| 11. |
- Demmelmaier, Ingrid, et al.
(author)
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Physiotherapists' telephone consultations regarding back pain : a method to analyze screening of risk factors
- 2010
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In: Physiotherapy Theory and Practice. - London : Informa Healthcare. - 0959-3985 .- 1532-5040. ; 26:7, s. 468-475
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Journal article (peer-reviewed)abstract
- Background and aimsThere is a gap between guidelines and clinical management of risk factors for prolonged disability in back pain. The aims of this study were; 1) to evaluate the inter-rater reliability of a research protocol designed to analyse screening of physical and psychosocial risk factors for prolonged disability in back pain during telephone consultations, and; 2) to describe the overall content and the nature and extent of physical and psychosocial risk factors assessed by physiotherapists in telephone consultations for diagnostic screening of patients with back pain. Method The material consisted of 17 initial telephone consultations regarding back pain recorded by five physiotherapists. A research protocol covering eight evidence-based risk factors was developed. Three raters performed separate analyses according to the protocol.ResultsIntraclass correlation of how many risk factors that were investigated was 0.82 (p<0.001.) Kappa values (pair-wise) of which risk factors that were screened were 0.79, 0.73 and 0.66 (p<0.001). A median of 2 risk factors were screened in each consultation; most frequent was signs of spinal pathology/radiating pain, followed by sick leave, disability, coping with pain and negative beliefs. Rating of pain intensity, depression and expectations of long-term pain were not screened. ConclusionsThe method of analysis appears reliable. It will be used in an intervention study that evaluates to what extent physiotherapists can learn to screen in concordance with guidelines in initial telephone consultations.
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| 12. |
- Demmelmaier, Ingrid, et al.
(author)
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Tailored skills training for practitioners to enhance assessment of prognostic factors for persistent and disabling back pain : Four quasi-experimental single subject studies
- 2012
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 28:5, s. 359-372
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Journal article (peer-reviewed)abstract
- The well-known gap between guidelines and behaviour in clinical practice calls for effective behaviour change interventions. One example showing this gap is physiotherapists' insufficient assessment of psychosocial prognostic factors in back pain (i.e., yellow flags). The present study aimed to evaluate an educational model by performing a tailored skills training intervention for caregivers and studying changes over time in physiotherapists' assessment of prognostic factors in telephone consultations. A quasi-experimental single-subject design over 36 weeks was used, with repeated measurements during baseline, intervention, and postintervention phases. Four physiotherapists in primary health care audiorecorded a total of 63 consultations with patients. The tailored intervention included individual goal setting, skills training, and feedback on performance. The primary outcome was the number of assessed prognostic factors (0–10). Changes were seen in all four participants. The amount of assessed prognostic factors increased from between 0 and 2 at baseline to between 6 and 10 at postintervention. Time spent on assessment of psychosocial factors increased, and time spent on discussions about biomedical pain symptoms decreased. Knowledge and biopsychosocial attitudes toward back pain were congruent with guidelines at inclusion and did not change markedly during the intervention. Self-efficacy for assessment of cognitive and emotional prognostic factors increased during the study phases. The results suggest that a tailored skills training intervention using behaviour change techniques, such as individual goal setting, skills training, and feedback on performance, is effective in producing change in specific clinical behaviours in physiotherapists.
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| 15. |
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| 16. |
- Jönsson, Charlotta, et al.
(author)
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The effects of pole walking on arm lymphedema and cardiovascular fitness in women treated for breast cancer: a pilot and feasibility study.
- 2014
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 30:4, s. 236-242
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Journal article (peer-reviewed)abstract
- Abstract The benefit of exercise for breast cancer-treated women is well documented. However, studies of cardiovascular fitness training for women with breast cancer-related arm lymphedema are rare. The purpose of this study was to investigate the effects of intensive pole walking on arm lymphedema in women treated for breast cancer. Thirty-five women with unilateral lymphedema were included and twenty-three completed an eight-week exercise intervention consisting of pole walking 3-5 times per week, for 30-60 min, at 70%-80% of their maximum heart rate, preceded by a two-week control period. Measurements of arm lymphedema (water displacement method), body weight, cardiovascular fitness (sub-maximal bicycle ergometer test) and subjective assessments (disability of the arm, shoulder and hand (DASH) questionnaire; heaviness and tightness using a visual analogue scale (VAS); and well-being) were performed before the control period and before and after the exercise intervention. The results indicated a significant reduction in total arm volume of the lymphedema arm (p = 0.001), in lymphedema absolute volume (p = 0.014) and lymphedema relative volume (p = 0.015). Significant decreases of heart rate (p = 0.004), DASH score (p = 0.053) and rating of tightness in the arm (p = 0.043) were found. Positive and negative influences on well-being were reported. The conclusion of this study is that pole walking is feasible for breast cancer-treated women with arm lymphedema.
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| 17. |
- Larsson, Caroline, et al.
(author)
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Psychometric properties of the Tampa Scale of Kinesiophobia (TSK-11) among older people with chronic pain.
- 2014
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In: Physiotherapy Theory and Practice. - : Informa UK Limited. - 0959-3985 .- 1532-5040. ; 30:6, s. 421-428
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Journal article (peer-reviewed)abstract
- Abstract Objectives: The study aimed to test the construct validity, factor structure and reliability of the 11-item version of the Tampa Scale for Kinesiophobia (TSK-11, Swedish version) among older people (65+) with chronic pain. Design: Methodological study. Subjects: 433 participants with chronic pain (mean age 74.8, 65-98 years) completed postal questionnaires. 264 of the participants completed a test-retest assessment. Methods: Construct validity was evaluated through corrected item-total correlations. Convergent validity was analyzed by correlations with activity/activities of daily living (ADL) dependence, pain intensity and physical activity (all of which are constructs related to kinesiophobia according to fear-avoidance theories). Factor structure was tested through confirmatory factor analysis. Reliability was assessed with Cronbach's α and test-retest reliability, analyzed by intra-class correlation coefficient (ICC) and weighted κ coefficient analysis. Results: Evidence of convergent validity was shown by significant positive correlations with activity/ADL dependence (r = 0.20) and pain intensity (r = 0.31), and a significant negative correlation with physical activity (r = -0.38). Confirmatory factor analysis showed that both one- and two factor-solutions were possible. Cronbach's α coefficients ranged between 0.74 and 0.87. Test-retest analysis showed strong agreement regarding ICC (r = 0.75, 95% confidence interval 0.64-0.82). The weighted κ coefficients for the individual items showed fair to moderate reliability. Conclusion: The Swedish version of TSK-11 had acceptable construct validity, factor structure, and reliability and, hence, can be considered suitable for older people with chronic pain.
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| 18. |
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| 19. |
- Larsson, Maria E H, 1969, et al.
(author)
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Is patient responsibility for managing musculoskeletal disorders related to self-reported better outcome of physiotherapy treatment?
- 2010
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In: Physiotherapy theory and practice. - : Informa UK Limited. - 1532-5040 .- 0959-3985. ; 26:5, s. 308-17
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Journal article (peer-reviewed)abstract
- Musculoskeletal disorders are prevalent and a major burden on individuals and society. Information on relationships of patient involvement and responsibility to outcome is limited. This study aimed to explore relationships between self-reported outcome of physiotherapy treatment and attitudes toward responsibility for musculoskeletal disorders. A cross-sectional postal survey design was used. Patients (n=615) from an outpatient physiotherapy clinic, who had finished their physiotherapy treatment within the last 6 months were sent a questionnaire that included the Attitudes regarding Responsibility for Musculoskeletal disorders instrument (ARM), self-reported outcome of treatment and sociodemographic data. A total of 279 (45%) completed forms were returned. Multiple logistic regression analysis was used. The patients' scores on the four dimensions of ARM ("responsibility self active," "responsibility out of my hands," "responsibility employer," and "responsibility medical professionals"), controlled for age, sex, education, and physical activity as well as for number of treatments, main treatment, and physiotherapist, were associated with the patients' self-reported treatment outcome. Patients who attributed responsibility more to themselves were more likely (OR 2.37 and over) to report considerable improvement as the outcome of physiotherapy treatment. Because this study was conducted at only one physiotherapy outpatient clinic and had a cross-sectional design, the results should be replicated in other settings. Because patients' attitudes regarding responsibility for musculoskeletal disorders can possibly affect the outcome of physiotherapy treatment, it might be useful to decide whether to systematically try to influence the person's attitude toward responsibility for the management of the disorder or to match treatment to attitude.
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