The growing complexity of care and healthcare workforce shortages in the Netherlands necessitates exploring interprofessional collaboration (IPC). However, the predominant single-professional education may result in a professional identity (PI) among healthcare students, which may not support successful IPC. Internships in student-run interprofessional learning wards (SR-IPLW) could foster interprofessional identity (IPI) development. There is a need for a better understanding of the intricacies involved in learning to work collaboratively, particularly when undergraduates are still shaping their professional identities. Our aim, therefore, was to identify facilitators and barriers for interprofessional education (IPE), IPC, and identity development among 21 healthcare students during a 20-week clinical placement on a SR-IPLW in rehabilitation medicine. An action-based prospective study using grounded theory analysis of nine focus groups across three semesters identified 17 theoretical codes. These codes are elaborated in a conceptual model highlighting facilitators and barriers for IPC and identity development, emphasizing the importance of fostering feelings of relatedness, competence, and autonomy. There are indications that professional and interprofessional identities changed during the internship. Implications for preceptors are delineated, showing the importance of personal relationships and elements of a positive learning climate.

Article: Effects of asymmetrical support on lower limb muscle activity during Lokomat guided gait in persons with a chronic stroke: an explorative study - European Journal of Physical and Rehabilitation Medicine 2022 Sep 14 - Minerva Medica - Journals

A decreased propulsive capacity post stroke is associated with a diminished walking ability. When walking with a restraining force applied to the pelvis, more propulsion is required to enable forward progression. This may stimulate propulsion capacity in people post-stroke. Before incorporating restraining forces into training, their effects on propulsion mechanics and other gait characteristics must be evaluated. This study investigated: (1) the immediate bilateral effects of restraining forces during treadmill walking on propulsive force, braking force, and mechanical work in people post-stroke, and (2) the impact of this manipulation on step length symmetry, single support time symmetry and muscle activity. Additionally, we explored whether these effects vary with gait speed and force magnitude. 13 individuals post-stroke walked on a treadmill at 0.28 m/s and 0.56 m/s while a horizontal restraining force (0 %, 5 % or 10 % of their body weight) was applied to the pelvis. During walking, ground reaction forces and muscle activity of gluteus Medius, rectus Femoris, vastus Medialis, biceps Femoris, tibialis anterior, medial gastrocnemius and soleus were bilaterally recorded FINDINGS: Applying restraining forces up to 10 % of body weight increased propulsive impulse and mechanical work while reducing braking impulse. Although no significant effects were found on step length symmetry or swing phase symmetry, subtle changes in muscle activity were observed when walking with restraining forces INTERPRETATION: Restraining forces up to 10 % of body weight can activate propulsive capacity. Future research should explore how this direct effect translates into long-term training effects.

Background/Objectives: Swing leg resistance may stimulate propulsive force, required for forward progression and leg swing, in post-stroke patients. To assess the potential of swing leg resistance in rehabilitation, more knowledge is needed on how this unilateral manipulation affects gait. Therefore, we explored the bilateral effects of a unilateral swing leg resistance on muscle activity, kinematics, and kinetics of gait in able-bodied individuals. Methods: Fourteen able-bodied participants (8 female, aged 20.7 ± 0.8 years, BMI 23.5 ± 1.9) walked on an instrumented treadmill at 0.28 m/s, 0.56 m/s, and 0.83 m/s with and without unilateral swing leg resistance provided by a weight (0 kg, 0.5 kg, 1.25 kg, and 2 kg) attached to the leg through a pulley system. Propulsion and braking forces, swing time, step length, transverse ground reaction torques, and muscle activity in the gluteus medius (GM), biceps femoris (BF), rectus femoris (RF), vastus medialis (VM), medial gastrocnemius (MG), and soleus (SOL) were compared between conditions. Statistical analyses were performed using repeated measures ANOVAs, with a significance level of 5%. Results: Peak propulsive force and propulsive duration increased bilaterally, while peak braking force decreased bilaterally with unilateral swing leg resistance. In addition, the swing time of the perturbed leg increased with swing leg resistance. Muscle activity in the perturbed leg (GM, BF, RF, VM, MG) and the unperturbed leg (GM, BF, VM, MG, SOL) increased. Only in the BF (perturbed leg, late swing) and MG (unperturbed leg, early stance) did the muscle activity decrease with swing leg resistance. No adaptations in step length and transverse ground reaction torques were observed. Specific effects were enhanced by gait speed. Conclusions: Unilateral swing leg resistance can evoke effects that might stimulate the training of propulsion. A study in post-stroke patients should be conducted to test whether prolonged exposure to unilateral swing leg resistance leads to functional training effects.

PurposeeHealth might contribute to changes in roles and responsibilities of patients and healthcare professionals (HCPs), including the patient's potential to enhance self-regulation. The aim of this study was to identify important aspects and experiences of self-regulation and factors that may support self-regulation in blended rehabilitation care.Materials and methodsSemi-structured interviews were conducted among HCPs and patients regarding perceptions and experiences with self-regulation in relation to a telerehabilitation portal. Thematic analysis was used to identify themes.ResultsAccording to HCPs (n = 18), aspects of self-regulation are: an active role of patients, a facilitating role for HCPs, and collaboration. Patients and parents (n = 24) experienced self-regulation by: having an active role and having a voice. Aspects of eHealth that support self-regulation are: at home usage, flexible scheduling, easily accessible communication, using it as a reference work, using it to stimulate motivation, and adapting usage to different phases of treatment.ConclusionPatients and HCPs agree that patients having an active role is important for experiencing self-regulation. A telerehabilitation portal that can be flexibly used at home, with a communication and log module, can support self-regulation. Optimising eHealth design to stimulate self-regulation, and measuring the impact of eHealth on self-regulation should be further studied.