Tags

Type your tag names separated by a space and hit enter

Physical therapists' perspectives on using contextual factors in clinical practice: Findings from an Italian national survey.
PLoS One. 2018; 13(11):e0208159.Plos

Abstract

BACKGROUND

Contextual factors (CFs) represent a potential therapeutic tool to boost physiotherapy outcomes, triggering placebo effects. Nevertheless, no evidence about the use of CFs among physical therapists is currently available.

OBJECTIVE

To investigate the use of CFs and the opinion of Italian physical therapists specialized in Orthopaedic Manual Therapy (OMTs) on their therapeutic benefits.

DESIGN

An exploratory cross-sectional online survey.

METHODS

A 17-item questionnaire and 2 clinical vignettes assessed the perspective of OMTs on the adoption of CFs in daily clinical practice. The target population was composed of 906 OMTs. An online survey was performed in 2016 using SurveyMonkey Software. Data were analyzed by descriptive and inferential statistics.

RESULTS

A total of 558 volunteers (61.6% of the target OMT population) participated in the study. Half of the participants (52.0%) claimed to use CFs frequently in their practice. More of 50% of OMTs valued the therapeutic significance of CFs for different health problems as determined by a combined psychological and physiological effect. OMTs considered the use of CFs ethically acceptable when they exert beneficial therapeutic effects and their effectiveness has emerged in previous clinical experiences (30.6%). They disagreed on the adoption of CFs when they are deceptive (14.1%). Moreover, OMTs did not communicate the adoption of CFs to patients (38.2%), and CFs were usually used in addition to other interventions to optimize clinical responses (19.9%). Psychological mechanisms, patient's expectation and conditioning were believed to be the main components behind CFs (7.9%).

LIMITATIONS

Considering that the data collected were self-reported and retrospective, recall and response biases may limit the internal and external validity of the findings.

CONCLUSIONS

OMTs used CFs in their clinical practice and believed in their therapeutic effect. The knowledge of CFs, placebo and nocebo mechanisms and their clinical effects should be included in physical therapists' university studies.

Authors+Show Affiliations

Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.Department of Medical and Biological Sciences, University of Udine, Udine, Italy.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.Department of Neurosciences, Biomedicine and Movement Sciences, University of Verona, Verona, Italy.Department of Pain Translational Symptom Science, School of Nursing, University of Maryland, Baltimore, Maryland, United States of America. Departments of Anesthesiology and Psychiatry, School of Medicine, University of Maryland, Baltimore, Maryland, United States of America. Center to Advance Chronic Pain Research, University of Maryland, Baltimore, Maryland, United States of America.Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova - Campus of Savona, Savona, Italy.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

30500838

Citation

Rossettini, Giacomo, et al. "Physical Therapists' Perspectives On Using Contextual Factors in Clinical Practice: Findings From an Italian National Survey." PloS One, vol. 13, no. 11, 2018, pp. e0208159.
Rossettini G, Palese A, Geri T, et al. Physical therapists' perspectives on using contextual factors in clinical practice: Findings from an Italian national survey. PLoS ONE. 2018;13(11):e0208159.
Rossettini, G., Palese, A., Geri, T., Fiorio, M., Colloca, L., & Testa, M. (2018). Physical therapists' perspectives on using contextual factors in clinical practice: Findings from an Italian national survey. PloS One, 13(11), e0208159. https://doi.org/10.1371/journal.pone.0208159
Rossettini G, et al. Physical Therapists' Perspectives On Using Contextual Factors in Clinical Practice: Findings From an Italian National Survey. PLoS ONE. 2018;13(11):e0208159. PubMed PMID: 30500838.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Physical therapists' perspectives on using contextual factors in clinical practice: Findings from an Italian national survey. AU - Rossettini,Giacomo, AU - Palese,Alvisa, AU - Geri,Tommaso, AU - Fiorio,Mirta, AU - Colloca,Luana, AU - Testa,Marco, Y1 - 2018/11/30/ PY - 2017/06/29/received PY - 2018/11/13/accepted PY - 2018/12/1/entrez PY - 2018/12/1/pubmed PY - 2019/5/9/medline SP - e0208159 EP - e0208159 JF - PloS one JO - PLoS ONE VL - 13 IS - 11 N2 - BACKGROUND: Contextual factors (CFs) represent a potential therapeutic tool to boost physiotherapy outcomes, triggering placebo effects. Nevertheless, no evidence about the use of CFs among physical therapists is currently available. OBJECTIVE: To investigate the use of CFs and the opinion of Italian physical therapists specialized in Orthopaedic Manual Therapy (OMTs) on their therapeutic benefits. DESIGN: An exploratory cross-sectional online survey. METHODS: A 17-item questionnaire and 2 clinical vignettes assessed the perspective of OMTs on the adoption of CFs in daily clinical practice. The target population was composed of 906 OMTs. An online survey was performed in 2016 using SurveyMonkey Software. Data were analyzed by descriptive and inferential statistics. RESULTS: A total of 558 volunteers (61.6% of the target OMT population) participated in the study. Half of the participants (52.0%) claimed to use CFs frequently in their practice. More of 50% of OMTs valued the therapeutic significance of CFs for different health problems as determined by a combined psychological and physiological effect. OMTs considered the use of CFs ethically acceptable when they exert beneficial therapeutic effects and their effectiveness has emerged in previous clinical experiences (30.6%). They disagreed on the adoption of CFs when they are deceptive (14.1%). Moreover, OMTs did not communicate the adoption of CFs to patients (38.2%), and CFs were usually used in addition to other interventions to optimize clinical responses (19.9%). Psychological mechanisms, patient's expectation and conditioning were believed to be the main components behind CFs (7.9%). LIMITATIONS: Considering that the data collected were self-reported and retrospective, recall and response biases may limit the internal and external validity of the findings. CONCLUSIONS: OMTs used CFs in their clinical practice and believed in their therapeutic effect. The knowledge of CFs, placebo and nocebo mechanisms and their clinical effects should be included in physical therapists' university studies. SN - 1932-6203 UR - https://www.unboundmedicine.com/medline/citation/30500838/Physical_therapists'_perspectives_on_using_contextual_factors_in_clinical_practice:_Findings_from_an_Italian_national_survey_ L2 - http://dx.plos.org/10.1371/journal.pone.0208159 DB - PRIME DP - Unbound Medicine ER -