Pub Date : 2025-01-17DOI: 10.1016/j.physio.2025.101464
Débora Petry Moecke , Travis Holyk , Kristin L. Campbell , Kendall Ho , Pat G. Camp
<div><h3>Objectives</h3><div>This study aimed to develop best practice recommendations for physiotherapists providing telerehabilitation to First Nations people.</div></div><div><h3>Design</h3><div>Modified Delphi study.</div></div><div><h3>Participants</h3><div>Eighteen experts from four groups were selected: (a) physiotherapists who provide telerehabilitation to First Nations people, (b) Carrier Sekani Family Services leaders (CSFS, First Nations-led health organization/research partners), (c) telehealth experts from British Columbia (BC), Canada, and (d) First Nations individuals (end users) with experience in telerehabilitation.</div></div><div><h3>Methods</h3><div>Panelists rated recommendations on telehealth best practices in two rounds using an online questionnaire. Recommendations were synthesized from a scoping review and two qualitative studies. Each statement was rated on a four-point Likert scale indicating whether it was essential, useful, not useful, or unnecessary for inclusion in the best practices. Statements endorsed by ≥80% of panel members were considered for inclusion in the final document.</div></div><div><h3>Results</h3><div>Following the Delphi process, 77 recommendations covering foundational components, information technology utilization, professional expertise, therapeutic relationships, cultural safety, and the telehealth visit were validated for inclusion in the policy document. Participants also validated the methodology.</div></div><div><h3>Conclusion</h3><div>The recommendations offer a valuable resource for continuing education and professional development, empowering physiotherapists to enhance their skills and competencies in delivering culturally competent telerehabilitation to the First Nations population. The adoption of these best practices ensures that First Nations people are getting the best standard of care, potentially enhancing uptake and experiences with telehealth. It also enables healthcare organizations and policymakers to monitor adherence to established standards and identify areas for improvement.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This paper provides best practice recommendations for physiotherapists delivering telerehabilitation to First Nations people, addressing unique cultural aspects and virtual relationship building.</div></span></li><li><span>•</span><span><div>The study offers physiotherapists expert guidance to enhance the quality and cultural appropriateness of telerehabilitation services for First Nations populations.</div></span></li><li><span>•</span><span><div>The recommendations serve as a valuable resource for continuing education and professional development, enabling physiotherapists to deliver culturally competent and effective care.</div></span></li><li><span>•</span><span><div>These best practices facilitate accountability and quality assurance, helping healthcare organizations and policymakers monitor adherence to standa
{"title":"Best practice recommendations for physiotherapists providing telerehabilitation to First Nations people: a modified Delphi study","authors":"Débora Petry Moecke , Travis Holyk , Kristin L. Campbell , Kendall Ho , Pat G. Camp","doi":"10.1016/j.physio.2025.101464","DOIUrl":"10.1016/j.physio.2025.101464","url":null,"abstract":"<div><h3>Objectives</h3><div>This study aimed to develop best practice recommendations for physiotherapists providing telerehabilitation to First Nations people.</div></div><div><h3>Design</h3><div>Modified Delphi study.</div></div><div><h3>Participants</h3><div>Eighteen experts from four groups were selected: (a) physiotherapists who provide telerehabilitation to First Nations people, (b) Carrier Sekani Family Services leaders (CSFS, First Nations-led health organization/research partners), (c) telehealth experts from British Columbia (BC), Canada, and (d) First Nations individuals (end users) with experience in telerehabilitation.</div></div><div><h3>Methods</h3><div>Panelists rated recommendations on telehealth best practices in two rounds using an online questionnaire. Recommendations were synthesized from a scoping review and two qualitative studies. Each statement was rated on a four-point Likert scale indicating whether it was essential, useful, not useful, or unnecessary for inclusion in the best practices. Statements endorsed by ≥80% of panel members were considered for inclusion in the final document.</div></div><div><h3>Results</h3><div>Following the Delphi process, 77 recommendations covering foundational components, information technology utilization, professional expertise, therapeutic relationships, cultural safety, and the telehealth visit were validated for inclusion in the policy document. Participants also validated the methodology.</div></div><div><h3>Conclusion</h3><div>The recommendations offer a valuable resource for continuing education and professional development, empowering physiotherapists to enhance their skills and competencies in delivering culturally competent telerehabilitation to the First Nations population. The adoption of these best practices ensures that First Nations people are getting the best standard of care, potentially enhancing uptake and experiences with telehealth. It also enables healthcare organizations and policymakers to monitor adherence to established standards and identify areas for improvement.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This paper provides best practice recommendations for physiotherapists delivering telerehabilitation to First Nations people, addressing unique cultural aspects and virtual relationship building.</div></span></li><li><span>•</span><span><div>The study offers physiotherapists expert guidance to enhance the quality and cultural appropriateness of telerehabilitation services for First Nations populations.</div></span></li><li><span>•</span><span><div>The recommendations serve as a valuable resource for continuing education and professional development, enabling physiotherapists to deliver culturally competent and effective care.</div></span></li><li><span>•</span><span><div>These best practices facilitate accountability and quality assurance, helping healthcare organizations and policymakers monitor adherence to standa","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"127 ","pages":"Article 101464"},"PeriodicalIF":3.1,"publicationDate":"2025-01-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143217209","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2025-01-16DOI: 10.1016/j.physio.2025.101463
Sarah Smith , Simon Godley , Adele Anderson , Paul K. Miller
Objectives
The UK government has moved to increase pre-qualification training places across all Allied Health Professions by 50%, without any reduction in quality of education. Universities and healthcare teams are therefore being asked to change their ways of working and consider alternative practice supervision models during placements. This study explores the experiences of pre-qualifying physiotherapy learners involved in a trial of one such model, a coaching and peer-learning approach. The work described assesses its facility as an augmentation to the traditional one-to-one clinical supervision model.
Design
A qualitative-thematic approach using semi-structured interviews was employed. Detailed, open-ended interviews were conducted in order to ascertain the nuanced experiences of participants involved in the trial.
Setting
An intervention in multiple sites (both hospital inpatient and community care) within a single NHS trust, administered by a single UK university.
Participants
Participants Seventeen pre-qualifying participants involved in the trial consented to be interviewed. Of these, 11 were final year undergraduate learners, and 6 were final year postgraduates, of which 12 identified as female and 5 identified as male..
Results
Analysis revealed four interconnected major themes: 1. Teamwork, Camaraderie and Hierarchical Tensions in Peer-Support; 2. Adapting to Leadership and Being Led; 3. Safety Nets versus Supervisors; 4. Fast Starts and Variable Endings in Learning and Experience.
Conclusion and implications
The model was broadly well-received by participants, and ultimately gave rise to greater workplace confidence, with potential impact for capacity, though the nuanced outcomes of the research indicated contingencies around gradual assimilation and group dynamics that should be considered in future development.
Contribution of the Paper
•
The coaching model of placement supervision was broadly well-received among learners, and has facility as a part of the expansion process in physiotherapy workforce development.
•
Freedom from the need for persistent clinical scrutiny can reduce the pressure on learners and also on practice educators.
•
Social dynamics in teams are not an arbitrary contingency but need to be a core feature of the design in any given case.
{"title":"Employing a coaching model of supervision during physiotherapy placements: charting the learner experience in England","authors":"Sarah Smith , Simon Godley , Adele Anderson , Paul K. Miller","doi":"10.1016/j.physio.2025.101463","DOIUrl":"10.1016/j.physio.2025.101463","url":null,"abstract":"<div><h3>Objectives</h3><div>The UK government has moved to increase pre-qualification training places across all Allied Health Professions by 50%, without any reduction in quality of education. Universities and healthcare teams are therefore being asked to change their ways of working and consider alternative practice supervision models during placements. This study explores the experiences of pre-qualifying physiotherapy learners involved in a trial of one such model, a coaching and peer-learning approach. The work described assesses its facility as an augmentation to the traditional one-to-one clinical supervision model.</div></div><div><h3>Design</h3><div>A qualitative-thematic approach using semi-structured interviews was employed. Detailed, open-ended interviews were conducted in order to ascertain the nuanced experiences of participants involved in the trial.</div></div><div><h3>Setting</h3><div>An intervention in multiple sites (both hospital inpatient and community care) within a single NHS trust, administered by a single UK university.</div></div><div><h3>Participants</h3><div>Participants Seventeen pre-qualifying participants involved in the trial consented to be interviewed. Of these, 11 were final year undergraduate learners, and 6 were final year postgraduates, of which 12 identified as female and 5 identified as male..</div></div><div><h3>Results</h3><div>Analysis revealed four interconnected major themes: 1. Teamwork, Camaraderie and Hierarchical Tensions in Peer-Support; 2. Adapting to Leadership and Being Led; 3. Safety Nets versus Supervisors; 4. Fast Starts and Variable Endings in Learning and Experience.</div></div><div><h3>Conclusion and implications</h3><div>The model was broadly well-received by participants, and ultimately gave rise to greater workplace confidence, with potential impact for capacity, though the nuanced outcomes of the research indicated contingencies around gradual assimilation and group dynamics that should be considered in future development.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>The coaching model of placement supervision was broadly well-received among learners, and has facility as a part of the expansion process in physiotherapy workforce development.</div></span></li><li><span>•</span><span><div>Freedom from the need for persistent clinical scrutiny can reduce the pressure on learners and also on practice educators.</div></span></li><li><span>•</span><span><div>Social dynamics in teams are not an arbitrary contingency but need to be a core feature of the design in any given case.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"127 ","pages":"Article 101463"},"PeriodicalIF":3.1,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143217204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-12-31DOI: 10.1016/j.physio.2024.101452
{"title":"Corrigendum to “Abstracts from the Chartered Society of Physiotherapy (CSP) 2023 Annual Conference” [Physiotherapy 123(Suppl. 1) (2023) e1–e272]","authors":"","doi":"10.1016/j.physio.2024.101452","DOIUrl":"10.1016/j.physio.2024.101452","url":null,"abstract":"","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101452"},"PeriodicalIF":3.1,"publicationDate":"2024-12-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143152974","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-13DOI: 10.1016/j.physio.2024.101453
A. Demont , R. Vervaeke , S. Lafrance , F. Desmeules , A. Dumas , A. Bourmaud
Objectives
In France, early access to physiotherapy for people with musculoskeletal disorders (MSKDs) depends on prescription and referral by the family physician in the physician-led model of care. The readiness of French people for direct access to physiotherapy is not known. This survey aims to identify the perceptions of French adults regarding physiotherapists' competence to diagnose and manage MSKDs if they were primary care practitioners, confidence in their ability to provide quality care, and satisfaction with the last episode of care for those concerned; and to identify factors associated with these three variables.
Design
French population-based cross-sectional survey.
Participants
A representative sample of the French adult population was surveyed between June 2020 and September 2021.
Outcome measures
Collected variables included previous physiotherapy experience, perception of competence to diagnose and manage MSKDs as primary care practitioners, confidence about quality of care, and self-referral preferences. Multivariate logistic regression analyses were performed to identify the factors associated with these three variables.
Results
A total of 1000 participants completed the survey; 854 (85%) believed that physiotherapists would be competent primary care practitioners, and 920 (92%) were confident about the quality of care. Most had previously consulted a physiotherapist (n = 823, 82%); of these, 762 (91%) were satisfied with care received.
Conclusion
This large sample of French adults considered physiotherapists as competent to diagnose and treat some MSKDs as primary care practitioners, and that they provided quality care. Further studies should investigate the scope of care, safety, and efficacy of a direct access physiotherapy model.
Contribution of Paper
•
Physiotherapists were considered competent as primary care practitioners.
•
Participants were satisfied with previous physiotherapy received.
•
Our results support the implementation of direct access physiotherapy in France.
{"title":"Acceptability of physiotherapists as primary care practitioners for the care of people with musculoskeletal disorders: a French population-based cross-sectional survey","authors":"A. Demont , R. Vervaeke , S. Lafrance , F. Desmeules , A. Dumas , A. Bourmaud","doi":"10.1016/j.physio.2024.101453","DOIUrl":"10.1016/j.physio.2024.101453","url":null,"abstract":"<div><h3>Objectives</h3><div>In France, early access to physiotherapy for people with musculoskeletal disorders (MSKDs) depends on prescription and referral by the family physician in the physician-led model of care. The readiness of French people for direct access to physiotherapy is not known. This survey aims to identify the perceptions of French adults regarding physiotherapists' competence to diagnose and manage MSKDs if they were primary care practitioners, confidence in their ability to provide quality care, and satisfaction with the last episode of care for those concerned; and to identify factors associated with these three variables.</div></div><div><h3>Design</h3><div>French population-based cross-sectional survey.</div></div><div><h3>Participants</h3><div>A representative sample of the French adult population was surveyed between June 2020 and September 2021.</div></div><div><h3>Outcome measures</h3><div>Collected variables included previous physiotherapy experience, perception of competence to diagnose and manage MSKDs as primary care practitioners, confidence about quality of care, and self-referral preferences. Multivariate logistic regression analyses were performed to identify the factors associated with these three variables.</div></div><div><h3>Results</h3><div>A total of 1000 participants completed the survey; 854 (85%) believed that physiotherapists would be competent primary care practitioners, and 920 (92%) were confident about the quality of care. Most had previously consulted a physiotherapist (<em>n</em> = 823, 82%); of these, 762 (91%) were satisfied with care received.</div></div><div><h3>Conclusion</h3><div>This large sample of French adults considered physiotherapists as competent to diagnose and treat some MSKDs as primary care practitioners, and that they provided quality care. Further studies should investigate the scope of care, safety, and efficacy of a direct access physiotherapy model.</div></div><div><h3>Contribution of Paper</h3><div><ul><li><span>•</span><span><div>Physiotherapists were considered competent as primary care practitioners.</div></span></li><li><span>•</span><span><div>Participants were satisfied with previous physiotherapy received.</div></span></li><li><span>•</span><span><div>Our results support the implementation of direct access physiotherapy in France.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101453"},"PeriodicalIF":3.1,"publicationDate":"2024-11-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142744726","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-11-07DOI: 10.1016/j.physio.2024.101449
F. Kennedy , C. Ní Cheallaigh , R. Romero-Ortuno , D. Murray , J. Broderick
Background
Physical function deficits and frailty are commonly reported in people experiencing homelessness and addiction. Typically, geriatric, or general physical performance measures are employed to evaluate these constructs.
Objectives and setting
We aimed to investigate the feasibility of a broad test battery to evaluate physical functioning and frailty in a non-geriatric community-based population of people experiencing homelessness and addiction.
Design and methods
Physical function and the presence of frailty was evaluated using combined data from two linked low-threshold exercise pre-post intervention studies (LEAP-I and II).
Participants
Seventy-four participants attending an open-access day-service centre (18 to 65 years) were evaluated. Participants with acute confusion or behavioural issues, or major medical conditions precluding safe participation were excluded.
Intervention
A broad test battery was performed which evaluated physical functioning and frailty.
Main outcome measures
Outcome measures included were the Short Physical Performance Battery, Single Leg Stance, Chair Stand Test, 10mWT and 2 Minute Walk Tests, limb circumference, dynamometry, Clinical Frailty Scale, SHARE-Frailty Instrument, Numerical Pain Rating Scale and Short Form-12.
Results
Test completion was 100% for all outcomes except pain rating (81% and 79% for LEAP-I and II, respectively), and balance and walking tests (95% and 93% in LEAP-II). A ceiling effect was detected for the Short Physical Performance Battery.
Conclusion
High feasibility of the test batteries was demonstrated. An optimised test battery was proposed based on findings. This has important implications for clinicians working in inclusion health settings.
Clinical Trial Registration Number
Clinical Trials.gov: NCT05700305.
Contribution of the Paper
•
This paper proposes a suitable test battery to enable clinicians to evaluate physical functioning and frailty in people experiencing homelessness and addiction challenges in community settings.
•
There is a paucity of research evaluating outcome measures for this population and no core outcome set has been reported.
•
This test battery would allow the effect of treatment and targeted interventions to be evaluated in this marginalised population.
{"title":"Acceptability and utility of a broad test battery to evaluate physical functioning and frailty in community-based settings for people experiencing homelessness and addiction–Findings from the LEAP trials","authors":"F. Kennedy , C. Ní Cheallaigh , R. Romero-Ortuno , D. Murray , J. Broderick","doi":"10.1016/j.physio.2024.101449","DOIUrl":"10.1016/j.physio.2024.101449","url":null,"abstract":"<div><h3>Background</h3><div>Physical function deficits and frailty are commonly reported in people experiencing homelessness and addiction. Typically, geriatric, or general physical performance measures are employed to evaluate these constructs.</div></div><div><h3>Objectives and setting</h3><div>We aimed to investigate the feasibility of a broad test battery to evaluate physical functioning and frailty in a non-geriatric community-based population of people experiencing homelessness and addiction.</div></div><div><h3>Design and methods</h3><div>Physical function and the presence of frailty was evaluated using combined data from two linked low-threshold exercise pre-post intervention studies (LEAP-I and II).</div></div><div><h3>Participants</h3><div>Seventy-four participants attending an open-access day-service centre (18 to 65 years) were evaluated. Participants with acute confusion or behavioural issues, or major medical conditions precluding safe participation were excluded.</div></div><div><h3>Intervention</h3><div>A broad test battery was performed which evaluated physical functioning and frailty.</div></div><div><h3>Main outcome measures</h3><div>Outcome measures included were the Short Physical Performance Battery, Single Leg Stance, Chair Stand Test, 10mWT and 2 Minute Walk Tests, limb circumference, dynamometry, Clinical Frailty Scale, SHARE-Frailty Instrument, Numerical Pain Rating Scale and Short Form-12.</div></div><div><h3>Results</h3><div>Test completion was 100% for all outcomes except pain rating (81% and 79% for LEAP-I and II, respectively), and balance and walking tests (95% and 93% in LEAP-II). A ceiling effect was detected for the Short Physical Performance Battery.</div></div><div><h3>Conclusion</h3><div>High feasibility of the test batteries was demonstrated. An optimised test battery was proposed based on findings. This has important implications for clinicians working in inclusion health settings.</div></div><div><h3>Clinical Trial Registration Number</h3><div>Clinical Trials.gov: <span><span>NCT05700305</span><svg><path></path></svg></span>.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This paper proposes a suitable test battery to enable clinicians to evaluate physical functioning and frailty in people experiencing homelessness and addiction challenges in community settings.</div></span></li><li><span>•</span><span><div>There is a paucity of research evaluating outcome measures for this population and no core outcome set has been reported.</div></span></li><li><span>•</span><span><div>This test battery would allow the effect of treatment and targeted interventions to be evaluated in this marginalised population.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101449"},"PeriodicalIF":3.1,"publicationDate":"2024-11-07","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142774698","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-10-31DOI: 10.1016/j.physio.2024.101451
Jennifer James , Wendy Hardeman , Mark Goodall , Helen Eborall , John P.H. Wilding
Objectives
To describe the systematic development of a physiotherapist led group behaviour change intervention targeting physical activity and sedentary behaviour in individuals who have undergone bariatric surgery.
Study design
Intervention development including evidence synthesis, qualitative research and mapping of intervention components, using the 2008 MRC framework for complex interventions.
Methods
We conducted a systematic review to identify the evidence for promising interventions and components to increase physical activity and reduce sedentary behaviour following bariatric surgery. We also conducted primary qualitative research exploring these behaviours with three key stakeholder groups: patients, clinicians and commissioners. We selected two contemporary behaviour change frameworks to inform intervention development and developed a conceptual matrix in which intervention objectives were defined to inform selection of appropriate behaviour change techniques, proposed mechanisms of action(s), and mode of delivery. We also developed two intervention handbooks for participants and facilitators to support delivery and receipt of the intervention.
Results
We have developed a behaviour change intervention targeting physical activity and sedentary behaviour in patients following bariatric surgery. Eight intervention objectives were defined and mapped to the Behaviour Change Wheel and Theoretical Domains Framework. We identified what the intervention must be able to do (intervention functions), behaviour change techniques that could be used to achieve this, the proposed mechanism of action, and mode of delivery. This intervention will be subject to a feasibility study, with the intervention delivered online over a six-week period to participants who have had bariatric surgery within the previous five years.
Contribution of the Paper
•
This paper clearly explains the process involved in developing a theory and evidence-based physiotherapy-led complex behaviour change intervention.
•
The full specification of the intervention including proposed mechanism of effect has been provided, which should facilitate faithful intervention delivery and allow it to be comprehensively evaluated in a planned feasibility study.
•
This paper aims to enable physiotherapists to develop their own complex interventions, targeting behaviours that are relevant to their patients in their own areas of clinical practice.
{"title":"Systematic development of a complex intervention: a theory and evidence-based physiotherapist led group intervention to increase physical activity and reduce sedentary behaviour following bariatric surgery (PARIS)","authors":"Jennifer James , Wendy Hardeman , Mark Goodall , Helen Eborall , John P.H. Wilding","doi":"10.1016/j.physio.2024.101451","DOIUrl":"10.1016/j.physio.2024.101451","url":null,"abstract":"<div><h3>Objectives</h3><div>To describe the systematic development of a physiotherapist led group behaviour change intervention targeting physical activity and sedentary behaviour in individuals who have undergone bariatric surgery.</div></div><div><h3>Study design</h3><div>Intervention development including evidence synthesis, qualitative research and mapping of intervention components, using the 2008 MRC framework for complex interventions.</div></div><div><h3>Methods</h3><div>We conducted a systematic review to identify the evidence for promising interventions and components to increase physical activity and reduce sedentary behaviour following bariatric surgery. We also conducted primary qualitative research exploring these behaviours with three key stakeholder groups: patients, clinicians and commissioners. We selected two contemporary behaviour change frameworks to inform intervention development and developed a conceptual matrix in which intervention objectives were defined to inform selection of appropriate behaviour change techniques, proposed mechanisms of action(s), and mode of delivery. We also developed two intervention handbooks for participants and facilitators to support delivery and receipt of the intervention.</div></div><div><h3>Results</h3><div>We have developed a behaviour change intervention targeting physical activity and sedentary behaviour in patients following bariatric surgery. Eight intervention objectives were defined and mapped to the Behaviour Change Wheel and Theoretical Domains Framework. We identified what the intervention must be able to do (intervention functions), behaviour change techniques that could be used to achieve this, the proposed mechanism of action, and mode of delivery. This intervention will be subject to a feasibility study, with the intervention delivered online over a six-week period to participants who have had bariatric surgery within the previous five years.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>This paper clearly explains the process involved in developing a theory and evidence-based physiotherapy-led complex behaviour change intervention.</div></span></li><li><span>•</span><span><div>The full specification of the intervention including proposed mechanism of effect has been provided, which should facilitate faithful intervention delivery and allow it to be comprehensively evaluated in a planned feasibility study.</div></span></li><li><span>•</span><span><div>This paper aims to enable physiotherapists to develop their own complex interventions, targeting behaviours that are relevant to their patients in their own areas of clinical practice.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101451"},"PeriodicalIF":3.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142824104","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Little is known about how sex and/or gender is reported in trials on physiotherapy interventions.
Objectives
To determine the nature and extent of reporting sex and/or gender information in randomised controlled trials of physiotherapy interventions.
Data sources
Physiotherapy, Journal of Physiotherapy, Physical Therapy, Brazilian Journal of Physical Therapy, and Journal of Orthopaedics and Sports Physical Therapy.
Study selection or eligibility criteria
Randomised controlled trials of physiotherapy interventions published between 2018 and 2024 were independently screened by two reviewers throughout title/abstract and full-text stages, then data were extracted from eligible full texts. Information on whether and how sex and/or gender data were collected, reported, and defined were extracted.
Synthesis methods
Data were analysed descriptively using frequencies and percentages.
Results
Of 182 studies included in the review, 153 studies did not have sex and/or gender exclusive recruitment. Of these, 136 studies (89%) used the terms “sex” or “gender” when reporting demographic characteristics. Three studies used the term “sex assigned at birth”. When reporting sex and/or gender, 82/139 (59%) studies provided two descriptors for sex and/or gender (e.g., male and female; men and women), 39/139 (28%) studies provided one descriptor (e.g., female) despite not being sex and/or gender exclusive. Four studies provided more than 2 descriptors (e.g., transgender women). In all studies, it was unclear how sex and/or gender was defined. In all but three studies, it was unclear how sex and/or gender was collected and whether data collection methods allowed for gender diverse options (e.g., non-binary) to be selected.
Limitations
Only 5 journals were surveyed.
Conclusions and implications of key findings
The lack of inclusive reporting of gender and/or sex characteristics limits the scope and applicability of research in physiotherapy to the full spectrum of human experiences.
PROSPERO Registration
CRD42022383976.
Contribution of the Paper
•
Researchers should refer to up-to-date reporting guidelines when designing, collecting, and reporting sex and/or gender-based analyses.
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Researchers should engage in sex and gender inclusive research practices when conducting and reporting physiotherapy research.
{"title":"Reporting of sex and/or gender in randomised controlled trials of physiotherapy interventions remains problematic: a systematic review","authors":"Emre Ilhan, Kathleen Solis, Cindy Liu, Jamal Khawaja, Tran Dang Khoa Chau, Kelly Gray","doi":"10.1016/j.physio.2024.101450","DOIUrl":"10.1016/j.physio.2024.101450","url":null,"abstract":"<div><h3>Background</h3><div>Little is known about how sex and/or gender is reported in trials on physiotherapy interventions.</div></div><div><h3>Objectives</h3><div>To determine the nature and extent of reporting sex and/or gender information in randomised controlled trials of physiotherapy interventions.</div></div><div><h3>Data sources</h3><div>Physiotherapy, Journal of Physiotherapy, Physical Therapy, Brazilian Journal of Physical Therapy, and Journal of Orthopaedics and Sports Physical Therapy.</div></div><div><h3>Study selection or eligibility criteria</h3><div>Randomised controlled trials of physiotherapy interventions published between 2018 and 2024 were independently screened by two reviewers throughout title/abstract and full-text stages, then data were extracted from eligible full texts. Information on whether and how sex and/or gender data were collected, reported, and defined were extracted.</div></div><div><h3>Synthesis methods</h3><div>Data were analysed descriptively using frequencies and percentages.</div></div><div><h3>Results</h3><div>Of 182 studies included in the review, 153 studies did not have sex and/or gender exclusive recruitment. Of these, 136 studies (89%) used the terms “sex” or “gender” when reporting demographic characteristics. Three studies used the term “sex assigned at birth”. When reporting sex and/or gender, 82/139 (59%) studies provided two descriptors for sex and/or gender (e.g., male and female; men and women), 39/139 (28%) studies provided one descriptor (e.g., female) despite not being sex and/or gender exclusive. Four studies provided more than 2 descriptors (e.g., transgender women). In all studies, it was unclear how sex and/or gender was defined. In all but three studies, it was unclear how sex and/or gender was collected and whether data collection methods allowed for gender diverse options (e.g., non-binary) to be selected.</div></div><div><h3>Limitations</h3><div>Only 5 journals were surveyed.</div></div><div><h3>Conclusions and implications of key findings</h3><div>The lack of inclusive reporting of gender and/or sex characteristics limits the scope and applicability of research in physiotherapy to the full spectrum of human experiences.</div></div><div><h3>PROSPERO Registration</h3><div>CRD42022383976.</div></div><div><h3>Contribution of the Paper</h3><div><ul><li><span>•</span><span><div>Researchers should refer to up-to-date reporting guidelines when designing, collecting, and reporting sex and/or gender-based analyses.</div></span></li><li><span>•</span><span><div>Researchers should engage in sex and gender inclusive research practices when conducting and reporting physiotherapy research.</div></span></li></ul></div></div>","PeriodicalId":54608,"journal":{"name":"Physiotherapy","volume":"126 ","pages":"Article 101450"},"PeriodicalIF":3.1,"publicationDate":"2024-10-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142848430","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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