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- Bergbom, Sofia, 1982-, et al.
(author)
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Relationship Among Pain Catastrophizing, Depressed Mood, and Outcomes Across Physical Therapy Treatments
- 2011
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In: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 754-764
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Journal article (peer-reviewed)abstract
- Background: Pain catastrophizing and emotional distress can act as prognosticfactors for pain and disability. Research on how these variables interact withinindividuals and over time is in an early stage. Understanding various patterns ofprognostic factors and how these factors change during treatment is important fordeveloping treatments targeting important factors.Objective: The primary aim of this study was to investigate relationships betweenpain catastrophizing and depressed mood in people seeking primary care for mus-culoskeletal pain. An additional aim was to relate these patterns of prognostic factorsto outcomes during a 6-month period.Design: The design was prospective; data were obtained at baseline and atfollow-up.Methods: Forty-two physical therapists taking part in an educational programrecruited, from their clinical practices in primary care, consecutive patients whowere currently experiencing a pain problem. Patients received various physicaltherapy interventions between baseline and follow-up.Results: On the basis of patterns of scoring for pain catastrophizing and depressedmood, 4 subgroups of participants were found. Belonging to a subgroup withelevated levels of either pain catastrophizing or depressed mood at baseline wasrelated to the absence of improvement and elevated levels of disability after physicaltherapy interventions. Furthermore, elevated levels of both variables were related tothe highest levels of disability.Limitations: The analyses relied on self-report. Neither treatment content norpain-related fear was measured. The sample was a mixture of participants reportingacute pain and subacute pain.Conclusions: The results stress the importance of assessing and targeting prog-nostic factors. Moreover, the results suggest the need to tailor treatments to matchpatterns of prognostic factors and the need to target depressed mood and paincatastrophizing in physical therapy interventions.
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- Bernhardsson, Susanne, 1958, et al.
(author)
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Determinants of Guideline Use in Primary Care Physical Therapy: A Cross-Sectional Survey of Attitudes, Knowledge, and Behavior
- 2014
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 94:3, s. 343-354
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Journal article (peer-reviewed)abstract
- Background. Understanding of attitudes, knowledge, and behavior related to evidence-based practice (ESP) and use of evidence-based clinical practice guidelines in primary care physical therapy is limited. Objectives. The objectives of this study were: (1) to investigate self-reported attitudes, knowledge, behavior, prerequisites, and barriers related to EBP and guideline use among physical therapists in primary care and (2) to explore associations of self-reported use of guidelines with these social cognitive factors 'along with demographic and workplace characteristics. Methods. A web-based survey of 419 physical therapists in primary care in western Sweden was performed. Multiple logistic regression analysis was performed to examine factors associated with guideline use. Results. The response rate was 64.7%. Most respondents had positive attitudes toward EBP and guidelines: 90% considered EBP necessary, and 96% considered guidelines important. Approximately two thirds reported confidence in finding and using evidence. One third reported being aware of guidelines. Thirteen percent knew where to find guidelines, and only 9% reported having easy access to guidelines. Fewer than half reported using guidelines frequently. The most important barriers to using guidelines were lack of time, poor availability, and limited access to guidelines. Young age and brief work experience were associated with positive attitudes toward EBP. A postgraduate degree was associated with higher application of EBP. Positive attitudes, awareness of guidelines, considering guidelines to facilitate practice, and knowing how to integrate patient preferences with guideline use were associated with frequent use of guidelines. Limitations. Data were self-reported, which may have increased the risk of social.desirability bias. Conclusions. Use of guidelines was not as frequent as could be expected in view of the positive attitudes toward EBP and guidelines among physical therapists. Awareness of and perceived access to guidelines were limited. The identified determinants can be addressed when developing 'guideline implementation strategies.
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- Bernhardsson, Susanne, 1958, et al.
(author)
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Measuring Evidence-Based Practice in Physical Therapy: Translation, Adaptation, Further Development, Validation, and Reliability Test of a Questionnaire
- 2013
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 93:6, s. 819-832
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Journal article (peer-reviewed)abstract
- Background. Evidence-based practice (EBP) and evidence-based clinical practice guidelines are Objective. The 3 objectives of this study were: (1) to translate and cross-culturally adapt a Design. This was an instrument development study with validity and reliability testing. Methods. A previously used questionnaire about EBP was translated and cross-culturally adapted to a Results. The development process resulted in a first questionnaire draft containing 48 items. The Limitations. Only face validity and content validity were tested. Conclusions. The final translated and adapted questionnaire was determined to have good face and
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| 5. |
- Forsberg, Anette, et al.
(author)
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Validity of the Dynamic Gait Index in People With Multiple Sclerosis
- 2013
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 93:10, s. 1369-1376
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Journal article (peer-reviewed)abstract
- Background: Evaluation of walking capacity and risk of falls in people with multiple sclerosis often are performed in rehabilitation. The Dynamic Gait Index (DGI) evaluates walking during different tasks, but the feasibility in identifying people at risk for falls needs to be further investigated.Objective: The objective of this study was to investigate (1) the construct validity (known groups, convergent, and discriminant) of the DGI and (2) the accuracy of predicting falls and establishing a cutoff point to identify fallers.Design: This trial was a multicenter, cross-sectional study.Methods: A convenience sample was composed of 81 people with multiple sclerosis with subjective gait and balance impairment who were able to walk 100 m (comparable to Expanded Disability Status Scale 1-6). Mean age of the participants was 49 years; 76% were women. The 25-Foot Timed Walk Test, Timed "Up & Go" Test, Four Square Step Test, Timed Sit-to-Stand Test, MS Walking Scale, Multiple Sclerosis Impact Scale, and self-reported falls during the previous 2 months were used for validation, to establish cutoff points for identifying fallers, and to investigate predictive values.Results: Significantly lower DGI scores (P <=.001) were found for participants reporting falls (n=31). High sensitivity (87%) in identifying falters was found, with a cutoff score <= 19. The positive predictive value was 50%, and the negative predictive value was 87%. The positive likelihood ratio was 1.77, and the negative likelihood ratio was 0.26. The convergent validity was moderate to strong (rho=0.58-0.80), with the highest correlation coefficient found for the 25-Foot Timed Walk Test. Discriminant validity was shown with low correlation for the psychological subscale of the Multiple Sclerosis Impact Scale.Limitations: The sample included ambulatory people participating in a randomized controlled trial investigating balance training.Conclusions: The DGI is a valid measure of dynamic balance during walking for ambulatory people with multiple sclerosis. With the cutoff point of <= 19, sensitivity was high in identifying people at risk of falls.
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- Huisstede, Bionka M A, et al.
(author)
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Consensus on a Multidisciplinary Treatment Guideline for De Quervain Disease: Results From the European HANDGUIDE Study.
- 2014
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In: Physical therapy. - : Oxford University Press (OUP). - 1538-6724 .- 0031-9023. ; 94:8, s. 1095-1110
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Journal article (peer-reviewed)abstract
- ObjectiveTo achieve consensus on a multidisciplinary treatment guideline for De Quervain's disease.MethodsA European Delphi consensus strategy was initiated. A systematic review reporting on the effectiveness of surgical and non-surgical interventions was conducted and published, and used as an evidence-based starting point for this study. In total, 35 experts (hand therapists/hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation physicians) participated in the Delphi consensus strategy. Each Delphi round consisted of a questionnaire, an analysis and a feedback report.ResultsConsensus was achieved on the description, symptoms and diagnosis of De Quervain's disease. The experts agreed that patients with this disorder should always receive instructions and that these instructions should be combined with another form of treatment and should not be used as a sole treatment. Instructions combined with NSAIDs, splinting, NSAIDs plus splinting, corticosteroid injection, corticosteroid injections plus splinting, or surgery were considered suitable treatment options. Details on the use of instructions, NSAIDs, splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of the above-mentioned treatment options were identified: severity and duration of the disorder, and previous treatments given. A relation between the severity and duration, and choice of therapy was indicated by the experts and reported in the guideline.ConclusionsThis multidisciplinary treatment guideline may help in the treatment of and research on De Quervain's disease.
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| 7. |
- Huisstede, Bionka M A, et al.
(author)
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Multidisciplinary Consensus Guideline for Managing Trigger Finger: Results From the European HANDGUIDE Study.
- 2014
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In: Physical therapy. - : Oxford University Press (OUP). - 1538-6724 .- 0031-9023. ; 94:10, s. 1421-1433
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Journal article (peer-reviewed)abstract
- BackgroundTrigger finger is characterized by -sometimes painful- snapping or locking when flexing the finger. Although trigger finger is frequently seen in clinical practice, no standard treatment protocol has been established as 'best practice'.ObjectiveTo achieve consensus on a multidisciplinary treatment guideline for trigger finger.DesignA European Delphi consensus strategy was initiated. Systematic reviews reporting on the effectiveness of surgical and non-surgical interventions were conducted and used as an evidence-based starting point for this study.SettingIn total, 35 experts (hand therapists /hand surgeons selected by the national member associations of their European federations, and Physical Medicine & Rehabilitation (PM&R) physicians) participated in the Delphi consensus strategy.MeasurementsEach Delphi round consisted of a questionnaire, an analysis and a feedback report.ResultsAfter four Delphi rounds, consensus was achieved on the description, symptoms, and diagnosis of trigger finger. The experts agreed that splinting, corticosteroid injections, corticosteroid injections plus splinting, and surgery are suitable treatment options. Relevant details for the use of splinting, corticosteroid injections, and surgery were described. Main factors for selecting one of these treatment options were identified as severity and duration of the disease, and previous treatments received. A relation between the severity/duration and choice of therapy was indicated by the experts and reported on in the guideline.LimitationsThe results represent a group's opinion at a given point in time. When the evidence for the effectiveness of interventions increases, experts' opinions will change and the guideline should be re-evaluated and adjusted in view of these new insights.ConclusionsThis multidisciplinary treatment guideline may help involved therapists and physicians in the treatment of trigger finger, and indicate areas requiring additional research.
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| 8. |
- Igelström, Helena, 1976-, et al.
(author)
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Level of agreement between methods for measuring moderate-to-vigorous physical activity and sedentary time in people with obstructive sleep apnea and obesity
- 2013
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 93:1, s. 50-59
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Journal article (peer-reviewed)abstract
- BackgroundThere is ambiguity about what measures to use to best identify physical activity and sedentary behavior, and agreement between methods for measuring physical activity and sedentary behavior in people with obstructive sleep apnea syndrome (OSAS) and obesity has not been evaluated.ObjectiveThe objective of this study was to examine the level of agreement between an accelerometer and a self-report questionnaire (International Physical Activity Questionnaire [IPAQ]) or a logbook for measuring time spent on moderate to vigorous physical activity and time spent sedentary in people with OSAS and obesity.DesignThis prospective study was a psychometric evaluation of agreement between measurement methods.MethodsThirty-nine people who were obese (mean body mass index 36.1 kg/m2, SD=4.35) and had moderate to severe OSAS (apnea-hypopnea index of ≥15) were consecutively recruited from a sleep clinic in Sweden. All were treated with continuous positive airway pressure and were waiting for a follow-up sleep evaluation.ResultsAgreement between the measurement methods was limited. For physical activity, the mean difference between the accelerometer and the IPAQ was 47 minutes, and the mean difference between the accelerometer and the logbook was 32 minutes. Agreement was limited for sedentary time as well; the mean difference between the accelerometer and the IPAQ was 114 minutes, and the mean difference between the accelerometer and the logbook was 86 minutes.LimitationsThe small sample size may affect the interpretation and generalizability of the results.ConclusionsThe results imply that the methods cannot be used interchangeably. A combination of an accelerometer and a daily logbook seems to provide a detailed description of physical activity and sedentary behavior.
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| 9. |
- Kjeken, Ingvild, et al.
(author)
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How to Develop Patient-Centered Research: Some Perspectives Based on Surveys Among People With Rheumatic Diseases in Scandinavia
- 2010
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In: Physical Therapy. - : Oxford University Press (OUP). - 0031-9023 .- 1538-6724. ; 90:3, s. 450-460
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Journal article (peer-reviewed)abstract
- Patient-centered research addresses the research agenda of patients and captures aspects of health and functioning that they consider important. Yet, those who live with a disease or condition have limited influence when it comes to setting the research agenda, and we know little about how they experience being participants in research studies. Furthermore, knowledge is limited concerning factors enhancing or hindering patients' participation in trials and the format that people with rheumatic diseases and their families prefer for dissemination of the results from clinical research. This perspective article describes the research priorities of people with rheumatic diseases in Scandinavia, their experiences and attitudes concerning participation in research projects, and which format for research information they prefer. Based on results from 3 surveys organized by the Scandinavian Rheumatism Associations and on related research literature, the possible implications for future research also are discussed.
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| 10. |
- Linton, Steven J., et al.
(author)
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Impact of psychological factors in the experience of pain
- 2011
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In: Physical Therapy. - : Oxford University Press. - 0031-9023 .- 1538-6724. ; 91:5, s. 700-711
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Journal article (peer-reviewed)abstract
- This article reviews the role of psychological factors in the development of persistent pain and disability, with a focus on how basic psychological processes have been incorporated into theoretical models that have implications for physical therapy. To this end, the key psychological factors associated with the experience of pain are summarized, and an overview of how they have been integrated into the major models of pain and disability in the scientific literature is presented. Pain has clear emotional and behavioral consequences that influence the development of persistent problems and the outcome of treatment. Yet, these psychological factors are not routinely assessed in physical therapy clinics, nor are they sufficiently utilized to enhance treatment. Based on a review of the scientific evidence, a set of 10 principles that have likely implications for clinical practice is offered. Because psychological processes have an influence on both the experience of pain and the treatment outcome, the integration of psychological principles into physical therapy treatment would seem to have potential to enhance outcomes.
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