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J. Blandon1, M. Cantieni2, A. Hagengimana3
1International Committee of the Red Cross, Nairobi, Kenya, 2International Committee of the Red Cross, Lomé, Togo, 3International Committee of the Red Cross, Kigali, Rwanda
Background: To offer an appropriate physical therapy treatment, it is important to understand the beliefs that physiotherapists have around the health conditions they treat and why the persons are seeking physical therapy services. Depending on the context, this can be very different; thus, the treatment, including patient education, needs to be adapted.
Purpose: The purpose of this study was to explore the beliefs of physiotherapists about flatfeet treatment, and the implications of such beliefs in the treatment choices, modalities, and goals.
Methods: An anonymous cross-sectional survey was conducted online with SurveyMonkey® among 55 Rwandan Physiotherapists between August and September 2022. Findings were analyzed and reported in accordance with STROBE (STrenthening the Report of OBservative studies in Epidemiology).
Results: All responders (21 out of 55) believed that physical therapy could be useful in the treatment of persons with flatfeet. 13 of them (56.52%) think that the main reason behind the parents seeking treatment was the fear of social stigma and/or rejection, followed by pain or functional limitation (39.13%).
Regarding the cause of flatfeet, 20 physiotherapists (90.91%) believe that most cases have no cause, or that the cause is unknown. Only 1 physiotherapist (4.55%) answered that the cause was the natural human variability.
The main reason for treating flatfeet was, for 18 physiotherapists (81.82%), to avoid a permanent deformity or improve the function of the foot.
Regarding the treatment modalities, 16 physiotherapists (76.19%) believe that the most effective treatment are foot orthoses and appropriate shoes. 4 (19.05%) think that the most effective treatment is therapeutic exercise and 1 (4.76%) believes that it is parents’ education.
Regarding the outcomes, 7 physiotherapists (33.33%) are satisfied with the results in most of the cases, and 10 (47.62%) in some cases.
Almost no physiotherapist working in Rwanda believe that parent’s education is the most important part of the treatment, despite the parent’s demand which is mostly based on social inclusion and participation concerns.
Regarding the cause of flatfeet, 20 physiotherapists (90.91%) believe that most cases have no cause, or that the cause is unknown. Only 1 physiotherapist (4.55%) answered that the cause was the natural human variability.
The main reason for treating flatfeet was, for 18 physiotherapists (81.82%), to avoid a permanent deformity or improve the function of the foot.
Regarding the treatment modalities, 16 physiotherapists (76.19%) believe that the most effective treatment are foot orthoses and appropriate shoes. 4 (19.05%) think that the most effective treatment is therapeutic exercise and 1 (4.76%) believes that it is parents’ education.
Regarding the outcomes, 7 physiotherapists (33.33%) are satisfied with the results in most of the cases, and 10 (47.62%) in some cases.
Almost no physiotherapist working in Rwanda believe that parent’s education is the most important part of the treatment, despite the parent’s demand which is mostly based on social inclusion and participation concerns.
Conclusions: Most physiotherapists who completed the survey think that the parents of children with flatfeet are looking for a treatment to avoid social stigma or rejection of their children. Pain or functional limitation are a secondary concern for them.
They also think that flatfoot is an idiopathic condition that needs to be treated to avoid a permanent deformity or to improve the function of the foot. Almost no physiotherapist believes that flatfeet are part of the natural variability of the children.
They also think that flatfoot is an idiopathic condition that needs to be treated to avoid a permanent deformity or to improve the function of the foot. Almost no physiotherapist believes that flatfeet are part of the natural variability of the children.
Implications: This study shows that there is a discrepancy between the parent’s needs and concerns perceived by the physiotherapists and their therapeutic approach. Physiotherapists in Rwanda should consider the demands and concerns of parents of children with flat feet when establishing treatment goals and plans and measuring outcomes, in example providing systematic caregiver education within the physiotherapy treatment plans. Health policymakers and rehabilitation stakeholders should encourage a more patient-centered approach and inclusion of the parents in the treatment process. These measures could be integrated in the Rwandan community-based rehabilitation system to avoid overloading the healthcare services.
Funding acknowledgements: The authors express gratitude for the support received from ICRC during this research.
Keywords:
flatfeet
beliefs
physiotherapy
flatfeet
beliefs
physiotherapy
Topics:
Professionalism & ethics
Community based rehabilitation
Paediatrics
Professionalism & ethics
Community based rehabilitation
Paediatrics
Did this work require ethics approval? No
Reason: This presentation will address new and unique developments in practice, theory, education, management, policy, and resources within rehabilitation programmes on the field for the ICRC. It describes innovative ways in which established methods have been adapted to meet the changing needs of practice.
All authors, affiliations and abstracts have been published as submitted.
