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The Development and Implementation of a Rheumatology Referral-Based, General Internal Medicine-Led Fibromyalgia Clinic and Preliminary Patient Outcomes. 以风湿病学转诊为基础、普通内科为主导的纤维肌痛诊所的发展与实施以及患者的初步疗效。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-09-01 DOI: 10.1002/msc.1935
Catherine Pressimone, Katherine Lane, Kristine Ruppert, Trisha Miller, Carly Gabriel, Jillian Kyle, Rachel Vanderberg
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引用次数: 0
Major Determinants of Well-Being in Patients With Axial Spondyloarthritis: 2 Year Follow-Up. 轴性脊椎关节炎患者幸福感的主要决定因素:两年随访。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-09-01 DOI: 10.1002/msc.1942
Elif Durak Ediboglu, Esra Erpek, Deniz Bayraktar, Mustafa Özmen, Dilek Solmaz, Servet Akar

Objectives: Bath Ankylosing Spondylitis Patient Global Score (BAS-G) is a uni-dimensional scale that enables patients to evaluate the effects of their illness on their health. The aim of this study was to determine the impact of disease related outcomes on the BAS-G scores in patients with axSpA.

Methods: A total of 309 patients (56.6% of whom were male, mean age 44 ± 11) were included in the study. Socio-demographic characteristics (age, sex and education level) and clinical characteristics such as disease activity (BASDAI and CRP), spinal mobility (BASMI), functional status (BASFI), radiographic structural damage (mSASS, mNY, and BASRI-hip), and health related quality of life (SF-36 and ASQoL) of the patients were recorded at baseline. In addition, BASDAI total and each item score, BASFI, BAS-G, and CRP levels were collected at 6, 12, and 24 months.

Results: Female patients had significantly higher BAS-G scores (p = 0.037). Baseline BASDAI total score (p < 0.001) and all BASDAI item scores (p < 0.001 for each item), BASFI total score (p < 0.001), ASQoL total score (p < 0.001), and SF-36 PCS sum-score (p < 0.001) were moderately/highly correlated with BAS-G. Multivariate analysis revealed that back pain (BASDAI Q2) (p < 0.001) and the severity of morning stiffness (BASDAI Q5) (p < 0.001) were the main determinants of BAS-G in patients with axSpA. In 2-year follow-up, BASDAI Q1, BASDAI Q5, and BASFI scores were independent determinants of BAS-G in patients with axSpA.

Conclusion: According to the results of the present study, patients with axSpA mainly rely on morning stiffness and back pain to determine their global health status. Moreover, fatigue, severity of morning stiffness and function are the determinants of BAS-G during follow-up.

目的:巴斯-强直性脊柱炎患者综合评分(BAS-G)是一种单维度量表,可帮助患者评估疾病对其健康的影响。本研究旨在确定疾病相关结果对 axSpA 患者 BAS-G 评分的影响:研究共纳入 309 名患者(其中 56.6% 为男性,平均年龄(44 ± 11)岁)。基线时记录了患者的社会人口学特征(年龄、性别和教育水平)和临床特征,如疾病活动度(BASDAI 和 CRP)、脊柱活动度(BASMI)、功能状态(BASFI)、影像学结构损伤(mSASS、mNY 和 BASRI-hip)以及与健康相关的生活质量(SF-36 和 ASQoL)。此外,还收集了 6、12 和 24 个月时的 BASDAI 总分和各项目得分、BASFI、BAS-G 和 CRP 水平:结果:女性患者的 BAS-G 评分明显更高(p = 0.037)。结果:女性患者的 BAS-G 评分明显更高(P = 0.037),基线 BASDAI 总分(P根据本研究的结果,axSpA 患者主要依靠晨僵和背痛来判断其总体健康状况。此外,疲劳、晨僵严重程度和功能是随访期间 BAS-G 的决定因素。
{"title":"Major Determinants of Well-Being in Patients With Axial Spondyloarthritis: 2 Year Follow-Up.","authors":"Elif Durak Ediboglu, Esra Erpek, Deniz Bayraktar, Mustafa Özmen, Dilek Solmaz, Servet Akar","doi":"10.1002/msc.1942","DOIUrl":"https://doi.org/10.1002/msc.1942","url":null,"abstract":"<p><strong>Objectives: </strong>Bath Ankylosing Spondylitis Patient Global Score (BAS-G) is a uni-dimensional scale that enables patients to evaluate the effects of their illness on their health. The aim of this study was to determine the impact of disease related outcomes on the BAS-G scores in patients with axSpA.</p><p><strong>Methods: </strong>A total of 309 patients (56.6% of whom were male, mean age 44 ± 11) were included in the study. Socio-demographic characteristics (age, sex and education level) and clinical characteristics such as disease activity (BASDAI and CRP), spinal mobility (BASMI), functional status (BASFI), radiographic structural damage (mSASS, mNY, and BASRI-hip), and health related quality of life (SF-36 and ASQoL) of the patients were recorded at baseline. In addition, BASDAI total and each item score, BASFI, BAS-G, and CRP levels were collected at 6, 12, and 24 months.</p><p><strong>Results: </strong>Female patients had significantly higher BAS-G scores (p = 0.037). Baseline BASDAI total score (p < 0.001) and all BASDAI item scores (p < 0.001 for each item), BASFI total score (p < 0.001), ASQoL total score (p < 0.001), and SF-36 PCS sum-score (p < 0.001) were moderately/highly correlated with BAS-G. Multivariate analysis revealed that back pain (BASDAI Q2) (p < 0.001) and the severity of morning stiffness (BASDAI Q5) (p < 0.001) were the main determinants of BAS-G in patients with axSpA. In 2-year follow-up, BASDAI Q1, BASDAI Q5, and BASFI scores were independent determinants of BAS-G in patients with axSpA.</p><p><strong>Conclusion: </strong>According to the results of the present study, patients with axSpA mainly rely on morning stiffness and back pain to determine their global health status. Moreover, fatigue, severity of morning stiffness and function are the determinants of BAS-G during follow-up.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142298426","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}
引用次数: 0
Translation and Cross-Cultural Adaptation of the Osteoarthritis Knowledge Scale Into Turkish. 将骨关节炎知识量表翻译成土耳其语并进行跨文化改编
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-09-01 DOI: 10.1002/msc.1939
Hilal Ata Tay, Gönül Acar, Mert Gündoğdu, Murat Kaya, Hasan Hilmi Muratli, Ben Darlow

Background: The Osteoarthritis Knowledge Scale (OAKS) is a validated tool for assessing knowledge about hip and knee osteoarthritis (OA). However, to date, there has been no translation and adaptation of the OAKS for the Turkish population.

Objectives: To translate and cross-culturally adapt the OAKS into Turkish and to assess its psychometric properties in the Turkish population with and without hip or knee OA.

Methods: The OAKS was translated following accepted guidelines. A validation study assessed internal consistency, test-retest reliability and measurement error. An exploratory factor analysis was conducted to assess the factor structure.

Results: A total of 278 participants (n = 70 with hip OA, n = 105 with knee OA, and n = 103 without OA) were included. Internal consistency was 0.72, 0.79 and 0.79 for participants with hip OA, knee OA, and no OA, respectively. The test-retest intraclass correlation coefficient was 0.72 (95% CI; 0.45-0.85), 0.89 (95% CI; 0.82-0.93) and 0.88 (95% CI; 0.79-0.93) for participants with hip OA, knee OA and no OA, respectively. It had three principal components accounting for 57.2% of the total variance.

Conclusions: The Turkish version of the OAKS is a reliable and valid tool for measuring OA knowledge in the Turkish population, including those with and without hip and knee OA. Test-retest reliability was below acceptable levels in the population with hip OA only. Therefore, we recommend that the ICC be interpreted with caution when used in this population.

背景:骨关节炎知识量表(OAKS骨关节炎知识量表(OAKS)是评估髋关节和膝关节骨关节炎(OA)知识的有效工具。然而,迄今为止,还没有针对土耳其人的骨关节炎知识量表的翻译和改编:将 OAKS 翻译成土耳其语并进行跨文化改编,评估其在患有和未患有髋关节或膝关节 OA 的土耳其人群中的心理测量特性:方法:按照公认的指南翻译 OAKS。一项验证研究评估了内部一致性、重测可靠性和测量误差。进行了探索性因子分析,以评估因子结构:共纳入 278 名参与者(髋关节 OA 70 人,膝关节 OA 105 人,无 OA 103 人)。髋关节OA、膝关节OA和无OA患者的内部一致性分别为0.72、0.79和0.79。髋关节OA、膝关节OA和无OA患者的测试-重复类内相关系数分别为0.72(95% CI;0.45-0.85)、0.89(95% CI;0.82-0.93)和0.88(95% CI;0.79-0.93)。它有三个主成分,占总方差的57.2%:土耳其版OAKS是一种可靠有效的工具,可用于测量土耳其人群的OA知识,包括患有和未患有髋关节和膝关节OA的人群。仅在患有髋关节OA的人群中,测试-再测可靠性低于可接受水平。因此,我们建议在这一人群中使用 ICC 时应谨慎解释。
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引用次数: 0
An Analysis of the Structures People With Shoulder Pain Recall After Receiving Their Diagnostic Imaging Results. 肩痛患者在收到诊断成像结果后对结构的回忆分析。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-09-01 DOI: 10.1002/msc.1946
Yotam B Brotman, Peter Malliaras, Melanie K Farlie

Aims: Rotator cuff related shoulder pain (RCRSP) is a prevalent cause of musculoskeletal pain. Patients presenting with this condition often undergo diagnostic imaging. However, many patients appear to have difficulty recalling the nature of their diagnosis. This may impact their rehabilitation outcomes. The aim of this study was to explore peoples' recall of their structural features relating to RCRSP by comparing their recalled description of their condition with the contents of their imaging reports as reported in an online questionnaire. In doing so, we aim to explore the potential emphasis they place on structural features related to their condition.

Methods: This study was a content analysis embedded within a larger survey study published previously. Data containing patients' recall of their diagnosis was used from the study, and analysed using content analysis to quantify content in terms of codes and categories. The aims of frequency, completeness and accuracy of recall were then explored.

Results: The analysis identified eight categories of terminology either recalled by patients or reported in imaging reports. The most frequent categories in reports were tendinopathy (71%) and joint (67%), but only 17% and 36% of participant responses contained these codes, respectively. Participants' completeness of recall compared with their imaging report was 30% on average. In terms of accuracy, only 8 out of 95 participants recalled their diagnoses 100% correctly.

Conclusion: This study indicates that patients have poor overall recall of their RCRSP-related structural features. We contend that participants may have been able to recall what they viewed to be the most prominent structural feature in their imaging findings. It may be important for clinicians to consider the impact of diagnostic labelling, and whether a patient's ability to recall such labelling may have an influence on their outcomes.

目的:肩袖相关性疼痛(RCRSP)是导致肌肉骨骼疼痛的常见原因。出现这种情况的患者通常要接受影像学诊断。然而,许多患者似乎很难回忆起诊断的性质。这可能会影响他们的康复效果。本研究的目的是通过比较患者对其病情的回忆描述和在线问卷中的影像学报告内容,探索患者对与 RCRSP 相关的结构特征的回忆。在此过程中,我们旨在探索他们对与其病情相关的结构特征的潜在重视程度:本研究是一项内容分析,包含在之前发表的一项大型调查研究中。研究中使用了包含患者对其诊断的回忆的数据,并使用内容分析法对这些数据进行了分析,根据代码和类别对内容进行了量化。然后对回忆的频率、完整性和准确性进行了探讨:结果:分析确定了患者回忆或成像报告中报告的八类术语。报告中最常见的类别是肌腱病(71%)和关节(67%),但分别只有 17% 和 36% 的参与者的回答包含这些代码。与影像报告相比,参与者回忆的完整性平均为 30%。在准确性方面,95 名参与者中只有 8 人的诊断回忆正确率为 100%:本研究表明,患者对其 RCRSP 相关结构特征的整体回忆能力较差。我们认为,参与者可能能够回忆起他们认为成像结果中最突出的结构特征。对于临床医生来说,考虑诊断标记的影响以及患者回忆此类标记的能力是否会对其结果产生影响可能非常重要。
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引用次数: 0
Correction to Clinical reasoning in managing chronic hip pain: One in two Australian and New Zealand physiotherapists diagnosed a case vignette with clinical criteria for hip OA as hip OA. A cross-sectional survey. 更正:管理慢性髋关节疼痛的临床推理:每两名澳大利亚和新西兰物理治疗师中就有一人将符合髋关节 OA 临床标准的病例诊断为髋关节 OA。一项横断面调查。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-09-01 DOI: 10.1002/msc.1919
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引用次数: 0
Contextual Factors-Enriched Standard Care on mechanical neck pain (ContextualizAR trial): Protocol for a randomised controlled trial. 针对机械性颈部疼痛的情境因素强化标准护理(ContextualizAR 试验):随机对照试验方案。
IF 1.3 Q2 Health Professions Pub Date : 2024-06-01 DOI: 10.1002/msc.1894
Mauro Federico Andreu, Santiago Soliño, Federico Villalba, Pablo Oscar Policastro, María Lourdes Laurens, Gonzalo D'Aversa, Martín Mastandrea, Federico Rodriguez, Alexis Ramirez, Chad Cook, Giacomo Rossettini

Background: Understanding the influence of contextual factors (CFs) on interventions for mechanical neck pain (MNP) is essential for evidence-based practice in physical therapy. However, the specific effects and synergies of combining different CFs remain unclear.

Objective: The primary purpose of this study will be to determine if a CFs-Enriched Standard Care (SC) approach is an effective treatment for MNP in terms of reducing pain and improving function.

Methods: This will be an assessor-blinded, 2-group (1:1) randomised clinical trial (RCT) aiming to enrol 94 participants with neck pain persisting for more than 4 weeks. Both groups will undergo 4 weeks of SC twice weekly, following established clinical practice guidelines. In the intervention group, CFs will be enhanced, encompassing the physical, psychological, and social elements inherent in the clinical encounter, based on existing evidence. The primary outcomes will encompass changes in pain and disability after 4 weeks of treatment, with a follow-up reassessment at week 12 post-treatment. Secondary outcomes will include changes in Active Range of Motion, Global Rating of Change, and Satisfaction with treatment. The change between groups after treatment and at the 12-week follow-up will be reported for all outcomes, considering the difference from scores recorded at baseline.

Results: We hypothesise that a 4-week CFs-Enriched SC approach will be superior to SC alone in terms of patient-reported disability and pain, with measurements conducted using the Northwick Park Neck Pain Questionnaire and the Numeric Pain Rating Scale, respectively.

Conclusion: This RCT rigorously assesses the effect of purposeful manipulation of CFs during MNP treatment. By elucidating the role of these factors, our findings have the potential to significantly refine clinical practice in managing MNP, thereby enhancing patient care, and advancing the fields of physical therapy and rehabilitation.

背景:了解环境因素(CFs)对机械性颈痛(MNP)干预措施的影响对于物理治疗的循证实践至关重要。然而,结合不同情境因素的具体效果和协同作用仍不清楚:本研究的主要目的是确定在减轻疼痛和改善功能方面,CFS-Enriched 标准护理(SC)方法是否是治疗 MNP 的有效方法:方法:这将是一项评估者盲法、两组(1:1)随机临床试验(RCT),旨在招募94名颈部疼痛持续4周以上的参与者。按照既定的临床实践指南,两组患者都将接受为期 4 周、每周两次的 SC 治疗。在干预组中,将根据现有证据加强CF,包括临床治疗中固有的生理、心理和社会因素。主要结果将包括治疗 4 周后疼痛和残疾程度的变化,并在治疗后第 12 周进行随访再评估。次要结果将包括活动范围的变化、总体变化评分和对治疗的满意度。考虑到与基线分数的差异,所有结果都将报告治疗后和 12 周随访时组间的变化:我们假设,在患者报告的残疾和疼痛方面,为期 4 周的 CFs 增强 SC 方法将优于单纯 SC 方法:本研究严格评估了在 MNP 治疗过程中有目的地操作 CFs 的效果。通过阐明这些因素的作用,我们的研究结果有可能极大地改进管理 MNP 的临床实践,从而加强对患者的护理,并推动物理治疗和康复领域的发展。
{"title":"Contextual Factors-Enriched Standard Care on mechanical neck pain (ContextualizAR trial): Protocol for a randomised controlled trial.","authors":"Mauro Federico Andreu, Santiago Soliño, Federico Villalba, Pablo Oscar Policastro, María Lourdes Laurens, Gonzalo D'Aversa, Martín Mastandrea, Federico Rodriguez, Alexis Ramirez, Chad Cook, Giacomo Rossettini","doi":"10.1002/msc.1894","DOIUrl":"10.1002/msc.1894","url":null,"abstract":"<p><strong>Background: </strong>Understanding the influence of contextual factors (CFs) on interventions for mechanical neck pain (MNP) is essential for evidence-based practice in physical therapy. However, the specific effects and synergies of combining different CFs remain unclear.</p><p><strong>Objective: </strong>The primary purpose of this study will be to determine if a CFs-Enriched Standard Care (SC) approach is an effective treatment for MNP in terms of reducing pain and improving function.</p><p><strong>Methods: </strong>This will be an assessor-blinded, 2-group (1:1) randomised clinical trial (RCT) aiming to enrol 94 participants with neck pain persisting for more than 4 weeks. Both groups will undergo 4 weeks of SC twice weekly, following established clinical practice guidelines. In the intervention group, CFs will be enhanced, encompassing the physical, psychological, and social elements inherent in the clinical encounter, based on existing evidence. The primary outcomes will encompass changes in pain and disability after 4 weeks of treatment, with a follow-up reassessment at week 12 post-treatment. Secondary outcomes will include changes in Active Range of Motion, Global Rating of Change, and Satisfaction with treatment. The change between groups after treatment and at the 12-week follow-up will be reported for all outcomes, considering the difference from scores recorded at baseline.</p><p><strong>Results: </strong>We hypothesise that a 4-week CFs-Enriched SC approach will be superior to SC alone in terms of patient-reported disability and pain, with measurements conducted using the Northwick Park Neck Pain Questionnaire and the Numeric Pain Rating Scale, respectively.</p><p><strong>Conclusion: </strong>This RCT rigorously assesses the effect of purposeful manipulation of CFs during MNP treatment. By elucidating the role of these factors, our findings have the potential to significantly refine clinical practice in managing MNP, thereby enhancing patient care, and advancing the fields of physical therapy and rehabilitation.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140853105","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}
引用次数: 0
Barriers and enablers to the implementation and sustainability of short-stay arthroplasty programs for elective primary total hip and knee replacement: A systematic review with qualitative evidence synthesis. 实施短期关节置换计划并使其可持续发展的障碍和有利因素:系统回顾与定性证据综述。
IF 1.5 Q2 Health Professions Pub Date : 2024-06-01 DOI: 10.1002/msc.1897
Danielle Berkovic, Patrick Vallance, Ian A Harris, Justine M Naylor, Peter L Lewis, Richard de Steiger, Rachelle Buchbinder, Zanfina Ademi, Ilana N Ackerman

Introduction: We aimed to systematically review contemporary evidence on the barriers and enablers to implementing and sustaining short-stay arthroplasty programs for elective primary total hip and knee replacement from the perspectives of patients, health professionals, carers, healthcare administrators, funders and policymakers and to map the findings to the Theoretical Domains Framework (TDF).

Methods: Medline, Cumulative Index to Nursing and Allied Health Literature, EMBASE, and the Cochrane Central Register of Controlled Trials were searched (up to 19 August 2023). Primary qualitative or mixed-methods studies reporting on perspectives relating to the review aims that utilised a short-stay programme were eligible for inclusion. Study quality was assessed using the qualitative critical appraisal tool from the Joanna Briggs Institute. Data were analysed inductively. The final themes were mapped to the TDF. The confidence in the findings was assessed using GRADE CERQual.

Results: Fifteen studies were included. Twelve barrier themes and twelve enabler themes were identified. Three themes were graded with high confidence, 10 were graded with moderate confidence, three were graded with low confidence, and eight were graded with very low confidence. The most pertinent domains that the themes were mapped to for patients were beliefs about capabilities, reinforcement, and the environmental context and resources. Health professionals identified knowledge, environmental context and resources as important domains. Two domains were identified for carers: (1) social/professional role and identity and (2) memory, attention, and decision processes.

Conclusion: We identified key barrier and enabler themes linked to the TDF that can be used to guide implementation initiatives and promote the sustainability of short-stay arthroplasty programs.

导言:我们旨在从患者、医疗专业人员、护理人员、医疗管理者、资助者和政策制定者的角度出发,系统地回顾有关实施和维持短期关节置换计划的障碍和促进因素的当代证据,并将研究结果与理论领域框架(TDF)进行对比:方法:检索 Medline、《护理与专职医疗文献累积索引》、EMBASE 和《Cochrane 对照试验中央登记册》(截至 2023 年 8 月 19 日)。与综述目的相关的、采用短期项目的主要定性或混合方法研究均符合纳入条件。研究质量采用乔安娜-布里格斯研究所(Joanna Briggs Institute)提供的定性关键评估工具进行评估。对数据进行归纳分析。最终的主题被映射到 TDF 中。使用 GRADE CERQual 对研究结果的可信度进行评估:结果:共纳入 15 项研究。确定了 12 个障碍主题和 12 个促进主题。其中 3 个主题被评为高度可信,10 个主题被评为中度可信,3 个主题被评为低度可信,8 个主题被评为极低度可信。这些主题与患者最相关的领域是能力信念、强化、环境背景和资源。医疗专业人员认为知识、环境背景和资源是重要的领域。照顾者的两个领域是:(1) 社会/专业角色和身份;(2) 记忆、注意力和决策过程:我们确定了与 TDF 相关的关键障碍和促进因素主题,可用于指导实施计划和促进短期关节置换术计划的可持续性。
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引用次数: 0
An online training resource for clinicians to optimise exercise prescription for persistent low back pain: Design, development and usability testing. 为临床医生提供在线培训资源,以优化针对顽固性腰背痛的运动处方:设计、开发和可用性测试
IF 1.3 Q2 Health Professions Pub Date : 2024-06-01 DOI: 10.1002/msc.1907
Lianne Wood, Sarah Dean, Vicky Booth, Jill A Hayden, Nadine E Foster

Background: Low back pain (LBP) is the leading cause of disability worldwide. A recent realist review identified the behavioural mechanisms of trust, motivation, and confidence as key to optimising exercise prescription for persistent LBP.

Objectives: Our objectives were to (1) design and develop an online training programme, and (2) gain end-user feedback on the useability, usefulness, informativeness and confidence in using the online training programme using a mixed-methods, pre-post study design.

Participants and intervention: The online training programme was designed and developed using the results from a realist review, and input from a multi-disciplinary stakeholder group. A five-module online training programme was piloted by the first 10 respondents who provided feedback on the course. Further modifications were made prior to additional piloting. The satisfaction, usefulness, ease of use, and confidence of clinicians in applying the learned principles were assessed on completion.

Results: The online programme was advertised to clinicians using social media. Forty-four respondents expressed initial interest, of which 22 enrolled and 18 completed the course. Of the participants, most were physiotherapists (n = 16/18, 88.9%), aged between 30 and 49 (n = 11/18, 61.1%). All participants were satisfied with the course content, rated the course platform as easy to use and useful, and reported that they were very confident to apply the learning. Most (n = 10/14, 71.4%) reported that their manner of prescribing exercise had changed after completion of the course.

Conclusions: An online training programme to optimise exercise prescription for persistent LBP appears to be easy to use, informative and improves confidence to apply the learning.

背景:腰背痛(LBP)是导致全球残疾的主要原因。最近的一篇现实主义评论指出,信任、动机和信心等行为机制是优化针对顽固性腰背痛的运动处方的关键:我们的目标是:(1) 设计和开发一个在线培训项目;(2) 采用混合方法、前-后研究设计,获得最终用户对在线培训项目的可用性、实用性、信息量和使用信心的反馈:在线培训计划是根据现实主义审查的结果和多学科利益相关者小组的意见设计和开发的。首批 10 名提供反馈意见的受访者试用了五模块的在线培训课程。在进行更多的试点之前,还做了进一步的修改。培训结束后,对临床医生的满意度、实用性、易用性以及应用所学原则的信心进行了评估:通过社交媒体向临床医生宣传了在线课程。44 名受访者表示了初步兴趣,其中 22 人报名参加,18 人完成了课程。在参与者中,大多数是物理治疗师(n = 16/18,88.9%),年龄在 30 至 49 岁之间(n = 11/18,61.1%)。所有学员都对课程内容感到满意,认为课程平台易于使用且非常有用,并表示他们非常有信心应用所学知识。大多数人(n = 10/14,71.4%)表示,在完成课程后,他们开运动处方的方式有所改变:结论:针对顽固性腰椎间盘突出症优化运动处方的在线培训项目似乎易于使用,内容丰富,并能提高应用所学知识的信心。
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引用次数: 0
Maintaining resilience over time: A qualitative exploration of the experiences of living with chronic musculoskeletal pain. 随着时间的推移保持复原力:对慢性肌肉骨骼疼痛患者生活经历的定性探索。
IF 1.5 Q3 RHEUMATOLOGY Pub Date : 2024-06-01 DOI: 10.1002/msc.1913
Elīna Zelčāne, Anita Pipere

Background: Living with chronic pain can have several negative consequences. However, some individuals are more resilient despite pain. Although a large body of research exploring resilience-enhancing factors exists, there is a lack of research focused on the changes of individual's resilience over time.

Objectives: This study aims to explore how people with chronic musculoskeletal pain (CMP) describe their experience regarding the maintenance of resilience in the long term.

Methods: Within the framework of the qualitative research strategy, semi-structured interviews and two focus groups with 17 purposefully selected research participants (ages 29-64) were conducted. The data were analysed by integrating thematic analysis and narrative analysis.

Results: To maintain resilience in the long term, it is important to take responsibility for one's physical and mental well-being by practicing regular ability-adjusted physical activity, giving up unrealistic expectations, focussing on finding opportunities, not obstacles, maintaining a positive future perspective, and finding significance in life despite experiencing chronic pain. Financial support from the government and access to rehabilitation can facilitate better self-care for those with limited finances.

Conclusion: This study may be useful for healthcare professionals, psychologists, social workers, and other specialists who daily encounter patients with CMP and aspire to understand the main challenges and needs of this particular group of patients.

背景介绍生活在慢性疼痛中会产生一些负面影响。然而,有些人尽管身患疼痛,却具有较强的恢复能力。尽管有大量研究探讨了增强复原力的因素,但缺乏对个人复原力随时间变化的研究:本研究旨在探讨慢性肌肉骨骼疼痛(CMP)患者如何描述他们长期保持复原力的经历:在定性研究策略的框架内,对 17 名特意挑选的研究参与者(29-64 岁)进行了半结构式访谈和两个焦点小组。数据分析采用了主题分析和叙事分析相结合的方法:要想长期保持复原力,重要的是要对自己的身心健康负责,定期进行适应能力的体育锻炼,放弃不切实际的期望,集中精力寻找机会而不是障碍,保持积极的未来观,并在经历慢性疼痛的情况下找到生活的意义。政府提供的财政支持和康复服务可以帮助那些经济条件有限的人更好地进行自我护理:这项研究可能对医护人员、心理学家、社会工作者和其他专家有所帮助,因为他们每天都会接触到 CMP 患者,并希望了解这一特殊患者群体所面临的主要挑战和需求。
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引用次数: 0
Preoperative lifestyle modifications combined with a structured exercise protocol on patient outcomes following total knee replacement surgery: A systematic review. 术前生活方式调整与结构化锻炼方案相结合对全膝关节置换手术后患者疗效的影响:系统性综述。
IF 1.5 Q2 Health Professions Pub Date : 2024-06-01 DOI: 10.1002/msc.1899
A Kan, K Page, N Devine, A Rabajoli, L Sattler

Background: Medical guidelines recommend structured prehabilitation protocols consisting of lifestyle modifications and exercise to enhance post-operative outcomes for patients undergoing a total knee replacement (TKR). However, current research showing effectiveness is limited and has primarily focused on outcomes of exercise-based prehabilitation.

Objectives: To investigate whether a structured prehabilitation protocol consisting of exercise and lifestyle modifications improves physical function and patient-reported outcomes following TKR surgery compared with usual care.

Design: Systematic review.

Methods: Five databases were searched to identify randomised controlled trials comparing structured prehabilitation programs consisting of lifestyle modifications and exercise, with usual care, for those undergoing a TKR. Methodological quality of included studies was assessed via the RoB 2.0 tool and results synthesis via a Grading of Recommendation Assessment, Development and Evaluation approach was performed to determine the certainty evidence for each outcome.

Results/findings: Four studies were included in this review. Despite a positive trend supporting the inclusion of a structured prehabilitation protocol, additional improvements in post-operative pain, physical function and self-reported function were only seen in one study. Reductions in hospital length of stay were also seen in one study. No additional improvements in post-operative quality of life following prehabilitation were reported.

Conclusion: Limited evidence supporting prehabilitation reported in our review is likely attributed to the intervention type, intensity, and delivery model of included studies. However, there remains to be strong evidence supporting the use of a structured prehabilitation protocol consisting of lifestyle modifications and exercise to improve post-operative outcome.

背景:医学指南建议,为提高全膝关节置换术(TKR)患者的术后效果,应制定由生活方式调整和运动组成的结构化康复方案。然而,目前显示其有效性的研究有限,而且主要集中在以运动为基础的术前康复结果上:目的:与常规护理相比,研究由运动和生活方式调整组成的结构化康复方案是否能改善 TKR 术后的身体功能和患者报告的疗效:设计:系统回顾:对五个数据库进行了检索,以确定针对接受 TKR 术者的随机对照试验,这些试验比较了由生活方式调整和运动组成的结构化预康复方案与常规护理。通过RoB 2.0工具对纳入研究的方法学质量进行评估,并通过建议分级评估、发展和评价方法对结果进行综合,以确定每项结果的确定性证据:本综述纳入了四项研究。尽管有支持纳入结构化康复治疗方案的积极趋势,但只有一项研究发现术后疼痛、身体功能和自我报告功能有额外改善。有一项研究还发现住院时间有所缩短。结论:支持术前康复的证据有限:结论:我们的综述中报告的支持术前康复的证据有限,这可能与纳入研究的干预类型、强度和实施模式有关。不过,仍有强有力的证据支持使用由生活方式调整和锻炼组成的结构化预康复方案来改善术后效果。
{"title":"Preoperative lifestyle modifications combined with a structured exercise protocol on patient outcomes following total knee replacement surgery: A systematic review.","authors":"A Kan, K Page, N Devine, A Rabajoli, L Sattler","doi":"10.1002/msc.1899","DOIUrl":"10.1002/msc.1899","url":null,"abstract":"<p><strong>Background: </strong>Medical guidelines recommend structured prehabilitation protocols consisting of lifestyle modifications and exercise to enhance post-operative outcomes for patients undergoing a total knee replacement (TKR). However, current research showing effectiveness is limited and has primarily focused on outcomes of exercise-based prehabilitation.</p><p><strong>Objectives: </strong>To investigate whether a structured prehabilitation protocol consisting of exercise and lifestyle modifications improves physical function and patient-reported outcomes following TKR surgery compared with usual care.</p><p><strong>Design: </strong>Systematic review.</p><p><strong>Methods: </strong>Five databases were searched to identify randomised controlled trials comparing structured prehabilitation programs consisting of lifestyle modifications and exercise, with usual care, for those undergoing a TKR. Methodological quality of included studies was assessed via the RoB 2.0 tool and results synthesis via a Grading of Recommendation Assessment, Development and Evaluation approach was performed to determine the certainty evidence for each outcome.</p><p><strong>Results/findings: </strong>Four studies were included in this review. Despite a positive trend supporting the inclusion of a structured prehabilitation protocol, additional improvements in post-operative pain, physical function and self-reported function were only seen in one study. Reductions in hospital length of stay were also seen in one study. No additional improvements in post-operative quality of life following prehabilitation were reported.</p><p><strong>Conclusion: </strong>Limited evidence supporting prehabilitation reported in our review is likely attributed to the intervention type, intensity, and delivery model of included studies. However, there remains to be strong evidence supporting the use of a structured prehabilitation protocol consisting of lifestyle modifications and exercise to improve post-operative outcome.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.5,"publicationDate":"2024-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141238469","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}
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Musculoskeletal Care
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