning everything essential. Information seeking skills and ability to work in a group are experienced as needed when using the PBL method. Critical and analytical relation to learning is seen in the students’ stories already in the beginning of studies. The students also think about problems they face in real working life. In
addition to tutorials students see multiple teaching methods as important. Professional identity starts developing when students face a real patient in instructed practical training. The main episodes of professional development are: earlier studies, new way of learning, understanding the physiotherapy and turning to be professional in physiotherapy. Three story models based on the students’ stories were formed: the story of the development of an autonomous learner, the story of becoming a physiotherapy community member and the story of the development of critical developer. Conclusion(s): The results of the study help to understand the entirety of professional development and professional development when using PBL method in learning. The critical stages of learning become clear in the four-level transition -steps of the physiotherapy students’ professional development. Especially seeing the turning points of the story models help to recognize when the different kinds of learners need guidance the most. Implications: The knowledge is useful to create new curricula for physiotherapy students’ programmes. It is important to take into account the stories of how to become a physiotherapist and the critical turning points in students’ learning process. Keywords: Problem-based learning; Physiotherapy student; Narrative research Funding acknowledgements: The work was unfunded. Ethics approval: The University of Jyväskylä Ethical Committee 2012. http://dx.doi.org/10.1016/j.physio.2015.03.3669 Research Report Poster Presentation Number: RR-PO-15-18-Mon Monday 4 May 2015 13:00 Exhibit halls 401–403 DEVELOPMENT OF THE TOILET ASSISTANCE CHART AND EXAMINATION OF ITS VALIDITY IN A CONVALESCENT REHABILITATION WARD M. Kota 1 , J. Ushirogochi 1 , K. Kobayashi 1 , H. Sunahori 1 , H. Hirayama 1 , H. Kudo 1 , A. Shirai 2 1 Hiroshima
City Rehabilitation Hospital, Department of Rehabilitation, Hiroshima City, Japan; 2 Hiroshima City Rehabilitation Hospital, Department of Nurse, Hiroshima City, Japan Background: Convalescent rehabilitation wards in Japan house many patients who need assistance with toilet-related activities. The independence level of toilet-related activities is usually assessed using the Functional Independence Measure (FIM). The FIM includes some toilet-related items such as dressing the lower body, toileting, transfers, and locomotion.