Scott-Dempster Clare, Toye Francine, Truman Juliette, Barker Karen
Physiotherapy Department, Nuffield Orthopaedic Centre, Oxford University Hospitals NHS Trust , Headington, Oxford , UK and.
Physiother Theory Pract. 2014 Jul;30(5):319-28. doi: 10.3109/09593985.2013.869774. Epub 2013 Dec 30.
Activity pacing is a strategy used by physiotherapists treating people with chronic pain. Questions as to the usefulness of activity pacing with people with chronic pain have been raised clinically and in research. This study explores physiotherapists' experiences of using activity pacing with people with chronic musculoskeletal pain.
We interviewed six physiotherapists and used the methods of Interpretative Phenomenological Analysis (IPA) to explore the meaning of pacing.
We identified three master themes. First, activity pacing was perceived as part of a process whereby patients came to realize that change is possible, and that life could be different. Second, in order to use activity pacing effectively the physiotherapist needs to shift from a "fix it" to a "sit with" approach to the treatment. Third physiotherapists described how they used many combined therapeutic approaches in managing chronic pain.
This study increases our understanding of activity pacing and will help to make the best use of activity pacing in clinical practice, and optimize outcomes for the patients. These findings suggest that physiotherapists need to develop reflective listening skills, and use an experiential learning approach to facilitate activity pacing.
活动节奏控制是物理治疗师治疗慢性疼痛患者时采用的一种策略。临床上和研究中都有人对慢性疼痛患者采用活动节奏控制的有效性提出了疑问。本研究探讨物理治疗师对慢性肌肉骨骼疼痛患者采用活动节奏控制的经验。
我们采访了六位物理治疗师,并采用解释现象学分析(IPA)方法来探究节奏控制的意义。
我们确定了三个主要主题。第一,活动节奏控制被视为患者逐渐认识到改变是可能的,生活可以有所不同这一过程的一部分。第二,为了有效运用活动节奏控制,物理治疗师需要从“解决问题”的方法转变为“陪伴患者”的治疗方法。第三,物理治疗师描述了他们在管理慢性疼痛时如何运用多种综合治疗方法。
本研究增进了我们对活动节奏控制的理解,将有助于在临床实践中充分利用活动节奏控制,并为患者优化治疗效果。这些发现表明,物理治疗师需要培养反思性倾听技巧,并采用体验式学习方法来促进活动节奏控制。