Jocelyn E. Blouin, Miranda A Cary, Mackenzie G Marchant, N. Gyurcsik, D. Brittain, Jenelle Zapski
Purpose: Twenty percent of Canadians experience chronic pain. Exercise is an effective management strategy, yet participation levels are low. Physiotherapists can be key to counselling clients to engage in long-term unsupervised exercise. Yet, investigations that identify psychosocial factors related to physiotherapists' intention to counsel are lacking. The purpose of this study was to examine whether physiotherapists' knowledge of chronic pain, beliefs about pain, and self-efficacy to counsel on exercise predicted their intention to counsel clients with chronic pain on exercise. Method: Practicing physiotherapists (N = 64) completed an online survey that assessed their knowledge of chronic pain, beliefs about pain, self-efficacy, and intention to counsel. A two-step hierarchical multiple regression predicted intention. Step 1 controlled for years of practice, and Step 2 included study variables significantly correlated with intention. Results: Beliefs about pain (r = -0.35, p < 0.01) and self-efficacy (r = 0.69, p < 0.01) were significantly correlated with intention. The overall regression model was significant, F 3,60 = 18.73; p < 0.001. Self-efficacy was the sole significant predictor, t 60 = 5.71, p < 0.0001, sr 2 = 28%. Conclusions: Self-efficacy may facilitate physiotherapists' intention to counsel on exercise for chronic pain. If shown to be a causal factor, interventions that target a change in physiotherapists' self-efficacy should be pursued.
目的:20%的加拿大人患有慢性疼痛。锻炼是一种有效的管理策略，但参与率很低。物理治疗师是建议客户进行长期无监督运动的关键。然而，确定与物理治疗师的咨询意向相关的心理社会因素的调查是缺乏的。本研究的目的是探讨物理治疗师对慢性疼痛的认知、对疼痛的信念和运动咨询的自我效能是否能预测他们对慢性疼痛患者的运动咨询意愿。方法:执业物理治疗师(N = 64)完成了一项在线调查，评估了他们对慢性疼痛的认识、对疼痛的信念、自我效能感和咨询意愿。两步层次多元回归预测意图。步骤1以实践年数为对照，步骤2纳入与意向显著相关的研究变量。结果:疼痛信念(r = -0.35, p < 0.01)和自我效能感(r = 0.69, p < 0.01)与意向显著相关。整体回归模型显著，f3,60 = 18.73;P < 0.001。自我效能是唯一显著的预测因子，t 60 = 5.71, p < 0.0001, sr 2 = 28%。结论:自我效能感可能有助于物理治疗师对慢性疼痛的运动建议。如果被证明是一个因果因素，针对物理治疗师自我效能感变化的干预措施应该被追求。
{"title":"Understanding Physiotherapists' Intention to Counsel Clients with Chronic Pain on Exercise: A Focus on Psychosocial Factors.","authors":"Jocelyn E. Blouin, Miranda A Cary, Mackenzie G Marchant, N. Gyurcsik, D. Brittain, Jenelle Zapski","doi":"10.3138/PTC-2018-38","DOIUrl":"https://doi.org/10.3138/PTC-2018-38","url":null,"abstract":"Purpose: Twenty percent of Canadians experience chronic pain. Exercise is an effective management strategy, yet participation levels are low. Physiotherapists can be key to counselling clients to engage in long-term unsupervised exercise. Yet, investigations that identify psychosocial factors related to physiotherapists' intention to counsel are lacking. The purpose of this study was to examine whether physiotherapists' knowledge of chronic pain, beliefs about pain, and self-efficacy to counsel on exercise predicted their intention to counsel clients with chronic pain on exercise. Method: Practicing physiotherapists (N = 64) completed an online survey that assessed their knowledge of chronic pain, beliefs about pain, self-efficacy, and intention to counsel. A two-step hierarchical multiple regression predicted intention. Step 1 controlled for years of practice, and Step 2 included study variables significantly correlated with intention. Results: Beliefs about pain (r = -0.35, p < 0.01) and self-efficacy (r = 0.69, p < 0.01) were significantly correlated with intention. The overall regression model was significant, F 3,60 = 18.73; p < 0.001. Self-efficacy was the sole significant predictor, t 60 = 5.71, p < 0.0001, sr 2 = 28%. Conclusions: Self-efficacy may facilitate physiotherapists' intention to counsel on exercise for chronic pain. If shown to be a causal factor, interventions that target a change in physiotherapists' self-efficacy should be pursued.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124971602","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}
Purpose: We developed an evidence-informed Student Evaluation of the Clinical Placement form. This form gives students the opportunity to share their feedback and perceptions of their clinical placement experiences and provides meaningful data to all stakeholders. Method: We used a modified Delphi process to engage a sample of national stakeholders: physiotherapy clinical education leads of academic departments, centre coordinators of clinical education, clinical instructors, and students. An expert consultant panel, in addition to the investigators, reviewed the responses from each round and helped develop the questionnaire for the subsequent round and finalize the evaluation form. Results: The response rate was 65.3% (47 of 72) for Round 1, 76.6% (36 of 47) for Round 2, and 100% (36 of 36) for Round 3. After three rounds of questionnaires, 89% of participants thought that the evaluation form met their needs. Conclusions: We developed a revised Student Evaluation of the Clinical Placement form that is informed by the literature and meaningful to all stakeholders. This form is being implemented in physiotherapy university programmes across Canada to enable students to share their experiences at clinical sites.
{"title":"Students' Perspectives on Their Experience in Clinical Placements: Using a Modified Delphi Methodology to Engage Physiotherapy Stakeholders in Revising the National Form.","authors":"Brenda Mori, M. Quesnel, S. Wojkowski","doi":"10.3138/PTC-2018-43.E","DOIUrl":"https://doi.org/10.3138/PTC-2018-43.E","url":null,"abstract":"Purpose: We developed an evidence-informed Student Evaluation of the Clinical Placement form. This form gives students the opportunity to share their feedback and perceptions of their clinical placement experiences and provides meaningful data to all stakeholders. Method: We used a modified Delphi process to engage a sample of national stakeholders: physiotherapy clinical education leads of academic departments, centre coordinators of clinical education, clinical instructors, and students. An expert consultant panel, in addition to the investigators, reviewed the responses from each round and helped develop the questionnaire for the subsequent round and finalize the evaluation form. Results: The response rate was 65.3% (47 of 72) for Round 1, 76.6% (36 of 47) for Round 2, and 100% (36 of 36) for Round 3. After three rounds of questionnaires, 89% of participants thought that the evaluation form met their needs. Conclusions: We developed a revised Student Evaluation of the Clinical Placement form that is informed by the literature and meaningful to all stakeholders. This form is being implemented in physiotherapy university programmes across Canada to enable students to share their experiences at clinical sites.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122410405","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}
O. Lennon, K. Logeswaran, Srushti Mistry, Tara Moore, G. Severini, C. Cornall, C. O’Sullivan, Ulrik McCarthy Persson
Purpose: Neurodevelopmental techniques are commonly used in upper limb rehabilitation, but little evidence supports the facilitation techniques associated with this concept. This exploratory study determined whether a facilitation technique at the triceps muscle affected scapulothoracic muscle activity during reach in healthy participants compared with self-selected posture and reach. The secondary aim was to determine whether muscle activation levels differed between the facilitation technique and the optimized posture or guided movement. We also hypothesized that activity in the scapular stabilizers (lower trapezius [LT] and serratus anterior [SA]) would be increased during the facilitated movement than in the other conditions. Methods: The study included 17 healthy participants (aged 20-70 y). Surface electromyography recorded muscle activity in the upper trapezius (UT), middle trapezius (MT), and LT muscles and in the SA, middle deltoid (MD), and triceps during five performance conditions. We used Friedman's test to explore differences in muscle activity across conditions and Bonferroni's post hoc test to explore the differences between conditions. Results: The facilitation technique produced decreased activity in the SA, MD, and triceps muscles (p < 0.01) compared with the self-executed control condition. Compared with optimized posture with independent reach, facilitated movement again produced similar reductions in MD and triceps activity, with decreased LT activity also noted (p < 0.01). Lower activity levels were noted during facilitation than during manual guidance, with or without optimized posture, in the UT, MT, (p < 0.01), SA, and MD muscles (p < 0.05). Conclusions: Triceps facilitation did not increase scapular stability activity, but the activity levels in several other muscle groups (SA, MD, and triceps) were reduced during triceps facilitation compared with optimized posture or guided movement. Detailed analysis of this technique, including co-registered kinematic data and timing of muscle onset, is needed.
{"title":"Effect of the Triceps Brachii Facilitation Technique on Scapulohumeral Muscle Activation during Reach and Point in a Healthy Population.","authors":"O. Lennon, K. Logeswaran, Srushti Mistry, Tara Moore, G. Severini, C. Cornall, C. O’Sullivan, Ulrik McCarthy Persson","doi":"10.3138/PTC-2018-0012","DOIUrl":"https://doi.org/10.3138/PTC-2018-0012","url":null,"abstract":"Purpose: Neurodevelopmental techniques are commonly used in upper limb rehabilitation, but little evidence supports the facilitation techniques associated with this concept. This exploratory study determined whether a facilitation technique at the triceps muscle affected scapulothoracic muscle activity during reach in healthy participants compared with self-selected posture and reach. The secondary aim was to determine whether muscle activation levels differed between the facilitation technique and the optimized posture or guided movement. We also hypothesized that activity in the scapular stabilizers (lower trapezius [LT] and serratus anterior [SA]) would be increased during the facilitated movement than in the other conditions. Methods: The study included 17 healthy participants (aged 20-70 y). Surface electromyography recorded muscle activity in the upper trapezius (UT), middle trapezius (MT), and LT muscles and in the SA, middle deltoid (MD), and triceps during five performance conditions. We used Friedman's test to explore differences in muscle activity across conditions and Bonferroni's post hoc test to explore the differences between conditions. Results: The facilitation technique produced decreased activity in the SA, MD, and triceps muscles (p < 0.01) compared with the self-executed control condition. Compared with optimized posture with independent reach, facilitated movement again produced similar reductions in MD and triceps activity, with decreased LT activity also noted (p < 0.01). Lower activity levels were noted during facilitation than during manual guidance, with or without optimized posture, in the UT, MT, (p < 0.01), SA, and MD muscles (p < 0.05). Conclusions: Triceps facilitation did not increase scapular stability activity, but the activity levels in several other muscle groups (SA, MD, and triceps) were reduced during triceps facilitation compared with optimized posture or guided movement. Detailed analysis of this technique, including co-registered kinematic data and timing of muscle onset, is needed.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134252184","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":"Clinician's Commentary on Mori et al.","authors":"M. Hall","doi":"10.3138/ptc-2018-43-cc","DOIUrl":"https://doi.org/10.3138/ptc-2018-43-cc","url":null,"abstract":"","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131185237","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}
Kirsten Potter, R. Bowling, L. Kavanagh, Ashley Stone, Brittany Witt, A. Wooldridge
Purpose: The purpose of this study was to determine the reliability, validity, and responsiveness of the Mini-Balance Evaluation Systems Test (MBT) in persons with multiple sclerosis (pwMS). Method: A total of 32 pwMS completed a questionnaire on disease severity, the Activities-specific Balance Confidence Scale (ABC), and the MBT. The MBT was re-administered 1 week later. Results: The interrater and test-retest reliability of the total MBT and subscales were excellent. The standard error of measurement for the total MBT, calculated from test-retest and interrater reliability, respectively, was 1.32 and 1.07. The minimal detectable change (MDC) for the total MBT was 3.74; the MDC for the subscales ranged from 0.98 (sensory) to 2.38 (gait). The correlations between individual subscale scores and the total MBT, among subscales, and between the total MBT and disease severity and ABC were excellent. Correlations between the total MBT and age, MS type, and fall and imbalance histories were moderate. Disease severity and ABC scores were the strongest predictors of MBT score. No floor effects were found. Ceiling effects were found for two subscales, but not for the total MBT. Conclusions: The MBT is reliable and valid in pwMS. MDC values will facilitate assessing the effectiveness of treatment. Because ceiling effects were found for two subscales, but not the total MBT, it is recommended that clinicians administer the MBT in its entirety.
{"title":"Reliability, Validity, and Responsiveness of the Mini-Balance Evaluation Systems Test in Ambulatory Individuals with Multiple Sclerosis.","authors":"Kirsten Potter, R. Bowling, L. Kavanagh, Ashley Stone, Brittany Witt, A. Wooldridge","doi":"10.3138/PTC-2018-0071","DOIUrl":"https://doi.org/10.3138/PTC-2018-0071","url":null,"abstract":"Purpose: The purpose of this study was to determine the reliability, validity, and responsiveness of the Mini-Balance Evaluation Systems Test (MBT) in persons with multiple sclerosis (pwMS). Method: A total of 32 pwMS completed a questionnaire on disease severity, the Activities-specific Balance Confidence Scale (ABC), and the MBT. The MBT was re-administered 1 week later. Results: The interrater and test-retest reliability of the total MBT and subscales were excellent. The standard error of measurement for the total MBT, calculated from test-retest and interrater reliability, respectively, was 1.32 and 1.07. The minimal detectable change (MDC) for the total MBT was 3.74; the MDC for the subscales ranged from 0.98 (sensory) to 2.38 (gait). The correlations between individual subscale scores and the total MBT, among subscales, and between the total MBT and disease severity and ABC were excellent. Correlations between the total MBT and age, MS type, and fall and imbalance histories were moderate. Disease severity and ABC scores were the strongest predictors of MBT score. No floor effects were found. Ceiling effects were found for two subscales, but not for the total MBT. Conclusions: The MBT is reliable and valid in pwMS. MDC values will facilitate assessing the effectiveness of treatment. Because ceiling effects were found for two subscales, but not the total MBT, it is recommended that clinicians administer the MBT in its entirety.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"115569197","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}
Over the past 100 years, the Canadian Physiotherapy Association (CPA) has played an important role in promoting research activities to support the remarkable transformation of the physiotherapy profession from its beginnings in World War I to the evidence-based profession of today. In this editorial, I question whether the CPA is poised to continue to fulfill this role in the present and future research environments. It is useful first to review CPA’s past role in fostering research. As early as 1923, the first issue of Physiotherapy Canada was published to provide a means of communication for the fledgling association. In the early 1960s, the CPA leadership promoted research activities in two ways. First, it set up a Projects and Studies Committee “to encourage physiotherapists interested in doing simple research.”1(p.91) Over the years, this committee became the Clinical Studies Council, then the Clinical Studies Division, and finally the Research Division. Unfortunately, as confirmed by a nationwide survey in 1973, few physiotherapists had the qualifications to carry out credible research, and it was very difficult for them to obtain research funding.1 Second, Physiotherapy Canada published two articles, the first on the use of surveys and questionnaires and the second on the basic elements of a scientific paper and how to prepare a manuscript.2,3 An editorial also made the case for “comparative studies” and suggested that the CPA create an advisory council, consisting of consultants with methodological expertise, to help physiotherapists design simple projects.4 Later, physiotherapists with master’s and doctoral degrees joined the Physiotherapy Canada board to help drive its scientific evolution. A series of articles and editorials were published in 1980–1981 on subjects such as why research should be done, the contents of a scientific paper, manuscript review and the editing process, and a five-part series on research methodology and applied statistics.1 In 1981, the journal inaugurated the Silver Quill Award to encourage the publication of high-quality articles. This emphasis on scientific excellence, however, did not please all members of the CPA; many preferred a more clinically oriented approach. Thus, the association now also publishes a member magazine, Physiotherapy Practice. Throughout the 1980s, the Research Division promoted articles on the how-to of carrying out research as well as information on courses and abstracts of current physiotherapy research in its newsletter “Research News and Views.”1 In response to the lack of funds available to physiotherapists, the board created the Physiotherapy Foundation of Canada (PFC) in 1983 to provide funds to “support research which will add to the scientific base for the practice of physiotherapy.”1(p.97),5 The PFC has had its funding problems over the years, but it continues to play an important role in promoting physiotherapy research. University physiotherapy programmes evolved rapidly i
{"title":"Is the Canadian Physiotherapy Association Fulfilling Its Role in Promoting Research?","authors":"C. Richards","doi":"10.3138/ptc-71-4-gee","DOIUrl":"https://doi.org/10.3138/ptc-71-4-gee","url":null,"abstract":"Over the past 100 years, the Canadian Physiotherapy Association (CPA) has played an important role in promoting research activities to support the remarkable transformation of the physiotherapy profession from its beginnings in World War I to the evidence-based profession of today. In this editorial, I question whether the CPA is poised to continue to fulfill this role in the present and future research environments. It is useful first to review CPA’s past role in fostering research. As early as 1923, the first issue of Physiotherapy Canada was published to provide a means of communication for the fledgling association. In the early 1960s, the CPA leadership promoted research activities in two ways. First, it set up a Projects and Studies Committee “to encourage physiotherapists interested in doing simple research.”1(p.91) Over the years, this committee became the Clinical Studies Council, then the Clinical Studies Division, and finally the Research Division. Unfortunately, as confirmed by a nationwide survey in 1973, few physiotherapists had the qualifications to carry out credible research, and it was very difficult for them to obtain research funding.1 Second, Physiotherapy Canada published two articles, the first on the use of surveys and questionnaires and the second on the basic elements of a scientific paper and how to prepare a manuscript.2,3 An editorial also made the case for “comparative studies” and suggested that the CPA create an advisory council, consisting of consultants with methodological expertise, to help physiotherapists design simple projects.4 Later, physiotherapists with master’s and doctoral degrees joined the Physiotherapy Canada board to help drive its scientific evolution. A series of articles and editorials were published in 1980–1981 on subjects such as why research should be done, the contents of a scientific paper, manuscript review and the editing process, and a five-part series on research methodology and applied statistics.1 In 1981, the journal inaugurated the Silver Quill Award to encourage the publication of high-quality articles. This emphasis on scientific excellence, however, did not please all members of the CPA; many preferred a more clinically oriented approach. Thus, the association now also publishes a member magazine, Physiotherapy Practice. Throughout the 1980s, the Research Division promoted articles on the how-to of carrying out research as well as information on courses and abstracts of current physiotherapy research in its newsletter “Research News and Views.”1 In response to the lack of funds available to physiotherapists, the board created the Physiotherapy Foundation of Canada (PFC) in 1983 to provide funds to “support research which will add to the scientific base for the practice of physiotherapy.”1(p.97),5 The PFC has had its funding problems over the years, but it continues to play an important role in promoting physiotherapy research. University physiotherapy programmes evolved rapidly i","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123530876","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}
J. King, Ruth Barclay, J. Ripat, C. Dubouloz, C. Schwartz
Purpose: A significant change in one's health status creates a process of change that has an impact on one's health-related quality of life. This process has been conceptualized in several theories, including response shift (RS) and transformative learning (TL). The purpose of this study was to investigate occupational therapists' and physical therapists' perspectives on the process of change that occurs in clients during rehabilitation. Method: An interpretive description approach guided this study. Five profession-specific focus groups were conducted. Participants were asked about their ideas, thoughts, and understanding of processes of change. Focus group discussions were recorded and transcribed. Data analysis was carried out using both inductive and deductive methods. Results: Participants were 14 physiotherapists and nine occupational therapists with 5-30 years of experience in rehabilitation settings. Participants recognized personal change in clients and noted that it involves many steps. They tried to facilitate this change by identifying signs of readiness. Without using theory-specific terminology, participants described observing and using concepts of RS and TL. Conclusions: Occupational therapists and physiotherapists play an important role in helping people learn to live with their chronic illnesses and disabilities. Further studies are needed to investigate how therapists can facilitate the process of change, including using RS and TL concepts and how this facilitation could improve clients' health-related quality of life.
{"title":"An Investigation of Occupational Therapists' and Physical Therapists' Perspectives on the Process of Change That Occurs among Clients during Rehabilitation, Including Their Use of Response Shift and Transformative Learning.","authors":"J. King, Ruth Barclay, J. Ripat, C. Dubouloz, C. Schwartz","doi":"10.3138/PTC-2018-0047","DOIUrl":"https://doi.org/10.3138/PTC-2018-0047","url":null,"abstract":"Purpose: A significant change in one's health status creates a process of change that has an impact on one's health-related quality of life. This process has been conceptualized in several theories, including response shift (RS) and transformative learning (TL). The purpose of this study was to investigate occupational therapists' and physical therapists' perspectives on the process of change that occurs in clients during rehabilitation. Method: An interpretive description approach guided this study. Five profession-specific focus groups were conducted. Participants were asked about their ideas, thoughts, and understanding of processes of change. Focus group discussions were recorded and transcribed. Data analysis was carried out using both inductive and deductive methods. Results: Participants were 14 physiotherapists and nine occupational therapists with 5-30 years of experience in rehabilitation settings. Participants recognized personal change in clients and noted that it involves many steps. They tried to facilitate this change by identifying signs of readiness. Without using theory-specific terminology, participants described observing and using concepts of RS and TL. Conclusions: Occupational therapists and physiotherapists play an important role in helping people learn to live with their chronic illnesses and disabilities. Further studies are needed to investigate how therapists can facilitate the process of change, including using RS and TL concepts and how this facilitation could improve clients' health-related quality of life.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131649160","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}
Pub Date : 2019-11-01DOI: 10.3138/ptc-71-4-cochrane
The Cochrane Collaboration is an international not-for-profit and independent organization dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide. It produces and disseminates systematic re views of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of inter ventions. For more information, visit https://www.cochrane.org.
{"title":"What Does Cochrane Say about … Respiratory Physiotherapy for Children?","authors":"","doi":"10.3138/ptc-71-4-cochrane","DOIUrl":"https://doi.org/10.3138/ptc-71-4-cochrane","url":null,"abstract":"The Cochrane Collaboration is an international not-for-profit and independent organization dedicated to making up-to-date, accurate information about the effects of health care readily available worldwide. It produces and disseminates systematic re views of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of inter ventions. For more information, visit https://www.cochrane.org.","PeriodicalId":390485,"journal":{"name":"Physiotherapy Canada. Physiotherapie Canada","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"116188924","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}
Erica Zurawski, K. Behm, Charlotte Dunlap, James Koo, Farooq Ismail, C. Boulias, S. Reid, C. Phadke
Purpose: The purpose of this study was to estimate the interrater reliability of the Modified Ashworth Scale (MAS) using consistent movement speeds guided by a metronome when measuring wrist flexor and ankle plantar flexor spasticity in patients with an upper motor neuron (UMN) lesion. The MAS has been found to have inconsistent interrater reliability for scoring the degree of spasticity. Method: This quantitative cross-sectional pilot study occurred in the outpatient spasticity clinic of a community rehabilitation hospital. Participants were a convenience sample of 20 patients with UMN lesions receiving botulinum toxin type A injections for focal spasticity. For each of the muscle groups tested, different pairs of evaluators scored spasticity on the MAS at a velocity of 130° per second. Evaluators were physical therapy students trained by an experienced physical therapist in MAS assessment. Weighted κ values were calculated to measure interrater reliability for each muscle group. Results: The weighted κ values for the wrist flexors and ankle plantar flexors were, respectively, moderate (κw = 0.54; 95% CI: 0.21, 0.87) and slight (κw = 0.08; 95% CI: -0.34, 0.50). Conclusion: Using consistent movement velocity, novice evaluators were able to score spasticity with reasonable interrater reliability when assessing the wrist flexors but not the ankle plantar flexors.
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