Physiotherapy Research International [journal]
- The Pain Attitudes and Beliefs Scale for Physiotherapists: Dimensionality and Internal Consistency of the Norwegian Version. [JOURNAL ARTICLE]
- Physiother Res Int 2016 May 20.
The Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) is a self-administered instrument developed to assess the strength of two possible treatment orientations of physiotherapists towards the management of low back pain. The aim of this study was to translate the PABS-PT into Norwegian from the original 36-item Dutch version and to examine its dimensionality and internal consistency.The Norwegian version was generated in a forward-backward translation procedure. To examine construct validity, a cross-sectional web-based survey was conducted. A convenience sample of 3849 physiotherapists was invited to fill out the Norwegian PABS-PT, together with demographic and professional data. Only therapists who had been involved in back pain management for the last 6 months were included. Principal factor and Cronbach's alpha analyses were performed to determine the factor structure and internal consistency, respectively.The PABS-PT was successfully translated into Norwegian. Responses from 921 therapists were obtained (response rate 24.8%), and of these, 647 could be included in the factor analysis. Analysis revealed two factors, labelled 'biomedical' and 'biopsychosocial' treatment orientation, which confirmed the structure of the original Dutch version. Thirty-six items were reduced to 19, with 13 items loading on factor I and six items on factor II, explaining 18.1% and 7.1%, respectively, of the total variance. Cronbach's alpha of the biomedical sub-scale was 0.79 and 0.57 for the bio-psychosocial sub-scale.The Norwegian version of the PABS-PT appears to be equivalent to the original Dutch version, showing a similar structure and internal consistency. The two factors accounted for low explained variance, which may be indicative for problematic construct validity. Psychometric properties and usefulness will be further examined. Copyright © 2016 John Wiley & Sons, Ltd.
- A Non-surgical Intervention for Triangular Fibrocartilage Complex Tears. [CASE REPORTS]
- Physiother Res Int 2016 May 16.
The current literature contains no reports of treatment options other than surgery following failed conservative management of a triangular fibrocartilage complex (TFCC) tear. The purpose of this study is to describe the use of a novel brace as a non-surgical intervention for TFCC tears.This paper is a case study of a subject with a magnetic resonance imaging-confirmed TFCC tear. As an alternative to surgery, he consented to wear a novel brace for 12 weeks after conservative management of his injury had failed. His recovery from injury was monitored with a weight-bearing tolerance test and the disabilities of the arm, shoulder and hand (DASH) outcome measure.An increase in weight-bearing tolerance and upper extremity use was evident immediately after donning the brace. After 12 weeks, the subject demonstrated a return to normal weight-bearing tolerance and normal DASH outcome measure scores. These improvements were still evident at a 1-year follow-up appointment.Utilizing this novel brace resulted in functional status improvement in a subject with a TFCC tear as demonstrated by significant changes in his DASH outcome measure scores. This case study demonstrates the first non-surgical alternative treatment for a TFCC tear after conservative management has failed. Copyright © 2016 John Wiley & Sons, Ltd.
- Short-term Clinical Course of Knee Pain in Children and Adolescents: A Feasibility Study Using Electronic Methods of Data Collection. [JOURNAL ARTICLE]
- Physiother Res Int 2016 May 16.
Musculoskeletal disorders, such as knee pain, are common in children and adolescents, but there is a lack of high quality research that evaluates the clinical course of these conditions. The objective of this study was to evaluate the feasibility of conducting a prospective study of children and adolescents with knee pain using electronic methods of data collection.Children and adolescents with knee pain that presented to primary care physiotherapy clinics were enrolled and followed-up on a weekly basis via short messaging service (SMS) until their knee pain had recovered (i.e. two consecutive weeks of no pain). Feasibility was assessed in terms of recruitment, retention and response rates to SMS and an online questionnaire. Baseline and 6-month follow-up measures included pain, disability, physical function, physical activity and health related quality of life. Kaplan-Meier survival analysis was used to estimate the median time to knee pain recovery.Thirty participants (mean age 13.0 ± 2.2 years, 53% boys) were recruited over 26 months. The overall response rate to weekly SMS follow-up was 71.3% (809 received/1135 sent). One third of participants stopped responding to SMS prior to recovery, and these participants typically had a much lower response rate during the time they remained in the study. At 6-month follow-up, 80% of the cohort completed the final online questionnaire, and 29% of participants still reported current knee pain (≥1/10 VAS). The median time for knee pain recovery was 8 weeks (95%CI: 5, 10).Electronic data collection alone seems insufficient to track pain recovery in young people and may need to be supplemented with more traditional data collection methods. Researchers should consider further measures to address slow recruitment rates and high attrition when designing large prospective studies of children and adolescents in the future. Copyright © 2016 John Wiley & Sons, Ltd.
- Peer Review: Professionally Important and an Opportunity to Contribute. [Editorial]
- Physiother Res Int 2016 Jun; 21(2):67-9.
- What are the Main Physical Functioning Factors Associated With Falls Among Older People With Different Perceived Fall Risk? [JOURNAL ARTICLE]
- Physiother Res Int 2016 Mar 7.
Fall risk perceptions may influence the judgement over physical and functional competencies to avoid falls. However, few studies have explored the physical functioning characteristics associated with falls among older people with low perceived fall risk. This study aimed to identify the prevalence of falls and physical functioning factors associated with falling among community-dwelling older adults with low and high perceived fall risk.We conducted a cross-sectional population based study with 773 community-dwelling elders. Perceived fall risk was investigated using Falls Efficacy Scale International. We considered fallers those who reported at least one fall in the previous 12 months. Physical functioning measures used were grip strength, usual gait speed, sit-to-stand test, five step test, timed up and go test, one-legged stance test, anterior and lateral functional reach test.At least one fall was reported by 103 (30%) participants with low perceived fall risk and by 196 (46%) participants with high perceived fall risk. The odds of falling were lower among those with greater grip strength and with a greater stance time in one-legged test, and the odds of falling among elders with high perceived fall risk were higher among those who took more time in performing the five step test.We believe that our results highlight the need of not neglecting the risk of falls among active older adults with low perceived fall risk, particularly in those elders that show reduced stability in a small base of support and a lower leg strength. In addition, we suggest that elders with high perceived fall risk should be assessed using anticipatory postural adjustment tests. Particularly, our results may help physiotherapists to identify eligible elders with different perceptions of fall risk for tailored interventions aimed at reducing falls. Copyright © 2016 John Wiley & Sons, Ltd.
- Non-invasive Ventilation as Airway Clearance Technique in Cystic Fibrosis. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 29.
For patients with cystic fibrosis, chest physiotherapy is crucial for evacuating airway secretions. Because chest physiotherapy increases energy expenditure, fatigue and dyspnoea, non-invasive ventilation (NIV) could be beneficial for severely ill patients during airway clearance. The aim of the study is to evaluate and compare the effects between NIV and positive expiratory pressure (PEP) on airway clearance.Prospective, randomized trial compares PEP to NIV. Thirty-two subjects, mean age 31 years, mean forced expiratory volume in 1 second 47% (±14) and mean forced vital capacity 69% (±13), completed a 3-month randomized trial comparing NIV with standard PEP treatment as airway clearance technique. Lung functions testing, 6-minute walk test, blood gases, sputum culture and inflammatory parameters were measured before and after the treatment period.There was a significant reduction in lung clearance index (LCI) following NIV compared with PEP (p = 0.01). LCI is performed within the lung function testing.Non-invasive ventilation was shown to be a good alternative to PEP in chest physiotherapy for patients with cystic fibrosis who are severely ill.
- Evidence-based Practice Intentions and Long-term Behaviours of Physiotherapy Graduates Following an Intensive Education Programme. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 24.
Assisting physiotherapists to implement research evidence into clinical practice is essential to ensure the quality of practice and encourage lifelong learning and professional progression. However, many physiotherapists report barriers to implementing research, and there is little evidence regarding the sustainability of intended evidence-based practice (EBP) behaviours following EBP education programmes. This paper reports on intended and actual long-term EBP behaviours of physiotherapy students who completed an intensive EBP training programme embedded within a post-graduate coursework programme.An intensive 3-week course in quantitative health research methods and EBP was delivered annually from 2007 to 2014 as part of the programme to national and international students. Following the course, students were asked about their intention of using evidence to inform their future clinical practice. An online survey was used to evaluate EBP behaviours of graduates.Of a possible total of 202 students, contact details for 193 students were sourced, and 65 students responded to the survey (34% response rate). At course completion, 174 students (86%) indicated that they intended to use research to guide their clinical decisions at least once a week. At follow-up, most graduates reported frequently using research to inform their clinical practice; indicated by a mean score of 6.5 (±1.9) from a possible range of 0 (not at all) to 10 (all the time). On average, students reported spending 2.2 (±2.2) hours accessing and reading research evidence per week. The most common barriers to implementing evidence were lack of time, limited access to evidence sources and a perceived lack of generalizability of research findings to specific patient groups.Graduates of an intensive EBP training programme embedded within an existing post-graduate physiotherapy programme regularly implemented EBP in clinical practice. Barriers to evidence implementation were time, access to research and perceived lack of generalizability of research findings. Copyright © 2016 John Wiley & Sons, Ltd.
- Physiotherapy for Patients with Sciatica Awaiting Lumbar Micro-discectomy Surgery: A Nested, Qualitative Study of Patients' Views and Experiences. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 23.
Sciatica is a common clinical condition that can be extremely painful, disabling and life-changing. Whether conservative or surgical treatment for sciatica secondary to an intervertebral disc prolapse is most effective is still much debated. An important component of conservative treatment is physiotherapy, which aims to promote physical and psychological health for the patient, whilst resorption of the disc takes place. This paper reports a qualitative study of patients' views and experiences of a bespoke physiotherapy intervention for the treatment of sciatica.A qualitative study nested within a pilot randomized controlled trial of bespoke physiotherapy for the treatment of patients with sciatica awaiting lumbar microdiscectomy surgery. Patients randomized to receive bespoke physiotherapy in the intervention arm of the trial were invited to take part in semi-structured interviews. Twenty-one in-depth, semi-structured interviews took place. All interviews were recorded, fully transcribed and thematically analysed.Most patients in the sample found the physiotherapy valuable, appreciating the individual nature of the approach, the exercises to reduce pain and discomfort, techniques for improving functional spinal movement, walking and dynamic posture, and manual therapy and cardiovascular exercise. A small number did not find the physiotherapy of benefit. Sixteen patients in the sample went on to proceed with surgery, but most of these found value in having had the physiotherapy first.Many patients with sciatica appreciate the value of physiotherapy prior to surgery. Future research should examine patients' experiences of bespoke physiotherapy delivered within primary care. Copyright © 2016 The Authors Physiotherapy Research International published by John Wiley & Sons Ltd.
- The Effectiveness of Incorporating a Play-based Intervention to Improve Functional Mobility for a Child with Relapsed Acute Lymphoblastic Leukaemia: A Case Report. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 19.
Acute lymphoblastic leukaemia (ALL) is one of the most common forms of cancer seen in children, accounting for one-fourth of all childhood cancers. These children typically present with decreased functional mobility, weakened lower extremity muscle strength and reduced exercise endurance and interests because of disease progressions and chemotherapy treatments. The purpose of this case report was to examine the effectiveness of incorporating a play-based physical therapy (PT) intervention programme to improve functional mobility for an inpatient with relapsed ALL undergoing chemotherapy.The patient was a 3-year-old male admitted to the hospital for relapsed ALL. He was diagnosed approximately 1 year earlier for which he had undergone chemotherapy and was later considered in remission at that time. When the patient relapsed, he underwent another round of chemotherapy and was waiting for a bone marrow transplant during his treatment during the course of this case report. For PT intervention, therapeutic exercises were incorporated into play to strengthen his lower extremity strength and muscle endurance. Functional activities were also incorporated into play to improve his aerobic capacity and overall quality of life. Multi-attribute health status classification system (HUI3) utility scores, 6-minute walk test distance (6MWT), lower extremity (LE) strength, transfer and tolerated treatment time were assessed to identify the effect of a PT intervention.Despite experiencing fatigue, the patient completed most of the treatments incorporated into play. After 5 weeks of PT intervention, the participant improved on HUI3 (pre: 0.72 and post: 0.92), 6MWT (pre: 156 ft and post: 489 ft), LE strength (squat), transfer (sit to stand) and tolerated treatment time (pre: 16 minutes and post: 44 minutes).This case report suggests that incorporating a play-based PT intervention programme could be physically tolerable and functionally beneficial for a young child with relapsed ALL undergoing inpatient chemotherapy. Copyright © 2016 John Wiley & Sons, Ltd.
- Embedding Evidence-based Practice Education into a Post-graduate Physiotherapy Program: Eight Years of pre-Post Course Evaluations. [JOURNAL ARTICLE]
- Physiother Res Int 2016 Feb 19.
Little has been published about the effectiveness of training postgraduate physiotherapy coursework students in research methods and evidence-based practice (EBP) theory. Graduate qualities in most universities include lifelong learning. Inclusion of EBP in post-graduate coursework students' training is one way for students to develop the knowledge and skills needed to implement current best evidence in their clinical practice after graduation, thereby facilitating lifelong learning. This paper reports on change in confidence and anxiety in knowledge of statistical terminology and concepts related to research design and EBP in eight consecutive years of post-graduate physiotherapy students at one Australian university.Pre-survey/post-survey instruments were administered to students in an intensive 3-week post-graduate course, which taught health research methods, biostatistics and EBP. This course was embedded into a post-graduate physiotherapy programme from 2007 to 2014. The organization and delivery of the course was based on best pedagogical evidence for effectively teaching adult physiotherapists. The course was first delivered each year in the programme, and no other course was delivered concurrently.There were significant improvements in confidence, significantly decreased anxiety and improvements in knowledge of statistical terminology and concepts related to research design and EBP, at course completion. Age, gender and country of origin were not confounders on learning outcomes, although there was a (non-significant) trend that years of practice negatively impacted on learning outcomes (p = 0.09). There was a greater improvement in confidence in statistical terminology than in concepts related to research design and EBP.An intensive teaching programme in health research methods and biostatistics and EBP, based on best practice adult physiotherapy learning principles, is effective immediately post-course, in decreasing anxiety and increasing confidence in the terminology used in research methods and EBP. Copyright © 2016 John Wiley & Sons, Ltd.