Feasibility of the SOAR (Stop OsteoARthritis) program

Objective Assess the feasibility of a virtually-delivered, physiotherapist-guided knee health program (SOAR) that targets self-management of knee health and osteoarthritis risk after an activity-related knee injury. Design In this quasi-experimental feasibility study, individuals with varied lived experience of knee trauma completed a 4-week SOAR program. This included: 1) Knee Camp (group education, 1:1 exercise and activity goal-setting); 2) weekly home-based exercise and activity program with tracking, and; 3) weekly 1:1 physiotherapy-guided action-planning. SOAR program feasibility was assessed with implementation (attrition, adherence, intervention fidelity), practicality (adverse events, goal completion), acceptability and efficacy (change in Knee injury and Osteoarthritis Outcome Score subscales, Patient Specific Functional Scale (PSFS), Godin Leisure-Time Exercise Questionnaire (GLTEQ), Partner in Health Scale (PHS)) outcomes. Descriptive statistics, disaggregated by gender, were calculated. Results Thirty participants (60% women, median (min-max) age 30 years (19–50), time from injury 5.6 years (1.2–25.2)) were enrolled. No participant attrition or adverse events were reported, and 90% of mandatory program components were completed. Participants rated their adherence at 80%, and 96% of exercise-therapy and 95% of activity goals were fully or partially achieved. Both women and men reported significant group mean (95%CI) improvements in GLTEQ scores (women: 22 METS (6,37), men: 31 METS (8,54)), while women alone reported improvements in PHS (−7 (−11,-3) and PSFS (1.7 (0.6,2.8) scores. Conclusion The SOAR program is feasible for persons at various timepoints post-knee trauma, and gender may be an important consideration for SOAR implementation and assessment. A randomized controlled trial to assess intervention efficacy is warranted

Assessing the efficacy of the Stop OsteoARthritis (SOAR) program:A randomized delayed-controlled trial in persons at increased risk of early onset post-traumatic knee osteoarthritis

Objective: Assess the efficacy of an 8-week virtual, physiotherapist (PT)-guided knee health program (Stop OsteoARthritis (SOAR)) to improve knee extensor strength in individuals at risk of post-traumatic knee osteoarthritis (PTOA). Method: In this superiority, randomized delayed-control trial, persons aged 16–35 years, 1–4 years after a self-reported knee joint injury were randomly assigned (1:1) to receive the SOAR program immediately (experimental group) or after a 9-week delay (control group). SOAR includes 1) one-time Knee Camp (virtual PT-guided group education, knee assessment, 1:1 exercise and physical activity (PA) goal-setting); 2) Weekly personalized home-based exercise and PA program with tracking; 3) Weekly 1:1 PT counseling (virtual). The primary outcome was a change in isokinetic knee extensor strength (baseline to 9-weeks). Additional outcomes included change in self-reported knee-related quality-of-life (QOL), self-efficacy, self-management and kinesiophobia, and PA (accelerometer) at 9 and 18-weeks. Linear regression models estimated the effect of the 8-week intervention at the primary endpoint (9-week). Results: 49 of 54 randomized participants completed the study (91%). Participants were a mean ± standard deviation age of 27 ± 5.0 years, and 2.4 ± 0.9 years post-injury. No mean between group differences for the primary (0.05; 95% confidence interval (CI): −0.10, 0.19) or other outcomes were seen at 9 weeks except for greater improvements in perceived self-management (Partner in Health Scale; 11.3/96, 95%CI: 5.5, 17.1) and kinesiophobia (Tampa Scale of Kinesiophobia; −4.4/33, 95%CI: −7.0, −1.8). Conclusion: For active persons with elevated risk of PTOA, an 8-week SOAR program did not change knee-related strength, QOL, self-efficacy, or PA, on average, but may benefit the ability to self-manage knee health and kinesiophobia.</p

Digital education and exercise therapy versus minimal intervention for young people at high risk of early onset knee osteoarthritis after ACL reconstruction: a study protocol for the Stop OsteoARthritis (SOAR) randomized controlled trial

Background: People who tear their anterior cruciate ligament and have reconstruction surgery (ACLR) are at elevated risk of inactivity, obesity, and early-onset knee osteoarthritis. Consensus recommendations to prevent post-traumatic knee osteoarthritis include person-centered education and exercise-based treatments. The effectiveness of these recommendations is unknown. This study will assess if a digital education and exercise therapy intervention is superior to minimal intervention for improving knee-related symptoms, function, and quality of life in young people after ACLR. Methods: The Stop OsteoARthritis (SOAR) study is a parallel, two-arm, assessor-blinded, superiority, hybrid effectiveness-implementation type 1 randomized controlled trial. After baseline testing, 166 participants aged 16–35 years, 9–36 months past, a first-time ACLR with ongoing symptoms will be randomly allocated to one of two treatment groups (1:1 ratio, stratified by sex). Ongoing symptoms will be defined as not meeting a Patient Acceptable Symptom State (PASS) on the averaged Knee injury and Osteoarthritis Outcome Score pain, symptoms function in sport and recreation, and quality-of-life subscales (KOOS4 &lt; 79). Participants randomized to the experimental intervention will receive a digital (remote videoconferencing) 6-month program of group-based learning, individualized weekly home-based exercise therapy and physical activity program with tracking, and 1:1 physiotherapist-guided counseling. Participants randomized to the minimal intervention control group will receive an educational recording, best-practice guide for ACLR rehabilitation, one videoconferencing session, and tracking. The primary effectiveness outcome is the between-group difference in KOOS4 change from baseline to 6-months, with secondary endpoints at 12- and 24months. Secondary effectiveness outcomes include differences in the change of individual KOOS subscale scores, proportions of participants achieving KOOS subscale PASS scores, perceived self-management, and MRI features of knee OA. We will also assess secondary implementation (perceived barriers and facilitators of SOAR delivery), secondary efficiency (incremental cost-utility ratio), and exploratory outcomes. Missing data will be imputed and blinded intention-to-treat analyses performed. Discussion: By assessing the effect, implementation, and efficiency of a digital education and exercise-based intervention designed to improve the knee health of young people at increased risk of knee osteoarthritis, this study will provide a basis for future scale-up to help curb the mounting burden of osteoarthritis. Trial registration: ClinicalTrials.gov NCT06195423. Registered on December 22, 2023.</p

The mediating effects of first call resolution on call centers’ performance

This article aims to examine and validate the prepositions of the mediating impacts of first call resolution (FCR) on caller satisfaction within the contact center industry.A survey of 168 call center managers was analyzed through structural equation modeling, constituting an overall 43.3 per cent response rate for this study.The results show that FCR positively mediates the relationship between knowledge management, technology-based CRM and caller satisfaction within the inbound customer contact centers.We have empirically assessed call centers/contact centers’ success through caller satisfaction (an observed variable through their 2009 customer survey in Malaysia).Consequently, this study cannot generalize its findings in all other countries.Our strong argument is that within the operational variables, FCR is statistically significant and positively mediates knowledge management applications. But very important to note is that the customer contact centers are first touch points to a company's goods or services, and that many other factors such as product quality, company policy, target markets, decision-making processes and so on are also determinants of caller satisfaction, but fall outside the operational control of contact center activities.This research has empirically established that a company's capability in effectively acquiring a valid understanding of its current and potential customers’ information through CRM technologies will positively impact its acquisitions, customization, management and retention of customers.It also avails both the academic and contact center management the benefits that are inherent in measuring the impact of knowledge management and technology-based CRM on inbound FCR and caller satisfaction.This study finally recommends alternative areas for future research

Bedside Matters: A Conceptual Framework of the Therapeutic Relationship in Physiotherapy

Background The therapeutic relationship (TR) in physiotherapy, sometimes described as the rapport or the alliance between physiotherapist and patient, is an important aspect of clinical interactions. Physiotherapists are expected attend to the TR as a standard of patient-centred practice. Recent research that illustrates that better quality TRs can positively impact health outcomes, patient satisfaction with services, and patient adherence to treatment plans. However, a lack of conceptual development limits how the TR is addressed in research, clinical practice, and education. A specific definition of the TR and conceptual framework is needed to provide a foundation to understand and apply the TR in these 3 areas. This dissertation aimed to identify and conceptually describe the key components of the TR. Methods and Results The study design was interpretive description, a qualitative method. One-on-one interviews were completed with 11 physiotherapists and 7 patients managing musculoskeletal conditions in private practice clinics in Edmonton, Canada. Textual data was analyzed using qualitative content analysis, augmented by principles of constant comparison. Three components were identified and conceptually described: the necessary conditions of engagement, ways of establishing connections, and elements of the bond. This dissertation details each component in separate papers. The first paper (Chapter 4), “The necessary conditions of engagement for the therapeutic relationship in physiotherapy,” provides a detailed account of the circumstances that underlie development of the TR. The second paper (Chapter 5), “A framework for establishing connections in physiotherapy practice” reviews the various ways that physiotherapists and patients can develop meaningful attachments based on common ground and acknowledgement of personal and professional factors between them. The third paper, “The defining elements of the bond between physiotherapists and patients,” illustrates the nature of the affective resonance between physiotherapist and patient. Conclusion Findings provide an overarching conceptual framework that could advance the way the TR is approached in research, clinical practice, and education. Together, these 3 components illustrate that the nature and development of the TR in physiotherapy involves multiple factors. Moreover, the findings clarify that the TR is a mutual endeavour involving a complex mix of professional and personal factors that can vary between clinical situations

A review of selected chiral stationary phases for gas chromatography

Niniejsza praca zawiera przegląd literatury dotyczącej faz stacjonarnych stosowanych do rozdzielania mieszanin związków optycznie czynnych za pomocą techniki chromatografii gazowej. Oprócz faz stacjonarnych komercyjnie dostępnych, tj. pochodne aminokwasów, cyklodekstryny oraz fazy wykorzystujące chelaty metali w pracy scharakteryzowano również nowe – ostatnio opublikowane rozwiązania.This thesis includes a review of literature about stationary phases applied to separate mixtures of optically active compounds with the use of gas chromatography technique. Apart from commercially available stationary phases, that is, derivatives of amino acids, cyclodextrin and phases using metal chelates, new and recently published solutions were also described in this thesis

The Slash Sheet: A Simple Procedure for Risk Analysis in Cystic Fibrosis

lette