Physiotherapy Canada最新文献

{"title":"Cost Effectiveness of Physiotherapy Services for Chronic Condition Management: A Systematic Review of Economic Evaluations Conducted Alongside Randomized Controlled Trials","authors":"Jenna Smith-Turchyn, J. Richardson, Susanne Sinclair, Ying Xu, Silvana X Choo, Janelle Gravesande, Aiping Lai, Elyse Letts, M. Masrur, A. Morgan, Celeste Petrusevski, Holly Edward, Feng Xie","doi":"10.3138/ptc-2022-0016","DOIUrl":"https://doi.org/10.3138/ptc-2022-0016","url":null,"abstract":"To determine the cost-effectiveness of physiotherapy (PT) to manage individuals with chronic conditions. Design: Systematic review of randomized controlled trials (RCTs). Eligibility: RCTs with adult participants diagnosed with ≥1 chronic condition, an intervention delivered or supervised by a physiotherapist, including an economic evaluation of the intervention provided. Procedure: Eight databases were searched. Title/abstract screening, full-text review, and data extraction were performed in duplicate. The quality of included studies was assessed using Cochrane's Risk of Bias Assessment 2.0. Fifty-three articles were included in this review. Fifteen compared PT to no PT, 38 compared novel PT to conventional PT. Of the studies comparing PT to no PT, 53% found PT to be cost-effective. Of the studies comparing novel to conventional PT, 55% found novel interventions were cost-effective. Overall, PT was cost-effective in most studies related to arthritis, chronic LBP, and chronic neck pain. The heterogeneity of study characteristics limited the ability to perform a meta-analysis. Over half of included studies reported PT to be cost-effective. Future high quality RCTs performing rigorous economic evaluations are needed to determine the cost-effectiveness of different interventions delivered or supervised by a PT to prevent disability for those with chronic conditions.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46088538","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Identifying Outdoor Winter Walking Programs and Resources for Older Adults: A Scoping Review of the Grey Literature","authors":"Ruth Barclay, Sophia Mbabaali, O. Akinrolie, H. Chan, H. Loewen, J. Ripat, N. Salbach, Chelsea Scheller, Gina M. Sylvestre, S. Webber","doi":"10.3138/ptc-2022-0060","DOIUrl":"https://doi.org/10.3138/ptc-2022-0060","url":null,"abstract":"The objective was to synthesize outdoor winter walking programs and resources for older adults, identified as a priority by the Winter Walk team comprised of older adults; and researchers and trainees from the rehabilitation and geography sciences. A scoping review of web-based grey literature was conducted. Teams of two reviewers independently assessed eligibility and extracted data. Web-based resources were included if their content dealt with adults ≥65 years of age; an outdoor winter walking program, intervention, or general resource; and was written in English. Twenty-seven website resources were eligible and included in the review. Resources were from Canada or the United States and included information provided by government, non-profit organizations, media and businesses. All resources focused on some aspect of winter walking safety and only one mentioned a winter walking program. Web-based resources for outdoor winter walking were synthesized to assist older adults and clinicians with access to safe outdoor winter walking information.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46837660","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Using Geospatial Analysis to Determine the Proximity of Community Gyms for a Population-based Cohort of Young People with Cerebral Palsy","authors":"Yeshna Bhowon, L. Prendergast, N. Taylor, N. Shields","doi":"10.3138/ptc-2022-0064","DOIUrl":"https://doi.org/10.3138/ptc-2022-0064","url":null,"abstract":"To quantify a perceived barrier to physical activity participation (proximity to exercise facilities) by investigating the distance a population-based cohort of young people with cerebral palsy aged 13–30 years lived from community gyms. We developed a web-based application using open-access software that could be used to complete a geospatial analysis by simultaneously visualising, describing, and estimating the location of young people with cerebral palsy, using deidentified data from a cerebral palsy register, in terms of distance and travel time to all available community gyms in one metropolitan city. The suitability of facilities for individuals was not investigated. Distance to the closest gym for participants was measured using the “as the crow flies” and “street network” methods. The proportion of the cohort living 5, 7, and 9 km from a community gym was calculated using the “as the crow flies” method. Distances and travel times to the closest gym for each person were calculated using the “street network” method. Data analysis used one-dimensional (median, quartiles) and two-dimensional (spatial median, bagplot) dispersion measures. Of 568 young people with cerebral palsy, 97% lived within 7 km of a community gym, with a median absolute distance to their closest gym of 3.6 km (1st and 3rd quartiles 2.4, 5.1) and median travel time of 6.6 minutes (1st and 3rd quartiles 4.4, 8.8) by car. For the two-dimensional analysis, the spatial medians were 3.7 km and 6.5 minutes. The open-access, web-based application that was developed can be used by physiotherapists and others to study proximity of clinical and community infrastructure for other populations in other cities and regions. In this study, most young people with cerebral palsy living in one metropolitan city had reasonable access by car to a community gym.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49289277","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Snapshot of Hip and Knee Replacement Rehabilitation Care Across Canada: A Cross-Sectional Survey Using an Online Clinician Quality Indicator Questionnaire","authors":"M. Westby, Jean-François Lalande, C. Koehn, N. Johal","doi":"10.3138/ptc-2022-0083","DOIUrl":"https://doi.org/10.3138/ptc-2022-0083","url":null,"abstract":"To determine usability, feasibility, and reliability of an online questionnaire to assess clinicians’ adherence to 10 postacute rehabilitation quality indicators (QIs) for total hip (THR) and knee replacement (TKR) and explore current rehabilitation practices across Canada. Following usability testing with clinicians in BC and Quebec, we recruited rehabilitation clinicians across Canada to complete the online survey. Respondents rated adherence (past 3 months), importance, and feasibility for 10 QIs. We resent the survey 2–3 weeks later (test–retest reliability). Based on usability testing, we made minor changes in wording, altered response options, and created a French language version. In total, 238 clinicians completed all or parts of the English ( n = 123) and French ( n = 115) questionnaires. Respondents mostly practiced in the public sector (88%) and outpatient settings (42%). On average, clinicians met (“always” or “often” response) 23.3% (SD 13.7%, 95% CI 21.1, 25.4) of THR and 25.5% (SD 15.1%, 95% CI 23.0, 27.9) of TKR indicators. There were mixed views on the importance and feasibility of the QIs. Varied rehabilitation formats, duration, and dosage were described. Canadian rehabilitation clinicians report low overall adherence to THR and TKR rehabilitation QIs and differing rehabilitation approaches and models of care.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46790680","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinical Measures of Balance and Walking Ability in People with Stroke for Assessment via Videoconferencing","authors":"Tzu-Hsuan Peng, A. Harris, A. Tang, B. Sakakibara, J. Eng, C. Pollock","doi":"10.3138/ptc-2022-0039","DOIUrl":"https://doi.org/10.3138/ptc-2022-0039","url":null,"abstract":"This study modified established clinical balance and walking measures and estimated the reliability, validity, and feasibility of using these measures to assess people post-stroke via videoconferencing. Twenty-eight people with chronic stroke were recruited and completed the in-person balance and mobility tests. Five clinical measures were modified as virtual assessments over videoconferencing. Feasibility was evaluated by task completion rate, occurrence of adverse events, and technical difficulties. Test–retest reliability and agreement were examined by intra-class correlations and standard error of measurement between two testing days. Convergent validity was examined by the magnitude of associations between in-person and virtual assessments using Pearson or Spearman rank correlation. Twenty-one participants (52% female) participated in both in-person and virtual assessments. No adverse events occurred. Technical challenges were experienced by eight participants. Test–retest reliability for timed up and go test, 30-seconds sit-to-stand, five-times sit-to-stand, functional reach test, and tandem stance resulted in intra-class coefficients of 0.97, 0.90, 0.77, 0.54, and 0.50 respectively. The standard error of measurement was low across all virtual assessments. The timed up and go test, five-times sit-to-stand, and 30-seconds sit-to-stand showed relationship with in-person assessments ( r = −0.55 to −0.81). Virtual assessment of walking and balance function in ambulatory people post-stroke is feasible; however, technical challenges were experienced. The test–retest reliability of virtual assessments of timed up and go test and sit-to-stand tasks for people with stroke, together with strong convergent validity of the measures compared to in-person assessments is promising.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-03-02","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48520769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Active Rehabilitation Following Acute Mild Traumatic Brain Injury: A Systematic Review","authors":"Briar Coman, D. Powell, J. Das, Lisa Graham, R. Mason, M. Harrison, G. Rae, R. Vitório, A. Godfrey, S. Stuart","doi":"10.3138/ptc-2022-0050","DOIUrl":"https://doi.org/10.3138/ptc-2022-0050","url":null,"abstract":"Following mild traumatic brain injury (mTBI), patients are often advised to restrict physical activity until full symptom resolution followed by gradual return to activity. However, extended rest periods may prolong recovery and contribute to persistent symptoms. Emerging evidence suggests early active rehabilitation that increases heart rate without exacerbating symptoms may improve mTBI patient recovery. This review aims to: (1) appraise evidence on active rehabilitation intervention for mTBI recovery within one-month of injury (i.e., exercise type, duration, intensity, etc.); and (2) recommend evidence-based rehabilitation protocols. Pubmed, CINAHL, PsychARTICLES, SportDISCUS, and AMED databases were searched using key terms “mild Traumatic Brain Injury”, “Rehabilitation”, “Acute”, and their synonyms. Evidence was appraised using Cochrane RoB-2 and ROBINS-I. 434 citations were initially identified with seven papers systematically reviewed. Within the reviewed articles, only three were randomized controlled trials with low risk of bias, and four were non-randomized trials with low to moderate risk of bias. Findings highlighted that a range of active rehabilitation protocols were used with different exercise modalities (primarily treadmills and static cycling), durations (9–20 min, or until symptomatic, for 30–50 days or symptoms resolved), and intensities (low, moderate or high). Active rehabilitation did not cause any serious adverse events (i.e., death, hospitalisation etc.), and six studies reported that it did not exacerbate mTBI symptoms in any participants (with one participant having symptom worsening in one study). Overall, the majority of reviewed studies ( n = 4) showed that active rehabilitation decreased time to mTBI symptom resolution compared to controls (strict rest/stretching exercises). Individualized active rehabilitation prescribed within one-month post-mTBI appears to be safe and effective at decreasing recovery time to symptom resolution in mTBI. However, there is a lack of consensus regarding specific intervention protocols that needs to be addressed before adoption within clinical practice.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43798237","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Referrals from Healthcare Professionals to Community-Based Exercise Programs Targeting People with Balance and Mobility Limitations: An Interviewer-Administered Survey","authors":"Kyla Alsbury-Nealy, H. Colquhoun, S. Jaglal, S. Munce, N. Salbach","doi":"10.3138/ptc-2022-0069","DOIUrl":"https://doi.org/10.3138/ptc-2022-0069","url":null,"abstract":"To describe program representatives’ perceptions of the: (1) type and work setting of healthcare professionals who refer to community-based exercise programs with healthcare-community partnerships (CBEP-HCPs) by community size; (2) nature, frequency, and utility of strategies used to promote referral from healthcare professionals to CBEP-HCPs; and (3) facilitators and barriers to CBEP-HCP promotion. We invited individuals involved with the Together in Movement and Exercise (TIME™) program in 48 centres to participate in a cross-sectional survey. TIME™ is a group, task-oriented CBEP-HCP taught by fitness instructors; healthcare partners promote referrals. Data were summarized using frequencies and percentages. Content analysis was used for open-ended questions. Twenty-three representatives of 27 TIME™ programs (56% response rate) participated. Out of 26 healthcare partners identified, 69% were physical therapists. We report the most common findings: programs received referrals from physical therapists ( n = 16, 70%); programs gave healthcare partners promotional materials (e.g., flyers) to facilitate referrals ( n = 17, 63%); strong relationships with healthcare partners facilitated promotion ( n = 18, 78%); and representatives perceived their lack of credibility challenged promotion ( n = 3, 23%). Physical therapists were the most common referral source. Healthcare partners were instrumental in program promotion. Future research is needed to leverage referrals from physical therapists in settings other than hospitals and to better understand the role of healthcare partners in CBEP-HCPs.","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":" ","pages":""},"PeriodicalIF":1.0,"publicationDate":"2023-02-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44227658","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Clinician's Commentary on Lawrence et al.¹.","authors":"Tom Carter","doi":"10.3138/ptc-2021-0030-cc","DOIUrl":"10.3138/ptc-2021-0030-cc","url":null,"abstract":"","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 1","pages":"29"},"PeriodicalIF":1.0,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10211378/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9973736","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Pan-Canadian Perspective on Education and Training Priorities for Physiotherapists. Part 1: Foundations for Clinical Practice.","authors":"Michelle J Kleiner, David M Walton","doi":"10.3138/ptc-2020-0121","DOIUrl":"10.3138/ptc-2020-0121","url":null,"abstract":"<p><p><b>Purpose:</b> Canadian physiotherapists who participated in the Physio Moves Canada (PMC) project of 2017 identified the current state of training programmes as a threat facing professional growth of the discipline in Canada. One purpose of this project was to identify key priority areas for physiotherapist training programmes as identified by academics and clinicians across Canada. <b>Method:</b> The PMC project included a series of interviews and focus groups conducted across clinical sites in every Canadian province and in the Yukon Territory. Data were interpreted using descriptive thematic analysis; identified sub-themes were returned to participants for reflection. <b>Results:</b> Overall, 116 physiotherapists and 1 physiotherapy assistant participated in 10 focus groups and 26 semi-structured interviews. Participants identified critical appraisal of continuing professional development options, knowledge translation, cultural fluency, professionalism, pharmaceutical knowledge, and clinical reasoning as priorities. For clinical practice specifically, participants identified practical knowledge, scope of practice, exercise prescription, health promotion, care of complex patients, and digital technologies as the priorities. <b>Conclusion:</b> Training priorities identified by participants may be useful to physiotherapy educators in preparing graduates to be adaptable and flexible primary health care providers for the future needs of a diverse population.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 1","pages":"42-52"},"PeriodicalIF":1.0,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10211381/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599030","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Current Practice, Barriers to, and Facilitators of Exercise Testing and Training by Physiotherapists in Cystic Fibrosis Specialized Centres in Canada.","authors":"Sarib Malik, Bella Levi, Alan Chan, Hilary Cotnam, Luc Martineau, Eldon Thieu, Karl Zabjek, Poonam Sisodia, Kenneth Wu","doi":"10.3138/ptc-2021-0051","DOIUrl":"10.3138/ptc-2021-0051","url":null,"abstract":"<p><p><b><i>Purpose:</i></b> This study surveyed physiotherapists working at Canadian cystic fibrosis (CF) specialized centres to investigate the current practice, barriers to, and facilitators of exercise testing and training. <b><i>Method:</i></b> Physiotherapists were recruited from 42 Canadian CF centres. They responded to an e-questionnaire regarding their practice. The data were analyzed using descriptive statistics. <b><i>Results:</i></b> Eighteen physiotherapists responded (estimated response rate of 23%); median years of clinical experience was 15 (range, min-max, 3-30) years. Aerobic testing was administered by 44% of respondents, strength testing by 39%, aerobic training by 78%, and strength training by 67%. The most frequently reported barriers across all four types of exercise testing and training were insufficient funding (reported by 56%-67% of respondents), time (50%-61%) and staff availability (56%). More late career than early career physiotherapists reported utilizing aerobic testing (50% vs. 33% of respondents), strength testing (75% vs. 33%), aerobic training (100% vs. 67%), and strength training (100% vs. 33%). <b><i>Conclusions:</i></b> Exercise testing and training is underutilized in Canadian CF centres. Experienced physiotherapists reported utilizing exercise testing and training more than less-experienced physiotherapists. Post-graduate education and mentorship, especially for less-experienced clinicians, are recommended to emphasize the importance of exercise testing and training. Barriers of funding, time, and staff availability should be addressed to further improve quality of care.</p>","PeriodicalId":54606,"journal":{"name":"Physiotherapy Canada","volume":"75 1","pages":"1-9"},"PeriodicalIF":1.0,"publicationDate":"2023-02-08","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10211377/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9599037","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}