Abstract:

Introduction:
Grasp and Gait rehabilitation (GG-rehab) is a specific topic with practical significance in many fields of the clinical rehabilitation practice. The work (and the education) in GG-rehab requires the coordinated activity of different members of the multidisciplinary and multi-professional rehabilitation team – medical doctors (specialists in Physical and Rehabilitation Medicine /PRM/) and different types of health professionals (physiotherapists /PTs/, ergotherapists /ETs/, medical assistants, nurses, etc.).

Methodology:
In the year 2019, we prepared an electronic book with presentations and video-films on the topic GG-rehab. The e-book contains theoretical bases of the grasp, balance and gait – definitions, types, classical and contemporary methods of assessment and treatment procedures - in different conditions of the central or peripheral nervous system, and in musculoskeletal diseases.
Clinical cases are included, with explanation of practical skills for grasp, balance and gait training, and some activities in daily living (ADL).
The e-book is oriented to the necessary theoretical and practical knowledge of the medical and para-medical staff: medical doctors (PRM-specialists and PRM-trainees) and physiotherapists (bachelors in Rehabilitation, Kinesiotherapy, Ergotherapy; masters in Physiotherapy, Medical Rehabilitation and Balneology). We offered the book to all medical specialists and health professionals - participants in long-life-learning (LLL) training courses on GG-rehab, organized by the Medical University of Sofia during last years.
We created a set of tests and practical exams (including analysis of clinical cases) in the field of GG-rehab, adapted to the level of professional competences of members of the multidisciplinary and multi-professional rehabilitation team.
During LLL courses, we tested all participants: medical doctors (PRM-specialists and PRM-trainees) and physiotherapists (bachelors and masters in kinesiotherapy and rehabilitation). We evaluated the impact of the application of this e-book on the level of theoretical knowledge and practical skills in all groups of practitioners.
We compared the results of evaluation of acquired professional competence of different groups - in case of distance learning, face-to-face learning and combined learning. The students’ and teachers’ opinions concerning different types of learning process were analysed.

Results:
We observed an improvement of the level of professional competence of all members of the rehabilitation team, especially in the field of theoretical knowledge. The impact of distance learning on practical skills is significant only in groups with previous clinical practice in the correspondent field – medical doctors PRM specialists and physiotherapists – participants in LLL-courses.
For the young MD-PRM-trainees and students in physiotherapy and in ergotherapy the importance of face-to-face learning is significant and (for the moment) can’t be substituted by remote learning.

Conclusions:
Authors consider very effective the application of this e-book on the level of theoretical knowledge and practical skills of the medical specialists and health professionals in the field of grasp and gait rehabilitation. However, we must avoid that the electronic learning can be very useful only in case of reasonable combination with a successive course of face-to-face practical education.

Keywords:

Electronic book, video-film, e-learning, grasp, grip, gait, physical medicine, rehabilitation, quality of life.