Chartered Society of Physiotherapy

Tajikistan, a low-resource country in Central Asia, has only recently begun developing formal physiotherapy services and education programs. In response to a 2018 gap analysis conducted by World Physiotherapy, the Strengthening Rehabilitation Services in Health Systems (SRSHS) project was launched in 2019 to establish an entry level physiotherapy program (PT-ELP). This study analyzed the implementation of the SRSHS project (2019–2024) by mapping its activities to the World Health Organization (WHO) Stepwise Guide: Using a Contextualized Competency Framework to Develop Rehabilitation Programmes and Their Curricula (2020). The objectives were to (1) assess the alignment between project activities and the WHO Stepwise Guide, and (2) identify gaps and lessons learned to inform future rehabilitation education initiatives in low-resource settings. A qualitative document analysis was conducted using 178 project documents produced between 2019 and 2024. These were systematically mapped to the WHO Stepwise Guide’s five curriculum development phases. Triangulation with project stakeholders was used to validate findings and ensure credibility. Project activities demonstrated substantial alignment with the WHO framework. Planning (Steps 1–3) and construction/sequencing (Steps 4–8) were largely completed through stakeholder engagement, curriculum development workshops, and the creation of syllabi for eight physiotherapy courses. Steps 9–10 (assessment design and progression criteria) were partially achieved, with limited integration of assessment methods into learning objectives. Steps 11–12 (implementation and evaluation) progressed through bridge trainings and consultancy support, although a formal curriculum evaluation cycle was only initiated during the 2023–2024 extension phase. The Tajikistan PT-ELP illustrates how international frameworks can be effectively adapted to low-resource contexts through staged consultancy and locally tailored teaching resources. The experience highlights the importance of embedding assessment strategies and evaluation mechanisms from the outset, alongside sustained educator development to ensure successful implementation and long-term sustainability.

Background: The shift to remote and hybrid work models after the COVID-19 pandemic has introduced psychosocial hazards that may elevate burnout risk beyond levels observed in traditional high-contact professions. Although emotional exhaustion rates of 20–50% are well documented among healthcare and social service workers, prevalence in general remote and hybrid populations remains inconsistent, with limited data on modifiable predictors such as work–life boundaries, isolation, and supervisor support. Objective: To determine the prevalence of burnout and emotional exhaustion among remote and hybrid workers in technology, education, and finance sectors and to identify independent organisational and psychosocial predictors of high emotional exhaustion. Methods: We conducted a cross-sectional observational study from January to April 2025, recruiting 247 remote and hybrid employees via professional networks and workplace platforms. Burnout was assessed using the Maslach Burnout Inventory–Human Services Survey, with high emotional exhaustion defined as ≥27, high depersonalization as ≥10, and low personal accomplishment as ≤33. Psychosocial factors were measured with validated Likert-scale items. Multivariable logistic regression adjusted for gender, sector, work model, and confounders identified predictors of high emotional exhaustion. Results: High emotional exhaustion affected 63.1% (95% CI 56.9–68.9) of participants, and overall burnout (at least two elevated domains) 41.7% (95% CI 35.7–47.9). Fully remote workers had significantly higher emotional exhaustion than hybrid workers (mean difference 3.7, p=0.004). Independent predictors included poor work–life boundaries (adjusted OR 2.67, 95% CI 1.65–4.31), work hours >45/week (OR 2.11, 1.31–3.39), and isolation (OR 1.24 per unit, 1.10–1.40). Conclusion: Emotional exhaustion is highly prevalent among remote and hybrid workers and is strongly driven by blurred boundaries, extended hours, and isolation. Organizational interventions targeting these factors may reduce burnout risk in flexible workforces.

Background: Adolescent idiopathic scoliosis (AIS) is a three-dimensional spinal deformity often associated with postural misalignment, pain, and reduced quality of life. While conventional exercises are commonly prescribed, scoliosis-specific methods such as the Schroth Method may offer greater therapeutic benefits. Objective: To compare the effectiveness of the Schroth Method versus conventional exercise in improving posture and reducing pain in adolescents with AIS. Methods: This randomized controlled trial (RCT) was conducted under the CONSORT guidelines over a six-month period, from April to October 2024, at Hayatabad Medical Complex (HMC-MTI), Peshawar. In this randomized controlled trial, adolescents aged 10–18 years with a Cobb angle of 10°–30° were allocated to either a Schroth-based exercise program or a conventional exercise group for 12 weeks. Primary outcomes included craniovertebral angle, thoracic kyphotic angle, and Numeric Pain Rating Scale scores. Secondary outcomes included Cobb angle, angle of trunk rotation, SRS-22 scores, and balance parameters. Measurements were taken at baseline, 6, 12, and 24 weeks. Results: The Schroth group showed significantly greater improvements in postural alignment, Cobb angle reduction, and pain scores compared to the conventional group (p < 0.05). Improvements were sustained at 24-week follow-up. Conclusion: The Schroth Method demonstrated superior effectiveness over conventional exercises in managing posture and pain in AIS. Incorporating scoliosis-specific exercise into conservative management may enhance patient outcomes.

Faecal incontinence (FI) is common, yet clinical guidelines rely on low-quality evidence or expert opinion. A high proportion of research is focused on areas that may not be considered a priority by patients or clinicians. This project aimed to identify the top 10 research priorities for FI in adults in equal collaboration with patients, carers and healthcare professionals in a James Lind Alliance priority setting partnership (PSP). This PSP followed established methodology supported by a multidisciplinary steering group including those with lived experience of FI. Evidence uncertainties were gathered through a survey with free-text responses, summarised in indicative summary questions and prioritised in a second survey. An independently facilitated priority setting workshop used a nominal group technique to reach consensus on the order of research priorities, with a focus on the top 10. At all stages the views of healthcare professionals and individuals with a lived experience of FI were considered equally. After the initial survey, 512 respondents submitted 991 evidence uncertainties. These produced 54 indicative summary questions. In the second survey, 373 respondents generated a shortlist of 26 questions. Finally, the top 10 research priorities were determined by consensus at a face-to-face workshop and include unanswered questions concerning prevention, investigation, education, self-management and treatment of FI. This PSP has identified a comprehensive list of top research priorities, including items of importance to both healthcare professionals and individuals with a lived experience of FI. Researchers and funders should use these priorities to inform future work.

Background: Stroke, or cerebrovascular accident (CVA), is a leading global cause of long-term disability and the fourth leading cause of mortality. Impairments following stroke often affect upper limb motor function, impacting daily activities and quality of life. Rehabilitation strategies have evolved to include neurocognitive approaches such as the Carlo Perfetti method, designed to engage both sensory and motor pathways. Evaluating the effectiveness of such interventions in subacute stroke patients is vital for improving functional outcomes. Objective: To evaluate the effectiveness of the Carlo Perfetti method in improving upper extremity motor function in subacute stroke patients. Methods: A randomized clinical trial was conducted with 32 subacute stroke patients recruited from Allied Hospital, DHQ Hospital, and Faisal Hospital, Faisalabad. Participants were divided into two equal groups (n=16 each) using purposive sampling. Both groups received baseline Electrical Muscle Stimulation (EMS) three times weekly for 30 minutes over 10 weeks. Group A received additional treatment using the Carlo Perfetti method, while Group B received EMS only. Outcome measures included the Motricity Index, Motor Evaluation Scale for Upper Extremity, and Modified Ashworth Scale, assessed at baseline and at 2-week intervals up to week 10. Statistical analysis was performed using SPSS 20, applying the Friedman test for within-group comparisons. Results: Group A showed progressive improvement in motor function: Motricity Index mean rank increased from 1.00 at baseline to 6.00 at week 10; Motor Evaluation Scale improved from 1.03 to 6.00. Spasticity reduced significantly, with Modified Ashworth Scale mean rank decreasing from 4.72 to 1.56. All changes were statistically significant (p=0.000). Group B showed moderate improvement with final scores of 3.50, 3.20, and 3.00 respectively. Conclusion: The Carlo Perfetti method was significantly more effective than EMS alone in improving upper extremity motor function and reducing spasticity in subacute stroke patients.

Abstract While research evidence has the potential to improve classroom practice, research–practice gaps continue to persist not least owing to the limited relevance of research findings for practice. A common approach in healthcare to address the research–practice gap is to form research priority setting partnerships (PSPs) in which stakeholders identify questions they would like research to answer. This paper presents the results from such a PSP in education with a focus on cognitive science research, which has received increased attention in the past few years owing to its potential to explain memory and learning processes and inform classroom practice. Over 400 questions from teachers were collected using an online survey. The final 15 research priorities highlight the need for research on a wider range of subjects, settings and phases as well as research designs that take the complexity of classrooms into consideration and aim to answer how different teaching strategies interact with each other as well as student motivation and agency at the micro‐ and macro‐level. The role of teacher expertise vs. fidelity to original research designs should also be investigated further. Overall, this paper highlights the importance of taking teacher voice into account to ensure that new research in the field is both academically rigorous and practically relevant.

Operating as physiotherapist and doctor in the field of sports requires deepened knowledge and clinical skills in sports physiotherapy and sports medicine, specific information on the field being supported, a clear commitment to the duty of care and social skills. It is furthermore indispensable to clarify and be aware of the role of team physio and team doctor as well as to invest in good preparation. The article highlights these points and provides a suggested list of recommendations about do’s and don’ts for team physios and team doctors.