Development and Validity of the Questionnaire of Patients’ Experiences in Postacute Outpatient Physical Therapy Settings

Background: Patient feedback surveys are increasingly seen as a key component of 2 healthcare quality monitoring and improvement. Objective: To describe the 3 development and initial psychometric evaluation of a fixed-length questionnaire of 4 Patients’ Experiences undergoing physical therapy treatment in a Post-Acute 5 Outpatients settings (PEPAP-Q). Design: An instrument development study with 6 validity and reliability testing. Methods: A total of 465 patients from three 7 rehabilitation centres for musculoskeletal conditions completed the questionnaire. A 8 cognitive pretest was applied to the draft version (n=94), and a revised version was 9 tested for test-retest reliability (n=90). Analyses to evaluate variance and non-response 10 rates to items, the factor structure of the questionnaire and the metric properties of 11 multi-item scales were conducted. Results: Exploratory factor analyses yielded 12 evidence for a seven-factor structure to the PEPAP-Q, with three factors that may be 13 conceptually viewed as professionals’ attitudes and behaviour (providing information 14 and education, sensitive manners to patients’ changes and emotional support) and four 15 factors conceptually reflecting organizational environment (attendance duration, 16 interruptions during care delivery, waiting times and patient safety). Item scale 17 correlations ranged from 0.70 to 0.93. The percentage of scaling success was 100% for 18 all the scales. Cronbach’s alpha coefficient ranged from 0.70 to 0.87. Intraclass 19 correlation coefficients ranged from 0.57 to 0.80 (median=0.68). Limitations: 20 Generalization to other patients is not known. Conclusion: The PEPAP-Q is a reliable 21 test-retest and the scales have internal consistency and convergent and discriminant 22 validity. All the scales are distinct and unidimensional.Actividad Física y DeporteMedicinaTerapia y Rehabilitació

Proyecto de innovación educativa en fundamentos de fisioterapia

[SPA] Se presenta un proyecto dirigido a estructurar de manera general el contenido de la asignatura “Fundamentos de Fisioterapia” perteneciente al primer curso de Grado en Fisioterapia. Tras las diversas reuniones del grupo de trabajo, se creó material audiovisual para apoyo de la docencia que combinado con los recursos complementarios y el programa de los contenidos se adaptó al formato OCW (Open Course Ware). El proyecto se desarrolló durante el curso académico 2012/2013 consiguiendo material docente de nueva creación, mayor divulgación de los conocimientos de la asignatura en el contexto educativo y profesional y un incremento del contacto de los estudiantes con la plataforma de e-learning universitaria facilitando el acceso al conocimiento desde cualquier lugar. [ENG] A project to structure “Basics in Physiotherapy” subject belonging to the first degree course in Physiotherapy is presented. Following several meetings of the working group it was created audiovisual material to support teaching combined with complementary resources. All the content was adapted to OCW format (Open Course Ware). The project was developed during the 2012/2013 academic year getting newly created teaching materials, greater dissemination of knowledge of the subject in the educational and professional context and increased student contact with the universtity e-learning platform facilitating access to knowledge from anywhere

Predictive factors of adherence to frequency and duration components in home exercise programs for neck and low back pain: an observational study

<p>Abstract</p> <p>Background</p> <p>Evidence suggests that to facilitate physical activity sedentary people may adhere to one component of exercise prescriptions (intensity, duration or frequency) without adhering to other components. Some experts have provided evidence for determinants of adherence to different components among healthy people. However, our understanding remains scarce in this area for patients with neck or low back pain. The aims of this study are to determine whether patients with neck or low back pain have different rates of adherence to exercise components of frequency per week and duration per session when prescribed with a home exercise program, and to identify if adherence to both exercise components have distinct predictive factors.</p> <p>Methods</p> <p>A cohort of one hundred eighty-four patients with chronic neck or low back pain who attended physiotherapy in eight primary care centers were studied prospectively one month after intervention. The study had three measurement periods: at baseline (measuring characteristics of patients and pain), at the end of physiotherapy intervention (measuring characteristics of the home exercise program) and a month later (measuring professional behaviors during clinical encounters, environmental factors and self-efficacy, and adherence behavior).</p> <p>Results</p> <p>Adherence to duration per session (70.9% ± 7.1) was more probable than adherence to frequency per week (60.7% ± 7.0). Self-efficacy was a relevant factor for both exercise components (p < 0.05). The total number of exercises prescribed was predictive of frequency adherence (p < 0.05). Professional behaviors have a distinct influence on exercise components. Frequency adherence is more probable if patients received clarification of their doubts (adjusted OR: 4.1; p < 0.05), and duration adherence is more probable if they are supervised during the learning of exercises (adjusted OR: 3.3; p < 0.05).</p> <p>Conclusion</p> <p>We have shown in a clinic-based study that adherence to exercise prescription frequency and duration components have distinct levels and predictive factors. We recommend additional study, and advise that differential attention be given in clinical practice to each exercise component for improving adherence.</p

How do care-provider and home exercise program characteristics affect patient adherence in chronic neck and back pain: a qualitative study

<p>Abstract</p> <p>Background</p> <p>The aim of this study is to explore perceptions of people with chronic neck or low back pain about how characteristics of home exercise programs and care-provider style during clinical encounters may affect adherence to exercises.</p> <p>Methods</p> <p>This is a qualitative study consisting of seven focus groups, with a total of 34 participants presenting chronic neck or low back pain. The subjects were included if they were receiving physiotherapy treatment and were prescribed home-based exercises.</p> <p>Results</p> <p>Two themes emerged: home-based exercise programme conditions and care provider's style. In the first theme, the participants described their positive and negative experiences regarding time consumption, complexity and effects of prescribed exercises. In the second theme, participants perceived more bonding to prescribed exercises when their care provider presented knowledge about the disease, promoted feedback and motivation during exercise instruction, gave them reminders to exercise, or monitored their results and adherence to exercises.</p> <p>Conclusions</p> <p>Our experiential findings indicate that patient's adherence to home-based exercise is more likely to happen when care providers' style and the content of exercise programme are positively experienced. These findings provide additional information to health care providers, by showing which issues should be considered when delivering health care to patients presenting chronic neck or back pain.</p

Development and Validity of the Questionnaire of Patients’ Experiences in Postacute Outpatient Physical Therapy Settings

Background: Patient feedback surveys are increasingly seen as a key component of 2 healthcare quality monitoring and improvement. Objective: To describe the 3 development and initial psychometric evaluation of a fixed-length questionnaire of 4 Patients’ Experiences undergoing physical therapy treatment in a Post-Acute 5 Outpatients settings (PEPAP-Q). Design: An instrument development study with 6 validity and reliability testing. Methods: A total of 465 patients from three 7 rehabilitation centres for musculoskeletal conditions completed the questionnaire. A 8 cognitive pretest was applied to the draft version (n=94), and a revised version was 9 tested for test-retest reliability (n=90). Analyses to evaluate variance and non-response 10 rates to items, the factor structure of the questionnaire and the metric properties of 11 multi-item scales were conducted. Results: Exploratory factor analyses yielded 12 evidence for a seven-factor structure to the PEPAP-Q, with three factors that may be 13 conceptually viewed as professionals’ attitudes and behaviour (providing information 14 and education, sensitive manners to patients’ changes and emotional support) and four 15 factors conceptually reflecting organizational environment (attendance duration, 16 interruptions during care delivery, waiting times and patient safety). Item scale 17 correlations ranged from 0.70 to 0.93. The percentage of scaling success was 100% for 18 all the scales. Cronbach’s alpha coefficient ranged from 0.70 to 0.87. Intraclass 19 correlation coefficients ranged from 0.57 to 0.80 (median=0.68). Limitations: 20 Generalization to other patients is not known. Conclusion: The PEPAP-Q is a reliable 21 test-retest and the scales have internal consistency and convergent and discriminant 22 validity. All the scales are distinct and unidimensional.Actividad Física y DeporteMedicinaTerapia y Rehabilitació

Evaluación y mejora de la calidad estructural y de los contenidos de los protocolos clínicos de fisioterapia .

Tesis-Univerisdad de Murcia.MEDICINA ESPINARDO. DEPOSITO. MU-Tesis 710.Consulte la tesis en: BCA. GENERAL. ARCHIVO UNIVERSITARIO. T.M.-2250

Attributes Required by Physiotherapists to Increase Adoption and Implementation of Practice Management Software: A Qualitative Study Using Focus Groups

(1) Background: The aim of this study was to identify the practice management software (PMS) attributes required by physiotherapists to improve software design and development in order to increase the adoption and implementation of software and minimize the impact on the workflow of the clinic. (2) Methods: In total, 27 graduated physiotherapists with clinical and management expertise and experience in management software for physiotherapy services participated in six focus groups. Research staff members recorded, transcribed, and analyzed the focus groups, using a thematic analysis to code and classify the comments. (3) Results: A total of 43 categories of coded statements divided into 12 subthemes and five broad themes were identified and compiled in two core areas of content: clinical care and administrative tasks. In order to improve the adoption and implementation of physiotherapy PMS, this research provides experiential knowledge on the inefficiencies perceived by physiotherapists regarding current software programs and the specific attributes to assist practice management and facilitate workflows. The focus group analyses led us to map the multifaceted framework for physiotherapy PMS. (4) Conclusion: These findings provide valuable information as to what aspects are meaningful for the future design and development of physiotherapy PMS, thus providing guidance to both software developers and to end-users when benchmarking software solutions

Análisis de los desequilibrios musculares de la cadera en corredores aficionados

Objectives. Muscle strength is considered an important factor in both performance of athletes as in the development of various injuries. Although the agonist: antagonist ratio is one of the best predictors of muscle injury, there are no reference values ​​for imbalances and asymmetries in the hip of amateur runners, being the proposed objective of this investigation. Material and method. Three force measurements were made of the six hip muscle groups (abductors, adductors, flexors, extenders, external rotators and internal rotators) with a manual resistance dynamometer (Microfet 2 Handheld dynamometer) in 30 amateur runners that They traveled a minimum of 25 kilometers per week. Results. 29 subjects presented imbalances in the Flexion / Extension ratio and 100% in favor of extension in both members. Significant differences were found in the rotator muscle pair (p = 0.047) in frequency of imbalances between members. The Dominant / Non-dominant ratio was between 0.9 and 1.1 in all muscles. Conclusion. Hip muscle imbalances were found in most of the volunteers, both on the dominant and non-dominant sides. Approximately one third of the subjects presented imbalances between both hips in rotators and abductors.Objetivo. La fuerza muscular es considerada un factor importante tanto en el rendimiento de los deportistas como en el desarrollo de diversas lesiones. Aunque el ratioagonista: antagonista es uno de los mejores predictores de lesión muscular, no existen valores de referencia para desequilibrios y asimetrías en la cadera de corredores aficionados siendo el objetivo propuesto de esta investigación. Material y métodos. Se realizaron 3 mediciones de fuerza de los 6 grupos musculares de la cadera (abductores, aductores, flexores, extensores, rotadores externos y rotadores internos) con un dinamómetro de resistencia manual (Microfet 2 Handheld dynamometer) en 30 corredores aficionados que recorrían un mínimo de 25 kilómetros semanales. Resultados. 29 sujetos presentaron desequilibrios en el ratio Flexión/Extensión y el 100% a favor de la extensión en ambos miembros. Se encontraron diferencias significativas en el par muscular de los rotadores (p=0,047) en frecuencia de desequilibrios entre miembros. El ratio Dominante/No dominante se situó entre 0,9 y 1,1 en todas las musculaturas. Conclusiones. Se encontraron desequilibrios musculares de cadera en la mayoría de los voluntarios, tanto en el lado dominante como en el no dominante. Aproximadamente un tercio de los sujetos presentaron desequilibrios entre ambas caderas en rotadores y abductores

Mobility limitations related to reduced pulmonary function among aging people with chronic obstructive pulmonary disease.

Chronic obstructive pulmonary disease (COPD) is a major cause of disability. We aimed to analyse the impact of reduced pulmonary function on non-respiratory impairments and mobility activity limitations in an elderly population with COPD and to elucidate which specific limitations on mobility are related to reduced pulmonary function.Cross-sectional study of 110 patients with COPD, recruited from public and university hospital. The effect of impaired pulmonary function on the risk of non-respiratory impairments and mobility limitations was analysed using validated measures, including: the 6-Minute Walk Test (6MWT), skeletal muscle strength, the Short Physical Performance Battery (SPPB), and self-reported mobility questionnaire. Multivariate analysis was used to control for confounders such as age, sex, height, education, and cigarette smoking.Greater impairment of pulmonary function was associated with less distance walked during the 6MWT, poorer SPPB scores, and greater risk of self-reported mobility limitations (p<0.05). Lower forced expiratory volume in 1 s was also associated with a greater risk of limitations in carrying items under 10 pounds (4.54 kg), walking alone up and down a flight of stairs, and walking two or three neighbourhood blocks. There was no clear statistical relationship between pulmonary function impairment and skeletal muscle strength.Impaired pulmonary function was associated with the 6MWT score and limitations on performance-based and self-reported mobility activities, but not with skeletal muscle strength among elderly COPD patients