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Critically appraised paper: In adults with persistent dyspnoea following pulmonary embolism, an exercise-based rehabilitation program improved exercise capacity and quality of life compared with usual care [synopsis] 经过严格评审的论文:对于肺栓塞后出现持续性呼吸困难的成人,与常规护理相比,以运动为基础的康复计划可提高运动能力和生活质量[内容提要]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.003
Vinicius Cavalheri
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引用次数: 0
Remotely delivered physiotherapy is as effective as face-to-face physiotherapy for musculoskeletal conditions (REFORM): a randomised trial 远程物理治疗与面对面物理治疗对肌肉骨骼疾病同样有效(REFORM):随机试验。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.016
Hannah G Withers , Joanne V Glinsky , Jackie Chu , Matthew D Jennings , Ian Starkey , Rachel Parmeter , Max Boulos , Jackson J Cruwys , Kitty Duong , Ian Jordan , David Wong , San Trang , Maggie Duong , Hueiming Liu , Alison J Hayes , Tara E Lambert , Joshua R Zadro , Catherine Sherrington , Christopher Maher , Barbara R Lucas , Lisa A Harvey

Question

Is remotely delivered physiotherapy as good or better than face-to-face physiotherapy for the management of musculoskeletal conditions?

Design

Randomised controlled, non-inferiority trial with concealed allocation, blinded assessors and intention-to-treat analysis.

Participants

A total of 210 adult participants with a musculoskeletal condition who presented for outpatient physiotherapy at five public hospitals in Sydney.

Intervention

One group received a remotely delivered physiotherapy program for 6 weeks that consisted of one face-to-face physiotherapy session in conjunction with weekly text messages, phone calls at 2 and 4 weeks, and an individualised home exercise program delivered through an app. The other group received usual face-to-face physiotherapy care in an outpatient setting.

Outcome measures

The primary outcome was the Patient Specific Functional Scale at 6 weeks with a pre-specified non-inferiority margin of –15 out of 100 points. Secondary outcomes included: the Patient Specific Functional Scale at 26 weeks; kinesiophobia, pain, function/disability, global impression of change and quality of life at 6 and 26 weeks; and satisfaction with service delivery at 6 weeks.

Results

The mean between-group difference (95% CI) for the Patient Specific Functional Scale at 6 weeks was 2.7 out of 100 points (–3.5 to 8.8), where a positive score favoured remotely delivered physiotherapy. The lower end of the 95% CI was greater than the non-inferiority margin. Whilst non-inferiority margins were not set for the secondary outcomes, the 95% CI of the mean between-group difference ruled out clinically meaningful differences.

Conclusion

Remotely delivered physiotherapy with support via phone, text and an app is as good as face-to-face physiotherapy for the management of musculoskeletal conditions.

Trial registration

ACTRN12619000065190.

问题在治疗肌肉骨骼疾病方面,远程物理治疗的效果是否与面对面物理治疗相同或更好?随机对照、非劣效试验,采用隐蔽分配、评估者盲法和意向治疗分析法:共有 210 名患有肌肉骨骼疾病的成年参与者在悉尼的五家公立医院接受门诊物理治疗:一组接受为期6周的远程物理治疗项目,包括一次面对面物理治疗、每周一次短信、2周和4周一次电话以及通过应用程序提供的个性化家庭锻炼计划。另一组则在门诊接受常规的面对面物理治疗:主要结果为 6 周时的患者特定功能量表,预先设定的非劣效差为 -15(满分 100 分)。次要结果包括:26周时的患者特定功能量表;6周和26周时的运动恐惧、疼痛、功能/残疾、总体变化印象和生活质量;6周时的服务满意度:6周时患者特定功能量表的组间平均差异(95% CI)为2.7分(满分100分,-3.5至8.8分),正分有利于远程物理治疗。95% CI 的下限大于非劣效性边际。虽然次要结果未设定非劣效边距,但组间平均差异的95% CI排除了有临床意义的差异:结论:在肌肉骨骼疾病的治疗方面,通过电话、短信和应用程序提供支持的远程物理治疗与面对面物理治疗效果一样好:试验注册:ACTRN12619000065190。
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引用次数: 0
Physiotherapy management of breast cancer treatment-related sequelae 乳腺癌治疗相关后遗症的物理治疗管理。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.020
Nele Devoogdt , An De Groef
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引用次数: 0
Appraisal of Clinical Practice Guideline: World Health Organization guideline for non-surgical management of chronic primary low back pain in adults in primary and community care settings 临床实践指南评估:世界卫生组织关于在初级和社区医疗机构对成人慢性原发性腰背痛进行非手术治疗的指南。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.008
Kieran O’Sullivan
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引用次数: 0
Clinimetrics: The Cumulated Ambulation Score 临床测量学:累积行走评分
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.011
Simon P Vella, Gustavo C Machado
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引用次数: 0
Critically appraised paper: Eccentric resistance training may improve strength and power but not gait in patients with neurological conditions [synopsis] 经过严格评审的论文:偏心阻力训练可改善神经系统疾病患者的力量和功率,但不能改善步态[内容提要]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-04-01 DOI: 10.1016/j.jphys.2024.02.014
Prudence Plummer
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引用次数: 0
Critically appraised paper: Education-enhanced care was superior to conventional care on disability, but not on pain, for temporomandibular disorders [synopsis] 批判性评价论文:对于颞下颌疾病,教育强化护理在残疾方面优于传统护理,但在疼痛方面优于传统护理[摘要]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.006
Nina Østerås
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引用次数: 0
Critically appraised paper: Neck-specific exercise with internet support for chronic whiplash-associated disorders is noninferior to neck-specific exercise at a physiotherapy clinic [synopsis] 批评性评价论文:网络支持下的颈部专项运动治疗慢性鞭伤相关疾病的效果不逊于物理治疗诊所的颈部专项运动[摘要]。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.10.005
Nina Østerås
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引用次数: 0
Interactive clinical supervision training added to self-education leads to small improvements in the effectiveness of clinical supervision of physiotherapists: a randomised trial 一项随机试验:在自我教育的基础上增加互动式临床监督培训,使物理治疗师临床监督的有效性有了小的提高。
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/j.jphys.2023.11.002
Sarah Osiurak , Nicholas F Taylor , Timothy Albiston , Kimberley Williams , Taya A Collyer , David A Snowdon

Question

Does adding an interactive clinical supervision training program to self-education improve the effectiveness of clinical supervision of physiotherapists, reduce burnout, decrease intention to leave and increase participation in clinical supervision?

Design

Randomised controlled trial with concealed allocation, assessor blinding and intention-to-treat analysis.

Participants

Physiotherapists (n = 58) working at a publicly funded health service.

Intervention

Participants in both groups received a self-education clinical supervision training package. In addition, participants in the experimental group received interactive clinical supervision training consisting of three 90-minute workshops.

Outcome measures

The primary outcome measure was effectiveness of clinical supervision 4 months after training measured using the Manchester Clinical Supervision Scale (MCSS-26). Secondary outcomes were the Maslach Burnout Inventory, the Intention to Leave Scale, and participation in supervision. Focus groups were also used to gauge impressions of the intervention.

Results

The addition of interactive clinical supervision training slightly improved effectiveness of clinical supervision, with a between-group mean difference of 6.3 units (95% CI 0.3 to 12.3) on the MCSS-26. The estimate of the effect on the proportion of physiotherapists reporting effective clinical supervision (ie, MSCC-26 score ≥ 73) was unclear (OR 1.97, 95% CI 0.50 to 7.81). Physiotherapists in the experimental group reported slightly lower levels of depersonalisation (MD –3.0 units, 95% CI –4.6 to –1.3). There were negligible or uncertain effects on the other burnout domains, intention to leave and participation in clinical supervision. Qualitatively, participants reported that the workshops made them realise that supervisees could take greater ownership of where supervision focused.

Conclusion

Adding interactive clinical supervision training to self-education leads to small improvements in the effectiveness of clinical supervision of physiotherapists.

Registration

osf.io/yz3kx.

问题:在自我教育中加入互动式临床监督培训项目是否能提高物理治疗师临床监督的有效性,减少倦怠,减少离职意向,提高临床监督的参与度?设计:随机对照试验,采用隐蔽分配、评估盲法和意向治疗分析。参与者:在公立医疗服务机构工作的物理治疗师(n = 58)。干预措施:两组受试者均接受临床督导自我教育培训包。此外,实验组的参与者接受互动式临床监督培训,包括三个90分钟的讲习班。结果测量:主要结果测量是训练后4个月临床监督的有效性,使用曼彻斯特临床监督量表(MCSS-26)测量。次要结果为Maslach倦怠量表、离职意向量表和参与监督。焦点小组也被用来评估干预的印象。结果:互动式临床监督训练的增加略微提高了临床监督的有效性,MCSS-26的组间平均差异为6.3个单位(95% CI 0.3 ~ 12.3)。对报告有效临床监督的物理治疗师比例(即MSCC-26评分≥73)的影响估计尚不清楚(OR 1.97, 95% CI 0.50至7.81)。实验组物理治疗师报告的人格解体水平略低(MD -3.0单位,95% CI -4.6至-1.3)。其他倦怠领域、离职意向和参与临床监督的影响可以忽略不计或不确定。从质量上讲,与会者报告说,讲习班使他们意识到,监督者可以在监督的重点方面拥有更大的自主权。结论:在自我教育的基础上增加互动式临床监督培训,可使物理治疗师临床监督的效果有小幅提高。注册:osf.io / yz3kx。
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引用次数: 0
Title page 扉页
IF 12.1 1区 医学 Q1 Health Professions Pub Date : 2024-01-01 DOI: 10.1016/S1836-9553(23)00135-2
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Journal of Physiotherapy
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