Institut Régional de Formation aux Métiers de Rééducation et de Réadaptation des Pays de la Loire.
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Mention de date : February 2018
Physical Therapy / Jette, Alan M. . Vol. 98 n° 2
Paru le : 01/02/2018
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Physical Therapy's Role in Opioid Use and Management During Palliative and Hospice Care / Christopher M. Wilson in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] Physical Therapy's Role in Opioid Use and Management During Palliative and Hospice Care [texte imprimé] / Christopher M. Wilson, Auteur ; Richard Briggs, Auteur . - 2018 . - p. 83-94.
Point of view
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 83-94
Catégories : SOINS
ENVIRONNEMENT & MATIÈRES
Résumé : There has been a significant amount of necessary publicity and attention related to America's opioid crisis. In 2015 and 2016, multiple governmental agencies and professional associations endorsed a variety of aggressive measures to combat this critical problem. As this growing epidemic has caused addiction and deaths of thousands of Americans, these campaigns are well intentioned and important. With the level of focus that these campaigns are receiving, however, there are concerns of potential unintended negative consequences of the resulting regulatory reform and public perceptions, especially in regard to patients with life-threatening diagnoses or those in hospice and palliative care (HPC). The American Physical Therapy Association's (APTAs) ChoosePT campaign has been extremely successful and advocates a conversation between the patient and prescriber about pursuing physical therapy before receiving a prescription for an opioid medication. En ligne : https://academic.oup.com/ptj Permalink : [article]Pathological Movements of the Pelvis and Trunk During Gait in Children With Cerebral Palsy: A Cross-Sectional Study With 3-Dimensional Kinematics and Lower Lumbar Spinal Loading / Damien Kiernan in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] Pathological Movements of the Pelvis and Trunk During Gait in Children With Cerebral Palsy: A Cross-Sectional Study With 3-Dimensional Kinematics and Lower Lumbar Spinal Loading [texte imprimé] / Damien Kiernan, Auteur ; Rory O'Sullivan, Auteur . - 2018 . - p. 86-94.
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 86-94
Catégories : PHYSIOLOGIE
Infirmité motrice cérébrale
INFORMATION & COMMUNICATION
Thesaurus Santé Publique
Abdomen , Vertèbre
Résumé : Background: Increased loading at the lumbar spine, particularly in the coronal plane, has been reported in children with cerebral palsy (CP). As pelvic and trunk movements associated with Trendelenburg and Duchenne type gait are most significant in the coronal plane, the potential exists for lower lumbar spinal loading to be negatively affected in children with CP and these types of movement patterns.
Objective: The objective of this study was to assess trunk and pelvic kinematics and lower lumbar spinal loading patterns in children with CP and Trendelenburg and Duchenne type gait.
Design: This was a cross-sectional study.
Methods: Three-dimensional kinematic (lower limb and thorax) and L5-S1 kinetic data were recorded. Children were divided according to clinical presentation of Trendelenburg or Duchenne type gait. Several discrete kinematic and kinetic parameters were assessed between groups.
Results: Three distinct pelvic and trunk movement patterns were identified for children with CP: Trendelenburg, Duchenne, and complex TrendelenburgDuchenne. Peak L5-S1 lateral bending moments were increased by 62% in children with CP and Duchenne type gait. Children with CP and complex Trendelenburg-Duchenne gait demonstrated the largest deviations from normal, with increased peak ipsilateral and contralateral directed moments of 69% and 54%, respectively, compared with children with typical development.
Limitations: A test-retest reliability analysis or measure of minimal detectable change was not conducted as part of this study. Results suggest that measures of minimal detectable change may be high for some of the reported variables. In addition, the inverse dynamic approach determines only the net intersegmental reactive forces that reflect the effect of external loads. Previous studies have shown that spinal loads may be larger than the net intersegmental force.
Conclusions: Trendelenburg and Duchenne type movements were not always distinct, and a third type of movement, a combination of the two, was the most common in this study. Clinicians should be aware that children with CP and the Duchenne type or the complex Trendelenburg-Duchenne type of gait pattern experience abnormal loading that may have significant implications for the lower spine in the long term.
En ligne : https://academic.oup.com/ptj Permalink : [article]Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial / Alison Keogh in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] Feasibility of Training Physical Therapists to Deliver the Theory-Based Self-Management of Osteoarthritis and Low Back Pain Through Activity and Skills (SOLAS) Intervention Within a Trial [texte imprimé] / Alison Keogh, Auteur ; James Matthews, Auteur ; Ricardo Segurado, Auteur . - 2018 . - p. 95-107.
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 95-107
Catégories : PATHOLOGIE
Lombalgie , Ostéoporose
PROFESSION SANITAIRE & SOCIALE
Résumé : Background: Provider training programs are frequently underevaluated, leading to ambiguity surrounding effective intervention components.
Objective: The purpose of this study was to assess the effectiveness of a training program in guiding physical therapists to deliver the Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) group education and exercise intervention (ISRCTN49875385), using a communication style underpinned by selfdetermination theory (SDT).
Design: This was an assessment of the intervention arm training program using quantitative methods.
Methods: Thirteen physical therapists were trained using mixed methods to deliver the SOLAS intervention. Training was evaluated using the Kirkpatrick model: (1) Reactionphysical therapists satisfaction with training, (2) Learningtherapists confidence in and knowledge of the SDT-based communication strategies and intervention content and their skills in applying the strategies during training, and (3) Behavior8 therapists were audio-recorded delivering all 6 SOLAS intervention classes (n = 48), and 2 raters independently coded 50% of recordings (n = 24) using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention-specific measure.
Results: Reaction: Physical therapists reacted well to training (median [IRQ]; min-max = 4.7; [0.5]; 3.75.0). Learning: Physical therapists confidence in the SDT-based communication strategies and knowledge of some intervention content components significantly improved. Behavior: Therapists delivered the intervention in a needs-supportive manner (median HCCQ = 5.3 [1.4]; 3.96.0; median CCBS = 6.6 ([0.5]; 6.16.8; median intervention specific measure = 4.0 [1.2]; 3.24.9). However, goal setting was delivered below acceptable levels by all therapists (median 2.9 [0.9]; 2.04.0).
Limitations: The intervention group only was assessed as part of the process evaluation of the feasibility trial.
Conclusions: Training effectively guided physical therapists to be needs-supportive during delivery of the SOLAS intervention. Refinements were outlined to improve future similar training programs, including greater emphasis on goal setting.
En ligne : https://academic.oup.com/ptj Permalink : [article]Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework / David Beard in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] Evidence-Based Evaluation of Practice and Innovation in Physical Therapy Using the IDEAL-Physio Framework [texte imprimé] / David Beard, Auteur ; David Hamilton, Auteur ; Loretta Davies, Auteur . - 2018 . - p. 108-121.
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 108-121
Catégories : THÉRAPEUTIQUE
Résumé : The IDEAL framework is an established method for initial and ongoing evaluations of innovation and practice for complex health care interventions. First derived for surgical sciences and embedded at a global level for evaluating surgery/surgical devices, the IDEAL framework is based on the principle that innovation and evaluation in clinical practice can, and should, evolve together in an ordered manner: from conception to development and then to validation by appropriate clinical studies and, finally, longer-term follow-up. This framework is highly suited to other complex, nonpharmacological interventions, such as physical therapist interventions. This perspective outlines the application of IDEAL to physical therapy in the new IDEAL-Physio framework. The IDEAL-Physio framework comprises 5 stages. In stage 1, the idea phase, formal data collection should begin. Stage 2a is the phase for iterative improvement and adjustment with thorough data recording. Stage 2b involves the onset of formal evaluation using systematically collected group or cohort data. Stage 3 is the phase for formal comparative assessment of treatment, usually involving randomized studies. Stage 4 involves long-term follow-up. The IDEAL-Physio framework is recommended as a method for guiding and evaluating both innovation and practice in physical therapy, with the overall goal of providing better evidence-based care. En ligne : https://academic.oup.com/ptj Permalink : [article]The Revised Body Awareness Rating Questionnaire: Development Into a Unidimensional Scale Using Rasch Analysis / Tove Dragesund in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] The Revised Body Awareness Rating Questionnaire: Development Into a Unidimensional Scale Using Rasch Analysis [texte imprimé] / Tove Dragesund, Auteur ; Liv Inger Strand, Auteur ; Margreth Grotle, Auteur . - 2018 . - p. 122-132.
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 122-132
Catégories : SYMPTÔME
Douleur , Trouble musculosquelettique
INFORMATION & COMMUNICATION
Résumé : Background: The Body Awareness Rating Questionnaire (BARQ) is a self-report questionnaire aimed at capturing how people with long-lasting musculoskeletal pain reflect on their own body awareness. Methods based on classical test theory were applied to the development of the instrument and resulted in 4 subscales. However, the scales were not correlated, and construct validity might be questioned.
Objective: The primary purpose of this study was to explore the possibility of developing a unidimensional scale from items initially collected for the BARQ using Rasch analysis. A secondary purpose was to investigate the test-retest reliability of a revised version of the BARQ.
Design: This was a methodological study.
Methods: Rasch and reliability analyses were performed for 3 samples of participants with long-lasting musculoskeletal pain. The first Rasch analysis was carried out on 66 items generated for the original BARQ and scored by 300 participants. The items supported by the first analysis were scored by a new group of 127 participants and analyzed in a second Rasch analysis. For the test-retest reliability analysis, 48 participants scored the revised BARQ items twice within 1 week.
Results: The 2-step Rasch analysis resulted in a unidimensional 12-item revised version of the BARQ with a 4-point response scale (scores from 0 to 36). It showed a good fit to the Rasch model, with acceptable internal consistency, satisfactory fit residuals, and no disordered thresholds. Test-retest reliability was high, with an intraclass correlation coefficient of .83 (95% CI = .71.89) and a smallest detectable change of 6.3 points.
Limitations: The small sample size in the second Rasch analysis was a study limitation.
Conclusions: The revised BARQ is a unidimensional and feasible measurement of body awareness, recommended for use in the context of body-mind physical therapy approaches for musculoskeletal conditions.
En ligne : https://academic.oup.com/ptj Permalink : [article]Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures / Erik H. Hoyer in Physical Therapy, Vol. 98 n° 2 (February 2018)
[article] Toward a Common Language for Measuring Patient Mobility in the Hospital: Reliability and Construct Validity of Interprofessional Mobility Measures [texte imprimé] / Erik H. Hoyer, Auteur ; Daniel L. Young, Auteur ; Lisa M. Klein, Auteur . - 2018 . - p. 133-142.
Langues : Français (fre)
in Physical Therapy > Vol. 98 n° 2 (February 2018) . - p. 133-142
Catégories : MOTS OUTILS
Résumé : Background: The lack of common language among interprofessional inpatient clinical teams is an important barrier to achieving inpatient mobilization. In The Johns Hopkins Hospital, the Activity Measure for Post-Acute Care (AM-PAC) Inpatient Mobility Short Form (IMSF), also called 6-Clicks, and the Johns Hopkins Highest Level of Mobility (JH-HLM) are part of routine clinical practice. The measurement characteristics of these tools when used by both nurses and physical therapists for interprofessional communication or assessment are unknown.
Objective: The purposes of this study were to evaluate the reliability and minimal detectable change of AM-PAC IMSF and JH-HLM when completed by nurses and physical therapists and to evaluate the construct validity of both measures when used by nurses.
Design: A prospective evaluation of a convenience sample was used.
Methods: The test-retest reliability and the interrater reliability of AM-PAC IMSF and JH-HLM for inpatients in the neuroscience department (n = 118) of an academic medical center were evaluated. Each participant was independently scored twice by a team of 2 nurses and 1 physical therapist; a total of 4 physical therapists and 8 nurses participated in reliability testing. In a separate inpatient study protocol (n = 69), construct validity was evaluated via an assessment of convergent validity with other measures of function (grip strength, Katz Activities of Daily Living Scale, 2-minute walk test, 5-times sit-to-stand test) used by 5 nurses.
Results: The test-retest reliability values (intraclass correlation coefficients) for physical therapists and nurses were 0.91 and 0.97, respectively, for AM-PAC IMSF and 0.94 and 0.95, respectively, for JH-HLM. The interrater reliability values (intraclass correlation coefficients) between physical therapists and nurses were 0.96 for AM-PAC IMSF and 0.99 for JH-HLM. Construct validity (Spearman correlations) ranged from 0.25 between JH-HLM and right-hand grip strength to 0.80 between AM-PAC IMSF and the Katz Activities of Daily Living Scale.
Limitations: The results were obtained from inpatients in the neuroscience department of a single hospital.
Conclusions: The AM-PAC IMSF and JH-HLM had excellent interrater reliability and test-retest reliability for both physical therapists and nurses. The evaluation of convergent validity suggested that AM-PAC IMSF and JH-HLM measured constructs of patient mobility and physical functioning.
En ligne : https://academic.oup.com/ptj Permalink : [article]