Physiocongress Basel 2010 Physiocongress Basel 2010 Presentation of a Major Project for Presentation of a Major Project for Master of Rehabilitation Science Master of Rehabilitation Science (original) (raw)
Related papers
Disability and Rehabilitation, 2011
Purpose. To explore and describe what physiotherapists experience they need to know about patients with non-specific low back pain (NSLBP) to make decisions about intervention. Method. Four focus groups containing a total of 21 physiotherapists were carried out in Sweden. Interviews were transcribed and qualitative content analysis performed. The manifest content was coded and categorised, and a theme emerged. Extracted symptoms and signs were linked to ICF codes. Result. Physiotherapists' clinical reasoning represented a broad view on low back pain (LBP) including codes from all ICF components. The participants argued for individualisation of intervention to a specific patient's problems. A theme of case complexity emerged, involving three levels: easy case, characterised by impairment in body function with close relation to specific body structures; complex case, characterised by impairments in body function, particular mental functions, activity limitations and participation restrictions, particular management of activity level and very complex case, characterised by impairments in body function, activity limitations and participation restrictions, and contextual factors, with help-seeking behaviour as a particular feature. Conclusion. The physiotherapists' clinical reasoning reflected a broad view on patients with NSLBP, with variations related to case complexity. The use of ICF codes contributed to understanding that the physiotherapists applied a broad perspective on NSLBP as a health condition as well as to knowledge about how physiotherapists' understand patients with NSLBP. Physiotherapists' use of the ICF in clinical practice might facilitate identification and assessment of specific patient's back pain problem as they occur in daily life and therefore be helpful in rehabilitation planning. Findings might also have an educational value.
The Spine Journal, 2009
BACKGROUND CONTENT: Questionnaires for measuring the functional status of patients with low back pain (LBP) focus on disability and present responses for each question in a predetermined, fixed relationship between ''can do/difficulties and pain.'' Their design does not permit a separation of the two. PURPOSE: To present the development of The Assessment of Pain and Occupational Performance (POP) and to evaluate validity and reliability. STUDY DESIGN: A prospective, consecutive study of patients investigated by use of the POP. PATIENT SAMPLE: A total of 220 patients participated in the study. METHODS: In a cross-sectional study including 53 patients with chronic musculoskeletal pain, empirical tests of content and construct validity established the definitive version of the POP. The POP focuses on performance of activities. It is a disease-specific, discriminative assessment instrument designed for patients with back pain (BP) and LBP. Based on a semi-structured interview the POP investigates each of 36 activities in two dimensions, with separate, defined scales from ''normally healthy'' to ''extremes'' for level of activity (x-scale) and pain intensity (y-scale). The final scores are expressed in percent, 0% to 100%. Patients with chronic LBP (CLBP) (n5142) were allocated to the specific (S) group, that is, patients with specific LBP problems (n597) or to the nonspecific (NS) group, that is, those with NS BP (n545). The ability of the POP to differentiate between the two known groups was evaluated. Construct-convergent validity between the POP and the Oswestry Disability Index (ODI) was carried out for the S group. Interrater reliability was established between six pairs of raters who examined 25 patients recruited from primary health care, the P-LBP group. RESULTS: In construct known group validity, the median, the interquartile range, and the Mann-Whitney U test showed that the S group had a significantly higher level of activity (p!.001) combined with worse pain (p5.001) compared with the NS group. There were significant differences between the two groups in performing activities in the forward bending position (10 items) and in the upright standing position (9 items). The result of Spearman rank order correlation showed a strong relationship between the ODI and the POP for level of activity (r50.70, p#.001). The multiple correlation coefficient between the total score of the ODI (10 items) and the total score of the POP (36 items) was r50.72 and p#.001. Inter-rater reliabilitydthe standard deviation of the differences was less than 1 point (scale 0-5). A Bland-Altman plot showed the mean differences for the level of activity of the dressing/undressing item. The average percentage agreement was 80% on the x-and y-scales. In POP 36, the average Kappa for level of activity was 0.79, which is good agreement, and for pain 0.84, which is very good agreement.
Disability and Rehabilitation
Purpose: To present the process used to develop the low back pain (LBP) assessment tool including evaluation of the initial content validity of the tool. Methods: The development process comprised the elements: definition of construct and content, literature search, item generation, needs assessment, piloting, adaptations, design, and technical production. The LBP assessment tool was developed to assess the construct "functioning and disability" as defined by the International Classification of Functioning, Disability and Health (ICF). Involvement of patients and health professionals was essential. Results: The elements were collapsed into five steps. In total, 18 patients and 12 health professionals contributed to the content and the design of the tool. The LBP assessment tool covered all ICF components shared among 63 ICF categories. Conclusions: This study presents the process used to develop the LBP assessment tool, which is the first tool to address all ICF components and integrate biopsychosocial perspectives provided by patients and health professionals in the same tool. Initial evaluation of content validity showed adequate reflection of the construct "functioning and disability". Further work on the way will evaluate comprehensiveness, acceptability, and degree of implementation of the LBP assessment tool to strengthen its use for clinical practice. ä IMPLICATIONS FOR REHABILITATION A biopsychosocial and patients-centred approach is a strong foundation for identifying the many relevant aspects related to low back pain (LBP). Responding to a lack of tools to support a biopsychosocial and patients-centred approach the LBP assessment tool was developed using a robust, multi-step process with involvement of patients and health professionals. The LBP assessment tool is a strong candidate for a user-friendly tool to facilitate use of the International Classification of Functioning, Disability and Health in routine clinical practice.
Disability and Rehabilitation, 2021
Purpose: This paper outlines the first steps toward developing the ICF-based assessment schedule for manual medicine with a focus on low back pain (LBP). It reports on the results of a consensus process to develop the default and optional versions of the set of ICF categories (ManMed Set) the assessment schedule should cover, and gives insight in expert input toward building a toolbox of instruments for assessing the ManMed Set categories. Methods: A scoping review and qualitative study were conducted, each resulting in a list of ICF categories. These categories, along with the categories of the ICF Generic-30 Set, Comprehensive ICF Core Set for LBP, and from an existing Delphi study, served as the starting point for an established consensus process to decide on the ManMed Set. Results: After alternating plenary and working group sessions, an iterative ranking process and cutoff calculation, the multi-professional and international group of 20 experts in manual medicine included 23 categories in the default ManMed version (16 + the ICF Generic-7 Set categories) and 25 in the optional version. Conclusions: Their development is a major step toward developing an assessment schedule that can be employed in standardizing the assessment and reporting of functioning in manual medicine, initially of LBP patients. � IMPLICATIONS FOR REHABILITATION � The ICF assessment schedule for manual medicine has potential use in supporting rehabilitation practice, such as for planning interventions, defining rehabilitation goals, and measuring and documenting functioning outcomes. � It can be used to promote interdisciplinary coordination of care and facilitate communication between members of a multidisciplinary rehabilitation team within manual medicine and beyond. � The ICF assessment schedule for manual medicine can facilitate rehabilitation and manual medicine research by providing evidence for optimizing rehabilitation practice.
European Spine Journal, 2007
Many of the existing low back pain (LBP) questionnaires of function and symptoms have a content of different domains of disability presented as a single sum score, making it difficult to derive changes within a specific domain. The present study describes the development of a clinically derived back-specific questionnaire incorporating both a functional limitation and a symptom scale, with a further subdivision of the symptom scale in separate indices for severity and temporal aspects. The aims of the study were to assess the overall reliability and validity of the new questionnaire, named the Profile Fitness Mapping questionnaire (PFM). A total of 193 chronic LBP patients answered the PFM together with five validated criterion questionnaires. For the internal consistency of the questionnaires, the three indices of the PFM had the highest Cronbach's alpha (0.90-0.95) and all items had item-total correlations above 0.2. The correlation coefficients between the PFM and the back-specific criterion questionnaires ranged between 0.61 and 0.83, indicating good concurrent criterion validity. The best discriminative ability between patients with different pain severities was demonstrated by the functional limitation scale of the PFM. Well centered score distribution with no patient's score at the floor or the ceiling level indicates that the PFM has the potential to detect the improvement or worsening of symptoms and functional limitations in chronic LBP patients. Classification according to the International Classification of Functioning, Disability and health (ICF) of WHO revealed a high degree of homogeneous item content of the symptom scale to the domain of impairments, and of the functional limitation scale to the domain of activity limitations. The present study suggests that the PFM has a high internal consistency and is a valid indicator of symptoms and functional limitations of LBP patients. It offers the combination of a composite total score and the possibility of evaluations within specific domains of disability. Complementary evaluation of test-retest reliability and responsiveness to change is warranted.
Disability and health journal, 2017
The International Classification of Functioning, Disability and Health (ICF) Low Back Pain Core Set (LBP-CS) has been proposed as a tool to facilitate the description and measurement of chronic low back pain (CLBP) related disability. Patient ratings of ICF categories may serve as a practical and effective method for acquiring patient input on activity limitations and participation restrictions. To investigate the test-retest agreement and reliability of patient ratings of activity and participation according to the LBP-CS. A cross-sectional repeated-measures questionnaire study was undertaken with thirty-one medically stable adults with CLBP who presented for treatment at two public Australian hospitals. Participants completed the LBP-CS Self-Report Checklist (LBP-CS-SRC) on two occasions (mean = 12.5 (SD = 4.5) days between administrations). The LBP-CS-SRC permits patients to self-rate their functioning according to the LBP-CS activity and participation categories and enables the ...
Patient Related Outcome Measures, 2012
To determine the short-term effects of physiotherapy triage assessments on selfreported pain, functioning, and general well-being and quality of life in people with low backrelated disorders. Methods: Participants with low back-related complaints were recruited from those referred to a spinal triage assessment program delivered by physiotherapists (PTs). Before undergoing the triage assessment, the participants completed a battery of questionnaires covering a range of sociodemographic, clinical, and psychosocial features. The study used the Numeric Pain Rating Scale (NPRS), the Oswestry Disability Index (ODI), and the Medical Outcomes Survey 36-item short-form version 2 (SF-36v2) to assess self-reported pain, function, and quality of life. Baseline measures and variables were analyzed using a descriptive analysis method (ie, proportions, means, medians). Paired samples t-tests or Wilcoxon matched-pair signedrank tests were used to analyze the overall group differences between the pretest and posttest outcome measures where appropriate. Results: A total of 108 out of 115 (93.9%) participants completed the posttest survey. The Physical Component Summary of the SF36v2 was the only measure that demonstrated significant improvement (P , 0.001). Conclusion: A spinal triage assessment program delivered by PTs can be viewed as a complex intervention that may have the potential to affect a wide range of patient-related outcomes. Further research is needed to examine the long-term outcomes and explore potential mechanisms of improvement using a biopsychosocial framework.
Agreement among physiotherapists in assessing patient performance of exercises for low back pain
Annals of Physical and Rehabilitation Medicine, 2017
HAL is a multidisciplinary open access archive for the deposit and dissemination of scientific research documents, whether they are published or not. The documents may come from teaching and research institutions in France or abroad, or from public or private research centers. L'archive ouverte pluridisciplinaire HAL, est destinée au dépôt et à la diffusion de documents scientifiques de niveau recherche, publiés ou non, émanant des établissements d'enseignement et de recherche français ou étrangers, des laboratoires publics ou privés.
Pain, 2018
We describe qualitative and quantitative development and preliminary validation of the Patient Assessment for Low Back Pain-Impacts (PAL-I), a patient-reported outcome measure for use in chronic low back pain (cLBP) clinical trials. Concept elicitation and cognitive interviews (qualitative methods) were used to identify and refine symptom concepts. Classical test theory and Rasch measurement theory (quantitative methods) were used to evaluate item-level and scale-level performance of the PAL-I using an iterative approach between qualitative and quantitative methods. Patients with cLBP participated in concept elicitation interviews (N 5 43), cognitive interviews (N 5 38), and assessment of paper-to-electronic format equivalence (N 5 8). A web-based sample of self-reported patients with cLBP participated in quantitative studies to evaluate preliminary (N 5 598) and revised (n 5 401) drafts and patients with physician-diagnosed cLBP (N 5 45) participated in preliminary validation of the PAL-I. The instrument contained 9 items describing cLBP impacts (walking, sitting, standing, lifting, sleep, social activities, travelling, climbing, and body movements). Item-level performance, scale structure, and scoring seemed to be appropriate. One-week test-retest reproducibility was acceptable (intraclass correlation coefficient 0.88 [95% confidence interval, 0.78-0.94]). Convergent validity was demonstrated with PAL-I total score and Roland-Morris Disability Questionnaire (Pearson correlation 0.82), MOS-36 Physical Functioning (20.71), and MOS-36 Bodily Pain (20.71). Individual item scores and total score discriminated between numeric rating scale tertile groups and painDETECT categories. Interpretation of paper and electronic administration modes was equivalent. The PAL-I demonstrated content validity and is potentially useful to assess treatment benefit in clinical trials of cLBP therapies.
Spine, 2018
Study Design. A comparison study of Back Pain Functional Scale (BPFS) with Roland Morris Questionnaire (RMQ), Oswestry Disability Index (ODI), and Short Form 36-Health Survey (SF-36). Objective. The aim of this study is to investigate the correlation of BPFS with RMQ, ODI, and SF-36. Summary of Background Data. The primary goal in the treatment of patients with low back pain is to improve the patients' levels of activities and participation. Many questionnaires focusing on function have been developed in patients with low back pain. BPFS is one of these questionnaires. No studies have investigated the correlation of BPFS with ODI and SF-36. Methods. This study was conducted with 120 patients receiving outpatient and inpatient treatment in physiotherapy and rehabilitation units of a state hospital. BPFS, RMQ, ODI, and SF-36 questionnaires were used to assess the disability in low back pain. Spearman and Pearson Correlation were used to compare the data obtained in the study. Results. There was a good correlation among the 5 functional outcome measures (correlation r ¼ À0.693 for BPFS/RMQ, r ¼ À0.794 for BPFS/ODI, r ¼ 0.697 for BPFS/SF-36 Physical function and r ¼ 0.540 for BPFS/SF-36 Pain). Conclusion. BPFS demonstrated good correlation with RMQ, ODI, SF-36 physical function, and SF-36 pain.