H. Kranenburg, M. Schmitt, E. Puentedura, C. P. van der Schans, N. Heneghan, N. Hutting
{"title":"Manual therapists’ beliefs and use of spinal thrust joint manipulation","authors":"H. Kranenburg, M. Schmitt, E. Puentedura, C. P. van der Schans, N. Heneghan, N. Hutting","doi":"10.1080/21679169.2020.1857831","DOIUrl":"https://doi.org/10.1080/21679169.2020.1857831","url":null,"abstract":"Abstract Introduction Thrust Joint Manipulation (TJM) is a widely used intervention in spinal care, however there are differences in its use between countries and spinal regions. This survey analyzes the frequency of use of TJM, examines the thoughts about the effectiveness of, and the perceptions of Dutch certified manual therapists regarding safety, comfort, use and barriers related to the application of spinal TJM techniques. Method The 19-question e-survey was based on a similar survey in the U.S. Since the Netherlands has a separate professional standard for the upper cervical spine, questions enabled differentiation between upper- and mid/lower cervical spine. The survey was launched during a national manual therapy congress and distributed via social media (April-July 2018). Descriptive analyses, MANOVA and qualitative analyses were used. Results From the 211 responses, 150 were male, with a mean age of 44.9 (±11.2) years, a mean clinical experience of 12.8 (±9.6) years as manual therapist, 87% had a master’s degree and 97% worked in a private practice. Except for the upper cervical spine, more than 80% of the participants felt that TJM was safe, were comfortable performing TJM. Overall >80% of participants perform additional screening prior to TJM. Concerns about safety is the greatest barrier for upper cervical TJM. Discussion Findings indicate that overall Dutch manual therapists believe TJM to be safe and effective and are comfortable performing them, except for the upper cervical spine, where concerns exist regarding safety and acquiring written informed consent. Level of evidence 2b.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"262 - 269"},"PeriodicalIF":1.4,"publicationDate":"2020-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1857831","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48625275","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Shahabi, D. Skempes, Hosein Shabaninejad, Ahmad Ahmadi Teymourlouy, Masoud Behzadifar, K. Bagheri Lankarani
{"title":"Corruption in the physiotherapy sector in Iran: common drivers and potential combating strategies","authors":"S. Shahabi, D. Skempes, Hosein Shabaninejad, Ahmad Ahmadi Teymourlouy, Masoud Behzadifar, K. Bagheri Lankarani","doi":"10.1080/21679169.2020.1849397","DOIUrl":"https://doi.org/10.1080/21679169.2020.1849397","url":null,"abstract":"Abstract Background Globally, there is an unprecedented demand for physical rehabilitation services due to, among others, an increase in non-communicable diseases, and the ageing of the population. Iran is no exception and epidemiological trends suggest that population needs for physiotherapy services will rise significantly. However, inadequate insurance coverage, weak stewardship, the predominant role of the private sector in service delivery, and inappropriate supervision have created a favourable environment for corrupt practices in the Iranian physiotherapy sector. Objectives To identify drivers of corruption and potential combating strategies for the physiotherapy sector from the perspective of key stakeholders: physiotherapists, academics, and health policymakers. Methods In-depth semi-structured interviews were performed to explore physiotherapists', academics', and health policymakers' perceptions about corruption in Iranian physiotherapy sector. The individuals were recruited using purposive and snowball sampling. Thematic content analysis was used to analyse transcripts and identify relevant themes. Results On the whole, 22 individuals (5 physiotherapists, 8 academics, and 9 health policymakers) agreed to take part in the interviews. Several drivers and determinants of corruption in the physiotherapy sector as well as potential combating strategies were identified across five categories: (1) government regulator function, (2) payer function, (3) providers function, (4) suppliers function, and (5) patients function. Conclusions Corruption represents a real threat in the physiotherapy sector in Iran impeding accessibility and utilisation of rehabilitation services and therefore is a serious barrier to the achievement of Sustainable Developments Goals. Development and adoption of effective anti-corruption strategies are therefore necessary.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"243 - 252"},"PeriodicalIF":1.4,"publicationDate":"2020-11-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1849397","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46402891","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Body awareness in healthy subjects – a qualitative study","authors":"G. Kjölstad, A. L. Gyllensten, G. Gard","doi":"10.1080/21679169.2020.1845792","DOIUrl":"https://doi.org/10.1080/21679169.2020.1845792","url":null,"abstract":"Abstract Background Qualitative research concerning body awareness has focused on how patients with different diagnosis experience body awareness. No earlier study has focused on healthy adults’ experiences of body awareness. Aim The aim of this study was to explore and describe healthy adults’ experiences of body awareness. Methods Fifteen healthy informants were interviewed individually, and the transcripts were analysed according to qualitative content analysis. Results Three themes describing experiences of body awareness among healthy adults: A bodily grounding and identity forming process throughout life, Interpersonal relationships through the body, and To be visible and exposed in society. Conclusions Body awareness among healthy adults was experienced as a bodily and identity forming process throughout life. In this process interpersonal relationships were developed through the awareness of the body. Body awareness was also experienced as being visible and exposed in society. Body awareness was not only related to individuals experiences and affects our relations and behaviours from inside and out but was also related to group norms and societal norms. This is important for health promotion in different contexts in society.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"219 - 226"},"PeriodicalIF":1.4,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1845792","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46995127","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Ben van Koppen, P. Zandwijk, J. de Vries, H. van Mameren, R. D. de Bie
{"title":"Adherence to home-based exercises and/or activity advice in low back pain patients: a systematic review","authors":"Ben van Koppen, P. Zandwijk, J. de Vries, H. van Mameren, R. D. de Bie","doi":"10.1080/21679169.2020.1846783","DOIUrl":"https://doi.org/10.1080/21679169.2020.1846783","url":null,"abstract":"Abstract Background Poor adherence to treatment is a worldwide problem and is also recognised in managing low back pain (LBP). Objective This review aims to evaluate the rate of adhering to physical activity advice. Data sources A systematic review was conducted by searching 12 databases from January 2000 to December 2019. Study selection Studies were eligible when assessing LBP patients’ adherence to activity advice. Data extraction Key data extracted related to adherence to home-based exercise and/or physical activity advice given to patients over 18 who suffer from non-specific LBP. Data synthesis After screening, 28 studies (out of 1171) were eligible for analysis. Given the studies’ outcomes, a qualitative summary was created. Results Adherence rates varied from 8% to 91%. Bias was likely in three out of 18 randomised trials. Outcomes of the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies ranged from 5 to 11 positive scores out of 14. Limitations Variability in describing activity advice, the use of different types of outcomes and the use of subjective measurement tools compromised the outcomes of this review. Conclusions The proportion of fully adhering patients is unclear. Therefore, more objective and uniform assessment tools are needed to assess adherence in future studies.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"227 - 242"},"PeriodicalIF":1.4,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1846783","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42523013","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Fagner Luiz Pacheco Salles, Denise Maciel Ferreira, F. Lima, Pedro Henriques Orides da Silva
{"title":"Evaluation of the reliability of diagnostic thinking inventory for physical therapist and of the development of clinical reasoning in physiotherapy students","authors":"Fagner Luiz Pacheco Salles, Denise Maciel Ferreira, F. Lima, Pedro Henriques Orides da Silva","doi":"10.1080/21679169.2020.1842494","DOIUrl":"https://doi.org/10.1080/21679169.2020.1842494","url":null,"abstract":"Abstract Background Several instruments have been developed to assess clinical reasoning ability, regardless of specific knowledge. One of these instruments is the Diagnostic Thinking Inventory (DTI), used by doctors and medical students to determine their level of diagnostic clinical reasoning as it applies to the diagnosis. Objective The purposes of the pilot study were three-fold: (1) to assess internal consistency after adapting the DTI to the context of physical therapy (DTI-PT), (2) to assess the association between diagnostic clinical reasoning, self-assessment of clinical reasoning ability, and academic performance among physiotherapy students; and (3) to compare diagnostic clinical reasoning, self-assessment of clinical reasoning ability, and academic performance in the beginning and the end of the semester. Method A total of 40 physiotherapy students were assessed for the association of student performance, student clinical competence and DTI-PT between the beginning of August and the end of November 2017 in the discipline of assessment in physiotherapy. Results The results showed an improvement in the DTI-PT score and its sub-scales at the end of the semester. There was an improvement in the student clinical competence and in the students' performance score. Conclusion DTI-PT can be an effective tool to determine the clinical reasoning of physiotherapy students.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"208 - 218"},"PeriodicalIF":1.4,"publicationDate":"2020-11-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1842494","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46972035","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
R. M. A. van Erp, I. Huijnen, A. Köke, J. Verbunt, R. Smeets
{"title":"Feasibility of the biopsychosocial primary care intervention ‘Back on Track’ for patients with chronic low back pain: a process and effect-evaluation","authors":"R. M. A. van Erp, I. Huijnen, A. Köke, J. Verbunt, R. Smeets","doi":"10.1080/21679169.2020.1840627","DOIUrl":"https://doi.org/10.1080/21679169.2020.1840627","url":null,"abstract":"Abstract Purpose Literature shows promising effects for interdisciplinary biopsychosocial rehabilitation programs in patients with chronic low back pain (CLBP). Not every patient needs an interdisciplinary rehabilitation trajectory provided in a secondary care setting. Patients with moderate complex psychosocial complaints might benefit from biopsychosocial interventions offered in primary care under supervision of a physician in rehabilitation medicine (i.e. biopsychosocial integrated care intervention). This study investigated the feasibility and effectiveness of such intervention in patients with CLBP with moderate complex psychosocial complaints. Methods mixed-method. Patients (aged 18–65 years, low back pain ≥12 weeks, moderate complex psychosocial complaints) received the intervention (4 individual sessions, 8 group sessions) provided by trained primary care physiotherapists. Physicians in rehabilitation medicine provided one consultation afterwards. Data from patients (n = 18), physicians (n = 4) and physiotherapists (n = 12) were used. Results Physiotherapists were satisfied with the training. Patient attendance was good for individual sessions, less for groups. Physiotherapists sufficiently delivered the intervention, although recruitment and contextual factors influenced delivery. Patients reported significantly reduced functional disability (Quebec Back Pain Disability Scale) post-treatment (−8.3, 95% CI −13.3 to −2.7) and at 3 months follow-up (−7.6, 95% CI −12.9 to −2.2). Conclusions A biopsychosocial integrated intervention is feasible and potentially effective in patients with CLBP.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"24 1","pages":"197 - 207"},"PeriodicalIF":1.4,"publicationDate":"2020-11-06","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1840627","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48312381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Approaching intimacy, sexuality and ethics in the professional training of physiotherapy students in Norway","authors":"T. Dahl-Michelsen, D. Nicholls, K. S. Groven","doi":"10.1080/21679169.2019.1619833","DOIUrl":"https://doi.org/10.1080/21679169.2019.1619833","url":null,"abstract":"Abstract Background Historically, avoiding any association with prostitution was paramount in the process of making physiotherapy a recognised profession, and maintaining boundaries around intimacy, sexuality and ethics has been an important aspect of physiotherapy since the beginning of the profession. Objectives Against this background, we explore how matters of intimacy, sexuality and ethics are approached in the professional training of physiotherapy students. Methods The empirical data derive from participant observations in skills-training classes in a Norwegian physiotherapy education setting. The material includes in-depth interviews with students who attended the skills-training classes. The data are analysed thematically, using an inductive approach. Results Students and teachers approach intimacy, sexuality and ethics as tacit professional standards. The results are organised in two themes: (1) tacit codes of proper behaviour and (2) tacit competencies in interpreting intimate boundaries. Conclusion In order to enhance students’ approaches to intimacy, sexuality and ethics beyond mere tacit knowledge and technical skills, students must be taught the history of the profession. Matters of sexuality in physiotherapy must also be addressed from perspectives such as those of sexual health and inclusive practices. Accordingly, there is a need to think differently about the physiotherapy curriculum, professional regulation and scope of practice.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"22 1","pages":"318 - 324"},"PeriodicalIF":1.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2019.1619833","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41654256","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Nadège Lemeunier, M. Suri-Chilana, P. Welsh, H. Shearer, M. Nordin, Jessica J. Wong, P. Torres, Sophia Oolup-da Silva, Chelsea D'Silva, E. B. Jeoun, P. Stern, Hainan Yu, Kent Murnaghan, Deborah Sutton, P. Côté
{"title":"Reliability and validity of clinical tests to assess the function of the cervical spine in adults with neck pain and its associated disorders: part 5. A systematic review from the Cervical Assessment and Diagnosis Research Evaluation (CADRE) collaboration","authors":"Nadège Lemeunier, M. Suri-Chilana, P. Welsh, H. Shearer, M. Nordin, Jessica J. Wong, P. Torres, Sophia Oolup-da Silva, Chelsea D'Silva, E. B. Jeoun, P. Stern, Hainan Yu, Kent Murnaghan, Deborah Sutton, P. Côté","doi":"10.1080/21679169.2019.1626906","DOIUrl":"https://doi.org/10.1080/21679169.2019.1626906","url":null,"abstract":"Abstract The purpose of this study is to determine the reliability and validity of clinical tests used to assess cervical function, muscle strength and endurance in adults with neck pain and its associated disorders (NAD). Systematic review and update of the Bone and Joint Decade 2000–2010 Task Force on NAD. We systematically searched five electronic databases. Eligible reliability and validity studies were critically appraised using the QAREL and QUADAS-2 tools, respectively. Validity studies were ranked according to the Sackett and Haynes classification to determine clinical utility. Early studies of novel tests provide preliminary evidence, and phase III/IV studies are necessary to confirm the validity of tests in clinical practice. We conducted a best evidence synthesis. We screened 7846 citations and critically appraised 28 articles. Eighteen low risk of bias articles provide preliminary evidence of reliability and validity (phase I/II) for the cranio-cervical flexion test and deep cervical extensor (DCE) test in patients with NAD. Only two clinical tests were found to be reliable and valid. Cranio-cervical flexion test and DCE test could assess cervical muscle strength in adults with NAD. However, the evidence is supported by only phase I and II validity studies from the Sackett and Haynes classification.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"22 1","pages":"332 - 363"},"PeriodicalIF":1.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2019.1626906","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44169465","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Inter-rater reliability of Timed Up and Go test in older adults measured by physiotherapist and caregivers","authors":"G. Nepal, Manoj Basaula, Saurab Sharma","doi":"10.1080/21679169.2019.1623313","DOIUrl":"https://doi.org/10.1080/21679169.2019.1623313","url":null,"abstract":"Abstract Introduction Globally and in Nepal, 28–35% of older adults experience fall-related injuries annually. The ‘Timed Up and Go’ (TUG) test is a valid measure to assess risk of falls when administered by health professionals; but the reliability of the TUG administered by older adults’ primary caregiver is unknown. The aim of this study was to examine the inter-rater reliability of the TUG assessed by caregivers compared to a trained student physiotherapist in older adults. Methods One hundred older adults were recruited with their primary caregivers in a rural community of Nepal. The researchers trained primary caregivers prior to assessment following an a priori protocol. Both the caregiver and a trained student physiotherapist administered the TUG. The two tests were performed at an interval of five minutes, and the two testers were blinded to each other’s assessment. The inter-rater reliability was evaluated using the two-way random-effects model absolute agreement intra-class correlation coefficient (ICC2,1). The Bland–Altman plot was created to visualise systematic errors between the measurements. Results The ICC was found to be 0.87 (95% CI: 0.82–0.91) indicating excellent inter-rater reliability of the TUG between primary caregivers and the student physiotherapist. Conclusions Caregivers’ assessment of the TUG is reliable compared to a trained student physiotherapist. Therefore, caregivers could be used to assess risk of fall and to monitor changes after discharge, without having to be assessed by a physiotherapist in a rural community setting. This could help overcome both geographic and economic barriers.","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"22 1","pages":"325 - 331"},"PeriodicalIF":1.4,"publicationDate":"2020-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2019.1623313","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44375159","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"‘Knee osteoarthritis: through a biopsychosocial lens’","authors":"Rilind Shala","doi":"10.1080/21679169.2020.1837238","DOIUrl":"https://doi.org/10.1080/21679169.2020.1837238","url":null,"abstract":"Dear Editor, Osteoarthritis (OA) is a chronic and debilitating joint disease that causes damage to the articular cartilage and underlying bone [1]. Although commonly referred to as a ‘wear and tear...","PeriodicalId":45694,"journal":{"name":"European Journal of Physiotherapy","volume":"23 1","pages":"132 - 132"},"PeriodicalIF":1.4,"publicationDate":"2020-10-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1080/21679169.2020.1837238","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45621907","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}