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Javadi-Ardestani S, Zarezadeh A, Yeowell G, Sadeghi-Demneh E. A new ulnar-based orthosis for triangular fibrocartilage complex lesions: Design and production method. Hand Surg Rehabil 2024; 43:101681. [PMID: 38471642 DOI: 10.1016/j.hansur.2024.101681] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/03/2024] [Accepted: 03/04/2024] [Indexed: 03/14/2024]
Affiliation(s)
- Sajedeh Javadi-Ardestani
- Student Research Committee, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Abolghasem Zarezadeh
- Orthopaedic Surgery Department, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Maricar N, Yeowell G, David T, Khan B, Barton A, Hyrich KL, Hartley SE. Barriers and enablers to engagement in exercise and physical activity in non-English speaking South Asian people with chronic musculoskeletal disease. BMC Rheumatol 2024; 8:12. [PMID: 38462630 PMCID: PMC10926668 DOI: 10.1186/s41927-024-00372-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2023] [Accepted: 01/08/2024] [Indexed: 03/12/2024] Open
Abstract
BACKGROUND Exercise and physical activity (EPA) are recommended for people with chronic musculoskeletal disease; however, lower levels of engagement with EPA has been consistently reported in people from the South Asian community across a range of diseases. As language can pose a significant barrier in healthcare, this study aimed to understand the enablers and barriers to the acceptance of EPA among non-English speaking South Asian people who attended rheumatology clinics. METHODS 12 non-English speaking individuals from the South Asian community who had chronic musculoskeletal disease with significant pain scores were interviewed via telephone or face-to-face in their spoken languages. The audio recordings of the interviews were translated into English and transcribed verbatim. Data was analysed using thematic analysis implemented in the NVivo 12 Pro software program. RESULTS The mean age was 52 years (9 women and 2 men). One main theme was identified: 'Enablers and barriers to exercise and physical activity'. Enablers to EPA were having knowledge about the benefits of EPA, being given resources in a language that they understood, and supportive environments such as having access to community facilities for those who could not undertake EPA in their houses. Barriers included physical health such as pain and fatigue, lack of time, difficulties with transportation to exercise venues, dislike of group exercises and lack of understanding of what and how to do exercise and be physically active. Participants' beliefs about EPA and whether they impacted their physical health seemed to influence whether they were undertaken or not. There was a perception that their culture shaped their compatriots' beliefs about EPA, and it was not normal practice for people from their country of birth to engage in it. CONCLUSIONS This is the first qualitative study to explore the barriers and enablers to engagement in EPA in non-English speaking South Asian people with chronic musculoskeletal disease. Modifiable factors such as addressing the level of knowledge on the benefits of EPA in the management of chronic joint and muscle pain; aiding the development of the skills required to exercise safely and confidently despite chronic pain and providing information and services in the native language could promote the EPA engagement of non-English speaking South Asian individuals with chronic musculoskeletal disease. The findings may inform improvements within clinical services to promote the benefits, impact and self-efficacy of engagement with EPA as part of chronic musculoskeletal disease management. ETHICS APPROVAL The West Midlands-Edgbaston Research Ethics Committee (reference:20/WM/0305).
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Affiliation(s)
- Nasimah Maricar
- Northern Care Alliance NHS Foundation Trust, Salford Royal NHS Foundation Trust, Manchester, UK.
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK.
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK.
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Trixy David
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Behram Khan
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
| | - Anne Barton
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- Centre for Genetics and Genomics Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Kimme L Hyrich
- Centre for Epidemiology Versus Arthritis, Centre for Musculoskeletal Research, Division of Musculoskeletal and Dermatological Sciences, University of Manchester, Manchester, UK
- The Kellgren Centre for Rheumatology, Manchester University NHS Foundation Trust, Manchester, UK
- NIHR Manchester Biomedical Research Centre, Manchester Foundation NHS Trust, Manchester Academic Health Science Centre, Manchester, UK
| | - Sandra E Hartley
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Assame N, Greenhalgh S, Tingle J, Wright J, Yeowell G. How current law and policy supports providers of NHS healthcare in England to respond to patient harm: A scoping review protocol. PLoS One 2024; 19:e0299121. [PMID: 38466664 PMCID: PMC10927104 DOI: 10.1371/journal.pone.0299121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 02/05/2024] [Indexed: 03/13/2024] Open
Abstract
INTRODUCTION Harm arising from National Health Service (NHS) healthcare results in significant human cost for the patient, those who care for them, and the medical staff involved. Furthermore, patient harm results in substantial financial costs to the public purse. Improving how NHS providers in England respond to patient harm could reduce the number of claims for clinical negligence brought against NHS. Doing so will ensure those affected receive the justice they deserve and protect the public purse. Law and policy are key to supporting providers of NHS healthcare to respond to patient harm but are not necessarily understood and therefore can be challenging to apply to practice. Research exploring how law and policy supports this understanding is limited. The purpose of this scoping review is to address this knowledge gap and improve understanding by critically evaluating how law and policy supports providers of NHS healthcare in England to respond to patient harm. METHODS AND ANALYSIS The review will use the methodological framework proposed by Arskey and O'Malley, Levac et al and the Joanna Briggs Institute. Search strategies will be developed using selected key words and index terms. MEDLINE, CINAHL, and Westlaw and reference lists of relevant publications will be searched to identify relevant grey literature. Two reviewers will independently assess the extracted data against the eligibility criteria. All studies identified will be charted and the results presented as a narrative synthesis.
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Affiliation(s)
- Naomi Assame
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Susan Greenhalgh
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - John Tingle
- Birmingham Law School, University of Birmingham, Birmingham, United Kingdom
| | - Julie Wright
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
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Yeowell G, Leech R, Greenhalgh S, Willis E, Selfe J. The lived experiences of UK physiotherapists involved in Cauda Equina Syndrome litigation. A qualitative study. PLoS One 2023; 18:e0290882. [PMID: 37708146 PMCID: PMC10501620 DOI: 10.1371/journal.pone.0290882] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2023] [Accepted: 08/17/2023] [Indexed: 09/16/2023] Open
Abstract
BACKGROUND Cauda Equina Syndrome is a serious spinal pathology, which can have life changing physical and psychological consequences and is highly litigious. Litigation can have negative personal and professional effects on the healthcare professionals cited in a clinical negligence claim. There is an absence of research looking at the experience of the physiotherapist and as such, it is unknown the impact litigation is having on them. This study explored the lived experiences of UK physiotherapists in relation to Cauda Equina Syndrome litigation. METHODS A qualitative design, informed by Gadamerian hermeneutic phenomenology, using semi-structured interviews was used to explore participants' lived experiences of litigation. Interviews were audio-recorded and transcribed verbatim. Findings were analysed using an inductive thematic analysis framework. Nvivo software was used to facilitate analysis. The study is reported in accordance with the consolidated criteria for reporting qualitative (COREQ) research. RESULTS 40 interviews took place online or over the phone, with physiotherapists and stakeholders. Four themes were found; 'litigation effects', 'it feels personal', 'learning from litigation' and 'support and training'. CONCLUSION This is the first study to investigate the lived experiences of litigation in UK physiotherapists. Involvement in clinical negligence affected physiotherapists' physical and mental wellbeing and impacted their clinical practice. Most physiotherapists felt litigation was a personal attack on them and their ability to do their job. Physiotherapists highlighted perceptions of a 'blame culture' and perceived stigma associated with the claim, which often led to a lack of sharing and learning from litigation. Physiotherapists emphasised the need for emotional support for those going through a legal claim and that training was needed to understand the process of litigation and range of potential outcomes.
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Affiliation(s)
- Gillian Yeowell
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - Rachel Leech
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - Susan Greenhalgh
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
- Bolton NHS Foundation Trust, Orthopaedic Interface Service, Bolton One, Bolton, Manchester, United Kingdom
| | - Emma Willis
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - James Selfe
- Department of Health Professions, Faculty Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
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Whelan G, Yeowell G, Littlewood C. The impact of introducing hydrodistension as a treatment for frozen shoulder in a primary care musculoskeletal service: A retrospective audit. Musculoskeletal Care 2023; 21:953-957. [PMID: 36694385 DOI: 10.1002/msc.1736] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2023] [Accepted: 01/15/2023] [Indexed: 01/26/2023]
Abstract
INTRODUCTION Hydrodistension, where a relatively high volume of local anaesthetic, corticosteroid, and sterile saline are injected into the shoulder joint, is a treatment of interest for frozen shoulder. In the UK National Health Service this is typically provided in the hospital setting. In 2017 we introduced hydrodistension into our physiotherapy led musculoskeletal service. This report describes the findings from our audit of onward referral for orthopaedic assessment following the introduction of hydrodistension to our frozen shoulder treatment pathway. METHODS A retrospective audit of data from 102 patients who followed our hydrodistension treatment pathway for frozen shoulder since 2017 was conducted. All 102 patients received at least one hydrodistension procedure performed by a physiotherapist. This involved injecting the glenohumeral joint with a combination of local anaesthetic, corticosteroid, and saline under ultrasound guidance with a total volume of 25-35 mls. This data was compared to the outcomes of 102 patients who presented with frozen shoulder prior to 2017 who did not receive hydrodistension. RESULTS Of 102 patients who received hydrodistension within the musculoskeletal service, six patients required onward referral to orthopaedics. Of the 102 patients who did not receive hydrodistension prior to 2017, 58 required onward referral to orthopaedics. CONCLUSION We report a reduction in onward referral to orthopaedics following the introduction of hydrodistension to our physiotherapist-led treatment pathway for patients with frozen shoulder. This preliminary data identifies the need to further evaluate the clinical and cost-effectiveness of hydrodistension performed by physiotherapists for patients with frozen shoulder.
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Affiliation(s)
- Gareth Whelan
- York and Scarborough Teaching Hospitals NHS FT, York, UK
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May P, Mitham K, Maher N, Pitt L, Whelan G, Mazuquin B, Moffatt M, Selfe J, Yeowell G, Littlewood C. Developing an application for the UK Pre-Doctoral Clinical and Practitioner Academic Fellowship (PCAF): the collective experience of a community of physiotherapists. Physiotherapy 2023; 121:1-4. [PMID: 37536077 DOI: 10.1016/j.physio.2023.06.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2022] [Revised: 03/28/2023] [Accepted: 06/18/2023] [Indexed: 08/05/2023]
Abstract
For physiotherapists and other healthcare professionals, developing capability and expertise in research can be challenging. However, involvement in research is beneficial at organisational and individual levels, both for clinicians and patients. One way to embark on research is to apply for a personal fellowship such as the National Institute for Health and Care Research (NIHR) Pre-Doctoral Clinical Academic Fellowship (PCAF). While the NIHR has guidance on how to complete the application form, it can be difficult to implement this guidance and understand what a competitive application looks like. As a group of physiotherapists and academic supervisors, who have applied for NIHR PCAFs, what follows is a supportive resource, to inform others who might be thinking of applying. CONTRIBUTION OF PAPER.
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Affiliation(s)
- Pauline May
- Integrated Musculoskeletal, Pain and Rheumatology Service, East Lancashire Hospitals NHS Trust, St Peters Centre, Burnley, UK.
| | - Kieran Mitham
- Cambridgeshire Community Services NHS Trust, St Ives, UK
| | - Natasha Maher
- Calderdale and Huddersfield Foundation Trust, Halifax, UK
| | - Lisa Pitt
- Derby Shoulder Unit, University Hospitals of Derby & Burton NHS Foundation Trust, Derby, UK
| | - Gareth Whelan
- Musculoskeletal Service, York and Scarborough Teaching Hospitals NHS Foundation Trust, Clifton Park Clinic, York, UK
| | - Bruno Mazuquin
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Maria Moffatt
- Faculty of Health, Social Care and Medicine, Edge Hill University, St Helens Road, Ormskirk, UK
| | - James Selfe
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Chris Littlewood
- Faculty of Health, Social Care and Medicine, Edge Hill University, St Helens Road, Ormskirk, UK
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Jeans E, Talwalkar S, Gebrye T, Yeowell G, Fatoye F, Hayton M. Elective Ambulatory Unit: Experience of Local Anesthetic Only Surgery During the Pandemic. Hand (N Y) 2023:15589447231158810. [PMID: 37013257 PMCID: PMC10071184 DOI: 10.1177/15589447231158810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 04/05/2023]
Abstract
BACKGROUND The second COVID-19 wave severely limited access to elective surgery. METHODS Between December 2020 and May 2021, 530 patients underwent a procedure in the elective ambulatory unit (EAU), a walk-in and walk-out model of surgery, and we used a prepandemic cohort of day-case patients for comparison. RESULTS We have had no confirmed cases of COVID-19 transmission on-site. The infection rate for EAU and day-case units for carpal tunnel decompression was 1.36% and 2%, respectively, and this difference was not significant, P = .696. Patient satisfaction was excellent at 9.8 of 10. The waiting time from primary care referral to carpal tunnel decompression was cut from 36 weeks to 12 weeks during the study period. Significant benefit in efficiency and cost saving was also found. CONCLUSION Elective ambulatory unit provides a template to perform high-volume low-complexity hand and wrist surgery in a safe, efficient, and cost-effective manner.
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Alsaif H, Goodwin PC, Callaghan MJ, Sudell L, O'Neill TW, Yeowell G. Patient and healthcare provider experience and perceptions of a preoperative rehabilitation class for lumbar discectomy: A qualitative study. Musculoskelet Sci Pract 2023; 64:102740. [PMID: 36958123 DOI: 10.1016/j.msksp.2023.102740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/05/2022] [Revised: 01/29/2023] [Accepted: 02/28/2023] [Indexed: 03/25/2023]
Abstract
BACKGROUND Lumbar disc disease is a leading cause of low back pain. Lumbar discectomy (LD) may be indicated if symptoms are not managed conservatively. Rehabilitation has traditionally been delivered postoperatively; however, there is increasing delivery preoperatively. There are few data concerning perceptions and experiences of preoperative rehabilitation. Exploring experiences of preoperative rehabilitation may help in the development and delivery of effective care for patients. OBJECTIVES To develop an understanding of patient and healthcare provider (HCP) experiences, perspectives and preferences of preoperative LD rehabilitation, including why patients do not attend. DESIGN A qualitative interpretive approach using focus groups and individual interviews. METHODS Data were collected from; a) patients listed for surgery and attended the preoperative rehabilitation (October 2019 to March 2020), b) patients listed for surgery but did not attend rehabilitation, and c) HCPs involved in the delivery of rehabilitation. Data were transcribed verbatim and analysed using thematic analysis. RESULTS/FINDINGS Twenty participants were included, twelve patients and eight HCPs. The preoperative class was a valuable service for both patients and HCPs. It provided a solution to staffing and time pressures. It provided the required education and exercise content helping the patients along their surgery pathway. Travel distance, transportation links, parking difficulty and cost, lack of knowledge about the class aims, and previous negative experiences were barriers to patient attendance. CONCLUSIONS For most patients and HCPs, the preoperative class was valuable. Addressing the challenges and barriers could improve attendance. Future research should focus on management of patient expectations and preferences preoperatively.
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Affiliation(s)
- Hanan Alsaif
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Physiotherapy, King Fahad Military Medical Complex - KFMMC Dhahran, Kingdom of Saudi Arabia
| | - Peter C Goodwin
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Health and Professions, Manchester Metropolitan University, Manchester, United Kingdom.
| | - Michael J Callaghan
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Health and Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Lindsay Sudell
- Department of Physiotherapy, Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Terence W O'Neill
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; NIHR Manchester Biomedical Research Centre, Manchester University NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, United Kingdom; Department of Rheumatology, Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - Gillian Yeowell
- Centre for Epidemiology Versus Arthritis, Faculty of Biology, Medicine, And Health, Manchester Academic Health Science Centre, The University of Manchester, Manchester, United Kingdom; Department of Health and Professions, Manchester Metropolitan University, Manchester, United Kingdom
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Hartley SE, Ryad H, Yeowell G. Future-proofing the Profession: Physiotherapists' perceptions of their current and emerging role. Physiotherapy 2022; 119:72-79. [PMID: 36940489 DOI: 10.1016/j.physio.2022.11.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2022] [Revised: 11/15/2022] [Accepted: 11/28/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVES As healthcare systems continue to modernise, physiotherapists are required to transform their practice to remain contemporary and meet future population needs. The study aims to gain an insight into physiotherapists' perceptions of their current and emerging future role. The intention is to develop an understanding of the physiotherapist's role and how it can continue to evolve to support populations' needs in more sustainable and innovative ways. DESIGN A qualitative design using semi-structured interviews was undertaken informed by Gadamerian hermeneutic philosophy. PARTICIPANTS Participants were gained from a postgraduate physiotherapy programme in Northwest England that recruits physiotherapists from across the UK; via the research teams' professional networks and using snowball sampling. Interviews were digitally recorded and transcribed verbatim. Thematic analysis was undertaken. Ethical approval and informed consent was obtained. RESULTS 23 participants (15 female). 4 themes were identified: 'An underpinning philosophy of practice' that promotes holistic care and supports patient wellbeing. An 'evolving role broadening the scope of practice' with many 'agents of change shaping the profession'. When 'preparing the future workforce and their transition into practice', graduates were seen as more adaptable and resilient. However, more affiliation between the university and placement providers to enhance learning environments is needed. CONCLUSIONS Physiotherapists need to re-evaluate their role so a clear vision for the future can be co-created to ensure they remain contemporary and continue to optimise their potential. An emerging role that re-envisages a holistic approach that incorporates health promotion as fundamental to this role could support physiotherapists' transformation in practice. CONTRIBUTION OF THE PAPER.
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Affiliation(s)
- Sandra Elaine Hartley
- Department of Health Professions, Brooks Building, Birley Campus, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, England, UK.
| | - Hanane Ryad
- Department of Health Professions, Brooks Building, Birley Campus, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, England, UK.
| | - Gillian Yeowell
- Department of Health Professions, Brooks Building, Birley Campus, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, England, UK.
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Cuff A, Jesson T, Yeowell G, Dikomitis L, Foster NE, Littlewood C. Recommendations on patient-facing websites regarding diagnostic imaging for low back, knee, and shoulder pain: A scoping review. PEC Innov 2022; 1:100040. [PMID: 37213770 PMCID: PMC10194230 DOI: 10.1016/j.pecinn.2022.100040] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 12/15/2021] [Revised: 04/13/2022] [Accepted: 04/13/2022] [Indexed: 05/23/2023]
Abstract
Objective To describe and synthesise the content of public-facing websites regarding the use of diagnostic imaging for adults with lower back pain, knee, and shoulder pain. Methods Scoping review conducted in accordance with PRISMA guidance. A Google search was performed to identify public-facing websites that were either United Kingdom-based, or National Health Service affiliated. The DISCERN tool was used to appraise website quality before information regarding the use of imaging was synthesised using thematic analysis. Results Eighty-six websites were included, with 48 making reference to the use of imaging. The information within the majority (n = 43) of public-facing websites aligns with best available evidence. Where there is inconsistency, this may be explained by lower website quality. Three themes were apparent regarding the use of imaging - imaging to inform diagnosis and management; imaging in context; patient experience and expectations. Conclusion The recommendations and rationale for use of imaging contained within public-facing websites does not appear to justify the increase in imaging rates for musculoskeletal pain in the UK. Innovation Publicly available information following a novel search strategy, is largely aligned with best evidence, further understanding is required to determine reasons for requesting imaging from a patient and clinician perspective.
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Affiliation(s)
- Andrew Cuff
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, M15 6GX, UK
- Connect Health, The Light Box, Quorum Business Park, Benton Lane, Newcastle-upon-Tyne, NE13 8EU, UK
- Corresponding author at: Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, M15 6GX, UK.
| | - Thomas Jesson
- Connect Health, The Light Box, Quorum Business Park, Benton Lane, Newcastle-upon-Tyne, NE13 8EU, UK
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, M15 6GX, UK
| | - Lisa Dikomitis
- Kent and Medway Medical School, University of Kent and Canterbury Christ Church University, UK
| | - Nadine E. Foster
- Versus Arthritis Primary Care Centre, School of Medicine, David Weatherall Building, Keele University, Staffordshire, ST5 5BG, UK
- STARS Education and Research Alliance, Surgical Treatment and Rehabilitation Service, The University of Queensland and Metro North Health, Queensland, Australia
| | - Chris Littlewood
- Faculty of Health, Social Care and Medicine, Edge Hill University, Ormskirk, Lancashire, L39 4QP, UK
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Rezaeian Z, Andalib A, Bokaee F, Poorpooneh Najafabadi M, Yeowell G, Sadeghi-Demneh E. The efficacy of trunk bracing with an instrumented corrective exercise on spinal deformity, pulmonary function, trunk muscle endurance and quality of life in adolescent idiopathic scoliosis: Protocol for a parallel-groups clinical study (Preprint). JMIR Res Protoc 2022; 12:e43265. [PMID: 36989018 PMCID: PMC10131677 DOI: 10.2196/43265] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Revised: 11/26/2022] [Accepted: 11/28/2022] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Adolescent idiopathic scoliosis is a 3D spine distortion with an unidentified etiology. It results in noticeable trunk deformity, decreased muscle strength and endurance at the trunk, changes in chest volume, breathing issues, and ultimately a decline in the quality of life. Trunk bracing and corrective exercises make up most of the treatment of patients with scoliosis when their deformity is between 20° and 45°, and they have not yet attained skeletal maturity. Evidence suggests that spinal deformity in people with scoliosis may result from improper motor control. Automatic response training is an exercise therapy technique that can modify the pattern of trunk muscle control for supporting the spinal column in normal alignment. An apparatus called a cantilever device is required for this type of exercise, which facilitates training at home. In spite of research showing the benefit of braces and therapeutic exercise in adolescents with scoliosis, less emphasis has been given to the impact of home-based training, especially when this intervention is paired with braces. OBJECTIVE We aim to compare the efficacy of bracing and a conventional exercise program to a combination treatment that includes trunk bracing and exercises with a cantilever device performed at home on the degree of spine curvature, pulmonary function, trunk muscular endurance, and quality of life. METHODS This study was a 2-arms parallel-group clinical study. A total of 16 adolescents with idiopathic scoliosis and single lumbar and thoracolumbar curves of 20°-45° were recruited and randomly assigned into 2 groups. Group A received a combination of trunk bracing and exercise using an instrument known as a "cantilever." Group B (controls) received trunk bracing and a conventional exercise program (without a tool). The study outcomes were the Cobb angle of the scoliotic curve, pulmonary function, the endurance of the trunk muscles, and quality of life. The study outcomes were measured at 2 time points: before the intervention (T1) and 12 weeks following the start of the intervention (T2; at this time, the intervention period has been completed). Multivariate analysis of variance was used to test between- and within-group differences. RESULTS Recruitment for this study began in fall 2022 and is expected to be completed by the end of summer 2023. CONCLUSIONS We studied the efficacy of a combined trunk bracing program and postural response exercises using a cantilever device in treating adolescent idiopathic scoliosis and compared it with trunk bracing and conventional home exercises. Exercises performed at home using a cantilever device are anticipated to raise the endurance of trunk muscles, which will help reduce trunk deformity, enhance pulmonary function, and improve the quality of life of participants. TRIAL REGISTRATION Iranian Registry of Clinical Trials IRCT20220330054371N1; https://www.irct.ir/trial/62811. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) PRR1-10.2196/43265.
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Affiliation(s)
- Zeinab Rezaeian
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Ali Andalib
- Department of Orthopaedic Surgery, Musculoskeletal Research Center, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Fateme Bokaee
- Department of Physiotherapy, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | | | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ebrahim Sadeghi-Demneh
- Department of Orthotics and Prosthetics, Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Saiklang P, Puntumetakul R, Selfe J, Yeowell G. An Evaluation of an Innovative Exercise to Relieve Chronic Low Back Pain in Sedentary Workers. Hum Factors 2022; 64:820-834. [PMID: 33111563 DOI: 10.1177/0018720820966082] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
OBJECTIVE The purpose of the study was to examine the effectiveness of a novel supported dynamic lumbar extension with the abdominal drawing-in maneuver (ADIM) technique on stature change, deep abdominal muscle activity, trunk muscle fatigue, and pain intensity during prolonged sitting in chronic low back pain (CLBP) participants. BACKGROUND Prolonged sitting can cause trunk muscle fatigue from continuous contraction of deep trunk muscles in seated postures. Deficiency of activity of deep muscles can reduce muscular support of the spine, causing stress on spinal structures, which could result in pain. METHOD Thirty participants with CLBP were randomly allocated: (a) control-sitting without exercise, and (b) intervention-supported dynamic lumbar extension with the ADIM technique. RESULTS Compared to the intervention condition, the control condition demonstrated significantly greater deterioration in stature change, increased levels of deep trunk muscle fatigue, and an increase in pain during prolonged sitting. CONCLUSION The supported dynamic lumbar extension with the ADIM technique appears to provide a protective effect on detrimental stature change and deep trunk muscle fatigue. In addition, it prevented an increase in pain intensity during prolonged sitting in people with CLBP. APPLICATION Sedentary behavior harms health, particularly affecting the lower back. Clinicians can use the intervention to induce dynamic lumbar movement, and this exercise can maintain deep trunk muscle activity during prolonged sitting, thereby helping to prevent low back pain (LBP) problems.
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Jafarian FS, Jafari-Harandi M, Yeowell G, Sadeghi-Demneh E. The Efficacy of Lumbar Support on Pain, Disability, and Motor Control in Women With Postpartum Pelvic Girdle Pain: Protocol for a Randomized Controlled Trial. JMIR Res Protoc 2022; 11:e40553. [PMID: 35857366 PMCID: PMC9350821 DOI: 10.2196/40553] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 07/11/2022] [Accepted: 07/12/2022] [Indexed: 11/30/2022] Open
Abstract
Background Pregnancy-related posterior pelvic girdle pain (PPGP) is one of the most important clinical manifestations of postpartum back pain. Those affected often complain of discomfort during daily activities. It is hypothesized that altered motor control is associated with perceived pain. Pelvic support can regulate possible underlying altered motor control mechanisms and decrease pain. However, the influence of a lumbosacral orthosis, which is broader support that allows for a wider contact area and more skin sensory stimulation to restore proper motor function, has not yet been investigated in women with postpartum PPGP. Objective This study investigates the efficacy of broader lumbar support and narrower pelvic support on pain, proprioception, disability, and muscle strength in women with pregnancy-related PPGP. Methods This study will be a single-center, 3-armed, participant-blinded, randomized controlled trial. In total, 84 women diagnosed with pregnancy-related PPGP will be recruited and randomly assigned into 3 groups. Intervention groups A and B will receive pelvic and lumbar supports, respectively. Group C (control) will receive only a patient education leaflet containing advice on strengthening exercises, comfortable positions, and other practical information. The study outcomes are pain, effort score during the active straight leg raising test, maximum isometric hip flexion force, maximum isometric hip external rotation force, maximum isometric trunk rotation force, and joint position reproduction of hip abduction. The study outcomes will be measured at 4 time points: baseline (T1), immediately after the intervention (T2), 4 weeks following interventions began (at this time, the intervention period is completed) (T3), and 1 week after discontinuing the interventions (T4) to evaluate the possible lasting effects of wearing supports. Multivariate analysis of variance will be used to test between- and within-group differences. Results Recruitment for this study will be started in summer 2022 and is expected to be completed by the end of fall 2022. Conclusions This study will examine the efficacy of broader lumbar support as an early rehabilitative treatment for women receiving postpartum posterior pelvic pain support compared to those receiving a narrower pelvic support. We expect the broader lumbar support to impact pain management and disability better than the current narrower pelvic belt. Long-term follow-up studies will help determine whether such lumbosacral orthosis reduces pain and improves daily activities in women with pregnancy-related PPGP. Trial Registration Iranian Registry of Clinical Trials IRCT20150210021034N11; https://www.irct.ir/trial/54808 International Registered Report Identifier (IRRID) PRR1-10.2196/40553
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Affiliation(s)
- Fahimeh-Sadat Jafarian
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mahmonir Jafari-Harandi
- Department of Obstetrics & Gynecology, School of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Ebrahim Sadeghi-Demneh
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
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Yeowell G, Leech R, Greenhalgh S, Willis E, Selfe J. Medico-legal litigation of UK physiotherapists in relation to cauda equina syndrome: a multimethods study. BMJ Open 2022; 12:e060023. [PMID: 35820745 PMCID: PMC9274518 DOI: 10.1136/bmjopen-2021-060023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
OBJECTIVE The aim was to investigate the extent of cauda equina syndrome (CES) litigation and explore the process of medico-legal litigation in relation to physiotherapy in the UK. DESIGN A multimethods inquiry that followed on from a previously conducted scoping literature review was undertaken to address the aim. This included freedom of information requests and direct communication with relevant stakeholders and organisations. RESULTS A total of 2496 CES claims were found in the UK between 2012 and 2020. 51 of these were attributed to physiotherapists. There was little information available to physiotherapists regarding the legal process of litigation and much of this information was not from a physiotherapist's perspective. CONCLUSION This is the first study that has investigated the extent and process of CES litigation in physiotherapy in the UK. The extent of CES litigation appears to be high considering CES is a rare spinal condition. Furthermore, the extent of CES litigation is suspected to be considerably higher than the data reported in this study due to the issues identified in how CES claims are recorded. Finally, there is no clearly articulated, easily accessible information describing the process and support available for physiotherapists in receipt of a legal claim.
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Affiliation(s)
- Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Rachel Leech
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Susan Greenhalgh
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
- Orthopaedic Interface Service, Bolton One, Bolton NHS Foundation Trust, Bolton, UK
| | - Emma Willis
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - James Selfe
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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May P, Yeowell G, Connell L, Littlewood C. An analysis of publicly available National Health Service information leaflets for patients following an upper arm break. Musculoskelet Sci Pract 2022; 59:102531. [PMID: 35228112 DOI: 10.1016/j.msksp.2022.102531] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Revised: 01/27/2022] [Accepted: 02/16/2022] [Indexed: 10/19/2022]
Abstract
BACKGROUND Recovery following an upper arm break can be prolonged and cause loss of independence. Appropriate information provision to empower and enable active participation in rehabilitation is vital to achieve the best clinical outcomes. OBJECTIVES To identify and analyse, through the lens of health literacy, publicly available information leaflets produced for patients following upper arm breaks in the United Kingdom National Health Service (NHS) to understand their fitness for purpose. METHOD An electronic search of online search engines was undertaken using search terms to identify information leaflets for upper arm breaks. Relevant leaflets were retrieved and a thematic analysis was undertaken from a health literacy perspective. To complement this, each information leaflet was also formally assessed for readability. RESULTS Thirty-five information leaflets were analysed. Two main themes were generated: 'Empowerment' and 'Language Use', with subthemes of promoting recovery, readability and risk of misinterpretation. The information presented in these leaflets was often complicated and sometimes contradictory. Less than half (46%) of the information leaflets were presented at a level that would be understood by the general population. CONCLUSIONS Current information leaflets made available for patients following upper arm breaks are not fit for purpose and are written in a way that the general population would not readily understand. There is an urgent need to understand the information needs of patients and present such information in an accessible way to optimise clinical outcomes following upper arm breaks.
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Affiliation(s)
- Pauline May
- East Lancashire Hospitals NHS Trust, Burnley, UK.
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Louise Connell
- Allied Health Research Unit, University of Central Lancashire/Rakehead Rehabilitation Centre, East Lancashire Hospitals NHS Trust, Burnley, UK
| | - Chris Littlewood
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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Bello B, Hartley SE, Yeowell G. Nigerian physiotherapists’ knowledge, current practice and perceptions of their role for promoting physical activity: A cross-sectional survey. PLoS One 2022; 17:e0266765. [PMID: 35536853 PMCID: PMC9089902 DOI: 10.1371/journal.pone.0266765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2021] [Accepted: 03/25/2022] [Indexed: 12/03/2022] Open
Abstract
Background Nigeria has the highest rates of physical inactivity in Africa. As physical inactivity is a leading global risk factor for non-communicable diseases (NCD), physical activity promotion is a strategy for their mitigation. Physiotherapists are already ideally situated to undertake this role and can assist in the reversal of NCD. Gaining insight into how physiotherapists in Nigeria perceive their role in relation to physical activity promotion is needed to ensure this undertaking will be effective. This national survey aimed to investigate Nigerian physiotherapists’ knowledge and current practice for promoting physical activity across Nigeria and perceptions of their role related to this. Methods Following ethical approval, a cross-sectional, online questionnaire survey design was employed to investigate the aim. 330 qualified physiotherapists, working across Nigeria were recruited. Internal consistency of the survey was examined using Cronbach’s alpha. Descriptive statistics were used to analyse closed questions. Thematic content analysis was used to analyse open-ended questions. Chi-square inferential statistic was used to investigate the association between variables with alpha interpreted at a level of 0.05. Results The internal consistency of the questionnaire survey was good overall (Cronbach Alpha α = 0.71). 330 physiotherapists participated. 99.4% agreed that discussing the benefits of a physically active lifestyle with patients is part of their role. However, over 60% did not feel confident in suggesting specific physical activity programs for their patients. 59.7% were aware of one or more physical activity guideline. However, only 49.1% were incorporating it into their practice. 85.5% felt that developing a physical activity guideline specifically for Nigeria would promote physical activity. 63.3% of respondents did not use any resource in promoting physical activity. An association was found between the physiotherapist’s awareness of physical activity guidelines and male sex (χ2 = 8.95, df = 2, p = 0.01). Conclusion Whilst most physiotherapists had a positive perception of their role in promoting physical activity, translating this into practice would seem to be challenging. A systems approach to physical activity health promotion is recommended with the need for a commitment by the Nigerian Government to the development and implementation of national guidelines. Incorporating more training in physiotherapy education could foster more confidence in the delivery of these guidelines. Greater use of resources and working with community organisations could help to optimise physical activity uptake in Nigeria.
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Affiliation(s)
- Bashir Bello
- Department of Physiotherapy, Faculty of Allied Health Sciences, Bayero University Kano, Kano, Nigeria
| | - Sandra Elaine Hartley
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, United Kingdom
- * E-mail:
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Asgari N, Yeowell G, Sadeghi-Demneh E. A comparison of the efficacy of textured insoles on balance performance in older people with versus without plantar callosities. Gait Posture 2022; 94:217-221. [PMID: 35367850 DOI: 10.1016/j.gaitpost.2022.03.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/08/2022] [Accepted: 03/27/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND Textured insoles have been suggested to enhance foot sensation, which contributes to controlling upright balance. However, the interaction between plantar callosity and the textured surface has not been studied. RESEARCH QUESTION Firstly, to compare the efficacy of textured insoles on balance performance and foot position sense between two groups of older people: one group had plantar callosity, and the other did not. Secondly, to investigate the efficacy of textured insoles within each study group. METHODS Thirty older people with a history of falls (15 with plantar callosity and 15 without callosity) participated in this study. All participants underwent assessments of postural sway on a force plate, joint position sensation of the ankle with a slope box, and mobility using the "Timed Up and Go" test under three insole surface conditions: 1) smooth (control), 2) placebo and 3) textured surface. Two-way analyses of variance were used to compare the outcomes of the two groups and three conditions. RESULTS Older people with plantar callosity had worse ankle joint position sense and slower antero-posterior and mediolateral postural sway velocity than their peers who did not have plantar callosity. The textured insoles improved ankle joint position sense and mobility regardless of callus status in the plantar surface of older peoples' feet. The insole-callosity interaction was not significant for any study outcome. SIGNIFICANCE Textured insoles could be beneficial to older people with and without callosity as they have shown immediate improvements in ankle joint position sense and mobility.
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Affiliation(s)
- Narjes Asgari
- Student Research Committee, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Ebrahim Sadeghi-Demneh
- Musculoskeletal Research Center, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran.
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Bury J, Yeowell G, Jinks C, Selfe J, Littlewood C. Development of an intervention ‘The COMBINED approach’ to optimise current treatments for people with a rotator cuff disorder. Physiotherapy 2022. [DOI: 10.1016/j.physio.2021.12.146] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Sadeghi-Demneh E, Jafarian FS, Yeowell G. Cross-cultural adaptation and validation of the Bad Sobernheim Stress questionnaire in Iranian adolescents with idiopathic scoliosis using thoracolumbar orthoses. Adv Biomed Res 2022; 11:39. [PMID: 35814302 PMCID: PMC9259448 DOI: 10.4103/abr.abr_154_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Revised: 07/17/2021] [Accepted: 07/18/2021] [Indexed: 11/19/2022] Open
Abstract
Background: The assessment of the emotional consequences of having a spinal deformity and orthotic management in people with idiopathic scoliosis is essential. This study was aimed to translate and culturally adapt the Bad Sobernheim Stress questionnaire (BSSQ-Brace) for Iranian adolescents with idiopathic scoliosis using thoracolumbar orthoses. Materials and Methods: The BSSQ was translated into Persian according to a standard guideline. The Persian BSSQ-Brace was completed by 55 Iranian subjects with spinal deformities who agreed to participate in this research. The validity was determined by correlating the Persian BSSQ-Brace questionnaire (BrQ) and the revised Scoliosis Research Society-22 patient questionnaire (SRS-22r). To assess test-retest reliability, all participants completed the BSSQ-Brace twice, with a gap of 1-week. Intraclass Correlation Coefficient and Cronbach's alpha were measured to report reliability. Results: All population revealed items in the Persian BSSQ-Brace were easily understood, and there was no difficulty completing them. The psychometric properties of the Persian version of BSSQ-Brace demonstrated excellent test-retest reliability (interclass correlation coefficient = 0.94), excellent internal consistency (Chronbach's alpha = 0.94), and high construct validity with SRS-22r (r = 0.74). Conclusions: The Persian BSSQ-Brace is a reliable and valid instrument to assess the emotional domains in subjects wearing a spinal orthosis.
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Leech RL, Selfe J, Ball S, Greenhalgh S, Hogan G, Holway J, Willis E, Yeowell G. A scoping review protocol: Investigating the extent and legal process of cauda equina syndrome claims for UK physiotherapists. Musculoskeletal Care 2021; 19:457-461. [PMID: 34904357 DOI: 10.1002/msc.1550] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Revised: 02/19/2021] [Accepted: 02/20/2021] [Indexed: 11/11/2022]
Abstract
INTRODUCTION Cauda equina syndrome (CES) is a condition where early identification and treatment is crucial to avoid potentially devastating effects. There is a high number of litigation cases linked with CES given it is a relatively rare condition. This scoping review protocol proposes to explore the extent and process of CES litigation in UK healthcare context cases amongst UK physiotherapists. METHODS AND ANALYSIS The methodological framework recommended by Arksey and O'Malley, Levac et al. and the Joanna Briggs Institute will be used throughout this review to aid reporting and transparency. A patient and public involvement (PPI) group meeting was convened at the beginning of the review process in order to provide knowledge exchange to inform the search strategy and propose resources to be used during the scoping review. Two reviewers will independently review the literature in order to apply the inclusion and exclusion criteria. Once the studies to be included have been identified, the data from these studies will be extracted and charted. Results will show quantitative data of the studies included in the review and a narrative synthesis of the literature. DISSEMINATION This scoping review will evaluate the existing knowledge relating to CES and litigation and will map the key concepts around this topic. Results will be disseminated to practitioners and policy-makers through peer-reviewed publications, conferences, reports and social media. This method may prove helpful to others who are investigating extent and processes relating to medicolegal cases involving healthcare practitioners. REGISTRATION The current paper is registered with OSF registries (DOI 10.17605/OSF.IO/MP6Y3).
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Affiliation(s)
- Rachel L Leech
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - James Selfe
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Suzanne Ball
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Susan Greenhalgh
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.,Bolton NHS Foundation Trust, Bolton, UK
| | - Gareth Hogan
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Janene Holway
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Emma Willis
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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21
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Yeowell G, Burns D, Fatoye F, Gebrye T, Wright A, Mwacalimba K, Odeyemi I. Indicators of Health-Related Quality of Life in Cats With Degenerative Joint Disease: Systematic Review and Proposal of a Conceptual Framework. Front Vet Sci 2021; 8:582148. [PMID: 34869707 PMCID: PMC8636455 DOI: 10.3389/fvets.2021.582148] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Accepted: 10/19/2021] [Indexed: 11/13/2022] Open
Abstract
Objectives: The assessment of health-related quality of life (HRQoL) is becoming increasingly important in companion animals. This study describes a systematic review and development of a proposed conceptual framework to assess HRQoL in cats with osteoarthritis (OA). Methods: The conceptual framework was developed according to published guidelines. A comprehensive search of the CAB Direct, Scopus, PubMed, and Web of Science databases was carried out for publications in English from inception to November 12, 2019. Search words used were "cat", "feline", "chronic pain", "pain", and "quality of life". Publications were selected if they were full-text and peer-reviewed, based on primary data, and identified or measured behavioral symptoms of chronic musculoskeletal pain in cats. A systematic review was conducted according to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. A data extraction form was developed from categories identified in the literature review and piloted on a small number of studies to ascertain the appropriateness for relevant data extraction. Categories were then finalized, and key domains were identified. The domains were then synthesized to develop a conceptual framework. Results: A total of 454 studies were identified, of which 14 met the eligibility criteria and were included in the meta-synthesis. All 14 were assessed to be of good quality. Seven domains related to HRQoL in cats with OA were thematically identified from the data: mobility, physical appearance, energy and vitality, mood, pain expression, sociability, and physical and mental wellbeing. The three main HRQoL domains were pain expression, mobility, and physical and mental wellbeing, which impacted all the others. Pain and mobility impacted all six other domains, with increased pain and decreased mobility negatively impacting physical appearance, energy and vitality, mood, sociability, and physical and mental wellbeing. Conclusions and Relevance: This is the first study to develop an evidence-based conceptual framework for the assessment of HRQoL in cats with OA. The proposed conceptual framework suggests that effective management of chronic pain in cats may improve their overall HRQoL.
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Affiliation(s)
- Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Danielle Burns
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Tadesse Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
| | - Andrea Wright
- Outcomes Research, International Center of Excellence, Zoetis, Dublin, Ireland
| | | | - Isaac Odeyemi
- Outcomes Research, International Center of Excellence, Zoetis, Dublin, Ireland
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Leech RL, Selfe J, Ball S, Greenhalgh S, Hogan G, Holway J, Willis E, Yeowell G. A scoping review: Investigating the extent and legal process of cauda equina syndrome claims for UK physiotherapists. Musculoskelet Sci Pract 2021; 56:102458. [PMID: 34547610 DOI: 10.1016/j.msksp.2021.102458] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/06/2021] [Revised: 08/11/2021] [Accepted: 09/04/2021] [Indexed: 10/20/2022]
Abstract
INTRODUCTION Cauda Equina Syndrome (CES) is a condition where early identification and treatment is crucial to avoid potentially life changing devastating effects. This paper reviews the extent and process of CES litigation amongst UK physiotherapists. METHODS A well-established framework by Arksey and O'Malley was followed when completing the current scoping review. Records were identified via a comprehensive search of three databases as well as website and grey literature searching. Data was extracted and a descriptive analysis and thematic summary were formed. RESULTS AND DISCUSSION A total of N = 1639 records were identified, following removal of duplicates and screening of titles and abstracts N = 211 full text records were screened and N = 39 were included for full analysis. CONCLUSIONS This study is the first to investigate the extent and process of CES litigation for physiotherapists in the UK. Our data suggest that between 2009 and 2021 there were 15 CES claims recorded against physiotherapists which is 0.7% of all CES claims recorded in the UK. In terms of the legal process for CES claims, there is currently limited information for physiotherapists and what steps they would need to take once they receive notification they are being sued. REGISTRATION The current paper is registered with OSF registries (DOI 10.17605/OSF.IO/6FCXN).
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Affiliation(s)
- Rachel L Leech
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.
| | - James Selfe
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Suzanne Ball
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Susan Greenhalgh
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK; Bolton NHS Foundation Trust, Orthopaedic Interface Service, Bolton One, Bolton, Manchester, UK
| | - Gareth Hogan
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Janene Holway
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Emma Willis
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK
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Chatprem T, Puntumetakul R, Kanpittaya J, Selfe J, Yeowell G. A diagnostic tool for people with lumbar instability: a criterion-related validity study. BMC Musculoskelet Disord 2021; 22:976. [PMID: 34814879 PMCID: PMC8609735 DOI: 10.1186/s12891-021-04854-w] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2021] [Accepted: 11/08/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Several clinical tests used to identify patients with lumbar instability have reported diagnostic accuracy in separate studies with conflicting results. To augment the diagnostic process, tests that are better able to identify lumbar instability suitable for use in the clinical setting are required. The aim of this study was to identify the probability to diagnose patients with lumbar instability, using x-ray imaging as the reference standard. METHODS This study was a cross-sectional, diagnostic validity study. One hundred forty participants with chronic low back pain underwent an x-ray assessment and 14 clinical examinations. Data were analysed using multivariate regression methods to determine which clinical tests were most diagnostic for lumbar instability when they were applied together. RESULTS Eighteen (12.85%) participants had radiological lumbar instability. Three clinical tests i) interspinous gap change during flexion-extension, ii) passive accessory intervertebral movement tests, iii) posterior shear test demonstrated an ability to diagnose lumbar instability of 67% when they were all positive. At this probability threshold, sensitivity, specificity, positive likelihood ratio (+LR), and negative likelihood ratio (-LR) were 5.56, 99.18%, 6.78, and 0.95. CONCLUSIONS These 3 clinical tests could be useful in identifying patients with lumbar instability in the general community. These three tests are simple to perform by physical therapists, reliable to use in a clinical setting, and safe for patients. We recommend physical therapists use these three tests to assess patients who are suspected of having lumbar instability, in the absence of an x-ray assessment, to receive appropriate targeted intervention or referral for further investigation. TRIAL REGISTRATION Thai Clinial Trial Registry (TCTR 20180820001; 19th August 2018).
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Affiliation(s)
- Thiwaphon Chatprem
- Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, Thailand
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand
- The Thailand Research Fund (TRF), Bangkok, Thailand
| | - Rungthip Puntumetakul
- Research Center in Back, Neck, Other Joint Pain and Human Performance (BNOJPH), Faculty of Associated Medical Sciences, Khon Kaen University, Khon Kaen, 40002, Thailand.
| | - Jaturat Kanpittaya
- Department of Radiology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand
| | - James Selfe
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Faculty of Health and Education, Manchester Metropolitan University, Manchester, UK
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Yeowell G, Burns DS, Fatoye F. The burden of pharmacological treatment on health-related quality of life in people with a urea cycle disorder: a qualitative study. J Patient Rep Outcomes 2021; 5:110. [PMID: 34694515 PMCID: PMC8546029 DOI: 10.1186/s41687-021-00387-x] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 10/11/2021] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND Urea cycle disorders (UCD) are inborn errors of metabolism, typically presenting neonatally. Excess ammonia builds rapidly within the body risking hyperammonemic episodes and potentially death. Long-term management of the condition includes restrictive protein consumption, pharmacological interventions and, in extreme cases, liver transplantation. Pharmacological treatments such as sodium benzoate and sodium phenylbutyrate have proven effective but not without a multitude of negative attributes including poor taste, higher dosage and associated gastrointestinal discomfort that impacts health-related quality of life. Glycerol phenylbutyrate (GPB) has recently become a widely available pharmacological treatment with early reports of improved qualities, including taste and administration method. The following study aims to explore the burden of pharmacological treatment and the effects of the transition to GPB on health-related quality of life in people with a UCD. RESULTS Nine carers of children living with a UCD (mean age = 12.44, SD = 10.26) were interviewed regarding their experiences of pharmacological treatment in relation to their, and their child's, health-related quality of life after transitioning to GPB. Three main themes were identified: psychological health, physical health and social participation. Carers struggled with anxiety surrounding their child's condition and the battle of administering medication. Medication administration was perceived to have improved since the transition to GPB, alleviating distress for both carer and child. Issues involving school were described, ranging from difficulties integrating their child into mainstream schooling and the impact of treatment on participation in school and extracurricular activities. Carers encountered issues sourcing syringes to administer GPB, which induced stress. It could be suggested that some burden had been relieved by the transition to GPB. However, it appeared that difficulties associated with the illness would persist despite treatment, owing to the continuing nature of the condition. CONCLUSIONS Adhering to a strict pharmacological regime caused immense stress for both carers and children, severely impacting on typical social activities such as eating at a restaurant or going on holiday. GPB was perceived to have alleviated some burden in terms of administration given improved characteristics concerning taste and dosage, important characteristics for both carers and children living with UCD. Practitioners should consider these findings when making clinical decisions for children with UCD and the effect of pharmacological treatment on carer's health-related quality of life. Outreach work to facilitate greater understanding of the condition should be conducted with key locations, such as children's schools. This would also help to alleviate carer burden.
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Affiliation(s)
- Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6GX, UK.
| | - Danielle Stephanie Burns
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6GX, UK
| | - Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6GX, UK
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Mitham K, Mallows A, Yeowell G, Littlewood C. Management of recent onset tendon-related pain in a primary contact setting: A survey of practice. Musculoskeletal Care 2021; 20:86-98. [PMID: 33934483 DOI: 10.1002/msc.1556] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Revised: 03/27/2021] [Accepted: 03/31/2021] [Indexed: 11/08/2022]
Abstract
BACKGROUND Tendon-related pain is a common and debilitating condition that affects a wide range of people. To inform future research, it is important to understand healthcare professional's current practice. OBJECTIVES To describe the practice of First Contact Practitioners (FCPs) and Other Clinicians (OCs) for recent onset tendon pain in a primary contact setting. The secondary aim was to understand if practice differed between the locations of pain. DESIGN Cross-sectional online survey METHOD: The online survey asked for responses relating to one scenario of shoulder pain and one of Achilles pain. Except location of pain, the scenarios were identical. Responses were collected over a four-week period to December 2020. The Chi-Square test was used to analyse the difference in proportion of responses between FCPs and OCs, and between locations of pain. RESULTS 118 responses were received. Rotator Cuff Related Shoulder Pain (RCRSP) was preferred by 64/118 (54.2%) for the shoulder scenario. Achilles tendinopathy was the preferred term by 86/103 (83.5%) for the Achilles. FCPs were more likely to advise NSAIDs for both shoulder (p = 0.006) and Achilles (p = 0.046) scenarios than OCs. Amended duties were more likely to be advised for manual workers for the shoulder scenario compared to Achilles (p = <0.0001). CONCLUSION There were similarities in the management of recent onset tendon-related pain; the majority of respondents recommended against further investigations, steroid injections, and recommended exercise. Understanding whether these approaches are clinically effective requires further investigation.
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Affiliation(s)
- Kieran Mitham
- Dynamic Health, Physiotherapy Department, Cambridgeshire Community Services NHS Trust, Huntingdon, Cambridgeshire, UK
| | - Adrian Mallows
- School of Sport, Rehabilitation & Exercise Sciences, University of Essex, Colchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
| | - Chris Littlewood
- Department of Health Professions, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, Manchester, UK
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Fatoye F, Yeowell G, Wright JM, Gebrye T. Clinical and cost-effectiveness of physiotherapy interventions following total knee replacement: a systematic review and meta-analysis. Arch Orthop Trauma Surg 2021; 141:1761-1778. [PMID: 33554305 PMCID: PMC8437854 DOI: 10.1007/s00402-021-03784-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2020] [Accepted: 01/07/2021] [Indexed: 11/29/2022]
Abstract
PURPOSE Osteoarthritis is the single most common cause of pain and disability in older adults. This review addresses the question of the clinical effectiveness and cost-effectiveness of physiotherapy interventions following total knee replacement (TKR). METHODS A systematic review was conducted according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. MEDLINE, CINAHL, AMED, DARE, HTA and NHS EED databases were searched from inception to 02 May 2020. Search terms related to the clinical and cost-effectiveness of physiotherapy interventions were used. Studies meeting the inclusion criteria were identified and key data were extracted. Random effect meta-analysis was conducted for pain, physical function and range of motion (ROM). RESULTS In total, 1467 studies were identified. Of these, 26 studies were included; methodological quality of most studies was adequate. Physiotherapy interventions were more effective than control for function, SMD - 0.166 [95% Confidence Interval (CI) - 0.420 to 0.088.] and ROM, SMD - 0.219 [95% CI - 0.465 to 0.028] for a follow-up of 2 or 3 months. Patients in the intervention group showed improvement in pain at 12-13 weeks, SMD - 0.175 [95% CI - 0.416 to 0.067]. No evidence on the pooled estimate of cost-effectiveness of physiotherapy interventions was found. CONCLUSIONS This is the first systematic review and meta-analysis that has examined the clinical and cost-effectiveness of physiotherapy interventions following TKR. The findings of this review suggest that physiotherapy interventions were effective for improving physical function, ROM and pain in a short-term follow-up following TKR. Insufficient evidence exists to establish the benefit of physiotherapy in the long term for patient with TKR. Further study should examine the long-term effectiveness and cost-effectiveness of physiotherapy interventions.
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Affiliation(s)
- F Fatoye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK.
| | - G Yeowell
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
| | - J M Wright
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
| | - T Gebrye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
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Greenhalgh S, Selfe J, Yeowell G. A qualitative study to explore the experiences of first contact physiotherapy practitioners in the NHS and their experiences of their first contact role. Musculoskelet Sci Pract 2020; 50:102267. [PMID: 33032036 DOI: 10.1016/j.msksp.2020.102267] [Citation(s) in RCA: 15] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/24/2020] [Revised: 09/28/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022]
Abstract
PURPOSE First Contact Practitioner (FCP) roles have been developed for health professionals with advanced practice skills to take on many of the musculoskeletal responsibilities currently carried out by general practitioners. FCP roles are new and still developing. Currently there is little research that has investigated the experiences of FCPs. This knowledge could help stakeholders and other clinicians gain an understanding into what makes a successful FCP role. The aim of this research was to explore the experiences of FCP working in North West England to gain insight into the first point of contact service, and their experiences of this developing full time FCP role. METHODS A qualitative design using in-depth semi-structured, face-to-face interviews was undertaken to explore the experiences of FCP providing a first point of contact service. The study took place in an economically deprived and ethnically diverse location in North West England. FINDINGS Ten FCPs were recruited, four were appointed from Band 6 posts to FCP training posts, 9 were male. The mean years qualified was 12.8. Five themes were identified: 1. 'It's the level of clinical complexity that you're dealing with', 2. FCP role - rewards and challenges, 3. Own wellbeing, 4. Professional development and education, 5. Realities of working in practice governed by business. CONCLUSION FCP roles are an exciting development for people with MSK conditions, the physiotherapy profession, primary care providers and MSK physiotherapists. Mentorship support, workload and standards of training and practice are important when considering future expansion for the sustainability of these roles.
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Affiliation(s)
- S Greenhalgh
- Bolton NHS Foundation Trust, Orthopaedic Interface Service, Bolton One, Bolton, Manchester, UK; Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.
| | - J Selfe
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.
| | - G Yeowell
- Department of Health Professions, Faculty Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, UK.
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Delshad B, Zarean E, Yeowell G, Sadeghi-Demneh E. Response to the letter to the editor regarding our article: "The immediate effects of pelvic compression belt with a textured sacral pad on the sacroiliac function in pregnant women with lumbopelvic pain: A cross-over study". Musculoskelet Sci Pract 2020; 50:102247. [PMID: 32863194 DOI: 10.1016/j.msksp.2020.102247] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
Affiliation(s)
- Bahareh Delshad
- Student Research Committee, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Zarean
- Department of Obstetrics and Gynecology, Fato-maternal Medicine Unit, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Fatoye F, Wright JM, Yeowell G, Gebrye T. Clinical and cost-effectiveness of physiotherapy interventions following total hip replacement: a systematic review and meta-analysis. Rheumatol Int 2020; 40:1385-1398. [PMID: 32451696 PMCID: PMC7371665 DOI: 10.1007/s00296-020-04597-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/20/2020] [Accepted: 05/04/2020] [Indexed: 12/22/2022]
Abstract
To examine the reported clinical and cost-effectiveness of physiotherapy interventions following total hip replacement (THR). A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). MEDLINE, CINAHL, AMED, Scopus, DARE, HTA, and NHS EED databases were searched for studies on clinical and cost-effectiveness of physiotherapy in adults with THR published up to March 2020. Studies meeting the inclusion criteria were identified and key data were extracted. Risk of bias was assessed using the Cochrane Risk of Bias Tool and a Consolidated Health Economic Evaluation Reporting Standards (CHEERS). Data were summarised and combined using random-effect meta-analysis. A total of 1263 studies related to the aim of the review were identified, from which 20 studies met the inclusion criteria and were included in the review. These studies were conducted in Australia (n = 3), Brazil (n = 1), United States of America (USA) (n = 2), France (n = 2), Italy (n = 2), Germany (n = 3), Ireland (n = 1), Norway (n = 2), Canada (n = 1), Japan (n = 1), Denmark (n = 1), and United Kingdom (UK) (n = 1). The duration of follow-up of the included studies was ranged from 2 weeks to 12 months. Physiotherapy interventions were found to be clinically effective for functional performance, hip muscle strength, pain, and range of motion flexion. From the National Health Service perspective, an accelerated physiotherapy programme following THR was cost-effective. The findings of the review suggest that physiotherapy interventions were clinically effective for people with THR. However, questions remain on the pooled cost-effectiveness of physiotherapy interventions, and further research is required to examine this in patients with THR. Future studies are required to examine the cost-effectiveness of these interventions from patients, caregivers, and societal perspectives.Registration Prospero (ID: CRD42018096524).
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Affiliation(s)
- Francis Fatoye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK.
| | - J M Wright
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
| | - G Yeowell
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
| | - T Gebrye
- Department of Health Professions, Faculty of Health, Psychology, and Social Care, Manchester Metropolitan University, Brooks Building, 53 Bonsall Street, Manchester, M15 6GX, UK
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Blackburn J, Yeowell G. Patients’ perceptions of rehabilitation in the community following hip fracture surgery. A qualitative thematic synthesis. Physiotherapy 2020; 108:63-75. [DOI: 10.1016/j.physio.2020.02.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2019] [Indexed: 01/14/2023]
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Ashbrook J, Rogdakis N, Callaghan MJ, Yeowell G, Goodwin PC. The therapeutic management of back pain with and without sciatica in the emergency department: a systematic review. Physiotherapy 2020; 109:13-32. [PMID: 32846282 DOI: 10.1016/j.physio.2020.07.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Indexed: 11/16/2022]
Abstract
INTRODUCTION An increasing number of patients are attending the Emergency Department (ED) with back pain with or without sciatica. There is evidence to suggest that medical management is varied and inconsistent. OBJECTIVE The purpose of this study was to review the literature to determine the evidence base for the therapeutic management of adults presenting with back pain with or without sciatica in the ED. METHODS A systematic review of the literature included the therapeutic management of patients presenting in the ED. Articles published in peer review journals in English language up to August 2018 were searched for in the following data-bases: MEDLINE, EMBASE, SCOPUS, CINAHL, ZETOC, PubMed, The Cochrane Library (Cochrane Database of Systematic Reviews), Web of Science, Open Grey and ETHOS. A narrative synthesis approach was followed. RESULTS Twenty two studies, including 17 randomised control trials, one randomised control pilot study, two cohort studies, one cohort pilot study and one retrospective audit were included. The Downs and Black methodological quality scores ranged from 16 to 31 with a mean score of 24 out of a possible 32. CONCLUSION Evidence suggests that Naproxen alone should be considered as first line management in cases of back pain without sciatica. Intra-venous corticosteroids should be considered in the management of cases of severe sciatica. More high quality trials are needed to determine an evidence-based management protocol for the treatment of acute low back pain in the ED, specifically focusing on non-pharmacological management and the first line management of patients presenting with LBP with sciatica. Systematic Review Registration Number PROSPERO CRD42016042087.
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Affiliation(s)
- Jane Ashbrook
- Department of Health Professions, Manchester Metropolitan University, Manchester M15 6GX, UK.
| | - Nikolaos Rogdakis
- Physio Praxis Outpatient Clinic, 14, Ethnikis Aminis St., 54621 Thessaloniki, Greece
| | - Michael J Callaghan
- Department of Health Professions, Manchester Metropolitan University, Manchester M15 6GX, UK; Central Manchester NHS Foundation Trust, Oxford Road, Manchester M13 9WL, UK
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester M15 6GX, UK
| | - Peter Charles Goodwin
- Department of Health Professions, Manchester Metropolitan University, Manchester M15 6GX, UK
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Delshad B, Zarean E, Yeowell G, Sadeghi-Demneh E. The immediate effects of pelvic compression belt with a textured sacral pad on the sacroiliac function in pregnant women with lumbopelvic pain: A cross-over study. Musculoskelet Sci Pract 2020; 48:102170. [PMID: 32560872 DOI: 10.1016/j.msksp.2020.102170] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 04/08/2020] [Accepted: 04/17/2020] [Indexed: 10/24/2022]
Abstract
BACKGROUND Pelvic belt is being used to alleviate the symptoms of lumbopelvic pain. OBJECTIVE To investigate the immediate effects of a pelvic belt with a textured sacral pad in pregnant women with lumbopelvic pain. METHODS Twenty-eight pregnant women participated in a randomized crossover study. Hip joint position sense, maximum hip flexion force, and perceived effort during the active straight leg raising test were measured in twenty-eight pregnant women with lumbopelvic pain. Outcomes were measured in three randomized conditions including no pelvic belt (control), with a pelvic belt, and while a sacral pad was used with the pelvic belt. Data were analyzed using a one-way repeated measures analysis of variance for each variable. RESULTS Improvements in all study outcomes have been shown with a pelvic belt compared with the control condition. The addition of a textured sacral pad to the pelvic belt improved all study outcomes compared with the pelvic belt: hip joint position sense (p < 0.001; 95% confidence interval:1.3to2.3), perceived effort (p = 0.003; 95% confidence interval: 0.35 to 1.86), and maximum flexion force (p < 0.001; 95% confidence interval:2.77to6.47) in the active straight leg raising. CONCLUSION Further improvements were noted with the addition of the textured pad for all outcome measures. This finding may inform new benefits in adding a textured sacral pad to pelvic compression belts.
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Affiliation(s)
- Bahareh Delshad
- Student Research Committee, School of Rehabilitation Sciences, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Elaheh Zarean
- Department of Obstetrics and Gynecology, Feto-maternal Medicine Unit, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Hewitt S, Sephton R, Yeowell G. The Effectiveness of Digital Health Interventions in the Management of Musculoskeletal Conditions: Systematic Literature Review. J Med Internet Res 2020; 22:e15617. [PMID: 32501277 PMCID: PMC7305565 DOI: 10.2196/15617] [Citation(s) in RCA: 45] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2019] [Revised: 02/02/2020] [Accepted: 03/22/2020] [Indexed: 01/22/2023] Open
Abstract
Background Musculoskeletal conditions are the second greatest contributor to disability worldwide and have significant individual, societal, and economic implications. Due to the growing burden of musculoskeletal disability, an integrated and strategic response is urgently required. Digital health interventions provide high-reach, low-cost, readily accessible, and scalable interventions for large patient populations that address time and resource constraints. Objective This review aimed to investigate if digital health interventions are effective in reducing pain and functional disability in patients with musculoskeletal conditions. Methods A systematic review was undertaken to address the research objective. The review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The review protocol was registered with the International Prospective Register of Systematic Reviews before commencement of the study. The following databases were searched: Medical Literature Analysis and Retrieval System Online (MEDLINE), Excerpta Medica database (EMBASE), Cumulative Index to Nursing and Allied Health Literature, and Scopus from January 1, 2000, to November 15, 2019, using search terms and database specific−medical subject headings terms in various combinations appropriate to the research objective. Results A total of 19 English language studies were eligible for inclusion. Of the 19 studies that assessed musculoskeletal pain, 9 reported statistically significant reductions following digital intervention. In all, 16 studies investigated functional disability; 10 studies showed a statistically significant improvement. Significant improvements were also found in a range of additional outcomes. Due to the heterogeneity of the results, a meta-analysis was not feasible. Conclusions This review has demonstrated that digital health interventions have some clinical benefits in the management of musculoskeletal conditions for pain and functional disability. Digital health interventions have the potential to contribute positively toward reducing the multifaceted burden of musculoskeletal conditions to the individual, economy, and society. Trial Registration PROSPERO CRD42018093343; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=93343
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Affiliation(s)
- Stephanie Hewitt
- St Helens Therapy Department, North West Boroughs Healthcare NHS Foundation Trust, Merseyside, United Kingdom
| | - Ruth Sephton
- St Helens Therapy Department, North West Boroughs Healthcare NHS Foundation Trust, Merseyside, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, United Kingdom
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Stephens G, O'Neill S, Mottershead C, Hawthorn C, Yeowell G, Littlewood C. "It's just like a needle going into my hip, basically all of the time". The experiences and perceptions of patients with Greater Trochanteric Pain syndrome in the UK National Health Service. Musculoskelet Sci Pract 2020; 47:102175. [PMID: 32452392 DOI: 10.1016/j.msksp.2020.102175] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/20/2019] [Revised: 04/14/2020] [Accepted: 04/23/2020] [Indexed: 01/08/2023]
Abstract
BACKGROUND Greater Trochanteric Pain syndrome (GTPS) is a condition causing lateral hip pain, which can be both persistent and debilitating. Data suggests that NHS patients with GTPS often have complex presentations with greater risk of developing persistent pain. No research to date has looked to understand the lived experience of patients with GTPS. OBJECTIVES This data may help inform a programme of intervention development for testing in a future randomised controlled trial. Hence, this qualitative study aimed to provide insight into the experiences and perceptions of patients suffering with GTPS. DESIGN Qualitative study using semi-structured interviews. METHODS Ten patients diagnosed with GTPS in consultant-led clinic at one NHS Hospital. Patients were identified from the physiotherapy waiting list and approached via a postal letter. Once informed consent was gained, semi-structured telephone interviews were conducted, transcribed verbatim and analysed using the Framework Method. RESULTS Data were analysed with reference to five pre-determined themes (1) living with persistent pain; (2) understanding the problem and pain; (3) experiences of previous treatment; (4) beliefs about activity and exercise; (5) the future. CONCLUSION The participants with GTPS, interviewed in this study commonly suffered from debilitating pain, affecting them during activity and at rest. They were confused about the diagnoses they were given and the meaning of their pain in relation to activity. Furthermore, participants were often either uncertain or pessimistic about their potential to recover. CLINICAL TRIALS REGISTRY ClinicalTrials.gov Identifier: NCT03720587.
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Affiliation(s)
| | | | | | | | - Gillian Yeowell
- Department of Allied Health Professions, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, UK.
| | - Chris Littlewood
- Department of Allied Health Professions, Faculty of Health, Psychology & Social Care, Manchester Metropolitan University, UK; Primary Care Centre Versus Arthritis, School of Primary, Community and Social Care, Keele University, Staffordshire, UK.
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Blackburn J, Yeowell G. Patient perception of rehabilitation in the community following hip fracture surgery. A systematic review of qualitative research. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Yeowell G, Staniford L, Powell S, Fatoye F, Kelly B. A qualitative study exploring the provider and patient perspective of two rehabilitation programmes following knee replacement surgery. Physiotherapy 2020. [DOI: 10.1016/j.physio.2020.03.119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Richardson E, Lewis JS, Gibson J, Morgan C, Halaki M, Ginn K, Yeowell G. Role of the kinetic chain in shoulder rehabilitation: does incorporating the trunk and lower limb into shoulder exercise regimes influence shoulder muscle recruitment patterns? Systematic review of electromyography studies. BMJ Open Sport Exerc Med 2020; 6:e000683. [PMID: 32405430 PMCID: PMC7202723 DOI: 10.1136/bmjsem-2019-000683] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/08/2020] [Indexed: 11/25/2022] Open
Abstract
OBJECTIVE To investigate the influence of trunk and lower limb motion on electromyography (EMG) muscle activity and recruitment patterns around the shoulder. DESIGN Systematic review. DATA SOURCES MEDLINE, CINAHL, PEDro, AMED, PubMed, Cochrane Central Register of Controlled trials, Cochrane Database of Systematic reviews, SportsDiscuss and PROSPERO. ELIGIBILITY CRITERIA Studies investigating both multiregional kinetic chain (KC) shoulder exercises and localised non-kinetic chain (nKC) shoulder exercises in healthy subjects under the same experimental conditions were included in this review. RESULTS KC exercises produced greater EMG activation levels in 5 of 11 studies for the lower trapezius. Of the remaining studies, five found no difference between the exercise types and one favoured nKC exercises. KC exercises produced greater EMG activation levels in 5 of 11 studies for the serratus anterior. Of the remaining studies, three reported the opposite and three found no significant difference between the exercise types. nKC exercises produced greater EMG activation in infraspinatus in three of four studies. KC exercises produced the lowest trapezius muscle ratios in all studies. Studies investigating the upper trapezius, middle trapezius, supraspinatus, subscapularis, biceps brachii, latifissimus dorsi, pectoralis major, deltoid, and trapezius and serratus anterior ratios showed inconsistency. CONCLUSION This review found evidence that integrating the KC during shoulder rehabilitation may increase axioscapular muscle recruitment, produce lower trapezius muscle ratios and reduce the demands on the rotator cuff. Stepping appears preferable to squatting. PROSPERO REGISTRATION NUMBER CRD42015032557, 2015.
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Affiliation(s)
- Eleanor Richardson
- Department of Physiotherapy, BMI The Alexandra Hospital, Cheadle, UK
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Didsbury, Manchester, UK
| | - Jeremy S Lewis
- School of Health and Social Work, University of Hertfordshire, Hatfield, Hertfordshire, UK
- Therapy Department London, Central London Community Healthcare NHS Trust, London, UK
- Department of Physical Therapy and Rehabilitation Sciences, Qatar University, Doha, Qatar
| | - Jo Gibson
- Department of Physiotherapy, Royal Liverpool and Broadgreen Hospitals NHS Trust, Liverpool, UK
- The School of Health Sciences, University of Liverpool, Liverpool, UK
| | - Chris Morgan
- High Performance Unit, Medical Department, Arsenal Football Club, London, UK
| | - Mark Halaki
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Karen Ginn
- Faculty of Health Sciences, The University of Sydney, Sydney, New South Wales, Australia
| | - Gillian Yeowell
- Faculty of Health Psychology and Social Care, Manchester Metropolitan University, Didsbury, Manchester, UK
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Russell D, Atkin L, Betts A, Dowsett C, Fatoye F, Gardner S, Green J, Manu C, McKenzie T, Meally H, Mitchell L, Mullings J, Odeyemi I, Sharpe A, Yeowell G, Devlin N. Using a modified Delphi methodology to gain consensus on the use of dressings in chronic wounds management. J Wound Care 2019; 27:156-165. [PMID: 29509111 DOI: 10.12968/jowc.2018.27.3.156] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Managing chronic wounds is associated with a burden to patients, caregivers, health services and society and there is a lack of clarity regarding the role of dressings in improving outcomes. This study aimed to provide understanding on a range of topics, including: the definition of chronicity in wounds, the burden of illness, clinical outcomes of reducing healing time and the impact of early interventions on clinical and economic outcomes and the role of matrix metalloproteinases (MMPs) in wound healing. METHOD A systematic review of the literature was carried out on the role of dressings in diabetic foot ulcer (DFU), and venous leg ulcer (VLU) management strategies, their effectiveness, associated resource use/cost, and quality of life (QoL) impact on patients. From this evidence-base statements were written regarding chronicity in wounds, burden of illness, healing time, and the role of MMPs, early interventions and dressings. A modified Delphi methodology involving two iterations of email questionnaires followed by a face-to-face meeting was used to validate the statements, in order to arrive at a consensus for each. Clinical experts were selected, representing nurses, surgeons, podiatrists, academics, and policy experts. RESULTS In the first round, 38/47 statements reached or exceeded the consensus threshold of 80% and none were rejected. According to the protocol, any statement not confirmed or rejected had to be modified using the comments from participants and resubmitted. In the second round, 5/9 remaining statements were confirmed and none rejected, leaving 4 to discuss at the meeting. All final statements were confirmed with at least 80% consensus. CONCLUSION This modified Delphi panel sought to gain clarity from clinical experts surrounding the use of dressings in the management of chronic wounds. A full consensus statement was developed to help clinicians and policy makers improve the management of patients with these conditions.
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Affiliation(s)
- David Russell
- Consultant Vascular Surgeon and Honorary Clinical Associate Professor, Leeds Teaching Hospitals NHS Trust
| | - Leanne Atkin
- Vascular Nurse Specialist, Mid Yorkshire Hospitals NHS Trust
| | - April Betts
- Health Technology Assessment Project Manager, Manchester Metropolitan University
| | - Caroline Dowsett
- Nurse Consultant Tissue Viability, East London NHS Foundation Trust, London
| | - Francis Fatoye
- Professor of Health Economics and Outcomes, Manchester Metropolitan University
| | - Sarah Gardner
- Clinical Lead, Tissue Viability, Oxford Health NHS Foundation Trust
| | - Julie Green
- Senior Lecturer in Nursing, Director of Postgraduate Programmes, Keele University, School of Nursing and Midwifery
| | - Chris Manu
- Consultant Diabetologist and Clinical Researcher in Diabetic Foot, King's College Hospital, London
| | - Tracey McKenzie
- Head of Tissue Viability Services, Torbay and Southern Devon NHS Foundation Trust
| | - Helena Meally
- Hospital Podiatrist, Leeds Teaching Hospitals NHS Trust
| | | | - Julie Mullings
- Lead Tissue Viability Nurse, University Hospital of South Manchester, NHS Foundation Trust
| | - Isaac Odeyemi
- Visiting Professor of Health Technology Assessment and Health Policy, Manchester Metropolitan University
| | - Andrew Sharpe
- Advanced Podiatrist and Lecturer Practitioner, West Lancashire Community Service, Virgin Care and University of Huddersfield
| | - Gillian Yeowell
- MSc Advanced Physiotherapy Programme Leader, Manchester Metropolitan University
| | - Nancy Devlin
- Director of Research, Professor, Office of Health Economics, Victoria Street, London
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Clark JR, Nijs J, Yeowell G, Holmes P, Goodwin PC. Trait Sensitivity, Anxiety, and Personality Are Predictive of Central Sensitization Symptoms in Patients with Chronic Low Back Pain. Pain Pract 2019; 19:800-810. [PMID: 31215742 DOI: 10.1111/papr.12809] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2019] [Revised: 06/11/2019] [Accepted: 06/13/2019] [Indexed: 12/11/2022]
Abstract
BACKGROUND Sensitivity-related trait characteristics involving physical and emotional sensitivities and high trait anxiety personality types have been observed in individuals with nonspecific chronic low back pain (NSCLBP). High trait sensitivity to sensory stimulation combined with interpretation biases based on personality type may contribute to the development of central sensitization (CS) symptoms. To date, there is limited research that has considered both sensitivity levels and personality type in NSCLBP with CS. The purpose of this study was to investigate (1) relationships between trait sensory profiles, trait anxiety, and CS symptoms, and (2) the predictive capacity of sensory profiles, trait anxiety, and personality types on CS symptoms in people with NSCLBP. METHODS This was a cross-sectional observational study using 4 self-report measures on adults (N = 165, mean age = 45 ± 12 [standard deviation] years) from physiotherapy clinics in England, Ireland, and New Zealand. Inclusion: NSCLBP > 6 months, age 18 to 64 years, predominant CS pain presentation, no other pathology. Parametric and nonparametric correlation statistics and regression analyses were used. RESULTS Positive correlations were found between central sensitization inventory (CSI) scores and sensory hypersensitivity profiles and trait anxiety. CSI score increases could be predicted by sensory-sensitive, low-registration profiles; trait anxiety scores; and extreme defensive high anxious personality type. CONCLUSIONS Trait sensory hyper- and/or hyposensitivity and high trait anxiety-related personality type characteristics predict the extent of CS symptoms in people with NSCLBP. Further investigation is required to establish causality between these characteristics and CS symptoms.
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Affiliation(s)
- Jacqui R Clark
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, U.K.,Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Jo Nijs
- Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium.,Pain in Motion International Research Group, Brussels, Belgium
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, U.K
| | - Paul Holmes
- Musculoskeletal Science and Sports Medicine Research Centre, Manchester Metropolitan University, Manchester, U.K
| | - Peter C Goodwin
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, U.K
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Clark JR, Nijs J, Smart K, Holmes P, Yeowell G, Goodwin PC. Prevalence of Extreme Trait Sensory Profiles and Personality Types in Nonspecific Chronic Low Back Pain with Predominant Central Sensitization: Secondary Analysis of an International Observational Study. Pain Physician 2019; 22:E181-E190. [PMID: 31151341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
BACKGROUND Individuals with nonspecific chronic low back pain (NSCLBP) and central sensitization (CS) exhibit sensory hypersensitivity that may be related to pre-existing trait characteristics. Sensory profiles and trait anxiety-related characteristics have sensory sensitivity in common with CS. OBJECTIVES The objectives of this study were 1) to observe the prevalence of 4 personality types and extreme scores of 4 trait sensory profiles in people with NSCLBP and predominant CS; and 2) to compare these between 2 subgroups based on high and low self-reported CS symptoms. STUDY DESIGN An international cross-sectional observational study was undertaken. SETTING Adults (n = 165; mean age = 45 ± 12 standard deviation) were recruited from physiotherapy clinics across 3 countries and 2 continents. METHODS The inclusion criteria were: NSCLBP, aged 18-64 years, with clinically identified predominant CS pain, without specific pathology. The outcome measures were: Central Sensitization Inventory (CSI), Adolescent/Adult Sensory Profile, State/Trait Anxiety Inventory, and Marlowe Crowne Social Desirability Scale. Descriptive and comparative statistics were used. RESULTS CSI scores ranged from 19-79 (mean = 50). There was a high prevalence of extreme 1) trait sensory hyper- and, unexpectedly, hyposensitivity profile scores (P < 0.001) and Defensive High Anxious personality type (P < 0.01) in the high-CSI (CSI>= 40; 78%) subgroup, and 2) trait sensory hyposensitivity profile scores (P < 0.01) and Repressor personality type (P < 0.01) in the low-CSI subgroup (CSI < 40; 22%). LIMITATIONS Self-report measures only were used; limited demographics. CONCLUSIONS To our knowledge, these results are the first to demonstrate extreme trait sensory profiles and personality types in people with NSCLBP and predominant CS. A subgroup who reports low levels of CS symptoms may have a hyposensitive sensory profile and Repressor personality type. Further study is required to investigate the extent to which these trait characteristics may predict CS symptoms in people with NSCLBP. KEY WORDS Central sensitization, nonspecific chronic low back pain, prevalence of extreme trait characteristics, sensory profiles, trait anxiety-related personality types.
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Affiliation(s)
- Jacqui R Clark
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom; Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium: Pain in Motion international research collaboration, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Keith Smart
- St. Vincents University Hospital, St. Vincent's University Hospital, Dublin, Ireland
| | - Paul Holmes
- Manchester Metropolitan University, Manchester, United Kingdom
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Peter C Goodwin
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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Abstract
OBJECTIVES This study examined patient adherence and persistence to oral bisphosphonates for the treatment of osteoporosis in real-world settings. METHODS A systematic review was completed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Medical Literature Analysis and Retrieval System Online (MEDLINE), Cumulative Index to Nursing and Allied Health Literature (CINAHL), Allied and Complementary Medicine Database (AMED), Database of Abstracts of Reviews of Effects (DARE), Health Technology Assessment (HTA) and National Health Service Economic Evaluation Database NHS EED) databases were searched for studies published in English language up to April 2018. Prospective and retrospective observational studies that used prescription claim databases or hospital medical records to examine patient adherence and persistence to oral bisphosphonate treatment among adults with osteoporosis were included. The Newcastle-Ottawa quality assessment scale (NOS) was used to assess the quality of included studies. RESULTS The search yielded 540 published studies, of which 89 were deemed relevant and were included in this review. The mean age of patients included within the studies ranged between 53 to 80.8 years, and the follow-up varied from 3 months to 14 years. The mean persistence of oral bisphosphonates for 6 months, 1 year and 2 years ranged from 34.8% to 71.3%, 17.7% to 74.8% and 12.9% to 72.0%, respectively. The mean medication possession ratio ranged from 28.2% to 84.5%, 23% to 50%, 27.2% to 46% over 1 year, 2 years and 3 years, respectively. All studies included scored between 6 to 8 out of 9 on the NOS. The determinants of adherence and persistence to oral bisphosphonates included geographic residence, marital status, tobacco use, educational status, income, hospitalisation, medication type and dosing frequency. CONCLUSIONS While a number of studies reported high levels of persistence and adherence, the findings of this review suggest that patient persistence and adherence with oral bisphosphonates medications was poor and reduced notably over time. Overall, adherence was suboptimal. To maximise adherence and persistence to oral bisphosphonates, it is important to consider possible determinants, including characteristics of the patients.
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Affiliation(s)
- F Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - P Smith
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - T Gebrye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - G Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Yeowell G, Smith P, Nazir J, Hakimi Z, Siddiqui E, Fatoye F. Real-world persistence and adherence to oral antimuscarinics and mirabegron in patients with overactive bladder (OAB): a systematic literature review. BMJ Open 2018; 8:e021889. [PMID: 30467131 PMCID: PMC6252764 DOI: 10.1136/bmjopen-2018-021889] [Citation(s) in RCA: 71] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2018] [Revised: 09/12/2018] [Accepted: 09/25/2018] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To evaluate persistence and adherence of oral pharmacotherapy used in the treatment of overactive bladder (OAB) in a real-world setting. MATERIALS AND METHODS Systematic literature searches of six electronic publication databases were performed to identify observational studies of patients with OAB treated with antimuscarinics and/or mirabegron. Studies obtaining persistence and adherence data from sources other than electronic prescription claims were excluded. Reference lists of identified studies and relevant systematic reviews were assessed to identify additional relevant studies. RESULTS The search identified 3897 studies, of which 30 were included. Overall, persistence ranged from 5% to 47%. In studies reporting data for antimuscarinics and mirabegron (n=3), 1-year persistence was 12%-25% and 32%-38%, respectively. Median time to discontinuation was <5 months for antimuscarinics (except one study (6.5 months)) and 5.6-7.4 months for mirabegron. The proportion of patients adherent at 1 year varied between 15% and 44%. In studies reporting adherence for antimuscarinics and mirabegron, adherence was higher with mirabegron (mean medication possession ratio (MPR): 0.59 vs 0.41-0.53; mean proportion of days covered: 0.66 vs 0.55; and median MPR: 0.65 vs 0.19-0.49). Reported determinants of persistence and adherence included female (sex), older age group, use of extended-release formulation and treatment experience. CONCLUSION Most patients with OAB discontinued oral OAB pharmacotherapy and were non-adherent 1 year after treatment initiation. In general, mirabegron was associated with greater persistence and adherence compared with antimuscarinics. Combined with existing clinical trial evidence, this real-world review merits consideration of mirabegron for first-line pharmacological treatment among patients with OAB. PROSPERO REGISTRATION NUMBER CRD42017059894.
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Affiliation(s)
| | - Philip Smith
- Manchester Metropolitan University, Manchester, UK
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Clark JR, Goodwin PC, Yeowell G. Exploring the pre-morbid contexts in which central sensitisation developed in individuals with non-specific chronic low back pain. A qualitative study. Braz J Phys Ther 2018; 23:516-526. [PMID: 30503352 DOI: 10.1016/j.bjpt.2018.10.012] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/23/2018] [Accepted: 10/25/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Central sensitisation pain is a predominant mechanism in a proportion of individuals with non-specific chronic low back pain and is associated with poor outcomes. It is proposed that the pre-morbid experiences and contexts may be related to the development of central sensitisation. OBJECTIVES The objective of this study was to explore the pre-morbid experiences and personal characteristics of participants with central sensitisation pain from a non-specific chronic low back pain population. METHODS This was a qualitative, exploratory study, using a concurrent nested design within a mixed methods protocol. n=9 participants were recruited purposively based on sensory profiles and trait anxiety-related personality types. Data were collected through semi structured interviews, managed using QSR NVivo 10 software and analysed using theoretical thematic analysis. RESULTS Four themes emerged: developmental learning experiences, personal characteristics, sensitivity and trauma. Reported was lack of confidence, low esteem and a need to please others, physical hyper-sensitivities (smell, light, sound) and emotional sensitivity (anxiety) as well as physical hypo-sensitivity. Participants had also suffered emotional and/or physical trauma. Learning difficulties, sensory sensitivities and trauma are associated with autonomic stress responses, which in turn have been linked to physiological changes seen in central sensitisation pain. CONCLUSION Central sensitisation pain developed in the context of sensory processing differences related to learning difficulties, sensitivities and trauma, and personal characteristics of low confidence and control, in a group of participants with non-specific chronic low back pain. The role of pre-existing sensory processing differences, as a component of altered central nervous system function, in relation to central sensitisation pain warrants further investigation.
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Affiliation(s)
- Jacqui R Clark
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, Birley Campus, Manchester, United Kingdom; Department of Physiotherapy, Human Physiology and Anatomy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Jette Campus, Brussels, Belgium; Pain in Motion International Research Group, Brussels, Belgium(1).
| | - Peter C Goodwin
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, Birley Campus, Manchester, United Kingdom
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, Birley Campus, Manchester, United Kingdom
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Clark JR, Yeowell G, Goodwin PC. Trait anxiety and sensory processing profile characteristics in patients with non-specific chronic low back pain and central sensitisation - A pilot observational study. J Bodyw Mov Ther 2018; 22:909-916. [DOI: 10.1016/j.jbmt.2017.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/26/2017] [Revised: 10/26/2017] [Accepted: 11/15/2017] [Indexed: 01/06/2023]
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Yeowell G, Rooney J, Goodwin PC. Exploring the disclosure decisions made by physiotherapists with a specific learning difficulty. Physiotherapy 2018; 104:203-208. [PMID: 29301650 DOI: 10.1016/j.physio.2017.10.003] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2016] [Accepted: 10/17/2017] [Indexed: 11/15/2022]
Abstract
OBJECTIVES To explore the disclosure decisions made in the workplace by physiotherapy staff with a specific learning difficulty (SpLD). DESIGN & SETTING An exploratory qualitative design was used, which was informed by the social model of disability. The research was undertaken in North West England. It is presented according to the Consolidated Criteria for Reporting Qualitative Research. PARTICIPANTS A purposive sample of eight physiotherapists recognised as having a SpLD were recruited. All participants had studied on one of two programmes at a university in England between 2004-2012. Their NHS workplace experience was from across the UK. DATA GENERATION In-depth, semi-structured interviews were undertaken within the university setting or via telephone. Interviews lasted 40 to 70minutes and were digitally recorded. An interview guide was used to direct the interview. DATA ANALYSIS Interview data were transcribed verbatim and analysed using thematic analysis. FINDINGS Four participants were female. The mean number of years qualified as a physiotherapist was 4.5years (SD=2.27). Three themes were identified: 'Disclosing during the workplace application'; 'Positive about disabled people scheme'; 'Disclosing in the workplace'. CONCLUSIONS Disclosure of dyslexia is a selective process and is a central dilemma in the lives of individuals who have a concealable stigmatised identity. As a consequence, physiotherapy staff with dyslexia may choose to conceal their disability and not disclose to their employer. In order for staff with dyslexia to get the support they need in the workplace, disclosure is recommended. A number of recommendations have been made to facilitate the disclosure process.
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Affiliation(s)
- G Yeowell
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6XJ, UK.
| | - J Rooney
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6XJ, UK.
| | - P C Goodwin
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester, M15 6XJ, UK.
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Smith J, Yeowell G, Fatoye F. Clinical and economic evaluation of a Case Management Service for patients with back pain. J Eval Clin Pract 2017; 23:1355-1360. [PMID: 28762623 DOI: 10.1111/jep.12797] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2017] [Revised: 06/12/2017] [Accepted: 06/12/2017] [Indexed: 01/02/2023]
Abstract
AIM To evaluate the clinical-effectiveness and resource use associated with Case Management Services in a UK private sector DESIGN: An observational cohort study based on prospective data collection of patient reported outcome measures and data collection from an existing administrative health database. SETTING A United Kingdom (UK) private healthcare provider PARTICIPANTS: Consecutive referrals into the Case Management Service over a three-month period. INTERVENTIONS Participants were managed within the Case Management Service in accordance with usual pathways. MAIN OUTCOME MEASURES Outcome measures included EQ-5D-5L and PSFS. Measurements were taken at baseline, and repeated at the point at which the client's case was closed. The CARE measure examined patient reported experience. Cost Consequence analysis was completed using existing data for the same period of time in two separate years: 2014, two years after CMS implementation, and 2011, prior Case Management Service development RESULTS: There was a statistically significant improvement in quality of life (EQ-5D-5L p < 0.0001; EQ-VAS p < 0.001) and functional ability (p < 0.001) following the Physiotherapy Case Management. The CARE measure showed high levels of patient satisfaction with 96% of clients rating their individual case manager as good to excellent. The cost consequences analysis showed a cost reduction in therapy resource utilisation by £252 842 (from £10 772 875 to £10 520 034). CONCLUSIONS The Case Management Service showed the provision to be providing significant improvement in quality of life and functional outcomes within efficient use of resources, and service users are highly satisfied with their experience.
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Affiliation(s)
- Judith Smith
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
| | - Francis Fatoye
- Department of Health Professions, Manchester Metropolitan University, Manchester, UK
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Clark J, Nijs J, Yeowell G, Goodwin PC. What Are the Predictors of Altered Central Pain Modulation in Chronic Musculoskeletal Pain Populations? A Systematic Review. Pain Physician 2017; 20:487-500. [PMID: 28934779] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND Altered central pain modulation is the predominant pain mechanism in a proportion of chronic musculoskeletal pain disorders and is associated with poor outcomes. Although existing studies predict poor outcomes such as persistent pain and disability, to date there is little consensus on what factors specifically predict altered central pain modulation. OBJECTIVES To review the existing literature on the predictive factors specifically for altered central pain modulation in musculoskeletal pain populations. STUDY DESIGN This is a systematic review in accordance with supplemented PRISMA guidelines. METHODS A systematic search was performed by 2 mutually blinded reviewers. Relevant articles were screened by title and abstract from Medline, Embase, PubMed, CINAHL, and Web of Science electronic databases. Alternative sources were also sought to locate missed potential articles. Eligibility included studies published in English, adults aged 18 to 65, musculoskeletal pain, baseline measurements taken at the pre-morbid or acute stage, > 3-month follow-up time after pain onset, and primary outcome measures specific to altered central pain modulation. Studies were excluded where there were concurrent diseases or they were non-predictive studies. Risk of bias was assessed using the quality in prognostic studies (QUIPS) tool. Study design, demographics, musculoskeletal region, inclusion/exclusion criteria, measurement timelines, predictor and primary outcome measures, and results were extracted. Data were synthesized qualitatively and strength of evidence was scored using the grading of recommendations, assessment, development, and evaluations (GRADE) scoring system. RESULTS Nine eligible articles were located, in various musculoskeletal populations (whiplash, n = 2; widespread pain, n = 5; temporomandibular disorder, n = 2). Moderate evidence was found for 2 predictive factors of altered central pain modulation: 1) high sensory sensitivity (using genetic testing or quantitative sensory tests), and 2) psychological factors (somatization and poor self-expectation of recovery), at a pre-morbid or acute stage baseline. LIMITATIONS At the times of the article publications, the current definitions and clinical guidelines for identifying altered central pain modulation were not yet available. Careful interpretation of the information provided using current knowledge and published guidelines was necessary to extract information specific to altered central pain modulation in some of the studies, avoiding unwarranted assumptions. CONCLUSIONS Premorbid and acute stage high sensory sensitivity and/or somatization are the strongest predictors of altered central pain modulation in chronic musculoskeletal pain to date. This is the first systematic review specifically targeting altered central pain modulation as the primary outcome in musculoskeletal pain populations. Early identification of people at risk of developing chronic pain with altered central pain modulation may guide clinicians in appropriate management, diminishing the burden of persistent pain on patients and heath care providers alike. Systematic Review Registration no.: PROSPERO 2015:CRD42015032394.Key words: Predictive factors, pre-morbid and acute stage baselines, altered central pain modulation, chronic musculoskeletal pain, sensory processing, somatization.
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Affiliation(s)
- Jacqui Clark
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom; Faculty of Physical Education and Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium: Pain in Motion international research collaboration, Brussels, Belgium
| | - Jo Nijs
- Pain in Motion Research Group (www.paininmotion.be); Department of Human Physiology and Physiotherapy, Faculty of Physical Education & Physiotherapy, Vrije Universiteit Brussel, Brussels, Belgium; Department of Physical Medicine and Physiotherapy, University Hospital Brussels, Brussels, Belgium
| | - Gillian Yeowell
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
| | - Peter Charles Goodwin
- Faculty of Health, Psychology and Social Care, Manchester Metropolitan University, Manchester, United Kingdom
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Ashbrook JE, Shacklady C, Johnson S, Yeowell G, Goodwin PC. Is there an association between back pain and stress incontinence in adults with cystic fibrosis? A retrospective cross-sectional study. J Cyst Fibros 2017; 17:78-82. [PMID: 28476560 DOI: 10.1016/j.jcf.2017.04.006] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 02/26/2017] [Accepted: 04/01/2017] [Indexed: 10/19/2022]
Abstract
BACKGROUND Back pain and stress urinary incontinence (SUI) are common in adults with cystic fibrosis (CF). This study aimed to establish whether there is an association between back pain, lung function and stress urinary incontinence and its relative risk. METHOD This was a cross-sectional, retrospective analysis of the Manchester Musculoskeletal Screening Tool (MMST) data. It includes pain, (Short Form McGill Pain Questionnaire (SF-MPQ and VAS)) and International Consultation on Incontinence Short Form (ICIQ-UI-SF) measures. Associations were tested using Spearman's rank correlation coefficient. Relative risk of developing symptoms was calculated the sig level was p=0.05. RESULTS ICIQ-UI-SF was associated with back pain (SF-MPQ) (Rho=0.32, p<0.001) and pain (VAS) (Rho=0.23, p<0.01). RR of developing SUI with back pain was 2; RR of developing back pain with SUI was 1.3. CONCLUSIONS An association is indicated between back pain (SF-MPQ and VAS), and SUI in adults with CF. This information is important when developing management strategies in the CF population.
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Affiliation(s)
- Jane E Ashbrook
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Carol Shacklady
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Sue Johnson
- Manchester Adult Cystic Fibrosis Centre, Wythenshawe Hospital, Southmoor Rd, Manchester M23 9LT, United Kingdom
| | - Gillian Yeowell
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom
| | - Peter Charles Goodwin
- Department of Health Professions, Manchester Metropolitan University, 53 Bonsall Street, Manchester M15 6GX, United Kingdom.
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McCarthy CJ, Yeowell G. Newspaper response to the back pain myth busting advice: bruising but helpful. Br J Sports Med 2017; 51:758. [PMID: 28096069 PMCID: PMC5466921 DOI: 10.1136/bjsports-2016-097253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/13/2016] [Indexed: 11/04/2022]
Affiliation(s)
| | - Gillian Yeowell
- School of Physiotherapy, Manchester Metropolitan University, Manchester, UK
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Arden K, Fatoye F, Yeowell G. Evaluation of a rolling rehabilitation programme for patients with non-specific low back pain in primary care: an observational cohort study. J Eval Clin Pract 2017; 23:272-278. [PMID: 27436337 DOI: 10.1111/jep.12595] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2016] [Revised: 06/07/2016] [Accepted: 06/08/2016] [Indexed: 01/26/2023]
Abstract
AIM The Back Rehabilitation Programme (BRP) is a group exercise programme for patients with non-specific low back pain (NSLBP) that combines cognitive behavioural therapy principles and therapeutic exercise to empower patients to self-manage their condition. Poor attendance and high attrition rates resulted in changes to the format of the programme from a standard sequential approach to a continual rolling approach. The aim of this study was to evaluate the effectiveness of this new approach on patient outcomes and its impact on attendance rates. METHOD A service evaluation, using a retrospective, observational cohort design, of all patients with NSLBP who attended the BRP during a 12-month period was undertaken. Outcome measures used were as follows: Bournemouth Questionnaire (BQ); fitness tests: sit to stand test, step test and walk test (taken at baseline and post programme); and attendance (taken post programme). RESULTS Of the patients, 56% had an improved BQ score ≥ 47%, indicating a clinically significant change. Inferential testing showed statistically significant improvements in the BQ and all three fitness tests post programme (P< 0.0001). In total, 62 patients attended the rolling BRP, and 41 patients (66%) completed. Thus, the percentage of patients completing the new programme had doubled compared with the original standard programme. CONCLUSION Patients with NSLBP who attended the continual rolling BRP show clinical and statistical improvements. The rolling format also appeared to enhance patient attendance. As such, the rolling BRP should be considered by practitioners as an effective management strategy when treating patients with NSLBP.
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Affiliation(s)
- Kathleen Arden
- Musculoskeletal Clinical Assessment and Treatment Service, Bridgewater Community Healthcare NHS Foundation Trust, Lancashire, UK
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