THE NATIONAL COMPETITION FOR THE TRAINING OF ROMANIAN PHYSICAL THERAPIST IN A EUROPEAN CONTEXT

MARCU V., MARCU A., DAN M., MATEI C.

Oradea University, Department of Physical Therapy

Key words: competition, training, physical therapist

PURPOSE

 The Romanian Federation of Physical Therapy Association (FRAK) became a member with full rights of than World Confederation of Physical Therapy (WCPT) in 1999 in Yokohama, Japan. This fact was due to the acknowledgment of the Academic Curriculum, which represents the basis for professional formation in physical therapy in Romania.

 Even through in Romania the physical exercise has been used for therapeutic purposes ever since the end of the XIX^th century, it was only in 1992 when the first physical therapy faculties were born: Oradea, Bacau, Bucuresti. Therefore the first physical therapy graduate professionals appeared in Romania in 1996, and in 1997 the Romanian government adopted an accreditation decision for the physical therapy profession.

 The training standards for physical therapists in Romania have been established through FRAK rigors according to the description of the profession made at the WCPT Congress in Yokohama, to the benchmark statement and to the professional standards adopted by WCPT – the European region.

 Nowadays in Romania, the physical therapy specialization is a part of the Physical Education and Sport faculties, such specializations existing in the major academic centers of the country: Bacau, Bucuresti, Cluj-Napoca, Craiova, Drobeta Turnu-Severin, Galati, Iasi, Oradea, Pitesti, Timisoara.

 Although the number of faculties is high and the number of graduates per year is about 200, yet, reported to Romania's population, there is only one physical therapist for 8200 people. Under these circumstances, Romania has a not exactly favorable position in Europe (fig. 1).

Besides the international requirements, the Romanian physical therapists accomplish, as well, the objectives of occupational therapy. Within this context, we are trying to achieve the accreditation of a new profession in Romania, that of occupational therapist. 

RELEVANCE

 In 1992 was introduced a fundamental training during the first two years of faculty and a specialized training during the following two years, as the initial formationof the physical therapists.

 In the fundamental training, the orientation is towards the introduction of subject-matters for the study of human motion, of general kinetology and of physical education and sport in order to ensure the understanding the content and structure of the physical exercise, as well as its effects upon the entire neuro-mio-arthro-kinetic system, upon the tissues and internal organs. In the specialized training we have introduced theoretical and practical subject-matters for physical therapy rehabilitation in rheumatology, gynecology, gerontology, orthopaedy-traumatology, neurology, pediatrics, cardio-respiratory field.

 The academic curriculum also includes a complementary training starting with informatics and the use of computer and ending with deontology, legislation, scientific research methods and others. Practical training is achieved through the practical works on the specialized subject-matters as well as through clinical institution and specialized practice. Optionally we also have psycho-pedagogical and methodological training in order to form teachers for the special education (ortho-pedagogic).

According to the standards of the National Council of Academic Evaluation and Accreditation (CNEAA), the education plan for long term educational specializations is made on the basis of the European System of Credits (ECTS). The volume of the educational plan differs in correlation with the semester structure and on the number of compulsory and optional classes per week. Thus the number of classes during the 4 study years, structured in 8 semesters is between 2750 and 2960 actual hours. Out of this numbers of hours, 40-45% are represented by lectures and the rest are dedicated to practical and applicative activities. The curriculum of the future physical therapists is based upon 25-35% subject-matters which are part to the fundamental training, 65-70% special training and 5% complementary training.

 SUBJECTS

 We have included in the research 350 physical therapists, men and women from 7 series of graduates, specialists working in physical therapy rehabilitation in rheumatology, neurology, pediatrics, cardio-respiratory field and traumatology-orthopaedy.

METHODS

 Analyzing the national and international documents we set up a questionnaire which we applied to the lot of studied subjects and which was orientated towards:

• the most frequent pathology,
• the most frequent causes of the respective pathology,
• the number of patients a physical therapist works which during the 7 program hours,
• the most used methods in the rehabilitation program,
• the drawbacks which are encountered in the approach of rehabilitation,
• information sources used for the documentation,
• the efficiency of the theoretical courses for an efficient intervention in the practical activity,
• the value of other complementary subject-matters among the necessary knowledge in approaching the patients,
• what should be done for improvement in the field of activity,
• organization, administrative and deontological problems.

THE ANALYSIS AND INTERPRETATION OF THE RESULTS

 The data obtained from the interviews and questionnaire applied to the physical therapists, have been centralized and scientifically processed. Both the analytical syllabuses of the fundamental subject-matters and those of specialized ones, as well as those of complementary ones and practice has been taken into consideration. We wanted to emphasized the objectives of the academic curriculum of physical therapy in faculties and the level of the professional's aspirations in the aria of special practice. We have not compared the results obtained from practice with the professional standards as were latter imposed by FRAK in the phase of initial formation of the physical therapists.

Fig. 4. The incidence of pathology

 The incidence of pathologies is explained by the number of physical therapists working in various rehabilitation fields. An other aspect would be the incidence of pathologies especially at elderly people.

The causes of pathologies are determined by the population's lack of awareness regarding physical exercises practice for prophylactic purpose, medical analyses and physical therapy which could came far too late for many persons' with unequilibrated and disorganized life style. Unfortunately in our country education regarding movement and physical education is still deficient.

The percentages obtained after using these methods are explained by pathologies that physical therapist are confronted with and by their efficiency in the rehabilitation plan made for each patient. Our programs are personalized also because in rehabilitation as well as in the other fields, it is more important to prevent than to cure.

Fig. 5. Causes of pathologies

Fig. 6. Methods used

Fig. 7. Information sources

The result obtained were interesting in the segment 'information sources', which is the first place held by the special literature and closely the experience exchanges. For Romania this is a very important fact because the acquirement of theoretical knowledge represents the basis for practical activity and through experience exchanges this knowledge both theoretical and practical may be communicated and shared between physical therapists. Even though it is a very accessible way, yet, in Romania, we have noticed that the internet is not much used for research by physical therapists, probable because of logistical causes.

 CONCLUSIONS

 Although the profession of physical therapist is relatively new in Romania, dating since 1997, it has found among the specialists of the field its well established place and role in the population's health insurance system. As it can be observed in the presented graphics, during the physical therapists initial formation, they have learned what the human body means in normal and pathological situation, what movement means for the body and they have acquired application skills regarding exercises, specific techniques and methods necessary to provide kinetic assistance in all researched domains. However, we consider that in the continuous formation, in the after graduation improvement there are significant drawbacks, even trough measures have been taken in this respect.

 From the organizational point of view, we cannot state that we do not have problems. Although we have a high number of physical therapists – 950, only 250 are part of the professional organization and FRAK members. This present situation could be explained due to the fact that in our health system there is no official document, yet, to establish the professional standards for a physical therapist. From the total number of physical therapy graduates (950) only 450 are working within the medical rehabilitation system of Romania, 150 within the rehabilitation system from abroad, and 350 within others activity areas.

 We believe that the lack of a continuous formation system of improvement in the field, represents another of our drawbacks and this is probably because of the sporadic participation to international session, to which only a low number of specialists participate.

Abstract

As it was established in 1999, in Yokohama the profile of the initial and the continuous forming of the physical therapists in Romania aims to prepare a professional at the level of WCPT. Although the first faculties were established in 1992, the Romanian Physical Therapist Federation implemented a high standard of professionals training.

RELEVANCE: We intend to compare the professional level of the Romanian physical therapists with the WCPT standards.

SUBJECTS: Our research included 50 physical therapists from all the seven series of graduates, 350 physical therapists in total.

METHODS: During the research we have used the method of analysis with national and international documents, the interview and the questionnaire. The subjects were selected under a medical specialization criteria: rehabilitation in rheumatology, rehabilitation in neurology, rehabilitation in traumatology, rehabilitation in cardiopulmonary diseases, rehabilitation in pediatrics.

ANALYSES: The results were statistically analyzed, we have realized graphics with it and we have studied all the differences we found.

RESULTS: The results are presented in graphics and tables and appreciated as being at an international level of competences.

CONCLUSION: Although it was recently implemented in our Professional Classification (C.O.R - 1997), the physical therapist profession found its place and its role in our health system. We can conclude that the steps we have made in the initial training of physical therapists represent a positive beginning. Meanwhile we understand that we still a lot of work to do, especially concerning the continuous training of the professionals, and also from an organizational point of view.

Rezumat

Prin formare initiala si continua a kinetoterapeutilor in Romania se cauta sa se perfectioneze profesional kinetoterapeuti la nivelul standardelor intenationale conform cerintelor W.C.P.T., cerinte stabilite in 1999 la Yokohama. Cu toate ca primele facultati au fost infiintate in 1992, F.R.A.K. implementeaza cele mai inalte standarde de pregatire profesionale. Noi intentionam sa comparam nivelele de pregatire profesionala ale kinetoterapeutilor din Romania cu standardele W.C.P.T.

Cercetarea noastra include 50 de kinetoterapeuti din cele 7 promotii de licentiati din totalul celor aproximativ 350 de kinetoterapeuti.

Pe parcursul cercetarii am folosit metode de analiza a materialelor nationale si internationale, interviul si chestionarele. Subiectii au fost selectati dupa specializarea medicala si anume reumatologie, neurology, traumatologie, afectiuni cardio-pulmonare si pediatrice.

Rezultatele au fost analizate statistic, reprezentate grafic si intabelate, rezultate care demonstreaza inaltul nivel de competente ale kinetoterapeutilor romani.

REFERENCES

Academic curriculum. University of Oradea. Oradea, 2002

Marcu, V., Marcu, Agneta, Dan, Mirela, Matei , Corina, The training of physical therapy in neurology rehabilitation. Paper presented at the 3^rd World Congress in Neurological Rehabilitation, Venice, Italy, 2002

Romanian Magazine of Physical Therapy, no. 9 – Description of Physical Therapy, Japan, May, 1999

Sbenghe, T., Kinesiology – science of motion. Bucharest, Editura Medicala, 2002

Specific standards - elaborate by CNEAA. Bucharest, 2002