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106. Physical therapist-delivered cognitive-behavioral therapy: a qualitative study of physical therapists' perceptions and experiences

Author

Nielsen, Mandy, Keefe, Francis J., Bennell, Kim, and Jull, Gwendolen A.

Subjects
Cognitive therapy -- Methods -- Patient outcomes, Vocational qualifications -- Research, Physical therapists -- Practice, Job qualifications -- Research, Health
Abstract

Background. The importance of the biopsychosocial model in assessment and management of chronic musculoskeletal conditions is recognized. Physical therapists have been encouraged to develop psychologically informed practice. Little is known about the process of physical therapists' learning and delivering of psychological interventions within the practice context. Objective. The aim of this study was to investigate physical therapists' experiences and perspectives of a cognitive-behavioral-informed training and intervention process as part of a randomized controlled trial (RCT) involving adults with painful knee osteoarthritis. Design. A qualitative design was used. Participants were physical therapists trained to deliver pain coping skills training (PCST). Methods. Eight physical therapists trained to deliver PCST were interviewed by telephone at 4 time points during the 12-month RCT period. Interviews were audiorecorded, transcribed verbatim into computer-readable files, and analyzed using Framework Analysis. Results. Thematic categories identified were: training, experience delivering PCST, impact on general clinical practice, and perspectives on PCST and physical therapist practice. Physical therapists reported positive experiences with PCST and program delivery. They thought that their participation in the RCT had enhanced their general practice. Although some components of the PCST program were familiar, the therapists found delivering the program was quite different from regular practice. Physical therapists believed the PCST program, a 3- to 4-day workshop followed by formal mentoring and performance feedback from a psychologist for 3 to 6 months and during the RCT, was critical to their ability to effectively deriver the PCST intervention. They identified a number of challenges in delivering PCST in their normal practice. Conclusion. Physical therapists can be trained to confidently deriver a PCST program. The physical therapists in this study believed that training enhanced their clinical practice. Comprehensive training and mentoring by psychologists was crucial to ensure treatment fidelity., There is increasing recognition of the benefits of incorporating the biopsychosocial model of health within physical therapist practice. (1,2) This increasing recognition reflects growing understanding of the limitations of purely [...]

Published
2014
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110. Neck Disability Index Reflects Allodynia and Headache Disability but Not Cervical Musculoskeletal Dysfunction in Migraine.

Author

Liang, Zhiqi, Thomas, Lucy, Jull, Gwendolen, and Treleaven, Julia

Subjects
MIGRAINE complications, PAIN measurement, NECK pain, SCIENTIFIC observation, CROSS-sectional method, COMPARATIVE studies, DESCRIPTIVE statistics, BLIND experiment, RESEARCH funding, HEADACHE, ALLODYNIA, SECONDARY analysis
Abstract

Objective The Neck Disability Index (NDI) is a self-rated disability tool originally developed for whiplash-associated disorders and validated in cervical musculoskeletal conditions. It is now commonly used to assess neck disability in migraine, but it is unknown whether NDI scores relate to migraine and hypersensitivity, cervical musculoskeletal dysfunction, or both. This single-blinded observational study aimed to determine whether the presence of cervical musculoskeletal dysfunction, migraine features, and hypersensitivity predict NDI scores and whether alternate versions of the NDI (NDI-physical, NDI-8, NDI-5) relate more to cervical musculoskeletal dysfunction. Methods Migraine and neck pain features, the Headache Impact Test (HIT-6), NDI, Allodynia Symptom Checklist (ASC12), and pressure pain thresholds were assessed in 104 participants with migraine and neck pain, 45 previously identified with cervical musculoskeletal dysfunction and 59 without. The NDI score was regressed on the presence or absence of cervical dysfunction, migraine features, HIT-6, total pressure pain threshold, and ASC12 while accounting for neck pain features. The presence of cervical dysfunction was regressed on the scores of NDI versions. Results The ASC12 (standardized ß = 0.20) and HIT-6 (standardized ß = 0.18) were significantly predictive of total NDI score, as were neck pain intensity (standardized ß = 0.32) and frequency (standardized ß = 0.44). No scores from alternate NDI versions related to cervical dysfunction. Conclusion The NDI score is a complex measure of neck disability influenced by migraine disability and hypersensitivity beyond the presence of cervical musculoskeletal dysfunction. This has implications for the clinical interpretation of NDI scores in patients with migraine. Impact Many patients with migraine and neck pain report neck disability; therefore, it is important to understand if migraine impacts neck disability. The results of this study indicate that clinicians need to consider migraine-related disability and hypersensitivity when managing neck disability in this population. [ABSTRACT FROM AUTHOR]

Published
2022
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111. Systematisk oversigt over måle-egenskaber ved performance baserede funktions tests hos patienter med nakkebesvær/sygdom

Author

McGee, Steven, Sipos, Taylor, Allin, Thomas, Chen, Celia, Greco, Alexandra, Bobos, Pavlos, MacDermid, Joy C., Sterling, Michele, Soderlund, Anne, Curatolo, Michele, Elliott, James M., Walton, David M., Kasch, Helge, Carroll, Linda J, Westergren, Hans, McLean, Samuel A., Jull, Gwendolen, Grant, Genevieve, Connelly, Luke, Nielsen, Mandy, Cote, Pierre, Andersen, Tonny Elmose, Rebbeck, Trudy, Maujean, Annick, Robins, Sarah, Chen, Kenneth, and Treleaven, Julia

Subjects
CAPACITY EVALUATION, psychometric properties, 0302 clinical medicine, Outcome Assessment, Health Care, Medicine and Health Sciences, Content validity, Medicine, 030212 general & internal medicine, Reliability (statistics), Original Research, Observer Variation, Neck pain, Neck Pain, cervical, General Medicine, Physical Functional Performance, cervikal, Test (assessment), psykometriske egenskaber, Data extraction, Convergent validity, RELIABILITY, HEALTH, medicine.symptom, SPINAL PAIN, medicine.medical_specialty, education, CINAHL, SELF-REPORT, Rehabilitation Medicine, 03 medical and health sciences, outcome measures, PEOPLE, Humans, VALIDITY, Physical Therapy Modalities, Whiplash Injuries, business.industry, DISABILITY, Construct validity, Reproducibility of Results, OUTCOME MEASURES, neck, functional, ASSESSMENTS, Physical therapy, PHYSICAL PERFORMANCE, business, 030217 neurology & neurosurgery
Abstract

ObjectivesThe purpose of this systematic review is to identify and synthesise studies evaluating performance-based functional outcome measures designed to evaluate the functional abilities of patients with neck pain.DesignSystematic review.Data sourcesA literature search using PubMed, Scopus, CINAHL, EMBASE, COCHRANE, Google Scholar and a citation mapping strategy was conducted until July 2019.Eligibility criteriaMore than half of the study’s patient population had neck pain or a musculoskeletal neck disorder and completed a functional-based test. Clinimetric properties of at least one performance-based functional tests were reported. Both traumatic and non-traumatic origins of neck pain were considered.Data extraction and synthesisRelevant data were then extracted from selected articles using an extraction guide. Selected articles were appraised using the Quality Appraisal for Clinical Measurement Research Reports Evaluation Form (QACMRR).ResultsThe search obtained 12 articles which reported on four outcome measures (functional capacity evaluations (FCE), Baltimore Therapeutic Equipment Work Simulator II (BTEWS II), Functional Impairment Test-Hand and Neck/Shoulder/Arm (FIT-HaNSA)) and a physiotherapy test package, to assess the functional abilities in patients with mechanical neck pain. Of the selected papers: one reports content validity, five construct validity, four reliability, one sensitivity to change and one both reliability and construct validity. QACMRR scores ranged from 68% to 95%.ConclusionsThis review found very good quality evidence that the FIT-HaNSA has excellent inter and intra-rater reliability and very weak to weak convergent validity. Excellent quality evidence of fair test-retest reliability, weak convergent validity and very weak known groups validity for the BTEWS II test was found. Good to excellent quality evidence exists that an FCE battery has poor to excellent reliability and very weak to strong validity. Good to excellent quality of weak to strong validity and trivial to strong effect sizes were found for a physiotherapy test package.Prospero registration numberCRD42018112358

Published
2019

123. Contributors

Author

Buitenhuis, Jan, primary, Connelly, Luke, additional, Curatolo, Michele, additional, de Jong, Peter, additional, Elliot, James, additional, Falla, Deborah, additional, Freckelton, Ian, additional, Holm, Lena, additional, Jaspers, Jan, additional, Jull, Gwendolen, additional, Kenardy, Justin, additional, MacLean, Samuel, additional, Maiman, Dennis J., additional, McGuire, Brian, additional, Pintar, Frank A., additional, Rebbeck, Trudy, additional, Spearing, Natalie, additional, Stemper, Brian, additional, Sterling, Michele, additional, Treleaven, Julia, additional, Versteegen, Gerbrig, additional, and Yoganandan, Narayan, additional

Published
2011
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124. Clinical Trial Registration in Physiotherapy Journals: Recommendations From the International Society of Physiotherapy Journal Editors

Author

COSTA, LEONARDO O.P., LIN, CHUNG-WEI CHRISTINE, GROSSI, DEBORA BEVILAQUA, MANCINI, MARISA COTA, SWISHER, ANNE K., COOK, CHAD, VAUGHN, DAN, ELKINS, MARK R., SHEIKH, UMER, MOORE, ANN, JULL, GWENDOLEN, CRAIK, REBECCA L., MAHER, CHRISTOPHER G., DE JESUS GUIRRO, RINALDO ROBERTO, MARQUES, AMÉLIA PASQUAL, HARMS, MICHELE, BROOKS, DINA, SIMONEAU, GUY G., and STRUPSTAD, JOHN HENRY

Published
2012
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136. Future Directions

Author

Jull, Gwendolen, primary, Sterling, Michele, additional, Falla, Deborah, additional, Treleaven, Julia, additional, and O'Leary, Shaun, additional

Published
2008
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138. Cervicogenic Headache

Author

Jull, Gwendolen, primary, Sterling, Michele, additional, Falla, Deborah, additional, Treleaven, Julia, additional, and O'Leary, Shaun, additional

Published
2008
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139. Clinical Assessment

Author

Jull, Gwendolen, primary, Sterling, Michele, additional, Falla, Deborah, additional, Treleaven, Julia, additional, and O'Leary, Shaun, additional

Published
2008
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140. Whiplash-associated Disorders

Author

Jull, Gwendolen, primary, Sterling, Michele, additional, Falla, Deborah, additional, Treleaven, Julia, additional, and O'Leary, Shaun, additional

Published
2008
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141. Introduction

Author

Jull, Gwendolen, primary, Sterling, Michele, additional, Falla, Deborah, additional, Treleaven, Julia, additional, and O'Leary, Shaun, additional

Published
2008
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