Tyson S F, DeSouza L H
Centre for Research in Rehabilitation, Department of Health and Social Care, Brunel University, London, UK.
Disabil Rehabil. 2003 Feb 4;25(3):120-6. doi: 10.1080/0963828021000013944.
The lack of models to define and describe rehabilitation processes have often been identified as limiting research and the development of clinical practice. This study describes the development of a clinical model to address a key aspect of stroke physiotherapy--the assessment of posture and balance.
Twenty seven experienced neurological physiotherapists (PT) in six focus groups were used. Participants were shown photographs of a typical stroke patient in sitting and standing positions and were asked 'What would you note if you were assessing the posture and balance of this patient?' Answers were displayed on flip charts to allow immediate feedback about the accuracy and completeness of data. Thematic content analysis was then used.
A complex reasoning process emerged to answer three main questions: What can the patient do? How does s/he do it? Why does s/he do it that way? To answer these questions physiotherapists established balance disability (by observing the patient's ability to perform a series of increasingly demanding balance tasks), identified postural and movement impairments (by observing alignment and movement of body segments relative to each other and to the expected norm for that patient) and assessed muscle activity (by observation and palpation).
Focus groups have been used to elicit a clinical model for the assessment of posture and balance, the content of which will be used to inform a new outcome measure.
缺乏用于定义和描述康复过程的模型常被认为限制了研究以及临床实践的发展。本研究描述了一种临床模型的开发，以解决中风物理治疗的一个关键方面——姿势和平衡的评估。
使用了六个焦点小组中的27名经验丰富的神经物理治疗师（PT）。向参与者展示了一名典型中风患者坐姿和站姿的照片，并询问“如果你正在评估该患者的姿势和平衡，你会注意到什么？”答案被展示在活动挂图上，以便立即反馈数据的准确性和完整性。然后使用主题内容分析法。
出现了一个复杂的推理过程来回答三个主要问题：患者能做什么？他/她是怎么做的？他/她为什么那样做？为了回答这些问题，物理治疗师确定平衡障碍（通过观察患者执行一系列要求越来越高的平衡任务的能力），识别姿势和运动损伤（通过观察身体各部分相对于彼此以及相对于该患者预期标准的排列和运动）并评估肌肉活动（通过观察和触诊）。
焦点小组已被用于得出一种评估姿势和平衡的临床模型，其内容将用于为一种新的结果测量方法提供信息。
