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Magel J, Bishop MD, Lonnemann E, Cochran G, Fritz JM, West N, Gordon AJ. The association between advanced orthopedic certification and confidence and engagement in prescription opioid medication misuse management practices: a cross-sectional study. J Man Manip Ther 2022; 30:228-238. [PMID: 34784850 PMCID: PMC9344956 DOI: 10.1080/10669817.2021.2000818] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
In the United States, attaining the orthopedic certified specialist (OCS) credential or the orthopedic subspecialty credential of Fellow of the American Academy of Orthopedic Manual Physical Therapists (FAAOMPT), may lead to a higher level of orthopedic practice. It is unknown whether attaining these credentials influences physical therapist confidence in and frequency of engagement in prescription opioid medication misuse (POMM) management practices. A national cross-sectional web-based survey of PTs identified whether respondents had an OCS or FAAOMPT credential. Self-report confidence in POMM-related management practices and the frequency of engaging in these practices were assessed. Logistic regression evaluated association between credential status and confidence in, and frequency of, engagement in POMM-related management practices. The analysis included 402 respondents with a mean age of 41.0 (SD = 11.2) and 203 (50.4%) females. There were 91 (22.6%) PTs with a FAAOMPT credential, 143 (35.6%) with an OCS but with no FAAOMPT credential and 168 (41.8%) had neither credential. Compared to those with an OCS credential, FAAOMPTs reported greater confidence in, and greater frequency of engagement in, POMM-related management practices (p< .05). Compared to those without an OCS or FAAOMPT credential and compared to those with an FAAOMPT credential, those with an OCS did not report greater confidence or greater engagement in any POMM-related management practice (p≥ .05). Obtain the FAAOMPT credential may increase PTs' confidence in some POMM-related management practices. Research is needed to determine why FAAOMPTs report greater confidence and engagement in POMM-related management practices.
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Affiliation(s)
- John Magel
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Mark D. Bishop
- Department of Physical Therapy Center for Pain Research and Behavioral Health, University of Florida, Gainesville, FL, United States
| | - Elaine Lonnemann
- Transitional Doctor of Physical Therapy Program, College of Health Sciences, University of St. Augustine for Health Sciences, St. Augustine, Fl, United States
| | - Gerald Cochran
- Program for Addiction, Research, Clinical Care, Knowledge, and Advocacy (PARCKA) and Greater intermountain Node (GIN) of the NIDA clinical Trials Network, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine and Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
| | - Julie M. Fritz
- Department of Physical Therapy and Athletic Training, University of Utah, Salt Lake City, UT, United States
| | - Nancy West
- Division of Epidemiology, University of Utah, Salt Lake City, UT, United States
| | - Adam J. Gordon
- Program for Addiction, Research, Clinical Care, Knowledge, and Advocacy (PARCKA) and Greater intermountain Node (GIN) of the NIDA clinical Trials Network, Division of Epidemiology, Department of Internal Medicine, University of Utah School of Medicine and Informatics, Decision-Enhancement, and Analytic Sciences (IDEAS) Center of Innovation, VA Salt Lake City Health Care System, Salt Lake City, UT, United States
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Dice JL, Dendy D, Sizer PS, Cook CE, Feuling S, Brismée JM. Manual Therapy in Preadolescent Children: A Delphi Investigation of Physical Therapists in the United States. Phys Ther 2021; 101:6123359. [PMID: 33513233 DOI: 10.1093/ptj/pzab027] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Revised: 10/24/2020] [Accepted: 11/29/2020] [Indexed: 11/12/2022]
Abstract
OBJECTIVE Limited research has investigated the use of manual therapy to treat the preadolescent (0-12 years of age) population with musculoskeletal and neurological impairments. The purpose of this study was to identify the following among physical therapists holding advanced credentials in pediatrics, neurodevelopmental treatment, or manual therapy: (1) consensus regarding effective techniques in the preadolescent population, (2) differences in opinion, and (3) perceived decision-making barriers and factors regarding use of manual therapy techniques. METHODS Credentialed physical therapists in the United States were recruited for a 3-round Delphi investigation. An electronic survey in Round 1 identified musculoskeletal and neurological impairments and the manual techniques considered effective to treat such conditions, in addition to factors and barriers. Responses were used to create the second round, during which a 4-point Likert scale was used to score each survey item. A third round of scoring established consensus. Descriptive statistics and composite scores were calculated for each manual technique by impairment. Between-group differences were calculated using the Mann-Whitney U test with Bonferroni correction. RESULTS Consensus was determined for several concepts. First, neuromuscular techniques were considered effective across all impairments, and joint mobilizations (grades I-IV) were believed to be effective to treat joint and muscle and myofascial impairments. Second, visceral manipulation and craniosacral therapy were considered ineffective in treating most impairments. There was lack of consensus and clear differences of opinion regarding the use of grade V mobilizations and dry needling. Significant barriers to use of manual therapy were: lack of knowledge, lack of evidence, and fear of litigation and harming patients. CONCLUSION This study is an initial step for developing manual therapy guidelines, research, and educational opportunities regarding manual therapy in pediatric physical therapy.
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Affiliation(s)
- Jenifer L Dice
- Texas Children's Hospital, Department of Physical Medicine and Rehabilitation, Houston, Texas, USA.,Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Doug Dendy
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Phillip S Sizer
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
| | - Chad E Cook
- Duke Clinical Research Institute, Duke University, Durham, North Carolina, USA
| | - Sara Feuling
- Texas Children's Hospital, Department of Physical Medicine and Rehabilitation, Houston, Texas, USA
| | - Jean-Michel Brismée
- Department of Rehabilitation Sciences, School of Health Professions, Texas Tech University Health Sciences Center, Lubbock, Texas, USA
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Malekmirzaei N, Salehi R, Shaterzadeh Yazdi MJ, Orakifar N. Intersegmental kinematic analysis of lumbar spine by functional radiography between two subgroups of patients with chronic low back pain. J Bodyw Mov Ther 2020; 25:183-187. [PMID: 33714493 DOI: 10.1016/j.jbmt.2020.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 10/20/2020] [Accepted: 11/04/2020] [Indexed: 11/30/2022]
Abstract
INTRODUCTION Kinematic deficits such as fault in joint accessory motion is one of the most important contributing factors for developing the movement impairment in the lumbar spine. Functional radiography is accessible method for detecting the artherokinematic disorders. The aim of this study was to compare lumbar spine intersegmental motion between low back pain (LBP) subgroups of movement system impairment (MSI) model by functional radiography. MATERIALS AND METHODS 20 subjects with chronic LBP in two subgroups of the MSI model (Rotation with Flexion and Rotation with Extension) participated in this study. Five x-rays were taken in different positions. Intersegmental linear translation and angular rotation of the lumbar segments were calculated. RESULTS In the Rotation with Extension subgroup, the translation and rotation values of the L3-4 segment from full to full position were significantly more than their values in the Rotation with Flexion subgroup ((mean difference = -1.69 (mm) P = 0.01), (mean difference = -3.80 (mm) P = 0.02) respectively). The translation of L2-3 segment from the neutral to the mid-flexion position was significantly greater in the Rotation with Flexion subgroup compared to the Rotation with Extension subgroup (mean difference = 1.12 (mm) P = 0.04). cumulative intersegmental angular rotation of all lumbar segments from mid to mid position was greater in the Rotation with Flexion subgroup compared to the Rotation with Extension subgroup (P = 0.03). CONCLUSION Changes in intersegmental translation and angular rotation of lumbar segments in subgroups of patients with LBP may be important contributing factors that induce direction specific lumbar spine loads and contribute to the development or persistence of LBP problems.
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Affiliation(s)
- Niloofar Malekmirzaei
- Master ِDegree of physical therapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Reza Salehi
- PhD of physical therapy, Associate Professor of Physical Therapy, Rehabilitation Research Center, Department of Rehabilitation Management, School of Rehabilitation Sciences, Iran University of Medical Sciences, Tehran, Iran.
| | - Mohammad Jafar Shaterzadeh Yazdi
- PhD of physical therapy, Associate Professor of Physical Therapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
| | - Neda Orakifar
- PhD of physical therapy, Assistant Professor of Physical Therapy, Musculoskeletal Rehabilitation Research Center, Ahvaz Jundishapur University of Medical Sciences, Ahvaz, Iran.
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Langevin P, Fait P, Frémont P, Roy JS. Cervicovestibular rehabilitation in adult with mild traumatic brain injury: a randomised controlled trial protocol. BMC Sports Sci Med Rehabil 2019; 11:25. [PMID: 31737275 PMCID: PMC6844027 DOI: 10.1186/s13102-019-0139-3] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2019] [Accepted: 10/09/2019] [Indexed: 12/12/2022]
Abstract
Background Mild traumatic brain injury (mTBI) is an acknowledged public health problem. Up to 25% of adult with mTBI present persistent symptoms. Headache, dizziness, nausea and neck pain are the most commonly reported symptoms and are frequently associated with cervical spine and vestibular impairments. The most recent international consensus statement (2017 Berlin consensus) recommends the addition of an individualized rehabilitation approach for mTBI with persistent symptoms. The addition of an individualized rehabilitation approach including the evaluation and treatment of cervical and vestibular impairments leading to symptoms such as neck pain, headache and dizziness is, however, recommended based only on limited scientific evidence. The benefit of such intervention should therefore be further investigated. Objective To compare the addition of a 6-week individualized cervicovestibular rehabilitation program to a conventional approach of gradual sub-threshold physical activation (SPA) alone in adults with persistent headache, neck pain and/or dizziness-related following a mTBI on the severity of symptoms and on other indicators of clinical recovery. We hypothesize that such a program will improve all outcomes faster than a conventional approach (between-group differences at 6-week and 12-week). Methods In this single-blind, parallel-group randomized controlled trial, 46 adults with subacute (3 to12 weeks post-injury) persistent mTBI symptoms will be randomly assigned to: 1) a 6-week SPA program or 2) SPA combined with a cervicovestibular rehabilitation program. The cervicovestibular rehabilitation program will include education, cervical spine manual therapy and exercises, vestibular rehabilitation and home exercises. All participants will take part in 4 evaluation sessions (baseline, week 6, 12 and 26) performed by a blinded evaluator. The primary outcome will be the Post-Concussion Symptoms Scale. The secondary outcomes will be time to clearance to return to function, number of recurrent episodes, Global Rating of Change, Numerical Pain Rating Scale, Neck Disability Index, Headache Disability Inventory and Dizziness Handicap Inventory. A 2-way ANOVA and an intention-to-treat analysis will be used. Discussion Controlled trials are needed to determine the best rehabilitation approach for mTBI with persistent symptoms such as neck pain, headache and dizziness. This RCT will be crucial to guide future clinical management recommendations. Trial registration ClinicalTrials.gov Identifier - NCT03677661, Registered on September, 15th 2018.
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Affiliation(s)
- Pierre Langevin
- Clinique Cortex and Physio interactive, 205-1035, avenue Wilfrid-Pelletier, QC Quebec, G1W 0C5 Canada.,2Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, bureau 4431, QC Quebec City, G1R 1P5 Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), 525, Boulevard Wilfrid Hamel, QC Quebec City, G1M 2S8 Canada
| | - Philippe Fait
- Clinique Cortex and Physio interactive, 205-1035, avenue Wilfrid-Pelletier, QC Quebec, G1W 0C5 Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), 525, Boulevard Wilfrid Hamel, QC Quebec City, G1M 2S8 Canada.,4Department of Human Kinetics, Université du Québec à Trois-Rivières, 3351, boul. des Forges, QC Trois-Rivières, G8Z 4M3 Canada.,5Research Center in Neuropsychology and Cognition (CERNEC), Pavillon Marie-Victorin, 90, rue Vincent d'Indy, QC Montreal, H2V 2S9 Canada
| | - Pierre Frémont
- 2Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, bureau 4431, QC Quebec City, G1R 1P5 Canada
| | - Jean-Sébastien Roy
- 2Department of Rehabilitation, Faculty of Medicine, Université Laval, Pavillon Ferdinand-Vandry, 1050, avenue de la Médecine, bureau 4431, QC Quebec City, G1R 1P5 Canada.,Centre for Interdisciplinary Research in Rehabilitation and Social Integration, Quebec Rehabilitation Institute (CIRRIS), 525, Boulevard Wilfrid Hamel, QC Quebec City, G1M 2S8 Canada
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Wattananon P, Ebaugh D, Biely SA, Smith SS, Hicks GE, Silfies SP. Kinematic characterization of clinically observed aberrant movement patterns in patients with non-specific low back pain: a cross-sectional study. BMC Musculoskelet Disord 2017; 18:455. [PMID: 29141615 PMCID: PMC5688632 DOI: 10.1186/s12891-017-1820-x] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/26/2017] [Accepted: 11/08/2017] [Indexed: 11/25/2022] Open
Abstract
Background Clinical observation of aberrant movement patterns during active forward bending is one criterion used to identify patients with non-specific low back pain suspected to have movement coordination impairment. The purpose of this study was to describe and quantify kinematic patterns of the pelvis and trunk using a dynamics systems approach, and determine agreement between clinical observation and kinematic classification. Method Ninety-eight subjects performed repeated forward bending with clinical observation and kinematic data simultaneously collected. Kinematic data were plotted using angle-angle, coupling-angle, and phase-plane diagrams. Accuracy statistics in conjunction with receiver operating characteristic curves were used to determine agreement between clinical observation and kinematic patterns. Results Kinematic patterns were consistent with clinical observation and definitions of typical and aberrant movement patterns with moderate agreement (kappa = 0.46–0.50; PABAK = 0.49–0.73). Early pelvic motion dominance in lumbopelvic coupling-angle diagram ≥59° within the first 38% of the movement represent observed altered lumbopelvic rhythm. Frequent disruptions in lumbar spine velocity represented by phase-plane diagrams with local minimum occurrences ≥6 and sudden decoupling in lumbopelvic coupling-angle diagrams with sum of local minimum and maximum occurrences ≥15 represent observed judder. Conclusion These findings further define observations of movement coordination between the pelvis and lumbar spine for the presence of altered lumbopelvic rhythm and judder. Movement quality of the lumbar spine segment is key to identifying judder. This information will help clinicians better understand and identify aberrant movement patterns in patients with non-specific low back pain.
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Affiliation(s)
- Peemongkon Wattananon
- Motor Control and Neural Plasticity Laboratory, Faculty of Physical Therapy, Mahidol University, 999 Phuttamonthon 4 Road, Salaya, Nakhon Pathom, 73170, Thailand.
| | - David Ebaugh
- Physical Therapy & Rehabilitation Sciences Department, Drexel University, 1601 Cherry Street, Philadelphia, PA, 19102, USA
| | - Scott A Biely
- Physical Therapy Program, Neumann University, One Neumann Drive, Aston, PA, 1901, USA
| | - Susan S Smith
- College of Nursing and Health Professions, Drexel University, 245 N 15th St, Philadelphia, PA, 19102, USA.,Department of Physical Therapy, University of Delaware, 540 S. College Ave, Suite 210E, Newark, DE, 19713, USA
| | - Gregory E Hicks
- Department of Physical Therapy, University of Delaware, 540 S. College Ave, Suite 210E, Newark, DE, 19713, USA
| | - Sheri P Silfies
- Physical Therapy & Rehabilitation Sciences Department, Drexel University, 1601 Cherry Street, Philadelphia, PA, 19102, USA
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Translating Policy into Practice for Community-Based Management of Rheumatoid Arthritis: Targeting Professional Development Needs among Physiotherapists. Int J Rheumatol 2012; 2012:240689. [PMID: 23209474 PMCID: PMC3502858 DOI: 10.1155/2012/240689] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2012] [Accepted: 09/27/2012] [Indexed: 01/06/2023] Open
Abstract
Introduction. Contemporary health policy promotes delivery of community-based health services to people with musculoskeletal conditions, including rheumatoid arthritis (RA). This emphasis requires a skilled workforce to deliver safe, effective care. We aimed to explore physiotherapy workforce readiness to co-manage consumers with RA by determining the RA-specific professional development (PD) needs in relation to work and educational characteristics of physiotherapists in Western Australia (WA). Methods. An e-survey was sent to physiotherapists regarding their confidence in co-managing people with RA and their PD needs. Data including years of clinical experience, current RA clinical caseload, professional qualifications, and primary clinical area of practice were collected. Results. 273 physiotherapists completed the survey. Overall confidence in managing people with RA was low (22.7-58.2%) and need for PD was high (45.1-95.2%). Physiotherapists with greater years of clinical experience, a caseload of consumers with RA, postgraduate qualifications in musculoskeletal physiotherapy, or who worked in the musculoskeletal area were more confident in managing people with RA and less likely to need PD. Online and face-to-face formats were preferred modes of PD delivery. Discussion. To enable community-based RA service delivery to be effectively established, subgroups within the current physiotherapy workforce require upskilling in the evidence-based management of consumers with RA.
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Taghipour-Darzi M, Takamjani EE, Salavati M, Mobini B, Zekavat H. The Validity of Vertebral Translation and Rotation in Differentiating Patients with Lumbar Segmental Instability. PHYSIOTHERAPY RESEARCH INTERNATIONAL 2012; 17:227-34. [DOI: 10.1002/pri.1522] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/18/2011] [Revised: 01/28/2012] [Accepted: 02/03/2012] [Indexed: 11/08/2022]
Affiliation(s)
- Mohammad Taghipour-Darzi
- Department of Physiotherapy, Faculty of Medicine; Babol University of Medical Sciences; Babol Iran
| | - Esmail Ebrahimi Takamjani
- Department of Physiotherapy, Faculty of Rehabilitation; Tehran University of Medical Sciences; Tehran Iran
| | - Mahyar Salavati
- Department of Physiotherapy; University of Social Welfare and Rehabilitation; Tehran Iran
| | - Bahram Mobini
- Orthopedic Department; Tehran University of Medical Sciences; Tehran Iran
| | - Hajar Zekavat
- Department of Radiology; Tehran University of Medical Sciences; Tehran Iran
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Sizer P, Sawyer S, Felstehausen V, Couch S, Dornier L, Cook C. Intrinsic and extrinsic factors important to manual therapy competency development: a delphi investigation. J Man Manip Ther 2011; 16:e9-e19. [PMID: 19119378 DOI: 10.1179/jmt.2008.16.1.9e] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022] Open
Abstract
A learner's development of orthopaedic manual physical therapy (OMPT) psychomotor skills may be influenced by selected intrinsic and extrinsic factors. The purposes of this study were to identify the factors that influence learners' development of manual physical therapy competencies and to define each factor as intrinsic or extrinsic. A 3-round Delphi method survey and a retrospective review of the data were used to develop composite scores and rankings. Eighty manual physical therapy educators participated in the 3 rounds. Thirty-six factor descriptor statements associated with manual physical therapy competency were established and further categorized as intrinsic (19 total), extrinsic (10 total), or conceptual outliers (7 total). Cognitive Processing ranked as the most important factor influencing manual physical therapy competency development. Adaptation ranked second, followed by Science Knowledge. This study is the first to establish manual physical therapy educational factors associated with attainment of competency. The majority of the factors distill into the theory of extrinsic and intrinsic factors identified by Schmidt and Lee. The outcomes of this study identify the factors to which OMPT educators should give particular attention when developing and executing the learning experiences for their learners.
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Affiliation(s)
- Phillip Sizer
- Phillip Sizer is professor and director of the Doctorate of Science Program in Physical Therapy at Texas Tech University Health Science Center, Lubbock, TX ( )
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Jacobsen R, Møldrup C, Christrup L. Danish Pain Specialists' Rationales behind the Choice of Fentanyl Transdermal Patches and Oral Transmucosal Systems—A Delphi Study. PAIN MEDICINE 2009; 10:1442-51. [DOI: 10.1111/j.1526-4637.2009.00724.x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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van Trijffel E, Oostendorp RA, Lindeboom R, Bossuyt PM, Lucas C. Perceptions and use of passive intervertebral motion assessment of the spine: A survey among physiotherapists specializing in manual therapy. ACTA ACUST UNITED AC 2009; 14:243-51. [DOI: 10.1016/j.math.2008.02.005] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2007] [Revised: 01/28/2008] [Accepted: 02/07/2008] [Indexed: 12/22/2022]
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Abbott JH, Flynn TW, Fritz JM, Hing WA, Reid D, Whitman JM. Manual physical assessment of spinal segmental motion: intent and validity. ACTA ACUST UNITED AC 2007; 14:36-44. [PMID: 17997344 DOI: 10.1016/j.math.2007.09.011] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 08/10/2007] [Accepted: 09/13/2007] [Indexed: 11/19/2022]
Abstract
Validity of a clinical test can be defined as the extent to which the test actually assesses what it is intended to assess. In order to investigate the validity of manual physical assessment of the spine, it is therefore essential to establish what physical therapists intend to assess when they are applying these tests. The aims of this study were to (1) establish what manual physical therapists are intending to assess while applying passive intervertebral motion tests; and (2) examine the face validity and content validity for manual physical assessment of the spine. We surveyed 1502 members of the national manual physical therapist organisations of New Zealand and the United States of America using a web-based survey instrument. Sixty-six percent of 466 respondents believed passive accessory intervertebral motion (PAIVM) tests were valid for assessing quantity of segmental motion, and 76% believed passive physiologic intervertebral motion (PPIVM) tests were valid for assessing quantity of segmental motion. Ninety-eight percent of manual physical therapists base treatment decisions at least in part on the results of segmental motion tests. Quality of resistance to passive segmental motion was considered of greater importance than quantity of kinematic motion during PAIVM tests, while the quality of complex kinematic motion was considered of greater importance than quantity of displacement kinematics during PPIVM tests. Manual physical therapists accept the face validity of manual physical assessment of spinal segmental motion to a great extent, however a minority voice scepticism. Content validity is dominated by concepts of segmental kinematics and the force-displacement relationship. Intent of assessment does, however, vary widely between therapists. These data will inform the design of concurrent validity studies. Further work is recommended to increase consistency of intent, methodology and terminology in manual physical assessment of the spine.
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Affiliation(s)
- J Haxby Abbott
- Centre for Physiotherapy Research, School of Physiotherapy, University of Otago, Dunedin, New Zealand.
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