Prolonged computer use, especially if fatigue ensues, is associated with visual and musculoskeletal symptoms. The aim was to determine the time-course of perceived fatigue in the wrist, forearm, shoulder and eyes during a 60-min mouse task (painting rectangles), and whether object size and/or mouse use demands were of infl uence. Also, we investigated performance (number of rectangles painted), and whether perceived fatigue was paralleled by local muscle fatigue or tissue oxygenation.
Ten women performed the task for three conditions (crossover design). At condition 1, rectangles were 45 25 mm, square paint cursor size 1.3 1.3 mm, and mouse – pointer movement ratio 1:26. At condition 2, the same cursor size and mouse – pointer movement ratio was used, but rectangles were smaller. At condition 3, the smaller rectangles were used, but the cursor size was also smaller and mouse – pointer movement ratio was 1:8. The results showed increased self-reported fatigue over time, with the observed increase greater for the eyes, but no change in physiological responses. Condition 2 resulted in higher performance and increased eye fatigue. Perceived fatigue in the muscles or physiological responses did not differ between conditions. In conclusion, computer work tasks imposing high visual and motor demands, and with high performance, seemed to have an infl uence on eye fatigue.
This study tests the concurrent validity and test–retest reliability of a new functional balance test – the Dynamic One Leg Stance (DOLS) in blind subjects and sighted, blindfolded subjects. Twelve blind and 12 sighted men and women between 19 and 61 years volunteered to participate. The correlation between DOLS and the commonly used One Leg Stance balance test (OLS) and the force platform test (FPT) was tested for both the right and left leg. The test–retest reliability of DOLS was analysed using three measurements at least 2 h apart. The correlation between DOLS and FPT and between DOLS and OLS for blind subjects was −0.13 (n.s.) and 0.77 for the left leg and −0.78 and 0.89 for the right leg. For blindfolded subjects, the correlations were −0.56 (n.s.) and 0.93 for the left leg and −0.61 and 0.71 for the right leg. The weighted Kappa values for DOLS were between 0.47 and 0.88 for blind subjects and between 0.47 and 0.72 for blindfolded subjects. Based on these findings, DOLS appears to be a fairly valid and reliable balance test for subjects with vision loss, acquired and experimental. However, further tests of DOLS are necessary.
This study evaluated the effect of a family-based multifactor intervention programme on physical activity among overweight or obese children. Children (n = 105, mean age 10.6 ± 1.07 years) with overweight or obesity were randomized into an intervention or control group. The intervention group participated in a 1-year programme aiming at lifestyle changes regarding food habits and physical activity. All children's physical activity was measured using SenseWear Armband at baseline and after 1 year. The children in both groups had a physical activity level (PAL) of 1.67 (0.27) at baseline. When comparing the intervention and control groups, no significant differences were found in physical activity outcome variables after 1 year of intervention. Contrarily to the hypotheses, both groups decreased their energy expenditure and time spent at >3 MET, and there was no change in steps and screen time after 1 year. Despite extensive efforts, the intervention showed no significant positive effect on overweight and obese children's PAL. Further studies are needed to obtain more knowledge on how to maintain or increase the PAL successfully among overweight and obese children.
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The aim was to examine the effect on physical activity of a 2-year family-based lifestyle intervention among overweight and obese Swedish children 8–12 years of age; 105 children were randomized to either intervention or control group. The intervention group was offered a 2-year lifestyle programme. Physical activity was measured using SenseWear Pro2 Armband during 4 consecutive days before and after the intervention. When comparing the intervention and control groups, no significant differences were found in the physical activity outcome variables after 2 years of intervention. However, the intervention group decreased their number of steps per day by 13%, p = 0.003 but had an unchanged screen time, whereas the control group had an unchanged number of steps but increased their screen time by 15%, p = 0.02, from baseline to 2-year measurement. There were no significant change in the intervention group, whereas significantly fewer children in the control group achieved the physical activity recommendations at 2-year measurement (88%) compared with at baseline (98%), p = 0.007. Future interventions regarding physical activity among overweight and obese children are of great importance even though the present one showed limited effects. In the continuing work, a greater effect may be received with an extended and more intense intervention regarding physical activity, focusing on reducing sedentary time rather than increasing the physical activity level.
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The aim was to improve the control of reaching movements in prematurely born children with impaired coordination. Fifteen 6-year-old prematurely born children (birth weight < 1500 g) practised mouse-controlled computer games daily for 4 weeks. In addition, as a control condition, each child practised trampoline jumping for an equally long perios. The outcome was measured in terms of: (1) computer game skill, (2) kinematic analysis of planar reaching movements on a digitizing tablet, and (3) motor performance measured with the Movement ABC. After intervention, all the assessments used showed an improvement although only the skill in performing the computer game was clearly related to the type of intervention. Lack of tight correlation between computer game practice and performance on the digitizing tablet might be due to minor but crucial differences in control aspects between the task. The present results indicate that the expectation of transfer even to every similar tasks should be low. The findings thus support a task-specific approach to practice, while corroborating the positive impact of non-specific intervention.
The aim of this study was to evaluate how recently graduated occupational therapists and physiotherapists, employed by the Swedish county councils and municipalities, experience working in public sector healthcare organization. The study group, 262 occupational therapists and physiotherapists who graduated in 1999, is a sub-sample drawn from a national cross-sectional survey. Data were collected in their third year after graduation. The Swedish Demand-control Questionnaire and the Effort-reward Imbalance Questionnaire together with self-constructed questions were used to evaluate psychosocial factors at work. The results reveal that few were exposed to job strain or effort-reward imbalance (ERI). More were defined as having work-related overcommitment (WOC). Logistic regression analyses revealed a significant association between WOC and ERI, sex, degree of effort and degree of reward. One quarter was dissatisfied with their work and this dissatisfaction was significantly associated with ERI, reward (in the ERI questionnaire), control (in the Demand-control Questionnaire) and type of employer. In conclusion, combining the Demand-control model and the ERI model made it possible to describe and analyse varying aspects of the work of novice occupational therapists and physiotherapists in public sector healthcare.
The aim of this study was to describe the clinical applicability of two different methods of aerobic fitness testing in patients with rheumatoid arthritis (RA). Five hundred and fifty-six patients with RA (median age 56 years, range 19-90, disease duration <=6.5 years, 75% women) were included from 17 rheumatology units. Each patient was scheduled to perform a submaximal test of aerobic fitness, either on a bicycle or on a treadmill; the assignment to method was mainly determined by access to equipment at each participating unit. Eighty-eight patients (16%) were never tested, mainly because of use of beta-blockers or impairments, 45 patients (8%) terminated their tests prematurely and 423 patients (76%) completed their assigned test. Their estimated aerobic fitness was mainly classified as "low" (30%), "fair" (40%) or "average" (23%). The determinants of completing either of the tests were female gender (OR=2.06, 95% CI 1.22-3.47), age <65 years (OR=6.50, 95% CI 4.00-10.55) and no (OR=4.67, 95% CI 2.10-10.40) or mild disability (OR=6.24, 95% CI 2.43-16.06). It thus appears as if a majority of patients with RA are able to perform aerobic fitness testing despite the expected limitations related to impairments.
Stretching is a common treatment for children with cerebral palsy, carried out by parents together with their children in the home. The aim of the present study was to explore parents’ experiences of carrying out stretching as a home programme. In order to capture the informants’ own perceptions and experiences, a qualitative method, the Grounded Theory, was chosen. Fifteen semi-structured interviews with parents, using open-ended questions, were analysed. One core category, “From authority to coach”, and two categories, “Prerequisites for parenting during stretching” and “Child and parent interaction”, emerged. The parents described a gradual development of their own role in the home stretching programme, from that of an authority, when the child was young, to that of a coach when the child grew older. With this gradual development came an increased level of participation from the child, enabling stretching to be carried out regularly. According to the parents, stretching could not be carried out without the child's active participation. Along with the process, the parents perceived increasing stress through added pressure and demands. Mobility, time, coping strategies for stress and support from professionals, in particular physiotherapists, were important prerequisites for parents to help their child best with stretching exercises.
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The aim of the study was to evaluate a high intensive exercise program in stroke subjects with risk of falls regarding balance, activities of daily life, falls efficacy, number of falls and lifestyle activities. The intervention program contained high intensity functional exercises (HIFE) implemented to real-life situations together with education on falls and security aspects. This was a single-center, single-blinded, randomized controlled trial. Consecutive >55-year-old patients with risk of falls were enrolled and randomized 3–6 months after first or recurrent stroke to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussions about hidden dysfunctions after stroke. Outcomes were Berg Balance Scale (BBS) primarily, Barthel Index (BI), Falls Efficacy Scale – International (FES-I) and number of falls secondarily and Frenchay Activities Index last 3 months (FAI-3) tertially. Assessments were done at baseline, post-intervention, 3- and 6-month follow-up by two physiotherapists and one nurse blinded to group allocation. Generalized Estimating Equations with Repeated-measure statistics were used to analyze the data. There were no significant differences between the IG and the CG regarding balance (BBS). BI at 6 months and FES-I post-intervention and 3 months follow-up showed significant improvement in the IG compared with the CG (p<0.05). Number of falls and FAI-3 were without significant change. This study suggests that our program consisting of HIFE implemented in real-life situations together with educational discussions may improve performance of everyday life activities and improve falls efficacy in stroke subjects with risk of falls.
The aim of the study was to evaluate the impact of a high-intensive exercise program containing high-intensive functional exercises implemented to real-life situations together with group discussions on falls and security aspects in stroke subjects with risk of falls. This was a pre-specified secondary outcome for this study. For evaluation, Short Form-36 (SF-36) health-related quality of life (HRQoL) and the Geriatric Depression Scale-15 (GDS-15) were used. This was a single-center, single-blinded, randomized, controlled trial. Consecutive ≥55 years old stroke patients with risk of falls at 3–6 months after first or recurrent stroke were randomized to the intervention group (IG, n=15) or to the control group (CG, n=19) who received group discussion with focus on hidden dysfunctions but no physical fitness training. The 5-week high-intensive exercise program was related to an improvement in the CG in the SF-36 Mental Component Scale and the Mental Health subscale at 3 months follow-up compared with baseline values while no improvement was seen in the IG at this time. For the SF-36 Physical Component Scale, there was an improvement in the whole study group at 3 and 6 months follow-up compared with baseline values without any significant changes between the IG and CG. The GDS-15 was unchanged throughout the follow-up period for both groups. Based on these data, it is concluded that high-intensive functional exercises implemented in real-life situations should also include education on hidden dysfunctions after stroke instead of solely focus on falls and safety aspects to have a favorable impact on HRQoL.
The aim of this prospective study was to analyse joint and muscle function and aerobic capacity over 2 years in a group of patients with early rheumatoid arthritis (RA; i.e. symptomatic for <12 months) in relation to age, pain and disease activity. Sixty-six patients with early RA were followed for 24 months. Joint and muscle function was measured using Signals of Functional Impairment (SOFI) index and aerobic capacity with sub-maximal test on ergometer bicycle. Pain was estimated on Visual Analogue Scale (VAS) and disease activity using 28-joint count Disease Activity Score (DAS 28). Joint and muscle function was impaired in almost all patients at inclusion and after 24 months. Male patients were more affected compared with females and the significant correlation with pain and DAS 28 decreased over time. Aerobic capacity was maintained and not influenced by sex, age or pain but related significantly to disease activity. The majority of the patients with early RA had impairments of the joint and muscle function over 24 months, even though disease activity decreased significantly. There is a need for regular evaluations of physical functions besides disease activity to prevent continuous development of functional losses.
Treatment with mechanical ventilation (MV) in an intensive care unit (ICU) can cause extensive problems for patients.There is, however, a dearth of research investigation into how ICU treatment affects a person’s body image. The aim of thisstudy was to enhance the knowledge and understanding of body awareness and body image in persons treated with MV in anICU. In order to capture the informants’ own perceptions and experiences, a qualitative method of Grounded Theory waschosen. Seven thematic in-depth interviews were carried out with former ICU patients. To increase credibility, triangulationof researchers and reference group checking was used. The analysis resulted in the core category Limited possibilitiesto act, which relates to the informants’ experiences of not being able to act as they normally would. The core category wasderived from the experiences of feeling like another person, the perceptions of not being in contact with their body andreality and the feeling of being restrained. This study adds a perspective of body awareness to the interpretations of ICUpatients’ experiences. It emphasizes the experience and movement aspects of the body and that physiotherapists have animportant role in the rehabilitation of ICU patients.
Rehabilitation after stroke has changed and more studies with intensive therapy have been conducted. When a new method – here lower-limb constraint-induced movement therapy (CIMT) – is introduced, it is important to investigate participants’ own experience of the therapy. The present purpose was accordingly to describe stroke patients’ experience of training with lower-limb CIMT. Qualitative interviews with seven stroke patients who had participated in lower-limb CIMT were conducted. The interviews were transcribed verbatim and analysed with qualitative content analysis. One theme, knowledge of myself and my prospects for leading an easier life, emerged. Two main categories were found: the therapy and me and my body, with four and three categories respectively. The therapy comprised the informants’ experience of preparation for CIMT, the actual intensive training and its effects, and their views on the physiotherapists involved. Me and my body comprised the informants’ reflections on their own significance for the therapy, how the reflections had affected them and what insight into their condition CIMT had given. The informants reported that CIMT for the lower extremity gave them knowledge of their body and their prospects for leading an easier life. The intensive training instilled hope, since the functional improvements showed the possibilities of improvements, increasing the respondents’ independence and self-esteem. Even though the intensive training is tough, it was experienced as entirely necessary.
In a prospective cohort study, 141 patients with a recent radius fracture [135 women (66±9.2 years) and six men (72±6.3 years)] were studied using bone mineral density (BMD) measurements, a risk factor questionnaire, a fall diary, functional tests of dynamic and static balance, and a one-leg rise from a chair test. The mean BMD T-score was -1.97. The results of the one-leg rise test were significantly associated with dynamic and static balance, but none of the functional tests was associated with the number of falls. Forty of 117 patients fell prospectively, 77 of them did not. Decreased height and cigarette smoking were the only risk factors, which significantly predicted low BMD. All risk factors were estimated to explain osteopenia and osteoporosis to an extent of 27%. The functional tests and the risk factor questionnaire seem to be of limited value for identifying people with a radius fracture who are at risk of falling or to have early osteoporosis. If functional tests on musculoskeletal function are considered for older and more frail, the one-leg rise test may be sufficient. Keywords: Bone mineral density (BMD); functional tests; one-leg rise test; radius fracture; risk factors for osteoporosis
Elastic resistance as a tool for evaluation of muscular strength has rarely been addressed even though it is commonly used in exercise and rehabilitation regimens involving the shoulder muscles. The aim was therefore to investigate the relationship and potential difference between development of force during maximal isokinetic (maximum peak force, maximum mean force and peak mean force) and elastic (one-repetition maximum (1 RM)) concentric shoulder fl exion in healthy older adults. A total of 30 voluntary adults over the age of 50 (15 women, 15 men) were included. Intraclass correlation coefficient absolute agreement was 0.85, 0.43 and 0.48 for the isokinetic values respectively, when all subjects were analysed together. No difference was found between the isokinetic maximum peak force value and the elastic 1 RM for all participants (0.15 kg, p 0.791), for men (0.80 kg, p 0.121) or women ( 0.49 kg, p 0.135). Variations at an individual level, i.e. 95% limits of agreement, were 3.3 kg for all participants, 2.8 kg for women and 3.2 kg for men. These results imply that elastic resistance could be used to evaluate shoulder fl exion strength in both older men and women. However, thevariation on an individual level and the lower agreement among women is important to consider.
The objective of this study was to illuminate anterior cruciate ligament (ACL)-reconstructed athletes’ experience of their injury, rehabilitation and recovery. Seven persons, aged 19–57 years, were interviewed on one occasion in autumn 2004, between 10 and 31 months after the ACL reconstruction. They were selected to reach a maximum variation sample according to gender, age, activity level, time between injury and ACL reconstruction and time between surgery and the interview. The analyses were carried out using the Grounded Theory method of constant comparison. One core category “From loss towards restored belief in one's ability” and three categories emerged. The core category represents the process starting when the informants were injured. The process contained phases that interacted with each other but more importantly were drawn out over a long period, especially the mental recovery. The informants used different procedures to manage situations that arose and strived towards restored belief in their ability. This study illuminates the complexity of the recovery process. The patients’ belief in their own ability took a long time to restore. It is important for physiotherapists to understand what patients with ACL injuries need while waiting for surgery. The process of rehabilitation can further equip people with the means to manage problems that can arise and help to strengthen their belief in their ability, as well as helping them with physical training.
Women report more pain from the musculoskeletal system, and more disability, than do men. As a consequence, women more often seek healthcare than men do, and are more often on sick leave. Research shows that female patients and male patients are treated differently by physicians and that the physician's gender also influenced the choice of treatment. The aim was to study whether the patients’ and/or the physiotherapists’ gender influences physiotherapy treatments for patients with neck and/or low back pain. During 3 days in April 2006, 73 physiotherapists in primary care and private practices collected information on 586 patients with neck and/or low back pain. The information included data on the affected pain sites and the treatment procedures used by the physiotherapist. Baseline data on the physiotherapists were collected with a questionnaire. The results showed that female and male physiotherapists mainly used the same treatment procedures, but with some differences. The female physiotherapists used significantly more acupuncture and procedures directed toward treatment of mental function. They also gave their patients a unique combination of treatment procedures to a greater extent than their male colleagues. The malte physiotherapists used significantly more training of joint mobility. Male and female patients were given the same treatment.
Isokinetic testing is often used to evaluate the effect of different types of interventions and also to interpret whether an individual is ready to return to physical activity. However, limited research exists concerning the suitability of evaluating the effect of isotonic training using isokinetic testing. The aim with this study was to assess the relation between the development of force during isokinetic and isotonic concentric maximal contractions. Fifty subjects (24 women and 26 men) performed maximal concentric isokinetic and isotonic elbow flexion. The isokinetic tests were performed in an isokinetic dynamometer and the isotonic tests in a pulley apparatus. The relationship between the isokinetic values (peak value and mean force value) and the isotonic values (1RM) was modeled by linear regression analysis. There was a significant linear correlation between both the isokinetic values and the isotonic value that explained 89% (peak) and 88% (mean) of the variation. From the linear regression analysis, two different formulas were derived to estimate the prediction of the isokinetic values. The significant relation between isokinetic and isotonic measures means that it may be possible to evaluate the effects of isotonic training by using an isokinetic dynamometer. However, there was a large variation around the predicted isokinetic values that has to be considered. It is important to point out that the results of this study are applicable only on healthy young men and women with similar strength as our subjects.
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In patients with eating disorders (ED) body awareness is of interest and the connection between body awareness and selfesteem has been discussed. The aim was to study the concordance of physiotherapist's (PT) observation and patient's own report of bodily expression in patients with ED. Characteristics of ED patients' specifi c bodily expression and implications of the fi ndings for clinical practice were also of interest. Two assessment scales were used, the Body Awareness Scale - Health (BAS-H), based on observations and the Interview Scale Body Ego (ISBE). Total scales and subscales were compared. Altogether 87 ED patients (Total Group, TG) were assessed. Twenty-six patients had anorexia nervosa (AN), 20 bulimia nervosa (BN) and 41 patients ED not otherwise specifi ed (EDNOS). Signifi cant correlations between total BAS-H and total ISBE (r = 0.48-0.57) were found for AN, EDNOS and TG groups. In the subscale centring, correlations were found for all groups (r = 0.42-0.60). In the subscale relations , correlations were found for AN, EDNOS and TG groups (r = 0.43-0.60). The ED patients were characterized by withheld breathing and restrictive expressions of body movements and emotions. Body awareness and self-awareness seemed to be reduced. Body Awareness Therapy might well be offered as a therapeutic tool in establishing a realistic body image. © 2010 Informa UK Ltd.
The main aim was to evaluate how thigh muscle performance in patients with chronic obstructive pulmonary disease (COPD) is affected after a 3-month training programme. Another aim was to investigate if responders to training could be discriminated from non-responders. Thirty patients participated in high-intensity physical training in water or on land, three times per week, and 13 patients constituted a non-training control group. Maximal dynamic strength and endurance in thigh muscles were tested in an isokinetic dynamometer (KinCom) before and after training. At baseline, physical and pulmonary function were tested and used in the analysis of responders/non-responders. Maximal knee flexion strength improved in both training groups, whereas knee extension was improved in the land and control group. Sixty-four percent of all patients were not able to complete the muscle endurance test at baseline and no change was seen in muscle endurance after training within or between groups. A normal body mass index seemed to predict an improvement in muscle performance in responders. We conclude that physical training in water and on land is effective regarding maximal thigh muscle strength in COPD patients. BMI seems to be a discriminating factor for an increased muscle strength. Thigh muscle endurance was decreased in the majority of the patients and did not improve with the evaluated training programme.
The aim of this study was to explore the experience of bodily illness among people with musculoskeletal disorders (MSDs) in the neck/shoulder region. The study had a grounded theory approach, with constant comparisons and simultaneous data collection and analysis. Initially, parts of interviews about health experiences related to MSDs previously performed among men and women with musculoskeletal symptoms in the neck/shoulder and/or back were analysed. Next, complementary semi-structured interviews among men and women with neck/shoulder problems were performed, focusing on the experience of bodily illness, until saturation was reached. The results describe the experiences of bodily illness among people with MSDs in the neck/shoulder region as being characterized by uncontrollable fluctuations. The experiences are presented as a model of the disease course as experienced by the affected. The process usually developed from a beginning with insidious symptoms to a state of constant discomfort. Along the line of this development, periods of intermittent events of increasing illness occurred with peaks of consuming intensity. A variety of different symptoms was present during the process, which are presented in this paper. An increased knowledge of the disease course can be useful in prevention and treatment as communication about the disorder can be more specific.
The aim was to study perceptions of professional role, education and the status of the profession among clinical physiotherapy supervisors. Five focus group discussions were conducted with 15 supervisors attached to four universities in Sweden. Qualitative analyses were carried out using constant comparisons. Triangulation of researchers was used to increase trustworthiness. The supervisors experienced themselves as being in the centre of two competing and changing fields - the academic setting and the clinic in healthcare organization. The contact with students and their updated knowledge base were the most positive aspects of being clinical supervisors. To create a good learning environment for the students was considered important, but lack of time in all aspects of the work created stress and dissatisfaction. Students’ hands-on skills and treatment techniques were regarded to be rather poor and there is too much emphasis on theoretical knowledge and research methods in the curriculum. The physiotherapy profession has potentials to develop in innovative fields such as health promotion and disease prevention outside the hospitals, but healthcare with its hierarchical organization is a hindrance for this development. Collaborative efforts to bridge the gap between university and clinical setting are needed.
Career choices are still strongly gendered in health care professions. In Sweden, physiotherapy is a middle-class women's profession that nowadays also attracts men. Career strategies and professional development in physiotherapy are sparsely studied from a gender perspective. The purpose of this qualitative study was to describe and analyse perceptions of individual professional development, physiotherapy education and the profession in general, among a group of women educators in physiotherapy, using a gender theoretical framework and some of Bourdieu's theoretical concepts in the analysis. Thematized in-depth interviews with fourteen educators in physiotherapy were performed. The analysis used the Grounded Theory method of constant comparison. To increase credibility, the study design used triangulation in interviewers and investigators, member checking and reference group checking. Three core categories were identified. The Competent Woman category involves the professional development of the educators, including aspects of competence, success, efficiency and flexibility. Perceptions of femininity and masculinity reflect the symbolic dimension of gender. Femininity is regarded as symbolic capital for empathy and care, while masculinity represents status and power. The core category Theory-Practice Gap describes the isolated position of physiotherapy education in relation to the field of health care. The fragmented and disintegrated professional knowledge base does not facilitate the development of the profession. The core category Profession under Change reflects ideas about physiotherapy in society. Other female health care professions, ongoing societal change and conservative physiotherapy practices constitute a threat to the future development of the field. Visions for future development of the field emphasized the importance of professional competence and engagement in innovative activities in new arenas and new professional roles. The results shed light on the symbolic dimension of gender in a professional field where femininity is connected with academic success, empathy and care, while masculinity is related to business mentality, status and power. Notions of competition include both internal and external factors affecting the field of physiotherapy.
This article focuses on reasons for the career choice and the longitudinal development of attitudes to healthcare work and the physiotherapy profession. The study is part of a larger project on professional development in physiotherapy. A cohort of 60 Canadian physiotherapy students was surveyed on two occasions during their educational programme. The questionnaire was constructed using a theoretical framework about professional socialization. Forty students completed both versions of the questionnaire yielding a response rate of 67%. Seventy-two per cent were women and 28% were men. Job accessibility or economic (25.5%) were the most frequently indicated reasons for the career choice. The most frequently chosen role models were the preceptors in clinical placements (52%). None of the students indicated having a faculty member as a role model. The desire to work in private practice and with adults was ranked highly in both administrations of the questionnaire. Few students regarded home care and community health as preferable healthcare facilities after graduation. Research, managerial work or occupational health were not given as preferable areas of practice. There advantages were statistically significant differences between women and men in their preferences for private practice work and the public sector of healthcare. The results are discussed in relation to gendered division of labour in healthcare and to the development of the profession.
The aim was to identify reasons for the career choice and professional preferences among students enrolled in the Swedish physiotherapy education. The study design was longitudinal and used a questionnaire administered to a cohort of 273 students in the beginning of the university programme in 1997 as well as at the completion of the programme in 1999, yielding a response rate of 93%. Data were analysed with factor analysis and univariate and multivariate logistic regression analysis. To test the relationship between the factors and outcomes that showed significant effect in the logistic regression analysis, a path analysis was performed. The two most preferred healthcare facilities after graduation were sports medicine clinics and fitness centres. Future work in private practice was highly endorsed by a majority of students. Health promotion was highly valued. Care of elderly and hospital work were not preferred. Significant differences between men and women appeared. Men were more likely to have chosen the programme because of their interest in sports and physical activity. Men were also more choice decided about future professional activities, whereas women were more open for several areas of practice. Men preferred to become the owner of a private clinic and to work with alternative approaches to healthcare, such as fitness training in sports medicine clinics.