Pub Date : 2023-12-01Epub Date: 2023-08-28DOI: 10.1002/msc.1813
Robin Vervaeke, Simon Lafrance, Anthony Demont
Introduction: To optimise the management of Musculoskeletal disorders (MSKDs), many countries have implemented direct access to physiotherapy; however, the core competencies required for first contact physiotherapists (PTs) have not been precisely defined. The aim of this scoping review is to identify and describe the core competencies required for first contact PTs treating adults with MSKDs.
Methods: We conducted a scoping review of the literature by searching eight databases and grey literature up to July 2023. We performed a thematic analysis of the competencies identified based on predefined themes relevant to first contact physiotherapy in direct access models in primary or emergency care settings.
Results: Sixty-five articles were included. Seventeen core competencies were identified and grouped into 5 themes: (1) Assessment and examination; (2) Management and interventions; (3) Communication; (4) Cooperation and collaboration; and (5) Professionalism and leadership.
Conclusions: Our findings provide an international perspective on the core competencies required for first contact PTs.
{"title":"Core competencies for first contact physiotherapists in a direct access model of care for adults with musculoskeletal disorders: A scoping review.","authors":"Robin Vervaeke, Simon Lafrance, Anthony Demont","doi":"10.1002/msc.1813","DOIUrl":"10.1002/msc.1813","url":null,"abstract":"<p><strong>Introduction: </strong>To optimise the management of Musculoskeletal disorders (MSKDs), many countries have implemented direct access to physiotherapy; however, the core competencies required for first contact physiotherapists (PTs) have not been precisely defined. The aim of this scoping review is to identify and describe the core competencies required for first contact PTs treating adults with MSKDs.</p><p><strong>Methods: </strong>We conducted a scoping review of the literature by searching eight databases and grey literature up to July 2023. We performed a thematic analysis of the competencies identified based on predefined themes relevant to first contact physiotherapy in direct access models in primary or emergency care settings.</p><p><strong>Results: </strong>Sixty-five articles were included. Seventeen core competencies were identified and grouped into 5 themes: (1) Assessment and examination; (2) Management and interventions; (3) Communication; (4) Cooperation and collaboration; and (5) Professionalism and leadership.</p><p><strong>Conclusions: </strong>Our findings provide an international perspective on the core competencies required for first contact PTs.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10110922","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 : 2023-12-01Epub Date: 2023-08-28DOI: 10.1002/msc.1810
Declan J O'Sullivan, Lindsay M Bearne, Janas M Harrington, Joseph G McVeigh
Background: Chronic musculoskeletal disorders (MSD) are a significant burden on individuals' quality of life and society and are made more complex by the presence of multimorbidity. It is recommended that interventions targeting MSD be sustainable, equitable and incorporate the biopsychosocial model of care (BPS).
Aims: A criticism of the BPS approach is that the social component of this model is not addressed adequately during the management of people with long-term MSD and that a gap exists between theory and implementation. The use of social prescribing (SP) as an intervention to bridge this gap is discussed.
Results and discussion: Social prescribing is a holistic non-medical person-centered approach to well-being that utilizes link workers (LW) to support individuals with long-term conditions (LTC) in the community. Social prescribing referrals are received from primary healthcare practitioners to LW and range from light touch signposting for employment or financial advice to more intensive support for LTC such as obesity, decreased physical activity and mental health needs.
Conclusion: There is evidence to suggest that SP interventions are effective in the management of LTC; however, due to the paucity of high-quality evidence, it is difficult to be conclusive. Large-scale randomised controlled trials are recommended to support the use of SP interventions in the management of LTC.
{"title":"Can social prescribing put the 'social' into the biopsychosocial management of people with long-term musculoskeletal disorders?","authors":"Declan J O'Sullivan, Lindsay M Bearne, Janas M Harrington, Joseph G McVeigh","doi":"10.1002/msc.1810","DOIUrl":"10.1002/msc.1810","url":null,"abstract":"<p><strong>Background: </strong>Chronic musculoskeletal disorders (MSD) are a significant burden on individuals' quality of life and society and are made more complex by the presence of multimorbidity. It is recommended that interventions targeting MSD be sustainable, equitable and incorporate the biopsychosocial model of care (BPS).</p><p><strong>Aims: </strong>A criticism of the BPS approach is that the social component of this model is not addressed adequately during the management of people with long-term MSD and that a gap exists between theory and implementation. The use of social prescribing (SP) as an intervention to bridge this gap is discussed.</p><p><strong>Results and discussion: </strong>Social prescribing is a holistic non-medical person-centered approach to well-being that utilizes link workers (LW) to support individuals with long-term conditions (LTC) in the community. Social prescribing referrals are received from primary healthcare practitioners to LW and range from light touch signposting for employment or financial advice to more intensive support for LTC such as obesity, decreased physical activity and mental health needs.</p><p><strong>Conclusion: </strong>There is evidence to suggest that SP interventions are effective in the management of LTC; however, due to the paucity of high-quality evidence, it is difficult to be conclusive. Large-scale randomised controlled trials are recommended to support the use of SP interventions in the management of LTC.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10440250","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 : 2023-12-01Epub Date: 2023-06-21DOI: 10.1002/msc.1793
Elise E Drum, Alexandre Kovats, Matthew D Jones, Sarah Dennis, Justine Naylor, Kathryn Mills, Jeanette M Thom
Objective: Crepitus is a feature of osteoarthritis that may affect one's participation in exercise. An informed understanding is required of the perceptions that people have of their knee crepitus and how it affects their exercise behaviours. This study aims to investigate the role that crepitus may play in beliefs about exercise and knee health.
Methods: Focus group and individual interviews were conducted online with participants who had knee crepitus. The transcripts were thematically analysed through an inductive approach.
Results: Five main themes were identified from 24 participants: (1) individual variation of, (2) occurrence of, (3) meaning of knee crepitus, (4) attitudes and exercise behaviours regarding crepitus, and (5) knowledge deficits and needs concerning crepitus during exercise. The variety of crepitus sounds described occurred with a range of exercises or after inactivity. For those already with osteoarthritis or other symptoms, crepitus was of less concern than symptoms such as pain. Most participants had not ceased exercise but may have modified movement due to crepitus and associated symptoms; some had increased intentional strength training to try alleviating it. Participants agreed that more understanding about the processes causing crepitus and what exercise was safe for knee health would be beneficial.
Conclusion: Crepitus does not appear to be a major cause of concern for people who experience it. However, it is a factor that influences exercise behaviours as is pain. If health professionals could guide people with concerns about their crepitus, they may be more confident in exercising to benefit their joint health.
{"title":"Creaky knees: Is there a reason for concern? A qualitative study of the perspectives of people with knee crepitus.","authors":"Elise E Drum, Alexandre Kovats, Matthew D Jones, Sarah Dennis, Justine Naylor, Kathryn Mills, Jeanette M Thom","doi":"10.1002/msc.1793","DOIUrl":"10.1002/msc.1793","url":null,"abstract":"<p><strong>Objective: </strong>Crepitus is a feature of osteoarthritis that may affect one's participation in exercise. An informed understanding is required of the perceptions that people have of their knee crepitus and how it affects their exercise behaviours. This study aims to investigate the role that crepitus may play in beliefs about exercise and knee health.</p><p><strong>Methods: </strong>Focus group and individual interviews were conducted online with participants who had knee crepitus. The transcripts were thematically analysed through an inductive approach.</p><p><strong>Results: </strong>Five main themes were identified from 24 participants: (1) individual variation of, (2) occurrence of, (3) meaning of knee crepitus, (4) attitudes and exercise behaviours regarding crepitus, and (5) knowledge deficits and needs concerning crepitus during exercise. The variety of crepitus sounds described occurred with a range of exercises or after inactivity. For those already with osteoarthritis or other symptoms, crepitus was of less concern than symptoms such as pain. Most participants had not ceased exercise but may have modified movement due to crepitus and associated symptoms; some had increased intentional strength training to try alleviating it. Participants agreed that more understanding about the processes causing crepitus and what exercise was safe for knee health would be beneficial.</p><p><strong>Conclusion: </strong>Crepitus does not appear to be a major cause of concern for people who experience it. However, it is a factor that influences exercise behaviours as is pain. If health professionals could guide people with concerns about their crepitus, they may be more confident in exercising to benefit their joint health.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"10025370","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 : 2023-12-01Epub Date: 2023-05-22DOI: 10.1002/msc.1784
Saoussen Miladi, Sirine Bouzid, Alia Fazaa, Hiba Boussaa, Yasmine Makhlouf, Leila Souabni, Kmar Ouenniche, Salma Kassab, Salma Chekili, Kaouther Ben Abdelghani, Ahmed Laatar
Background: Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date.
Aim: We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients.
Patients and methods: We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS.
Results: We included 40 knee OA patients, with a mean age of 59.85 ± 9.65 years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03 ± 19.9 [4-75]. The mean Lequesne for knees was 9.62 ± 4.57 [3-16.5]. Among our patients, 52% (n = 21) experienced heel pain. The heel pain was severe in 19% (n = 4). The mean MFPDI was 4.67 ± 4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n = 17) each. High and low arch deformities were seen in 23% (n = 9) and 40% (n = 16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n = 25). An abnormal hypoechoic plantar fascia was noted in 47% (n = 19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n = 2 (13%) versus n = 15 (60%), p = 0.004) and plantar flexion (n = 3 (20%) versus n = 14 (56%), p = 0.026). The range of supination was also less important in the plantar fasciitis group (17.73 ± 4.1 vs. 12.8 ± 6.46, p = 0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n = 9] vs. G0: 0% [n = 0], p = 0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n = 7] vs. G0: 60% [n = 9], p = 0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR = 3.889, 95% CI [0.017-0.987], p = 0.049).
Conclusion: In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.
{"title":"Is there an association between plantar fasciitis and knee osteoarthritis?","authors":"Saoussen Miladi, Sirine Bouzid, Alia Fazaa, Hiba Boussaa, Yasmine Makhlouf, Leila Souabni, Kmar Ouenniche, Salma Kassab, Salma Chekili, Kaouther Ben Abdelghani, Ahmed Laatar","doi":"10.1002/msc.1784","DOIUrl":"10.1002/msc.1784","url":null,"abstract":"<p><strong>Background: </strong>Knee osteoarthritis (OA) and plantar fasciitis share similar risk factors including ageing, occupation, obesity, and inappropriate shoe wear. However, the association between knee OA and heel pain caused by plantar fasciitis has received limited attention to date.</p><p><strong>Aim: </strong>We aimed to assess the prevalence of plantar fasciitis using ultrasound in patients with knee OA and to identify factors associated with plantar fasciitis in these patients.</p><p><strong>Patients and methods: </strong>We conducted a cross-sectional study including patients with Knee OA, fulfiling the European League Against Rheumatism criteria. The Western Ontario and McMaster Universities Osteoarthritis (WOMAC) and the Lequesne indexes were used to evaluate pain and function of the knees. The Manchester Foot Pain and Disability Index (MFPDI) was used to estimate foot pain and disability. Each patient underwent a physical examination, plain radiographs of the knees and the heels, and an ultrasound examination of both heels to find signs of plantar fasciitis. Statistical analysis was performed using SPSS.</p><p><strong>Results: </strong>We included 40 knee OA patients, with a mean age of 59.85 ± 9.65 years [32-74] and a male-to-female ratio of 0.17. The mean WOMAC was 34.03 ± 19.9 [4-75]. The mean Lequesne for knees was 9.62 ± 4.57 [3-16.5]. Among our patients, 52% (n = 21) experienced heel pain. The heel pain was severe in 19% (n = 4). The mean MFPDI was 4.67 ± 4.16 [0-8]. Limited ankle dorsiflexion and plantar flexion were noted in 47% of patients (n = 17) each. High and low arch deformities were seen in 23% (n = 9) and 40% (n = 16) of patients. Ultrasound revealed a thickened plantar fascia in 62% (n = 25). An abnormal hypoechoic plantar fascia was noted in 47% (n = 19), with the loss of normal fibrillar architecture in 12 cases (30%). No Doppler signal was exhibited. Patients with plantar fasciitis had significantly limited dorsiflexion (n = 2 (13%) versus n = 15 (60%), p = 0.004) and plantar flexion (n = 3 (20%) versus n = 14 (56%), p = 0.026). The range of supination was also less important in the plantar fasciitis group (17.73 ± 4.1 vs. 12.8 ± 6.46, p = 0.027). The low arch was statistically more present in patients with plantar fasciitis (G1: 36% [n = 9] vs. G0: 0% [n = 0], p = 0.015). However, the high arch deformity was statistically more present in patients without plantar fasciitis (G1: 28% [n = 7] vs. G0: 60% [n = 9], p = 0.046). Multivariate analysis showed that the risk factor for plantar fasciitis in knee OA patients was limited dorsiflexion (OR = 3.889, 95% CI [0.017-0.987], p = 0.049).</p><p><strong>Conclusion: </strong>In conclusion, our work showed that plantar fasciitis is frequent in knee OA patients, with reduced ankle dorsiflexion being the main risk factor for plantar fasciitis in these patients.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9869500","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 : 2023-12-01Epub Date: 2023-07-05DOI: 10.1002/msc.1795
Serge Perrot, Guillaume Roucoux, Philippe Bertin, Catherine Beauvais, Françoise Alliot-Launois, Olivier Chassany, Martin Duracinsky
Purpose: To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA).
Patients and methods: We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management.
Results: Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs.
Conclusion: The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.
目的:分析并比较患者和医护人员(HPs)对疼痛性骨关节炎(OA)患者护理路径的看法:我们对两个焦点小组进行了定性研究,这两个焦点小组分别对应八名疼痛性 OA 患者和八名参与 OA 管理的医护人员:访谈中出现了六个关键主题:(1) OA 的表征;(2) OA 疼痛;(3) 生活质量;(4) 护理路径;(5) 护理路径中的参与者;(6) 治疗。两组人都认为全科医生、药剂师和物理治疗师是一线医疗保健人员,没有发现明确的 OA 专家。患者和医疗保健人员报告了类似的困难,包括根据个人情况调整治疗方法、晚期诊断和治疗,而只有患者提到了经济问题。沟通困难被认为是患者和医疗保健人员之间以及医疗保健人员之间的主要问题。患者表示对疼痛和 OA 缺乏了解。各医疗机构之间需要进行协调,并开展有关疼痛和 OA 的教育。患者和医务人员都提出了几种可能的解决方案:结论:疼痛性 OA 患者的护理路径非常复杂,各医疗保健机构的角色定义不明确,协调性也不理想。应明确医疗保健人员的作用,发展医疗保健人员之间的合作。
{"title":"Cross-perspectives on care pathways for painful osteoarthritis: A qualitative analysis in patients and healthcare professionals.","authors":"Serge Perrot, Guillaume Roucoux, Philippe Bertin, Catherine Beauvais, Françoise Alliot-Launois, Olivier Chassany, Martin Duracinsky","doi":"10.1002/msc.1795","DOIUrl":"10.1002/msc.1795","url":null,"abstract":"<p><strong>Purpose: </strong>To analyse and compare patients' and healthcare professionals' (HPs) perspectives concerning patient care pathways for painful osteoarthritis (OA).</p><p><strong>Patients and methods: </strong>We performed a qualitative study of two focus groups corresponding to eight patients with painful OA and eight HPs involved in OA management.</p><p><strong>Results: </strong>Six key themes emerged from the interviews: (1) representations of OA, (2) OA pain, (3) quality of life, (4) care pathways, (5) actors involved in the care pathway, and (6) treatments. Both groups considered general practitioners, pharmacists and physiotherapists to be first-line HPs, and no well-defined OA specialist was identified. Patients and HPs reported similar difficulties concerning the adaptation of management to individual cases, late diagnosis and treatment, whereas only patients mentioned financial issues. Communication difficulties were identified as a major problem both between patients and HPs, and between HPs. Patients reported a lack of knowledge concerning pain and OA. The coordination between the various HPs is required, with education on both pain and OA. Several possible solutions were put forward by both patients and HPs.</p><p><strong>Conclusion: </strong>The care pathways of patients with painful OA are complex, with an unclear definition of the roles of the various HPs and suboptimal coordination. The role of HPs should be defined and collaboration between HPs developed.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9742838","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}
Background: Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that has a strong negative impact on the quality of life (QoL) of patients. The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire was the first disease-specific patient-derived instrument developed to measure the QoL in patients with PsA. Our objective was to translate the PsAQol into Arabic language and evaluate its reliability and validity in patients with PsA.
Methods: This was a cross-sectional study including patients with PsA. A clinical and biological assessment of the patients was performed at inclusion. The translation of the original PsAQoL into Arabic was performed by a professional bilingual and lay panel. Eight patients were interviewed to assess face and content validity. A separate sample of PsA patients (n = 30) were invited to participate in a test-retest postal study in order to investigate reproducibility and construct validity. One week separated the two administrations. The Arabic version of Health Assessment Questionnaire (HAQ) was used as a comparator instrument for convergent validity.
Results: Face and content validity were satisfactory. The Arabic version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. One item was excluded (item 16). It had no correlation with either the other 19 items or the total score of PsAQol. The Arabic PsAQol had excellent internal consistency (Cronbach's a = 0.926), and test-retest reliability (r = 0.982). There was a positive correlation between the total score of the PsAQoL and the Arabic version of HAQ (Spearman's r = 0.838, p < 10-3 ). Exploratory factor analysis had extracted two factors explaining 55% of the total variance.
Conclusion: Nineteen items were selected to compose the Arabic version of PsAQoL, which was found to be relevant and understandable and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine care for patients' assessment.
{"title":"Psoriatic Arthritis Quality of Life questionnaire: Translation, cultural adaptation and validation into Arabic language.","authors":"Rawdha Tekaya, Haifa Hajji, Leila Rouached, Selma Bouden, Meriem Jones, Wafa Hamdi, Nabil Sakly, Leila Metoui, Aicha Ben Tekaya, Ines Mahmoud, Olfa Saidane, Leila Abdelmoula","doi":"10.1002/msc.1788","DOIUrl":"10.1002/msc.1788","url":null,"abstract":"<p><strong>Background: </strong>Psoriatic arthritis (PsA) is a multifaceted inflammatory disease that has a strong negative impact on the quality of life (QoL) of patients. The Psoriatic Arthritis Quality of Life (PsAQoL) questionnaire was the first disease-specific patient-derived instrument developed to measure the QoL in patients with PsA. Our objective was to translate the PsAQol into Arabic language and evaluate its reliability and validity in patients with PsA.</p><p><strong>Methods: </strong>This was a cross-sectional study including patients with PsA. A clinical and biological assessment of the patients was performed at inclusion. The translation of the original PsAQoL into Arabic was performed by a professional bilingual and lay panel. Eight patients were interviewed to assess face and content validity. A separate sample of PsA patients (n = 30) were invited to participate in a test-retest postal study in order to investigate reproducibility and construct validity. One week separated the two administrations. The Arabic version of Health Assessment Questionnaire (HAQ) was used as a comparator instrument for convergent validity.</p><p><strong>Results: </strong>Face and content validity were satisfactory. The Arabic version of the PsAQoL was found to be relevant, understandable and easy to complete in only a few minutes. One item was excluded (item 16). It had no correlation with either the other 19 items or the total score of PsAQol. The Arabic PsAQol had excellent internal consistency (Cronbach's a = 0.926), and test-retest reliability (r = 0.982). There was a positive correlation between the total score of the PsAQoL and the Arabic version of HAQ (Spearman's r = 0.838, p < 10<sup>-3</sup> ). Exploratory factor analysis had extracted two factors explaining 55% of the total variance.</p><p><strong>Conclusion: </strong>Nineteen items were selected to compose the Arabic version of PsAQoL, which was found to be relevant and understandable and has excellent reliability and construct validity. The new measure will be a valuable new tool for use in routine care for patients' assessment.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9647251","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 : 2023-12-01Epub Date: 2023-10-13DOI: 10.1002/msc.1833
Julie Begum, Robert Clark, Trish Cornell, Sarah Ryan
{"title":"Transforming rheumatology telephone advice line services.","authors":"Julie Begum, Robert Clark, Trish Cornell, Sarah Ryan","doi":"10.1002/msc.1833","DOIUrl":"10.1002/msc.1833","url":null,"abstract":"","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"41215901","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 : 2023-12-01Epub Date: 2023-10-31DOI: 10.1002/msc.1837
Shania Liu, Hadi A Almansour, Lily Pham, Furkan Genel, Ian A Harris, Asad E Patanwala, Sam Adie, Jennifer Stevens, Geraldine Hassett, Kate Luckie, Jonathan Penm, Justine Naylor
Background: Total hip and knee arthroplasties are common surgeries performed worldwide, but the management of pain during the subacute period (defined as hospital discharge to 3 months postoperatively) is poorly understood. This study aimed to determine patients' experiences, facilitators and barriers to subacute pain management following total hip or knee arthroplasty.
Methods: Semi-structured interviews with a purposive sample of patients following total hip or knee arthroplasty were conducted between June and August 2022. Participants were recruited from two tertiary metropolitan hospitals. Interviews were audio-recorded and transcribed verbatim. Data were analysed using an inductive thematic approach to identify common themes.
Results: In total, 30 interviews were conducted with patients following hip or knee arthroplasty. Four main themes were identified: (i) Physical constitution before surgery (joint condition, analgesic use, age, and hearing); (ii) Attitude and knowledge (motivation, outlook on life, attitude towards taking medications, individual benchmarking, and knowledge); (iii) Socio-ethno-cultural factors (family and community connection, language, and religion), and (iv) Health-system support (health-professional delivered education, medications, services, staff, and costs).
Conclusions: Participants' experiences of subacute pain following hip or knee arthroplasty were shaped by multidimensional factors. Strategies to empower patients through increased education and support during postoperative opioid tapering as well as a shift to a biopsychosocial approach to pain management during the subacute period may improve patient and health-system outcomes.
{"title":"Patients' experiences of subacute pain management following total hip or knee arthroplasty: A qualitative study.","authors":"Shania Liu, Hadi A Almansour, Lily Pham, Furkan Genel, Ian A Harris, Asad E Patanwala, Sam Adie, Jennifer Stevens, Geraldine Hassett, Kate Luckie, Jonathan Penm, Justine Naylor","doi":"10.1002/msc.1837","DOIUrl":"10.1002/msc.1837","url":null,"abstract":"<p><strong>Background: </strong>Total hip and knee arthroplasties are common surgeries performed worldwide, but the management of pain during the subacute period (defined as hospital discharge to 3 months postoperatively) is poorly understood. This study aimed to determine patients' experiences, facilitators and barriers to subacute pain management following total hip or knee arthroplasty.</p><p><strong>Methods: </strong>Semi-structured interviews with a purposive sample of patients following total hip or knee arthroplasty were conducted between June and August 2022. Participants were recruited from two tertiary metropolitan hospitals. Interviews were audio-recorded and transcribed verbatim. Data were analysed using an inductive thematic approach to identify common themes.</p><p><strong>Results: </strong>In total, 30 interviews were conducted with patients following hip or knee arthroplasty. Four main themes were identified: (i) Physical constitution before surgery (joint condition, analgesic use, age, and hearing); (ii) Attitude and knowledge (motivation, outlook on life, attitude towards taking medications, individual benchmarking, and knowledge); (iii) Socio-ethno-cultural factors (family and community connection, language, and religion), and (iv) Health-system support (health-professional delivered education, medications, services, staff, and costs).</p><p><strong>Conclusions: </strong>Participants' experiences of subacute pain following hip or knee arthroplasty were shaped by multidimensional factors. Strategies to empower patients through increased education and support during postoperative opioid tapering as well as a shift to a biopsychosocial approach to pain management during the subacute period may improve patient and health-system outcomes.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"71414686","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 : 2023-12-01Epub Date: 2023-05-04DOI: 10.1002/msc.1775
Mosab M Aldabbas, Tarushi Tanwar, Iram Iram, Amer Ghrouz, Zubia Veqar
Background: Clinicians specialising in musculoskeletal medicine have observed that patients with neck pain often seek repeat consultations because of recurring neck pain. Despite this pattern, there is a lack of research exploring the persistence nature of neck pain. Understanding potential predictors of persistent neck pain could help clinicians develop effective treatment approaches to prevent the chronicity of these conditions.
Objective: The current study investigated the potential predictors of persistent neck pain over a 2-year period among patients with acute neck pain treated with physical therapy.
Methods: A longitudinal study design was employed. Data were collected at baseline and at 2-year follow-up from 152 acute neck pain patients aged (29.2 ± 6.7). Patients were recruited from physiotherapy clinics. Logistic regression was used for analysis. At 2-year follow-up, participants were reassessed for their pain intensity (Dependent variable) and categorised as recovered or reporting persistent neck pain. Baseline acute neck pain intensity, sleep quality, disability, depression, anxiety, and sleepiness were used as potential predictors.
Results: Among 152 participants, 51 (33.6%) patients with acute neck pain reported persistent neck pain at 2-year follow-up. 43% of the variation in the dependent variable was explained by the model. Despite the strong correlations between persistent pain at follow-up with all potential predictors, only sleep quality 95% CI (1.1,1.6), and anxiety 95% CI (1.1,1.4) were the significant predictors of persistent neck pain.
Conclusion: Our results suggest that poor sleep quality and anxiety may serve as potential predictors of persistent neck pain. The findings highlight the importance of a comprehensive approach to managing neck pain that addresses both physical and psychological factors. By targeting these co-morbidities, healthcare providers may be able to improve outcomes and prevent the progression of the case.
{"title":"Predictors of persistent pain in patients with acute neck pain treated with physical therapy: A prospective study with 2 years follow up.","authors":"Mosab M Aldabbas, Tarushi Tanwar, Iram Iram, Amer Ghrouz, Zubia Veqar","doi":"10.1002/msc.1775","DOIUrl":"10.1002/msc.1775","url":null,"abstract":"<p><strong>Background: </strong>Clinicians specialising in musculoskeletal medicine have observed that patients with neck pain often seek repeat consultations because of recurring neck pain. Despite this pattern, there is a lack of research exploring the persistence nature of neck pain. Understanding potential predictors of persistent neck pain could help clinicians develop effective treatment approaches to prevent the chronicity of these conditions.</p><p><strong>Objective: </strong>The current study investigated the potential predictors of persistent neck pain over a 2-year period among patients with acute neck pain treated with physical therapy.</p><p><strong>Methods: </strong>A longitudinal study design was employed. Data were collected at baseline and at 2-year follow-up from 152 acute neck pain patients aged (29.2 ± 6.7). Patients were recruited from physiotherapy clinics. Logistic regression was used for analysis. At 2-year follow-up, participants were reassessed for their pain intensity (Dependent variable) and categorised as recovered or reporting persistent neck pain. Baseline acute neck pain intensity, sleep quality, disability, depression, anxiety, and sleepiness were used as potential predictors.</p><p><strong>Results: </strong>Among 152 participants, 51 (33.6%) patients with acute neck pain reported persistent neck pain at 2-year follow-up. 43% of the variation in the dependent variable was explained by the model. Despite the strong correlations between persistent pain at follow-up with all potential predictors, only sleep quality 95% CI (1.1,1.6), and anxiety 95% CI (1.1,1.4) were the significant predictors of persistent neck pain.</p><p><strong>Conclusion: </strong>Our results suggest that poor sleep quality and anxiety may serve as potential predictors of persistent neck pain. The findings highlight the importance of a comprehensive approach to managing neck pain that addresses both physical and psychological factors. By targeting these co-morbidities, healthcare providers may be able to improve outcomes and prevent the progression of the case.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9461640","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}
Background: Orthopaedists are often the first point of contact for patients who present with low back pain (LBP) and chronic LBP in Brazil.
Aim: To explore the views of orthopaedists on therapeutic approaches for chronic non-specific low back pain (CNLBP) with a view to gain insights into aspects of clinical practice considered important to them.
Methods: A qualitative design underpinned by interpretivism was employed. Participants were (n = 13) orthopaedists with experience in treating patients with CNLBP. Following the pilot interviews, semi-structured interviews were conducted, audio-recorded, transcribed and de-identified. Interview data were thematically analysed.
Results: Four themes were identified. (1) Biophysical aspects are important and predominate, but sometimes their relevance can be unclear; (2) Psychosocial aspects and lifestyle factors influence the therapeutic approach; (3) Treatment of CNLBP - including medication, physical activity, surgery and other invasive procedures and other therapeutic modalities; and (4) Nuances of clinical practice - "it goes beyond medicine".
Conclusion: Brazilian orthopaedists value identifying the biophysical cause(s) of chronic low back pain. Psychological factors were often discussed secondary to biophysical aspects, whereas social aspects were rarely mentioned. Orthopaedists highlighted their difficulties in navigating patients' emotions and reassuring patients without referrals to imaging tests. Orthopaedists may benefit from training that targets communication and other relational aspects of care in order to work with people who present with CNLBP.
{"title":"What are Brazilian orthopaedists' views on the diagnosis and treatment of patients with chronic nonspecific low back pain? A qualitative investigation.","authors":"Fabiana Silveira Murray, Nathalia Costa, Fabianna Jesus-Moraleida, Ney Meziat-Filho","doi":"10.1002/msc.1778","DOIUrl":"10.1002/msc.1778","url":null,"abstract":"<p><strong>Background: </strong>Orthopaedists are often the first point of contact for patients who present with low back pain (LBP) and chronic LBP in Brazil.</p><p><strong>Aim: </strong>To explore the views of orthopaedists on therapeutic approaches for chronic non-specific low back pain (CNLBP) with a view to gain insights into aspects of clinical practice considered important to them.</p><p><strong>Methods: </strong>A qualitative design underpinned by interpretivism was employed. Participants were (n = 13) orthopaedists with experience in treating patients with CNLBP. Following the pilot interviews, semi-structured interviews were conducted, audio-recorded, transcribed and de-identified. Interview data were thematically analysed.</p><p><strong>Results: </strong>Four themes were identified. (1) Biophysical aspects are important and predominate, but sometimes their relevance can be unclear; (2) Psychosocial aspects and lifestyle factors influence the therapeutic approach; (3) Treatment of CNLBP - including medication, physical activity, surgery and other invasive procedures and other therapeutic modalities; and (4) Nuances of clinical practice - \"it goes beyond medicine\".</p><p><strong>Conclusion: </strong>Brazilian orthopaedists value identifying the biophysical cause(s) of chronic low back pain. Psychological factors were often discussed secondary to biophysical aspects, whereas social aspects were rarely mentioned. Orthopaedists highlighted their difficulties in navigating patients' emotions and reassuring patients without referrals to imaging tests. Orthopaedists may benefit from training that targets communication and other relational aspects of care in order to work with people who present with CNLBP.</p>","PeriodicalId":46945,"journal":{"name":"Musculoskeletal Care","volume":null,"pages":null},"PeriodicalIF":1.3,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"9478233","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}