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  • 1.
    Asenlöf, Pernilla
    et al.
    Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University, Uppsala.
    Denison, Eva
    Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University, Uppsala.
    Lindberg, Per
    Department of Public Health and Caring Sciences/Section of Caring Sciences, Uppsala University, Uppsala.
    Individually tailored treatment targeting motor behavior, cognition, and disability: 2 experimental single-case studies of patients with recurrent and persistent musculoskeletal pain in primary health care.2005Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 85, nr 10, s. 1061-77Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND AND PURPOSE: This article introduces an individually tailored intervention targeting motor behavior, cognition, and disability in patients managed by physical therapists in primary health care. Effects on self-rated disability, pain intensity, and pain control are described. SUBJECTS: Two women with recurrent or persistent disabling musculoskeletal pain were selected. METHODS: Two experimental single-subject A(1)-B-C-A(2) studies with multiple baselines across situations were used. Principal outcome data were collected daily with patient-specific continuous measures for 3 weeks before intervention, continuously during intervention, and for 2 weeks during each of the 1-, 4-, 6-, and 12-month follow-up examinations. RESULTS: Disability and pain intensity decreased, and pain control increased in both subjects. The results were maintained at the follow-up examinations. DISCUSSION AND CONCLUSION: Positive outcomes of the intervention were reported from 2 subjects with recurrent and persistent disabling pain. Procedures for systematic tailoring of treatment to behavioral goals and individual patient characteristics are available as a result of the successful application. The results need to be replicated in future clinical controlled group studies.

  • 2.
    Bergbom, Sofia
    et al.
    Örebro universitet.
    Boersma, Katja
    Örebro universitet.
    Overmeer, Thomas
    Örebro universitet.
    Linton, Steven
    Örebro universitet.
    Relationship among pain catastrophizing, depressed mood, and outcomes across physical therapy treatments.2011Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 91, nr 5, s. 754-764Artikel i tidskrift (Refereegranskat)
  • 3.
    Dean, E.
    et al.
    University of British Columbia, Canada.
    Skinner, M.
    University of Otago, Asia Western Pacific, Dunedin, New Zealand.
    Myezwa, H.
    University of Witwatersrand, Johannesburg, South Africa.
    Mkumbuzi, V.
    University of Malawi, Blantyre, Malawi.
    Mostert, K.
    University of Pretoria, Hatfield, South Africa.
    Parra, D. C.
    Washington University in St Louis School of Medicine, St Louis, USA.
    Shirley, D.
    The University of Sydney, Lidcombe, Australia, Asia Western Pacific, Australia.
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    de Andrade, A. D.
    Universidade Federal de Pernambuco, South America, Recife, Brazil.
    Abaraogu, U. O.
    University of Nigeria Enugu Campus, Enugu, Nigeria.
    Bruno, S.
    Universidade Federal do Rio Grande do Norte, South America, Natal, Brazil.
    Clark, D.
    University of Alabama, North America/Caribbean, Birmingham, AL, United Kingdom.
    Gylfadóttir, S.
    Reykjalundur Rehabilitation Center, Europe, Iceland.
    Jones, A.
    Department of Rehabilitation Sciences, The Hong Kong Polytechnic University, Hong Kong.
    Veluswamy, S. K.
    Hospitals, Asia Western Pacific, Bangalore, India.
    Lomi, C.
    Karolinska University Hospital, Europe, Stockholm, Sweden.
    Moffat, M.
    New York University, North America/Caribbean, NY.
    Morris, D.
    University of Alabama, USA.
    Stensdotter, A. -K
    Norwegian University of Science and Technology, NTNU, Europe, Trondheim, Norway.
    Wong, W. P.
    Singapore Institute of Technology, Asia Western Pacific, Singapore.
    Group, Global Health Working
    Health Competency Standards in Physical Therapist Practice2019Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 99, nr 9, s. 1242-1254Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although the physical therapist profession is the leading established, largely nonpharmacological health profession in the world and is committed to health promotion and noncommunicable disease (NCD) prevention, these have yet to be designated as core physical therapist competencies. Based on findings of 3 Physical Therapy Summits on Global Health, addressing NCDs (heart disease, cancer, hypertension, stroke, diabetes, obesity, and chronic lung disease) has been declared an urgent professional priority. The Third Summit established the status of health competencies in physical therapist practice across the 5 World Confederation for Physical Therapy (WCPT) regions with a view to establish health competency standards, this article's focus. Three general principles related to health-focused practice emerged, along with 3 recommendations for its inclusion. Participants acknowledged that specific competencies are needed to ensure that health promotion and NCD prevention are practiced consistently by physical therapists within and across WCPT regions (ie, effective counseling for smoking cessation, basic nutrition, weight control, and reduced sitting and increased activity/exercise in patients and clients, irrespective of their presenting complaints/diagnoses). Minimum accreditable health competency standards within the profession, including use of the WCPT-supported Health Improvement Card, were recommended for inclusion into practice, entry-to-practice education, and research. Such standards are highly consistent with the mission of the WCPT and the World Health Organization. The physical therapist profession needs to assume a leadership role vis-à-vis eliminating the gap between what we know unequivocally about the causes of and contributors to NCDs and the long-term benefits of effective, sustained, nonpharmacological lifestyle behavior change, which no drug nor many surgical procedures have been reported to match.

  • 4.
    Elvén, Maria
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Hochwälder, Jacek
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Dean, Elizabeth
    University of British Columbia, Canada .
    Söderlund, Anne
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd.
    Predictors of Clinical Reasoning Using the Reasoning 4 Change Instrument With Physical Therapist Students2019Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 99, nr 8, s. 964-976Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Although physical therapist students must be well prepared to integrate biopsychosocial and behavioral perspectives into their clinical reasoning, there is a lack of knowledge regarding factors that influence such competence. This study explored the associations among the independent variables-knowledge, cognition, metacognition, psychological factors, contextual factors, and curriculum orientation vis-a-vis behavioral medicine competencies-and the dependent variables-outcomes of input from client (IC), functional behavioral analysis (FBA), and strategies for behavior change (SBC) as levels in physical therapist students' clinical reasoning processes. This study used an exploratory cross-sectional design. The Reasoning 4 Change instrument was completed by 151 final-semester physical therapist students. Hierarchical multiple regression analyses for IC, FBA, and SBC were conducted. In the first step, curriculum orientation was inserted into the model; in the second step, self-rated knowledge, cognition, and metacognition; and in the third step, psychological factors. All independent variables except contextual factors explained 37% of the variance in the outcome of IC. Curriculum orientation explained 3%, cognitive and metacognitive factors an additional 22%, and attitudes another 15%. Variance in the outcomes of FBA and SBC were explained by curriculum orientation only (FBA change in R-2=0.04; SBC change in R-2=0.05). Higher scores of the dependent variables were associated with a curriculum having behavioral medicine competencies. The limitations of this study are that it was cross-sectional. Cognitive and metacognitive capabilities and skills and positive attitudes are important predictors of physical therapist students' clinical reasoning focused on behavior change at the IC level. Curricula with behavioral medicine competencies are associated with positive outcomes at all clinical reasoning levels.

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  • 5.
    Overmeer, Thomas
    et al.
    Mälardalens högskola, Akademin för hälsa, vård och välfärd, Hälsa och välfärd. Örebro University, Örebro, Sweden.
    Boersma, Katja
    Örebro University, Örebro, Sweden.
    What Messages Do Patients Remember?: Relationships Among Patients' Perceptions of Physical Therapists' Messages, Patient Characteristics, Satisfaction, and Outcome.2016Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 96, nr 3, s. 275-283Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    BACKGROUND: 

    Based on a behavioral medicine perspective, modern recommendations for physical therapists treating patients with spinal pain include performing a trustworthy physical examination, conveying the message that back pain is benign, and stressing that activity is a key to recovery. However, little evidence is available on how patients perceive these biopsychosocial messages and how patients' perceptions of these messages relate to their recovery.

    OBJECTIVES: 

    The aim of this study was to explore the relationships between perceptions of treatment delivery that are related to an evidence-based approach and psychological factors, treatment outcome, and treatment satisfaction.

    DESIGN: 

    A cohort study with 3 measurement points was conducted.

    METHODS: 

    Data on 281 participants were collected.

    RESULTS: 

    High catastrophizing and lower mood in the participants were correlated to "not perceiving the biopsychosocial message" measured at 6 weeks after treatment start. Participants who did not perceive the biopsychosocial message were at higher risk for disability and had lower treatment satisfaction 6 months after treatment start even when controlling for pretreatment pain intensity. "Not perceiving the biopsychosocial message" was not a mediator for treatment outcome and treatment satisfaction. Physical therapists' treatment orientations or attitudes were not related to the perception of the message by the patients.

    LIMITATIONS: 

    There was no measure of actual practice behavior.

    CONCLUSIONS: 

    Maladaptive cognitions and negative emotions appear to affect the way information provided during treatment is perceived by patients. The way information is perceived by patients influences treatment outcome and treatment satisfaction. Physical therapists are advised to check that patients with higher levels of catastrophizing and lower mood are correctly perceiving and interpreting a biopsychosocial message.

  • 6.
    Overmeer, Thomas
    et al.
    Örebro Universitet, Sweden.
    Boersma, Katja
    Örebro Universitet, Sweden.
    Denison, Eva
    Norwegian Knowledge Center for the Health Services, Oslo, Norway..
    Linton, Steven
    Örebro Universitet, Sweden.
    Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes?: A randomized controlled trial2011Ingår i: Physical Therapy, ISSN 0031-9023, E-ISSN 1538-6724, Vol. 91, nr 5, s. 804-819Artikel i tidskrift (Refereegranskat)
    Abstract [en]

    Background. Psychosocial prognostic factors are important in the development of chronic pain, but treatment providers often lack knowledge and skills to assess and address these risk factors. Objective. The aim of this study was to examine the effects on outcomes (pain and disability) in patients of a course about psychosocial prognostic factors for physical therapists. Design. This study was a randomized, controlled trial. Setting. The setting was primary care practice. Participants. Forty-two primary care physical therapists attended an 8-day university course (over 8 weeks) aimed at identifying and addressing psychosocial risk factors. Intervention. The physical therapists were randomly assigned to either the course or a waiting list. They treated consecutive patients with acute and subacute musculoskeletal pain both before and after the course. Measurements. We measured physical therapists' attitudes and beliefs about psychosocial factors, knowledge, and skills before and after the course. We measured patients' pain, disability, catastrophizing, and mood at the start of treatment and at a 6-month follow-up. Methods. The physical therapists were randomly assigned to either the course or a waiting list. They treated consecutive patients with acute and subacute musculoskeletal pain both before and after the course. Results. Pain and disability outcomes in all patients of physical therapists who had participated in the course or in patients at risk of developing long-term disability who had higher levels of catastrophizing or depression were not significantly different from those outcomes in patients of physical therapists who had not participated in the course. Pain and disability outcomes in patients with a low risk of developing long-term disability-and pain outcomes in patients with a high risk of developing long-term disability-were not dependent upon whether the attitudes and beliefs of their physical therapists changed during the course. However, disability outcomes in patients with a high risk of developing long-term disability may have been influenced by whether the attitudes and beliefs of their physical therapists changed. Limitations. A limitation of this study was that actual practice behavior was not measured. Conclusions. An 8-day university course for physical therapists did not improve outcomes in a group of patients as a whole or in patients with a risk of developing long-term disability. However, patients who had a risk of developing long-term disability and had higher levels of catastrophizing or depression may have shown greater reductions in disability if the attitudes and beliefs of their physical therapists changed during the course.

1 - 6 av 6
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