Interinstrument reliability of the RT3 accelerometer

The objective of this study was to assess the interinstrument reliability of six RT3 accelerometers for measuring physical activities. Each of the six healthy participants, mean age 36.1 years (SD 9.4), carried six RT3 accelerometers (same type and same producer) simultaneously placed ventrally at the waist belt. The participants performed three standardized activities: walking on a treadmill at 3.0 km/h and 5.0 km/h, and sitting on a chair. Each activity lasted 5 min. The recordings of the accelerometers were compared with each other to assess interinstrument reliability. A correlation of 0.75 or higher was interpreted as sufficient. The mean Pearson correlation between the six accelerometers was r = 0.78 (0.46-0.97). The intraclass correlation between the accelerometers was 0.75 (95% confidence interval: 0.46-0.95, P <0.01). In conclusion, the interinstrument reliability of the RT3 accelerometer is sufficient. However, the lower limit of the confidence interval is low, indicating a challenge to the reliability. International Journal of Rehabilitation Research 33:178-179 (C) 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins

Capturing case complexity:is clinician selected dose of vocational rehabilitation related to questionnaire results?

BACKGROUND: To establish an optimum dosage interdisciplinary vocational rehabilitation, it is important to be able to reliably and validly assess case complexity. Assessment of case complexity is currently clinician based because no validated means to assess case complexity is presently available. Indices assumed to associate with case complexity can contribute to the choice of dosage. The objective of this study was to explore the extent in which results of questionnaires were associated with the choice of treatment dosage in vocational rehabilitation. METHODS: Design: cross-sectional study of observational data. The study population consisted of workers on part-time or full-time sick leave due to chronic multifactorial problems. Thousand eighty-nine patients who were referred to a privately owned organization with outpatient vocational rehabilitation centers in the Netherlands between July 2016 and March 2017 were allocated to one of the three programs based on case complexity as determined by clinicians based on clinical interview and questionnaires. RESULTS: Questionnaires accounted for 13% of the variance in the total group, 13% in patients with chronic musculoskeletal pain (n = 662) and 29% in patients with chronic fatigue (n = 235). CONCLUSION: The results of the questionnaires contribute little in the assessment of case complexity and dose recommendation. Implications for Rehabilitation Assessment of case complexity of patients with chronic multifactorial complaints and disability is complex. The results of this study suggest that case complexity and choice of treatment dose is slightly explained by questionnaire results. It is largely determined on heuristics developed by knowledge and experience of clinicians. No reliable and validated means to assess case complexity is presently available in the field of rehabilitation and optimum treatment dose cannot be determined transparently. Routinely collected clinical data of baseline characteristics, process measures and results are a valuable source that can be used to answer research questions

'I think positivity breeds positivity': a qualitative exploration of the role of family members in supporting those with chronic musculoskeletal pain to stay at work

Background: It is proposed that family members are important sources of support in helping those with chronic musculoskeletal pain to remain at work, but the phenomenon remains largely unexplored. The aim of this study was to examine the extent and nature of support provided by family members in this respect. Methods: Qualitative data were collected from workers and their ‘significant others’ spouses/partners/close family members) in two un-related studies focused on working with pain; one conducted in the United Kingdom (n = 10 dyads) and one in the Netherlands (n = 21 dyads). Thematic analysis techniques were applied to both sets of data independently, and findings were then assimilated to establish common themes. Results: Findings were broadly similar in both studies. Workers acknowledged significant other support in helping them to manage their pain and remain at work, and their descriptions of the type of support provided and required were echoed by their significant others. Three common themes were identified - ‘connectivity’, ‘activity’ and ‘positivity’. Worker and significant other responses were largely congruent, but significant others provided more in-depth information on the nature of their support, their concerns and the impact on their relationship. Conclusions: This research presents novel insights about the specific contribution made by significant others in helping their relatives with chronic musculoskeletal pain to stay at work. These findings add to the under-represented ‘social’ dimension of the biopsychosocial model currently applied to our understanding and treatment of pain, and point to harnessing support from significant others as a potentially effective management strategy

Knowledge and attitudes toward musculoskeletal pain neuroscience of manual therapy postgraduate students in the Netherlands

BACKGROUND: Health care practitioners' knowledge and attitudes influence patients' beliefs and health outcomes in musculoskeletal (MSK) pain. It is unclear to what extent physiotherapists undertaking a postgraduate master in manual therapy (MT students) possess the knowledge and attitudes toward pain neuroscience to be able to apply the biopsychosocial model in patients with MSK pain. OBJECTIVES: The aim of this study was to assess the knowledge and attitudes toward pain neuroscience in MT students. DESIGN: A cross-sectional study. METHOD: Self-reported knowledge and attitudes were measured among students (n = 662) at baseline and in all years of the MT postgraduate programs in the Netherlands. The Knowledge and Attitudes of Pain questionnaire (KNAP) was used as a primary measure. Difference in KNAP-scores between baseline (0), year 1, year 2 and year 3 was tested using a one-way ANOVA (hypothesis: 0 < 1<2 < 3). A two factor ANOVA was used to determine the interaction effect of focused pain education and year in the curriculum with KNAP. RESULTS: There was an overall significant difference of KNAP scores with a medium effect size (F(3, 218.18) = 13.56, p < .001, ω2 = 0.059). Differences between years ranged from small to medium. Interaction effect of knowledge and attitudes and focused pain education was significant with a small effect size (F(6) = 2.597, p = .017, ω2 = 0.012). Sensitivity analyses were consistent with the main results. CONCLUSIONS: Positive differences in knowledge and attitudes toward pain neuroscience in MT students occur between the progressing years of the curriculum. Differences may be related to the provision of focused pain education

Instrument, system and methods for use in respiratory exchange ratio measurement

The instrument has sensors for sensing oxygen and/or carbon dioxide content in exhaled air received in a receiving area in front of a mouth, an air flow rate sensor for sensing exhaled air flow rates in a flow rate sensing location and an air shield for shielding the receiving area and the flow rate sensing location from air flows from the environment. The air shield leaves a space between the air shield and the mouth of the person in open communication with the environment. The air flow rate sensor senses air flow speed in a location spaced from the exhaled air receiving area, rearward of a front end of the exhaled air receiving area and above a lower end of the exhaled air receiving area. In another embodiment a sensor for sensing ambient wind is provided