UF team of physical therapy faculty and students teaches updated techniques to lone Nicaraguan physical therapy education program

Although a group of University of Florida physical therapy department members spent less than a week in Nicaragua, the impact of their visit on that country’s physical therapy education and patient care will be felt for years to come.

The group of two faculty members and two graduate students from the College of Health Professions’ physical therapy department recently provided instruction to the entire faculty of the only physical therapy education program in Nicaragua.

Gloria Miller, M.A., M.H.S., a program director and lecturer, Jennifer Stevens, Ph.D., M.P.T., a postdoctoral fellow, and master’s-degree students Rajani Mukalel and Heather Scott presented an intensive four-day course to physical therapy professors at the Universidad Nacional Autonoma de Nicaragua in Managua, the nation’s capital.

“We were able to carry over techniques to professors who will make a permanent change in the practice of physical therapy in Nicaragua,” Mukalel said. “It was a uniquely rewarding experience that not only helps professors within our profession but also patients.”

One of the poorest nations in the hemisphere, Nicaragua is slowing rebuilding after the devastation caused by U.S.-sponsored guerrilla attacks on the Sandinista government and trade embargoes in the 1980s, as well as Hurricane Mitch in 1998. Half of the nation’s 5 million citizens live below the poverty line.

Nicaraguan physical therapy education and clinical practices haven’t been updated in 12 to 15 years, Miller said. Most physical therapists in Nicaragua are unaware of the advances in therapy reviewed at the international Two-Step conference, held in 1990, which form the cornerstone of current physical therapy treatment.

“We felt our efforts would be more effective in the long term by teaching instructors who will be passing on the knowledge to others, rather than just treating patients,” Stevens said.

Stevens, whose father is the public affairs officer to the U.S. ambassador to Nicaragua, organized the trip.

Having spent several months in the country working with local therapists, she was aware of their desire for continuing education and proposed the trip to her UF colleagues.

The UF group provided instruction to 13 physical therapy faculty of the Nicaraguan university, four physical therapy clinicians from area facilities and a first-year physiatry resident. Coursework covered principles of motor control, which is particularly useful when developing treatments for patients who’ve suffered strokes, neurological impairments or orthopedic injuries.

Miller, who teaches a similar course at UF, presented the material in English while Stevens, who is fluent in Spanish, performed translation. A physician was on hand to help translate difficult technical terms. During laboratory sessions, Scott and Mukalel demonstrated therapy techniques.

“The material we presented is applicable in every aspect of physical therapy, and I feel very proficient in the area of motor control after putting the written material together and helping to teach it,” Scott said. “You really need to know what you are talking about if you want to explain it in another language.”

The members of the UF group reported that the Nicaraguan physical therapists were very appreciative of the information they received. “The faculty members were very open and careful to ask questions when they didn’t understand a concept,” Miller said. “As professors, they need to be able to have a firm grasp of the information so that they can teach it to their students.”

The UF group completed their stay in Nicaragua with a visit to Leon, a small town near Managua, where they toured a nursing home, hospital, pediatric clinic and prosthetics clinic.

Although the treatment facilities lacked much of the physical therapy equipment used in the United States, the group was impressed by the quality of care offered by the Nicaraguan therapists.

“It reminded me that as a physical therapist you don’t need high-tech equipment to provide excellent care,” Miller said.

Both Stevens and Miller plan to return to Nicaragua to provide instruction to the same faculty, who expressed interest in learning about therapies geared to the elderly and children.

Mukalel and Scott feel that the experience has helped prepare them for their future physical therapy careers by giving them opportunities to practice Spanish-speaking skills, interact with physical therapists from another country and perform teaching responsibilities.

The group’s trip was supported by donations of toys, physical therapy equipment and funds for travel expenses by Gainesville’s Grace Methodist Church, Option Care, Hygenic Corp., Kids on the Move and the College of Health Professions.

“A number of people contributed in so many ways through donations, translation of course material and teaching,” Stevens said. “This effort went far beyond the four of us.”