Work Type




Faculty Advisor

Holly Roberts, PT, DPT, GCS, NCS


Title: Utilization of Physical Therapy During Student Service Learning Project to Guatemala

Authors: Bonnie Cramer SPT, Hannah Hourie-Collins SPT, Lucas Willers SPT, Holly Roberts PT, DPT, GCS, NCS

Affiliation: School of Physical Therapy, University of Puget Sound

Purpose: The purpose of this project was to collect demographic information for a descriptive analysis of patients accessing physical therapy services in rural Guatemala over the course of a week-long international service learning project by student physical therapists. The goal of the international service learning project was to provide skilled physical therapy to resource limited communities, experience the Guatemalan culture, and develop the students’ physical therapy skills.

Methods: Data was collected over a five-day period at 4 clinical locations in the Zacapa region of Guatemala. Sites included two outpatient physical therapy clinics, one mobile clinic, and one outpatient clinic associated with a public hospital. All clinical sites were operated by the non-profit organization Hearts in Motion. Demographics were collected for each patient regarding their age, gender, diagnosis, treatment type, and facility location. Data was gathered by five physical therapy students from the University of Puget Sound who participated in the service learning project.

Results: A total of 97 patients (43 males, 54 females; ranging in age from 4 months to 87 years) were evaluated and/or treated for a variety of orthopedic and neurological conditions. The most frequent orthopedic condition seen was lower extremity dysfunction, predominantly knee injuries (38% of all orthopedic condition were related to the knee), followed by low back pain (20% of orthopedic conditions). A diagnosis of knee pain could be attributed to tendon, ligament, muscular or meniscal injuries as well as osteoarthritis. Cerebrovascular accidents were the most commonly treated neurological condition (67%). The majority of patients (24%) were age 55-74, with distribution being fairly even across other age ranges.

Discussion: A brief English language literature review of Guatemalan health demographics yielded limited results, therefore it is difficult to determine to what degree the patient population observed in this student learning project is representative of the larger Guatemalan population who seek healthcare services. One 2012 study surveyed 1000 subjects in rural and urban Guatemala, and showed that the most prevalent musculoskeletal diseases were 1) osteoarthritis, 2) soft tissue rheumatism, 3) rheumatoid arthritis, 4) low back pain, and 5) arthralgias of unknown etiology.1 Soft tissue rheumatism is the aggregate of clinical problems related to tendons, ligaments, fascia and bursae, often presenting as a regional problem. These results are comparable to our observations as we observed a high prevalence of osteoarthritis, orthopedic soft tissue rheumatism, and low back pain. A lack of data regarding physical therapy utilization in the United States makes comparison between the two countries difficult.


  1. Obregón-Ponce A, Iraheta I, García-Ferrer H, Mejia B, García-Kutzbach A. Prevalence of Musculoskeletal Diseases in Guatemala, Central America. JCR: Journal of Clinical Rheumatology. 2012;18(4):170-174. doi:10.1097/rhu.0b013e3182583803.


University of Puget Sound