Physiotherapy Canada最新文献

Purpose: To evaluate the dissemination and implementation impacts of a rehabilitation intervention.

Methods: Systematic evaluation of data sources including academic publishing metrics, publications, and surveys was used to describe the dissemination and implementation impact of the graded repetitive arm supplementary program (GRASP). Three categories in the Payback Framework were evaluated: knowledge production and dissemination, benefits to future research and research use, and real-world uptake and implementation.

Results: In the Knowledge production and dissemination category, seven publications, authored by the GRASP research team, were associated with the GRASP, and there were approximately 17,000 download counts of GRASP manuals from the website from 120 countries. In the Benefits to future research and research use category, 15 studies and 8 registered clinical trials, authored by researchers outside of the GRASP team, have used GRASP as an intervention. In the real-world uptake and implementation category, GRASP has informed recommendations in 2 clinical guidelines and 20 review papers, and had high implementation uptake (e.g., 35% [53/154] of UK therapists surveyed had used GRASP; 95% [649/681] who downloaded GRASP had used it). More than 75% of those who had used GRASP identified that GRASP provides more intensity in upper extremity rehabilitation, is evidence-based and easy to implement, and the equipment and manual are easy to obtain.

Conclusion: The Payback Framework is useful to evaluate the dissemination and implementation impacts of a rehabilitation intervention. GRASP has been implemented extensively in clinical practice and community in a relatively short time since it has been developed.

Purpose: To identify older Canadians' perception of the importance of expert-generated elements of walking quality, and the contributors to and consequences of perceived walking quality.

Method: Cross-sectional survey of 649 adults was conducted through a commercial participant panel, Hosted in Canada Surveys.

Results: Of the 649 respondents, 75% were between 65 and 74 years old (25% ≥ 75) and 49% were women. The most important elements were foot, ankle, hip, and knee mobility with little difference in ranks across walking perception (Fr χ¹² = 5.0, p > 0.05). People who were older by a decade were more likely to report poorer walking (POR: 1.4; 95% CI: 1.0, 1.7), as were women compared to men, and people who used a walking aid compared to none. Lung disease showed the highest association with a perception of not walking well (POR: 7.2; 95% CI: 3.7, 14.2). The odds of being willing to pay more for a technology to improve walking were always greater for those with a lower perception of their walking quality.

Conclusions: People who perceived their walking quality as poor were more likely to report poorer health and were willing to pay more for a technology to improve walking. This supports the opportunity of leveraging wearable technologies to improve walking.

Purpose: This study examines gender differences in the physiotherapy (PT) profession in the province of Quebec regarding: (1) areas of practice; (2) roles associated with the advancement of the profession; (3) formal disciplinary complaints; and (4) interests and competency perceptions of PT students.

Methods: We collected data from the Canadian Institute of Health Information, the Quebec Professional Order of Physiotherapy, Quebec university public Internet sites, and PT associations. We also surveyed PT students at the Université de Montréal.

Results: The PT workforce in Quebec was 76.6% women. The presidents of the four main PT associations were men. In the five university programmes, the percentage of male and female physiotherapists in tenure track positions was 46% and 54%, respectively. There were more sanctioned complaints of sexual misconduct and not maintaining continuing education for male physiotherapists, while more women were sanctioned for problems with documentation and billing. Among students, men were more interested in becoming administrators, but neither men nor women had a strong interest in research.

Conclusions: Male physiotherapists make up 23.4% of the PT workforce in Quebec but are more involved in leadership positions in the profession than women.

Purpose: This study examined what physiotherapists and physiotherapy students understand and know about executive functioning (EF), what EF outcome measures they use clinically, and whether their primary area of practice influences their assessment practices.

Method: An open online survey was distributed to registered members of the Canadian Physiotherapy Association, its various divisions, and colleges of physiotherapy within Canada that took approximately 15 minutes to complete and was available for 13 months. Pearson correlation was used to assess the relationship between subjective and objective understanding and knowledge of EF (UKEF) and a one-way multivariate analysis of variance was used to analyze differences in survey responses based on respondents' primary area of practice.

Results: A total of 335 respondents consented to participate (completion rate = 78.4%). There was a significant moderate positive correlation between subjective and objective UKEF (r = 0.43; 95% CI: 0.32, 0.54; n = 260; p < 0.001). Significant differences in survey responses were related to physiotherapists' primary areas of practice (i.e., musculoskeletal, neurological, cardiorespiratory, or multi-systems; F_12,555.89 = 2.29, p = 0.008; Wilks Λ = 0.880; partial η² = 0.042).

Conclusions: Respondents reported that they had good subjective UKEF, but this was only moderately correlated with objective UKEF.

Purpose: STarT Back Screening Tool and OSPRO-YF scales have been reported to be accurate tools for estimating risk for the development of persistent pain or prolonged disability in primary care settings. We performed a comparison of construct convergent and known-group validity and ceiling floor effect (CFE) of these tools using a common sample of patients seen at a tertiary care spine centre.

Methods: This was a cross-sectional study of patients with and without a work-related back injury. The Hospital Anxiety and Depression Scale (HADS) was used as the reference outcome measure for convergent validity. For known-group validity, we examined the ability of the scales to differentiate between different levels of compensation, presence of non-organic signs, and work status. The CFE values were calculated.

Results: Fifty consecutive injured workers were included along with 50 patients without an active compensation claim related to their low back pain. STarTBack and OSPRO-YF had moderate to high associations with the depression component of the HADS (0.69 to 0.77 respectively) with a statistically significant difference in favour of the OSPRO-YF. STarTBack's risk stratification categories were able to differentiate patients with a compensable injury, non-organic signs, and inability to work (p values ranging from 0.002 to < 0.001). The physical activity and work fear-avoidance beliefs constructs of the OSPRO-YF consistently outperformed other yellow flag constructs (p values ranging from 0.008 to < 0.001). The psychological sub-score of STarTBack showed a ceiling effect. There was a floor effect for the negative affect domain of OSPRO-YF. Neither total score had a floor or ceiling effect.

Conclusions: STarTBack and OSPRO-YF are short screening tools with acceptable convergent and known-group construct validity and no floor or ceiling effect of their total score. Both tools could assist with the identification, evaluation, and management of psychological distress in patients presenting to tertiary care spine centres.

Purpose: Research on fiscal implications of the bundled care (BC) model exist; however, patient-perceived experiences are less well known. As BC expands in Ontario, this study aims to examine these experiences with physiotherapy care within the total knee replacement (TKR) BC programme.

Methods: Qualitative cross-sectional study design. Semi-structured one-on-one telephone interviews were conducted with eight patients four to six weeks post-TKR. Thematic analysis was used.

Results: This exploratory study identified three themes across the care journey that patients perceived as influencing their physiotherapy experiences: timely access to physiotherapy care, quality of physiotherapy care, and patient outcomes. Communication, clinical support, and social support were sub-themes.

Conclusions: Patients' overall experiences with BC physiotherapy were positive. Areas for improvement included coordination of postoperative physiotherapy and return-to-work support. Patients valued group settings and were interested in meeting previous TKR patients. Health system planners are advised to consider incorporating patient experiences when evaluating and developing BC programmes to achieve patient-centred outcomes.