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Shea Palmer - One of the best experts on this subject based on the ideXlab platform.

  • Exercise prescription for patients with non-specific chronic low back pain: a qualitative exploration of decision making in Physiotherapy Practice.
    Physiotherapy, 2015
    Co-Authors: Rob Stenner, Annette Swinkels, Theresa Mitchell, Shea Palmer
    Abstract:

    Background: Providing an effective exercise prescription process for patients with non-specific chronic low back pain (NSCLBP) is a challenging task. Emerging research has indicated that partnership in care and shared decision making are important for people with NSCLBP and calls for further investigation into the approaches used to prescribe exercise. Objective: To explore how shared decision making and patient partnership are addressed by physiotherapists in the process of exercise prescription for patients with NSCLBP. Design: A qualitative study using a philosophical hermeneutic approach. Methods: Eight physiotherapists were each observed on three occasions undertaking their usual clinical activities (total n=24 observations). They conducted brief interviews after each observation and a later in depth semi-structured interview. Iterative hermeneutic strategies were used to interpret the texts and identify the characteristics and processes of exercise prescription for patients with NSCLBP. Findings: The findings revealed how Physiotherapy Practice often resulted in unequal possibilities for patient participation which were in turn linked to the physiotherapists? assumptions about the patients, clinical orientation, cognitive and decision making processes. Three linked themes emerged: (1) I want them to exercise, (2) Which exercise? - the tension between evidence and everyday Practice and (3) Compliance-orientated more than concordance based. Conclusions: This research, by focusing on a patient-centred approach, makes an important contribution to the body of evidence relating to the management of NSCLBP. It challenges physiotherapists to critically appraise their approaches to the prescription of exercise therapy in order to improve outcomes for these patients.

  • Diagnosis, Management and Assessment of Adults with Joint Hypermobility Syndrome: A UK-Wide Survey of Physiotherapy Practice.
    Musculoskeletal care, 2015
    Co-Authors: Shea Palmer, Fiona Cramp, Rachel Lewis, Shahid N Muhammad, Emma M Clark
    Abstract:

    Purpose: This study aimed to identify how Joint Hypermobility Syndrome (JHS) is diagnosed, managed and assessed in routine Physiotherapy Practice. Relevance: JHS is a heritable disorder associated with excessive joint range of motion and pain in the absence of inflammatory joint disease. Symptomatic joint hypermobility has been reported to affect approximately 5% of women and 0.6% of men. Although it is a relatively common cause of musculoskeletal pain it is generally understood to be under-recognised and poorly managed in clinical Practice. Participants: Paper copies of the survey were sent to 201 randomly selected secondary care organisations across the United Kingdom (UK) and an electronic version was advertised through Physiotherapy professional networks. Methods: Successive drafts of the survey tool were developed from similar Physiotherapy surveys of musculoskeletal Practice, a review of the literature, and consultation with researchers and clinicians before being finalised. Analysis: Results were analysed and presented using descriptive statistics. Results: A total of 66 responses (80% women) were received from physiotherapists with a wide range of clinical experience. 68% of respondents reported that they had not received any formal training in JHS management. 69% of respondents reported not using the recommended Brighton diagnostic criteria for JHS. The stated aims of Physiotherapy and the specific interventions employed seemed well matched, with a focus on advice, education, exercise and self-management. Although pain relief was not reported as a high priority in terms of treatment aims, pain was most often assessed as an outcome, suggesting a mismatch between what clinicians aim to achieve and what they measure. Conclusions: The results suggest that reported management strategies are broadly appropriate to long term musculoskeletal conditions but that additional training specific to JHS may be required, particularly in relation to diagnosis and assessment. Implications: Further education and training may be required for physiotherapists to adequately recognise, diagnose, manage and assess JHS.

Christopher G. Maher - One of the best experts on this subject based on the ideXlab platform.

  • Shared decision making should be an integral part of Physiotherapy Practice.
    Physiotherapy, 2019
    Co-Authors: Tammy Hoffmann, Jeremy Lewis, Christopher G. Maher
    Abstract:

    Abstract Shared decision making is integral to high-quality, evidence-based, and patient-centred Physiotherapy Practice. It involves therapists and patients collaboratively making a health-related decision after having discussed the options, the likely benefits and harms of each option, and considered the patient's values, preferences and circumstances. Despite being a crucial part of the final step in evidence-based Practice, the skills needed to facilitate shared decision making are rarely taught to physiotherapists. This Debate article explores the reasons for the importance of shared decision making to Physiotherapy Practice; its fundamental role in improving therapist-patient communication, informed decision-making, and evidence-based care; and illustrates some of the processes involved using clinical scenarios.

  • Core journals of evidence-based Physiotherapy Practice
    Physiotherapy Theory and Practice, 2001
    Co-Authors: Christopher G. Maher, Anne M. Moseley, Catherine Sherrington, Robert D. Herbert
    Abstract:

    To identify the core journals of evidence-based Physiotherapy Practice we conducted an analysis of the Physiotherapy Evidence Database (PEDro), the most comprehensive database of Physiotherapy clinical trials and systematic reviews. We compared our results to two earlier lists of core journals based upon citation analyses and rankings from the Institute for Scientific Information (ISI) impact factors. As of 2 June 2000 the PEDro database contained 2,231 papers that had been published in 519 different journals with a single journal contributing from 1 to 109 papers. When journals were ranked based upon the total number of papers contributed to PEDro the top five journals were: Archives of Physical Medicine and Rehabilitation, British Medical Journal, Spine, Physical Therapy, and Cochrane Database of Systematic Reviews. However when the journals were ranked based upon the average methodological quality of clinical trials the top five were: British Journal of Obstetrics and Gyn aecology, New England Journal ...

Tammy Hoffmann - One of the best experts on this subject based on the ideXlab platform.

  • Shared decision making should be an integral part of Physiotherapy Practice.
    Physiotherapy, 2019
    Co-Authors: Tammy Hoffmann, Jeremy Lewis, Christopher G. Maher
    Abstract:

    Abstract Shared decision making is integral to high-quality, evidence-based, and patient-centred Physiotherapy Practice. It involves therapists and patients collaboratively making a health-related decision after having discussed the options, the likely benefits and harms of each option, and considered the patient's values, preferences and circumstances. Despite being a crucial part of the final step in evidence-based Practice, the skills needed to facilitate shared decision making are rarely taught to physiotherapists. This Debate article explores the reasons for the importance of shared decision making to Physiotherapy Practice; its fundamental role in improving therapist-patient communication, informed decision-making, and evidence-based care; and illustrates some of the processes involved using clinical scenarios.

Megan Dalton - One of the best experts on this subject based on the ideXlab platform.

  • Acceptance of the 'Assessment of Physiotherapy Practice (Chinese)' as a standardised evaluation of professional competency in Chinese Physiotherapy students: an observational study.
    BMC medical education, 2020
    Co-Authors: Alice Y.m. Jones, Xuelian Zhou, Hua Zhai, Shirley P.c. Ngai, Ka Chun Siu, Megan Dalton
    Abstract:

    Background: Development of an entry-level Physiotherapy curriculum in China currently follows the World Confederation for Physical Therapy (WCPT) guidelines, however there is no standard, validated, assessment tool for Physiotherapy Practice in use in China. This article reports the process of translation of the "Assessment of Physiotherapy Practice" (APP), a validated assessment instrument adopted by all universities in Australia and New Zealand, into Chinese (APP-Chinese) and its implementation by Chinese Physiotherapy clinical educators (CEs) and students during clinical placements. Methods: The process of forward and backward translation of the APP was undertaken by a team of academics from universities in Shanghai, Hong Kong, United States and Australia. An APP-Chinese version was produced and used for assessment of the clinical performance of 4th year students at a university in Shanghai. Feedback on the implementation of the APP-Chinese was solicited from students and CEs using the same two questionnaires employed to assess implementation of the original APP. Results: All CEs agreed that the rules used to score the APP-Chinese were helpful in assessing student performance. Over 90% of the CEs considered the APP-Chinese was pragmatic for use in the clinical environment in China. All students agreed with the rating of their performance on the APP-Chinese marked by their educators, and that the performance indicators were useful in guiding their expected performance behaviour. Conclusion: The APP-Chinese is the first standardised assessment tool for evaluation of clinical performance of Physiotherapy students in China and was shown to be well accepted by both students and CEs in the clinical education unit and university involved in this study.

  • The assessment of Physiotherapy Practice (APP) is a reliable measure of professional competence of Physiotherapy students: a reliability study.
    Journal of physiotherapy, 2012
    Co-Authors: Megan Dalton, Megan Davidson, Jennifer Lyn Keating
    Abstract:

    Question What is the inter-rater reliability of the Assessment of Physiotherapy Practice (APP) instrument, and what is the error associated with individual scores? Design Cross-sectional inter-rater reliability study. Thirty pairs of clinical educators each assessed one student after observing student Practice over a 5-week clinical placement. Participants Sixty clinical educators from five Australian universities formed 30 independent pairs of assessors. Outcome measures Each pair completed two independent assessments of one student, providing 60 completed APP assessments and an associated Global Rating Scale score for analysis. Analysis Correlational coefficients and measurement error expressed in APP scale units were computed to provide a comprehensive analysis of the likely utility of APP scores and to enable score and change score interpretation. Results Percentage of agreement between assessors for each item ranged from 56% (Item 19, evidence-based Practice) to 83% (Item 20, risk management) and across all items averaged 70% (SD 7). The ICC(2,1) was 0.92 (95% CI 0.84 to 0.96) for the total APP score and 0.72 (95% CI 0.50 to 0.86) for the Global Rating Scale. The standard error of measurement for the total score (scale width 0–80) was 3.2 APP points and the MDC 90 was 7.86 representing 9% of the scale width. Bland-Altman analyses identified no systematic differences between raters. Conclusion Clinical educators demonstrated a high level of reliability when using the APP instrument to assess Physiotherapy students' level of professional competence in workplacebased Practice. [Dalton M, Davidson M, Keating JL (2012) The Assessment of Physiotherapy Practice (APP) is a reliable measure of professional competence of Physiotherapy students: a reliability study. Journal of Physiotherapy 58: 49–56]

  • the assessment of Physiotherapy Practice app is a valid measure of professional competence of Physiotherapy students a cross sectional study with rasch analysis
    Journal of Physiotherapy, 2011
    Co-Authors: Megan Dalton, Megan Davidson, Jenny Lyn Keating
    Abstract:

    Question Is the Assessment of Physiotherapy Practice (APP) a valid instrument for the assessment of entry-level competence in Physiotherapy students? Design Cross-sectional study with Rasch analysis of initial (n=326) and validation samples (n=318). Students were assessed on completion of 4, 5, or 6-week clinical placements across one university semester. Participants 298 clinical educators and 456 Physiotherapy students at nine universities in Australia and New Zealand provided 644 completed APP instruments. Results APP data in both samples showed overall fit to a Rasch model of expected item functioning for interval scale measurement. Item 6 (Written communication) exhibited misfit in both samples, but was retained as an important element of competence. The hierarchy of item difficulty was the same in both samples with items related to professional behaviour and communication the easiest to achieve and items related to clinical reasoning the most difficult. Item difficulty was well targeted to person ability. No Differential Item Functioning was identified, indicating that the scale performed in a comparable way regardless of the student's age, gender or amount of prior clinical experience, and the educator's age, gender, or experience as an educator, or the type of facility, university, or clinical area. The instrument demonstrated unidimensionality confirming the appropriateness of summing the scale scores on each item to provide an overall score of clinical competence and was able to discriminate four levels of professional competence (Person Separation Index=0.96). Person ability and raw APP scores had a linear relationship (r 2 =0.99). Conclusion Rasch analysis supports the interpretation that a student's APP score is an indication of their underlying level of professional competence in workplace Practice.

Jeremy Lewis - One of the best experts on this subject based on the ideXlab platform.

  • Shared decision making should be an integral part of Physiotherapy Practice.
    Physiotherapy, 2019
    Co-Authors: Tammy Hoffmann, Jeremy Lewis, Christopher G. Maher
    Abstract:

    Abstract Shared decision making is integral to high-quality, evidence-based, and patient-centred Physiotherapy Practice. It involves therapists and patients collaboratively making a health-related decision after having discussed the options, the likely benefits and harms of each option, and considered the patient's values, preferences and circumstances. Despite being a crucial part of the final step in evidence-based Practice, the skills needed to facilitate shared decision making are rarely taught to physiotherapists. This Debate article explores the reasons for the importance of shared decision making to Physiotherapy Practice; its fundamental role in improving therapist-patient communication, informed decision-making, and evidence-based care; and illustrates some of the processes involved using clinical scenarios.