Motor learning is particularly challenging in neurological rehabilitation: patients who suffer from neurological diseases experience both physical limitations and difficulties of cognition and communication that affect and/or complicate the motor learning process. Therapists (e.g.,, physiotherapists and occupational therapists) who work in neurorehabilitation are therefore continuously searching for the best way to facilitate patients during these intensive learning processes. To support therapists in the application of motor learning, a framework was developed, integrating knowledge from the literature and the opinions and experiences of international experts. This article presents the framework, illustrated by cases from daily practice. The framework may assist therapists working in neurorehabilitation in making choices, implementing motor learning in routine practice, and supporting communication of knowledge and experiences about motor learning with colleagues and students. The article discusses the framework and offers suggestions and conditions given for its use in daily practice.
Background: Determining what constitutes an excellent allied health care professional (AHCP) is important, since this is what will guide the development of curricula for training future physical therapists, oral hygienists, speech therapists, diagnostic radiographers, and dietitians. This also determines the quality of care.Aim: To describe perspectives of AHCPs on which characteristics are commonly associated with an excellent AHCP.Methods: AHCPs’ perspectives were derived from three focus group discussions. Twenty-one health care professionals participated. The final analysis of the focus group discussions produced eight domains, in which content validity was obtained through a Delphi panel survey of 27 contributing experts.Results: According to the survey, a combination of the following characteristics defines an excellent AHCP: (1) cognizance, to obtain and to apply knowledge in a broad multidisciplinary health care field; (2) cooperativity, to effectively work with others in a multidisciplinary con¬text; (3) communicative, to communicate effectively at different levels in complex situations; (4) initiative, to initiate new ideas, to act proactively, and to follow them through; (5) innovative, to devise new ideas and to implement alternatives beyond current practices; (6) introspective, to self-examine and to reflect; (7) broad perspective, to capture the big picture; and (8) evidence-driven, to find and to use scientific evidence to guide one’s decisions.Conclusion: The AHCPs perspectives can be used as a reference for personal improvement for supervisors and professionals in clinical practice and for educational purposes. These perspectives may serve as a guide against which talented students can evaluate themselves.
Purpose: Interprofessional collaboration and adaptation of e-health are necessary to implement innovative exercise and nutrition interventions in health practice. The aims of this qualitative study were 1) determine the relevant factors related to successful interprofessional collaboration, and 2) determine the relevant factors for implementation and susceptibility of our blended interventions in older adults, by allied health professionals in the Amsterdam metropolitan region.Methods: This explorative qualitative study was the next step in implementation, subsequent to the VITAMIN RCT. In total 45 physiotherapy and 27 dietician practices were selected for recruitment. We combined fourteen semistructuredinterviews with dieticians with two focus-groups of mixed exercise- and physiotherapists. After each focus-group and interview the two researchers evaluated and discussed the statements, factors and common believes in relation to the research questions. Transcripts were analyzed with MAXQDA software, and open, axial and selective coding was adapted by two independent researchers. A third researcher was available if consensus could not be reached.Results: In current practice interprofessional collaboration is not common, mainly due to lacking knowledge about the other profession. Location is a facilitator, as well is previous experience. External factors as higher financialcompensation to implement interprofessional work meetings were defined as possible facilitator to collaboration. The professionals defined a shared electronic patient database as necessity to interprofessional collaboration,especially due to the privacy regulations. Main encouraging factors related to blended interventions were timesaving consults, ability to reach immobile older adults, and cost saving healthcare. Main barrier was lacking e-health literacyof older adults.Conclusions: This study shows that the exercise and nutrition professionals have a positive attitude towards future implementation of these types of blended and combined interventions for older adults. Furthermore, interprofessional collaboration is a point of attention in our regional allied healthcare system. Several external factors related to implementation, like financial compensation, make the adaptation of combined interventions with e-health for older adults challenging.
Het is essentieel dat cliënten na een opname in een ziekenhuis of revalidatiecentrum blijven werken aan een actieve leefstijl die bijdraagt aan preventie, participatie en kwaliteit van leven. Hoewel gezondheid en gedrag primair de verantwoordelijkheid is van mensen zelf, is niet iedereen in staat na thuiskomst het geleerde zelfstandig voort te zetten. Na een opname wordt de transitie naar de thuissituatie door patiënten als moeilijk ervaren, soms met achteruitgang en heropnames als gevolg. Zorgprofessionals herkennen dit ook en willen de transitie naar huis beter vormgeven. De centrale vraag die Hogeschool Leiden (Lectoraat Eigen Regie bij Fysiotherapie en Beweegzorg), Haagse Hogeschool (Lectoraat Revalidatie en Technologie), Hanze Hogeschool (Lectoraat Healthy Ageing, Allied Health & Nursing Care), zorginstellingen Basalt (revalidatiecentrum) en Nij Smellinghe (ziekenhuis) en fysiotherapiepraktijken Medifit en Havenfysio (MKB-bedrijf) willen beantwoorden is: WAT is, gezien vanuit het perspectief van de ervaringsdeskundige cliënt, bepalend voor het fysiek actief blijven en integreren van duurzaam beweeggedrag in de eigen thuissituatie tot 1 jaar na transitie vanuit de intramurale zorg. Vanuit positieve gezondheid wordt breed onderzocht hoe mensen de fysieke, sociale en emotionele uitdagingen in relatie tot fysieke activiteit hebben benaderd en ervaren in hun thuissituatie na intramurale zorgopname. Cliënten wordt gevraagd naar hun meest waardevolle en frustrerende ervaringen en activiteiten met betrekking tot fysiek actief blijven in de eerste 3 tot 12 maanden na thuiskomst. Door het gebruik van storytelling worden de ervaringsdeskundigheid en dieperliggende motivaties van cliënten centraal gesteld binnen hun persoonlijke thuissituatie. We brengen vervolgens beïnvloedbare factoren van fysieke activiteit in de thuissituatie van mensen in kaart vanuit de perspectieven positieve gezondheid, eigen regie en gedrag. Op basis van de bevindingen wordt in co-creatie een innovatieve interventie agenda opgeleverd over hoe de betrokken partners fysieke activiteit in de thuissituatie kunnen ondersteunen en hoe de samenwerking in de zorgketen beter georganiseerd kan worden.
