Optimising physiotherapist delivery fidelity of exercise and physical activity advice for achilles tendinopathy: A prospective repeated-measures observational study
Rebecca Phillips , Fernando Sousa , Sanam Tavakkoli Oskouei , Melanie Farlie , Dylan Morrissey , Peter Malliaras
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Abstract
Objectives
To assess physiotherapist delivery fidelity and identify factors optimising delivery fidelity of an intervention based on recommended guidelines for Achilles tendinopathy.
Design
A prospective repeated-measures observational study of physiotherapist delivery fidelity with carefully defined exercise and physical activity advice.
Setting
An inter-disciplinary clinic in Melbourne, Australia, embedded in a randomised controlled trial.
Participants
Two physiotherapists delivering the intervention to five participants each, at three timepoints.
Intervention
All participants were expected to receive the same intervention. Feedback at timepoint one, guided boost-training to optimise delivery fidelity.
Main outcome measures
Proportion of exercise and physical activity advice components delivered as intended (high ≥80%; moderate 51–79%; low≤50%), with relationships between variables analysed using chi-square tests.
Results
Physiotherapist delivery fidelity improved significantly between timepoint one and two (χ2 = 83.3, p < 0.001), then sustained at timepoint three. At timepoint one, seven (70%) of intervention components were delivered with high fidelity, one (10%) with moderate fidelity and two (20%) with low fidelity. At timepoint two, after boost-training, nine (90%) were delivered with high fidelity and one (10%) with moderate fidelity. At timepoint three, all intervention components (100%) were delivered with high fidelity by both physiotherapists.
Conclusion
Physiotherapist delivery fidelity can be optimised with feedback, collaboration and boost-training.
期刊介绍：
Physical Therapy in Sport is an international peer-reviewed journal that provides a forum for the publication of research and clinical practice material relevant to the healthcare professions involved in sports and exercise medicine, and rehabilitation. The journal publishes material that is indispensable for day-to-day practice and continuing professional development. Physical Therapy in Sport covers topics dealing with the diagnosis, treatment, and prevention of injuries, as well as more general areas of sports and exercise medicine and related sports science.
The journal publishes original research, case studies, reviews, masterclasses, papers on clinical approaches, and book reviews, as well as occasional reports from conferences. Papers are double-blind peer-reviewed by our international advisory board and other international experts, and submissions from a broad range of disciplines are actively encouraged.
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