Transcultural adaption and preliminary evaluation of “understanding low back pain” patient education booklet

Abstract Background Low back pain (LBP) is the number one cause of disability globally. LBP is a symptom associated with biological, psychological and social factors, and serious causes for pain are very rare. Unhelpful beliefs about LBP and inappropriate imaging are common. Practitioners report pressure from patients to provide inappropriate imaging. A recently developed patient education and management booklet, ‘Understanding low back pain’, was designed to target previously identified barriers for reducing inappropriate imaging. The booklet includes evidence-based information on LBP and supports communication between patients and practitioners. Our aim was to 1) describe the translation …

"Tutkat päällä" : fysioterapeuttien käsityksiä lonkan tekonivelleikkauksen jälkeisestä fysioterapeuttisesta ohjauksesta

TIIVISTELMÄ Riikka Holopainen ja Anu Keskilä (2014) ”TUTKAT PÄÄLLÄ” Fysioterapeuttien käsityksiä lonkan tekonivelleikkauksen jälkeisestä fysioterapeuttisesta ohjauksesta. Terveystieteiden laitos, Jyväskylän yliopisto. Fysioterapian pro gradu-tutkielma. s. 51. Tämä pro gradu -tutkielma koostuu kahdesta osasta, joista ensimmäinen on systemaattinen kirjallisuuskatsaus koskien lonkan tekonivelleikkauksen jälkeisen fysioterapian vaikuttavuutta, ja toinen on empiiriseen tutkimustietoon perustuva fenomenografinen tutkimusartikkeli, joka kuvaa fysioterapeuttien käsityksiä lonkan tekonivelleikkauksen jälkeisestä fysioterapeuttisesta ohjauksesta. Lonkan tekonivelleikkausten määrä kasvaa väestön ikään…

Training of Physical Therapists to Deliver Individualized Biopsychosocial Interventions to Treat Musculoskeletal Pain Conditions: A Scoping Review

Abstract Objective Current guidelines recommend management of musculoskeletal pain conditions from a biopsychosocial approach; however, biopsychosocial interventions delivered by physical therapists vary considerably in effectiveness. It is unknown whether the differences are explained by the intervention itself, the training and/or competency of physical therapists delivering the intervention, or fidelity of the intervention. The aim was to investigate and map the training, competency assessments, and fidelity checking of individualized biopsychosocial interventions delivered by physical therapists to treat musculoskeletal pain conditions. Methods A scoping review methodology was employed,…

Harjoittelusta apua kroonisen kipupotilaan kokonaisvaltaiseen hyvinvointiin - Mitä, miksi ja miten

Jos liikunta olisi pilleri, se todennäköisesti olisi maailman myydyin lääke, koska sillä on niin paljon positiivisia vaikutuksia hyvinvointiimme. Fysioterapeutteina olemme tottuneet käyttämään terapeuttista harjoittelua työkaluna esimerkiksi korjaamaan asentoa, parantamaan fyysistä toimintakykyä, kuntoa ja yleistä terveyttä. Sekin on monille tuttua, että harjoittelu voi toimia kivunlievittäjänä esimerkiksi jännevaivoissa ja että se ennaltaehkäisee monia kroonisia sairauksia. Säännöllisen harjoittelun vaikutusten lista myös psyykkisen toimintakykymme kannalta on pitkä, sillä kehoa ja mieltä ei voida harjoittelunkaan suhteen erottaa toisistaan. Vaikutukset ulottuvat vähintäänkin emotionaalise…

Effectiveness of training in guideline-oriented biopsychosocial management of low-back pain in occupational health services – a cluster randomized controlled trial

Objective This study aimed to investigate the effectiveness of brief training in the guideline-oriented biopsychosocial management of low-back pain (LBP) in occupational health services using a cluster-randomized design. A small sample of physiotherapists and physicians from the intervention units (N=12) were given three- to seven-day training focusing on the biopsychosocial management of LBP, while professionals in the control units (N=15) received no such training. Methods Eligible patients with LBP, with or without radicular pain, aged 18-65, were invited to participate. A web-based questionnaire was sent to all recruited patients at baseline, three months and one year. The primary outco…

An adventurous learning journey : Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice

© 2020 Informa UK Limited, trading as Taylor & Francis Group Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. The present qualitative study aimed to explore physiotherapists’ conceptions of learning and integrating Cognitive Functional Therapy (CFT) into clinical practice in Finnish primary health care. Methods: We interviewed 22 physiotherapists, who participated in four to six days of CFT workshops. A phenomenographic approach was used to explore the variation in the physiotherapists’ conceptions of this process. Resu…

Physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions : a systematic review and metasynthesis of qualitative studies

Clinical practice guidelines recommend a biopsychosocial approach for the management of musculoskeletal pain conditions, but physiotherapists have reported feeling inadequately trained and lacking in confidence to deal with psychosocial issues. Although a growing number of studies is exploring physiotherapists’ perceptions of biopsychosocial training, the results have not been synthesized. Therefore, the aim of this systematic review and metasynthesis of qualitative studies was to explore physiotherapists’ perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions. A search of the electronic databases: MEDLINE, EMBASE, CINAHL, ERIC, Psyc…

Evaluation of training in guideline-oriented biopsychosocial management of low back pain in occupational health services:Protocol of a cluster randomized trial

Background To prevent low back pain (LBP) from developing into a prolonged disabling condition, clinical guidelines advocate early stage assessment, risk‐screening, and tailored interventions. Occupational health services recommend guideline‐oriented biopsychosocial screening and individualized assessment and management. However, it is not known whether training a limited number of health care professionals improves the management process. The primary objective of this study is to investigate whether training in the biopsychosocial practice model is effective in reducing disability. Furthermore, we aim to evaluate health‐economic impacts of the training intervention in comparison to usual m…

Association of STarT Back Tool and the short form of the Örebro Musculoskeletal Pain Screening Questionnaire with multidimensional risk factors.

AbstractThe Short form of the Örebro Musculoskeletal Pain Screening Questionnaire (ÖMPSQ-short) and the STarT Back Tool (SBT) have been developed to screen for risk factors for future low back pain (LBP) -related disability and work loss respectively. The aim of this study was to investigate the accordance of the two questionnaires and to evaluate the accumulation of risk factors in the risk groups of both screening tools in a large population-based sample. The study population consisted of 3079 participants of the Northern Finland Birth Cohort 1966 who had reported LBP over the previous 12 months and had SBT and ÖMPSQ-short data. We evaluated the association of depressive and anxiety sympt…

Physiotherapists’ validating and invalidating communication before and after participating in brief cognitive functional therapy training : Test of concept study

Objective The aim of this study was to investigate physiotherapists’ validating and invalidating communication, before and after brief Cognitive Functional Therapy (CFT) training that included a session on validation skills. Associations between validation/invalidation and the characteristics of the interviews and physiotherapists were also explored. Methods Eighteen physiotherapists treating patients with low back pain participated in the study. The study had a within-group design in which validation and invalidation for physiotherapists were rated before and after training using a reliable observational scale. We also collected data on interview length and physiotherapists’ and patients’ …

Selkäkipuinen tarvitsee oikeaa tietoa ja tukea

Lasten ja nuorten kivut ovat lisääntyneet 90-luvun alun jälkeen huomattavasti. Biomekaanisesta selitysmallista on haettu syytekijöitä: raskas koulureppu, kännykän käyttö, huono ryhti, “virheellinen” askellus, alaraajojen pituusero, heikot selkälihakset jne. Näiden merkitys on tutkimuksissa jäänyt kuitenkin vaatimattomaksi eikä nykynuorten tuki- ja liikuntaelimistö ole sen heikompaa tekoa kuin aiempien sukupolvien. nonPeerReviewed

An adventurous learning journey. Physiotherapists’ conceptions of learning and integrating cognitive functional therapy into clinical practice

Background: Recent low back pain guidelines recommend a BPS approach to the management of disabling low back pain. However, the most effective way of teaching physiotherapists to implement these approaches remains unknown. The present qualitative study aimed to explore physiotherapists' conceptions of learning and integrating Cognitive Functional Therapy (CFT) into clinical practice in Finnish primary health care.Methods: We interviewed 22 physiotherapists, who participated in four to six days of CFT workshops. A phenomenographic approach was used to explore the variation in the physiotherapists' conceptions of this process.Results: Four themes emerged from the data: 1) membership of work c…

From "Non-encounters" to autonomic agency. Conceptions of patients with low back pain about their encounters in the health care system.

Low back pain is a considerable health problem which affects people around the world, causing major healthcare costs. The use of qualitative research methods enables us to describe and understand patients' experience of, and attitudes to, healthcare. The aim of the present phenomenographic study was to identify and describe the contextual nature of the conceptions of patients with low back pain of their encounters in the HCS. Seventeen patients with chronic or episodic low back pain classified as "high risk" were interviewed in open recall interviews, using videos of patients' initial physiotherapy sessions that had been recorded previously. The data were analysed using the phenomenographic…

Becoming confidently competent: a qualitative investigation of training in cognitive functional therapy for persistent low back pain.

Background Physiotherapists trained to deliver biopsychosocial interventions for complex musculoskeletal pain problems often report difficulties in confidence and competency at the end of training. Cognitive Functional Therapy (CFT) is an individualized biopsychosocial intervention and understanding the facilitators and barriers to training in CFT will help inform future training programs. This study aimed to explore physiotherapists’ and trainers’ perceptions of the process of developing competency in CFT. Methods A cross-sectional qualitative design using interviews of 18 physiotherapists and two trainers investigated training in CFT for persistent LBP via reflexive thematic analysis. Res…

Biopsykososiaalisen lähestymistavan merkitys tuki- ja liikuntaelimistön vaivojen hoidossa : potilaiden ja fysioterapeuttien näkökulma

Biopsychosocial framework – pain impacting life on multiple biopsychosocial domains

The current main guidelines recommend management of musculoskeletal conditions within a biopsychosocial framework [1]. From time to time, a question arises whether this is too early as there is not...

Physiotherapists' perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions:a systematic review and metasynthesis of qualitative studies

Clinical practice guidelines recommend a biopsychosocial approach for the management of musculoskeletal pain conditions, but physiotherapists have reported feeling inadequately trained and lacking in confidence to deal with psychosocial issues. Although a growing number of studies are exploring physiotherapists' perceptions of biopsychosocial training, the results have not been synthesized. Therefore, the aim of this systematic review and metasynthesis of qualitative studies was to explore physiotherapists' perceptions of learning and implementing a biopsychosocial intervention to treat musculoskeletal pain conditions. A search of the electronic databases: MEDLINE, EMBASE, CINAHL, ERIC, Psy…

Patients’ conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy

To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT). As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions. The analysis revealed four descriptive categories: “hung out to dry,” “stuck,” “making sense and taking control,” and “holistic approach to care and living,” tha…

Patients' conceptions of undergoing physiotherapy for persistent low back pain delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in cognitive functional therapy.

To explore the conceptions of patients with persistent low back pain (LBP) of undergoing physiotherapy delivered in Finnish primary healthcare by physiotherapists who had participated in brief training in Cognitive Functional Therapy (CFT).As part of a feasibility implementation study exploring CFT in management of LBP in the Finnish primary healthcare system, we interviewed nine patients from four geographical areas in Finland after receiving care. We used a phenomenographic approach to explore the variation in their conceptions.The analysis revealed four descriptive categories: "hung out to dry," "stuck," "making sense and taking control," and "holistic approach to care and living," that …