Evolution of Physical Therapy Scholarship in the Philippines: A Scientometric Analysis of Peer-Reviewed Publications

ABSTRACT Introduction. The Philippine Journal of Physical Therapy began publication in 2021. The editorial board identified as a high-priority project to undertake a detailed analysis of current publishing practice among physical therapy researchers in the Philippines. Methods. This study systematically mined publications from Web of Science, Scopus and PubMed using the keywords “physical therapy” OR “physiotherapy” OR “physical therapist” OR “physiotherapist.” Results were further refined to only include English publications by authors from the Philippines. Publication, citation, collaboration, and text-co-occurrence network analysis were done using RStudio and VOSViewer. Results. A total of 122 publications from 1987 to 2022 were identified. Majority of the literature was primary studies (70.49%), secondary or review articles (13.93%) and proceedings of national and/or international conferences (10.65%). The most common and earliest collaborators of Filipino authors were from Australia, United States of America and Hong Kong. Five clusters of co-occurring keywords were identified: (1) case report, validity, function, mobility; (2) meta-analysis, systematic review, database, search; (3) perception, qualitative, barrier, value; (4) Evidence-based practice, attitude, need, confidence; and (5) COVID-19, pandemic, filipino, cross-sectional. Discussion. This study provides an overview and valuable guidance for physical therapy researchers, practitioners, educators, and policymakers to plan for the future direction of physical therapy research in the country. Stakeholders should consider the results of the study in identifying future projects to build capacity, develop research agendas and policy guidelines, and create collaborative opportunities to further improve physical therapy research productivity in the country

Reliability and Feasibility of the Four Square Step Test for Use in Children with Cerebral Palsy: A Pilot Study

Purpose: The ability to maintain standing balance with a moving base of support and while making rapid postural adjustments is important for independence in various functional activities. Clinical tests and measures have not addressed this ability in children with disability. This pilot study examined the feasibility and reliability of the Four Square Step Test (FSST) as a test of dynamic balance in children with cerebral palsy (CP). Method: Four children with CP (Gross Motor Function Classification Scale levels I-II) were tested on the FSST by 3 assessors on the first occasion (interrater reliability) and repeat-tested by 1 assessor after 2 weeks (test-retest reliability). Six children with typical development (TD) were tested on a separate occasion to explore any between-group difference in performance. Results: The FSST was easy to setup, required no specialized equipment, could be completed in 5 minutes, and might be carried out by clinicians with limited experience in pediatric therapy. It demonstrated excellent interrater reliability (ICC = 0.832) and test-retest reliability (ICC = 0.979) in children with CP. Compared with FSST times for children with TD (mean = 9.12 ± 2.67 seconds), times for children with CP (mean = 18.38 ± 9.02 seconds) were significantly slower (p = 0.019, Mann-Whitney U = -2.345). Conclusions and Recommendations: The pilot study provides initial evidence on the potential usefulness of the FSST as a test of dynamic standing balance in children with CP. This warrants further investigation of the clinimetric properties of the FSST using an adequate sample size

Improving back pain care in the hospital setting

Redesigning how care is structured and delivered has been identified as a potential solution to enable implementation of best practice care for back pain. Redesigning care requires a deep understanding of local needs and context, and participation of stakeholders in the process to promote relevance, acceptance, and uptake. This thesis includes studies that have contributed toward defining the problem, identifying potential solutions, and proposing a new service to improve care for people with chronic back pain. The aim of the thesis was to complete the design phase of a new service for chronic back pain in a hospital setting. This thesis used different methods of research to conduct needs assessment and service design guided by an intervention mapping approach. Needs assessment was conducted through quantitative and qualitative evaluations of current care (Chapter 2 and Chapter 3). Service design was undertaken by creating a logic model of the health problem and a logic model of change, and identifying key components of a new service using information from the needs assessment and stakeholder feedback (Chapter 4, Chapter 5, and Chapter 6). As part of service design, a feasibility study protocol was designed to test key components of a new service for chronic back pain (Chapter 7). The needs assessment studies demonstrated that current service delivery is largely not structured to provide patients with timely and coordinated, long-term management. Whilst the clinical record review showed that existing practice involved good uptake of guideline recommendations, the focus groups and interviews suggested that many patients might be disengaging due to misaligned care expectations and a pathoanatomical focus. The service design process with stakeholder participation showed overall agreement with the needs assessment findings and proposed key components of a new service. This participatory process also revealed potential barriers related to clinician sensitivities and challenges with reimagining traditional roles which could adversely impact progress in the next steps of the service development process. This thesis has contributed to achieving the aim of completing the design phase of a new service for chronic back pain in a hospital setting. Moreover, this thesis provided new insights into the structures and processes that would need to be created to enable and support best practice care for chronic back pain

Reliability of Breathing Rate Assessment and Chest Expansion Measurement: A Pilot Study in Typically Developing Children

Purpose: Despite the apparent acceptance of breathing rate assessment and chest expansion measurement (CEM) among physical therapists, little is known about the measurement properties of these tests and measures especially when administered to children. Reference data from typically developing children have been reported in the literature without investigating the reliability of measurements. This pilot study aimed to systematically explore the feasibility and inter-rater and test-retest reliability of these chest examination methods in children. Method: Nineteen children, 10 males and 9 females, with mean (SD) age of 11.11 (±1.29) years, were selected through convenience sampling. Assessors measured the breathing rate and chest expansion of the participants using a well-defined protocol. A second assessment was conducted after two weeks under similar testing conditions. Results:Breathing rate assessment yielded poor reliability across raters and testing occasions. CEM taken at the level of the fourth intercostal space revealed poor to excellent reliability (ICC=0.48 to 0.81), while measurements taken along the xiphoid process produced acceptable inter-rater reliability (ICC=0.6 to 0.7) and excellent test-retest reliability (ICC=0.88 to 0.94). Conclusions and Recommendations: CEM may be feasible and reliable to use on typically developing children given a well-defined protocol. Assessment of breathing rate may need to be evaluated further for clinical acceptability given potentially poor reliability in children

How Low Back Pain is Managed—A Mixed-Methods Study in 32 Countries. Part 2 of Low Back Pain in Low- and Middle-Income Countries Series

BACKGROUND: The Lancet Low Back Pain (LBP) Series highlighted the lack of LBP data from low- and middle-income countries (LMICs). The study aimed to describe (1) what LBP care is currently delivered in LMICs and (2) how that care is delivered. DESIGN: An online mixed-methods study. METHODS: A Consortium for LBP in LMICs (n = 65) was developed with an expert panel of leading LBP researchers (&gt;2 publications on LBP) and multidisciplinary clinicians and patient partners with 5 years of clinical/lived LBP experience in LMICs. Quantitative data were analyzed using descriptive statistics. Two researchers independently analyzed qualitative data using inductive and deductive coding and developed a thematic framework. RESULTS: Forty-seven (85%) of 55 invited panel members representing 32 LMICs completed the survey (38% women, 62% men). The panel included clinicians (34%), researchers (28%), educators (6%), and people with lived experience (4%). Pharmacotherapies and electrophysiological agents were the most used LBP treatments. The thematic framework comprised 8 themes: (1) self-management is ubiquitous, (2) medicines are the cornerstone, (3) traditional therapies have a place, (4) society plays an important role, (5) imaging use is very common, (6) reliance on passive approaches, (7) social determinants influence LBP care pathway, and (8) health systems are ill-prepared to address LBP burden. CONCLUSION: LBP care in LMICs did not consistently align with the best available evidence. Findings will help research prioritization in LMICs and guide global LBP clinical guidelines.</p