THEY'RE worlds apart and the technology physiotherapists in Brazil have access to is not a patch on here - but they've been forging links.

Dr Elcimar Reis, 35, is a Brazilian physiotherapist and lecturer who specialises in the upper body - for the past six weeks he's been sharing his expertise with the Bournemouth Nuffield Hospital.

Ken Joy, physiotherapy manager at the Nuffield, described Elcimar's visit as an opportunity for advances in patient treatment to be learnt in Bournemouth.

Though socially Elcimar's English is limited, the terms used in physiotherapy worldwide are largely derived from Latin so the language barriers don't apply as much in the workplace.

He said: "Here the patients ask more questions about their treatment. They want to know how they've done and are very knowledgeable about how their treatment works.

"In Brazil they accept what the doctor is saying, they don't question anything. I think that's down to a culture difference. People perceive the physiotherapist to be far above them - there is a huge class gap whereas England is more equal. They also make the language simpler for patients to understand in England.

"In Brazil we have to improvise a lot. If you fracture a bone and have to have a plate put in sometimes it can take up to five days to get that plate."

He says the lack of access to advanced equipment in Brazil makes them rely mostly on hands-on treatments.

Ken said: "Elcimar has come up with some evidence-based treatments that we were aware of but hadn't been able to explain. We've all learnt anatomy but having someone who teaches it has really helped - he's taught us specific shoulder treatments."

In Brazil physiotherapists are elevated to the title of Doctor.

Elcimar deals mostly with emergency care and those patients are dealt with immediately. But non-accident and emergency patients there typically wait up to five months for treatment

With a car manufacturer based near his practice, Elcimar says many of his patients have work-related shoulder injuries. But by far the most prevalent injuries there are damaged ligament suffered playing football - the most prevalent sport in Brazil.

While in Bournemouth Elcimar has shared his knowledge of hands-on treatment and come away with a feel of what it is like to work in a privileged area with some of the best technology there is.

Every year he organises an international conference on traumatology and he's invited Ken along to the next one.

And he couldn't wait to return to Brazil's warmer climates - though his weeks here saw scorching weather - he still felt cold.

If you've missed a particular Life & Soul story there is a good chance it will be on the Echo's website. Just log on to the following link: http://www.thisisbournemouth.co.uk/dorset/bournemouth/news/health.