The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care

Introduction Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. Purpose To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. Methods A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3–12 months from primary care. Results Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. Conclusion The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants.publishedVersio

Intra- and Inter-Rater Reliability of the Infant Motor Profile in Infants in Primary Health Care

Aim: To explore intra-rater and inter-rater reliability of the Infant Motor Profile (IMP). The IMP is a video-based method assessing movement quality (movement variation, adaptability, symmetry and fluency) and motor skills in infants aged 3 to 18 months. Method: The IMP assessment was performed on 50 infants aged 3 to 12 months recruited in connection with health control in primary health care, mean gestational age at birth 39.4 weeks, mean birthweight 3462 g. Seven infants had a moderately increased risk of developmental disorders. Three pediatric physiotherapists performed independent rating of the video recordings. One rater assessed the video recordings twice with a four-week interval. Results: Intraclass correlation coefficient (ICC) for intra-rater reliability was found satisfactory for the total IMP score (ICC = 0.95), and the domains: performance (ICC = 0.98), variation (ICC = 0.74), adaptability (ICC = 0.93) and fluency (ICC = 0.86). The ICC value for symmetry was 0.65. For inter-rater reliability, ICC values were satisfactory for the total IMP score (ICC = 0.86-0.91), and the domains: performance (ICC = 0.98), variation (ICC = 0.71-0.82), adaptability (ICC = 0.99) and fluency (ICC = 0.82-0.81). The ICC values for symmetry varied between 0.13-0.35. Conclusion: In this sample, including mostly low-risk infants, satisfactory intra- and inter-rater reliability for all domains were demonstrated, except for symmetry

Development of a Self-report Questionnaire in the Context of Norwegian Psychomotor Physiotherapy (NPMP)

Background: Body awareness is an essential aspect that is addressed in Norwegian Psychomotor Physiotherapy (NPMP). The term is described somewhat differently in different fields. In line with this, there is uncertainty about how the phenomenon should be assessed. Purpose: This PhD thesis concerns development, reliability and validity testing of the Body Awareness Rating Questionnaire (BARQ). Methods: Three studies are included in the PhD thesis (Papers I-III). Samples of physiotherapists specializing in NPMP, patients with long-lasting musculoskeletal pain, and healthy persons participated in the study. Initially a pool of items reflecting aspects of body awareness was developed. Exploratory factor analysis (EFA) of the items demonstrated four factors which were named Function, Mood, Feelings and Awareness. Test-retest reliability of the factors (subscales) was examined by calculating relative (ICC 2,1) and absolute reliability (Sw), and construct validity by testing hypothesis using Pearson (r) or Spearman rank (rs) correlation. The ability to discriminate between patients and healthy persons was examined using a receiver operating characteristic (ROC) curve. Responsiveness to important change was examined by one-way repeated measures analysis of variance (ANOVA), relating change scores of BARQ subscales to the Patient Global Impression of Change (PGIC) categories. Results: The three subscales Function, Feelings and Awareness, had satisfactory testretest reliability, construct and discriminative validity, while Function, and Awareness also demonstrated evaluative ability. The subscale Mood lacks evidence for satisfactory measurement properties and should be excluded from BARQ. Conclusion: Further efforts should be made to develop a better Mood subscale, as well as readjusting the subscale Feeling to improve the scale’s evaluative ability

Transferring patients’s experiences of change from the context of physiotherapy to daily life

Purpose: In the treatment of patients with long-lasting musculoskeletal pain, the challenge is to identify causal and sustaining factors and targeted treatment in order to improve function. Norwegian Psychomotor Physiotherapy (NPMP) is an approach often applied to patients with such pain. Long-term NPMP processes from the patients’ perspective have been studied and discussed in the light of phenomenology of the body. The study purpose was to explore what kind of changes patients with long-lasting musculoskeletal pain experience during NPMP and further transfer into daily life context. Methods: A phenomenological, descriptive, and retrospective design was applied. Two focus-group interviews were conducted with 11 patients receiving such treatment. The interviews were audiotaped, transcribed, and analysed inspired by Giorgi’s phenomenological methodology. Results: The analysis resulted in an overarching structure: “To develop embodied ownership of oneself over time”, and two themes describing the essence of change that the patients experienced: (1) “To get an embodied grip on oneself through treatment”; (2) “To give oneself space in daily life”. Conclusions: Enhanced embodied self-perception involving a sense of embodied ownership and agency seemed to be important both to be aware of own bodily needs and to transfer changes from treatment into daily life

Developing self-care in an interdependent therapeutic relationship: Patients’ experiences from Norwegian Psychomotor Physiotherapy

Factors causing and sustaining long-lasting musculoskeletal pain differ between patients, but must be identified in order to target treatment. During physiotherapy, there are multiple factors influencing the treatment outcome. The focus in the present study was to grasp patients’ experiences of how social burdens influence the development and persistence of symptoms of muscle pain, and how the relationship with the physiotherapist influences the process of change during Norwegian Psychomotor Physiotherapy. A phenomenological, descriptive, and retrospective design was chosen. Data were collected through focus-group interviews. Eleven patients participated. They ranged in age from 34 to 67 years. The analysis was inspired by Giorgi’s phenomenological method. The results identified a general, overarching structure; “Caring for others and developing self-care” and the two interwoven themes “Emerging awareness of overload” and “Receiving care from the physiotherapist.” These themes describe the essence of the experiences from the treatment process. To be recognized by the physiotherapist, both through the hands-on treatment and verbal communication, appears to be crucial for patients to develop an awareness of the factors causing and sustaining their pain problems. This awareness seemed necessary for the process of change to take place and for the patients to take more responsibility for their own care

Additional file 1: of Study protocol for Norwegian Psychomotor Physiotherapy versus Cognitive Patient Education in combination with active individualized physiotherapy in patients with long-lasting musculoskeletal pain – a randomized controlled trial

Norwegian Psychomotor Physiotherapy (DOCX 19 kb

Urinlekkasje og bekkenbunnstrening - også for menn?

Fagartikkelen gir forekomst av og årsaker til urinlekkasje hos menn, samt en beskrivelse av bekkenbunnstrening som mulig behandlingsform. Urinlekkasje rammer både kvinner og menn. Disponerende faktorer er alder, fysisk funksjonshemming, nevrologisk sykdom, overvekt, lidelser i nedre del av urinsystemet samt radikal kirurgi i nedre urinveier. Forekomsten av lekasjetypene, fra høy til lav, er hastverkslekkasje (40-80 prosent), blandingslekkasje (10-30 prosent), etterdryppslekkasje (17 prosent) og anstrengelseslekkasje (10 prosent). Hovedgrunnen til urinlekkasje hos menn er kirurgi i de nedre urinveier. Vi identifiserte, via PubMed, Cochrane og CINAHL, studier med konservativ behandling på urinlekkasje hos menn. Noen få studier tyder på effekt av bekkenbunnstrening mot urinlekkasje hos menn, men effekten er liten og treningsprinsippene i strid med evidensbaserte anbefalinger for kvinner. I påvente av flere studier som undersøker effekten av bekkenbunnstrening, anbefales menn med anstrengelseslekkasje etter operasjon å trene bekkenbunnen etter prinsipper som har vist seg effektive hos kvinner

Adolescents with severe anorexia nervosa in specialized healthcare - patients’ perspectives with experiences from Norwegian Psychomotor Physiotherapy

Purpose: The purpose of this study is to shed light on the experience of adolescents with severe anorexia nervosa with Norwegian Psychomotor Physiotherapy in the specialist healthcare. Design: The study has a qualitative research design Method: Adolescents (aged 12-18) with severe anorexia nervosa, who had attended psychomotor physiotherapy in specialist healthcare, were recruited. Six girls aged 14-16 were included. Individual semi-structured interviews were conducted and analyzed with systematic text condensation and discussed in light of Benjamin's intersubjective relational theory. Findings: The analysis led to two categories of results: "Bodily and linguistic interaction as a source of insight" and "Bodily experiences as aids in everyday life". The findings showed how the adolescents experienced the interaction with the physiotherapist during the treatment. Conclusion: The treatment gave the adolescents the opportunities to explore their own subjectivity through the bodily and verbal interaction with the physiotherapist, in what Benjamin refers to as thirdness. They gained insight and a better contact with their own bodies and needs, insight and experiences they transferred to their everyday lives. Security and recognition were crucial for the change and development. The treatment approach offered something complementary and different from the other treatments in the specialist healthcare. In light of Benjamins’s theory, the bodily psychomotor approach appears as a resource-oriented aid in tolerating strict restrictions and dietary regimens that the adolescents had to undergo. The study highlights the potential contributions of psychomotor physiotherapy in interdisciplinary treatment of adolescents with eating disorders

The ability of the Ages and Stages Questionnaire (ASQ) to indicate motor difficulties in infants in primary care

Introduction Delayed achievement of motor milestones may be an early indicator of motor difficulties. Parent-reported questionnaires may serve as an efficient, low-cost screening to identify infants in need of further clinical assessment, and thus be a helpful tool in busy health care centers. Purpose To examine the ability of the Ages and Stages Questionnaire, second edition (ASQ-2) to indicate motor difficulties in infants using the Infant Motor Profile (IMP) as the reference standard. Methods A cross-sectional design was applied to examine the correlation between parent-reported data of the ASQ-2 and data from physiotherapist assessment using IMP. Included were 432 mainly low-risk infants aged 3–12 months from primary care. Results Overall, ASQ-2 gross and fine motor scores did not correlate well with the IMP total or domain scores. The ASQ-2 gross motor cut point (> 2SD below the mean), showed 34.3% sensitivity and 96.7% specificity using the 15th percentile from IMP performance domain as reference standard. The positive predictive value to indicate motor difficulties was 48%. Conclusion The motor domains of ASQ-2 have poor ability to identify infants with motor difficulties as indicated by their IMP scores in low-risk infants