Swanenburg Jaap, Gruber Christina, Brunner Florian, Wirth Brigitte
Department of Physiotherapy, Balgrist University Hospital , Zürich , Switzerland .
Physiother Theory Pract. 2015 May;31(4):293-8. doi: 10.3109/09593985.2014.994152. Epub 2014 Dec 24.
The aims of this observational, prospective cohort study were to: assess the patients' and therapists' perception of change after physiotherapy in an orthopedic hospital's outpatient clinic; relate these retrospective assessments to a serial assessment of pain; and study the influence of patient characteristics on the perceived change.
161 patients of the outpatient clinic participated. The main outcome measures were the patient global impression of change (PGIC) and the clinical global impression of change (CGIC) after physiotherapy. The visual analogue scale was used as serial assessment.
The PGIC indicated improvement in 128 patients (80%) and the CGIC in 117 patients (73%). The correlation between PGIC and CGIC was good (rS = 0.71, p < 0.001). The perceived change correlated little to baseline pain (PGIC: rS = 0.24, p = 0.004; CGIC: rS = 0.18, p = 0.024) and change in pain due to physiotherapy (PGIC: rS = -0.22, p = 0.004; CGIC: rS = -0.31, p < 0.001). The logistic regression model revealed a significant influence of the patients' education level and the number of problems on the PGIC and the CGIC.
The addition of at least one GPC scale might be valuable in evaluating the outcome in physical therapy, which requires little time and thus may be ideal for a clinical setting. Patients' and therapists' perception of change is significantly influenced by the patients' education level and the number of problems, which might be of relevance when choosing adequate treatment strategies.
本观察性前瞻性队列研究的目的是:评估骨科医院门诊接受物理治疗后患者和治疗师对变化的感知;将这些回顾性评估与疼痛的系列评估相关联;研究患者特征对感知变化的影响。
161名门诊患者参与研究。主要结局指标是物理治疗后患者的整体变化印象量表(PGIC)和临床整体变化印象量表(CGIC)。采用视觉模拟量表进行系列评估。
PGIC显示128名患者(80%)有改善,CGIC显示117名患者(73%)有改善。PGIC与CGIC之间的相关性良好(斯皮尔曼等级相关系数rS = 0.71,p < 0.001)。感知变化与基线疼痛相关性较小(PGIC:rS = 0.24,p = 0.004;CGIC:rS = 0.18,p = 0.024),与物理治疗引起的疼痛变化相关性也较小(PGIC:rS = -0.22,p = 0.004;CGIC:rS = -0.31,p < 0.001)。逻辑回归模型显示患者的教育水平和问题数量对PGIC和CGIC有显著影响。
增加至少一个GPC量表可能对评估物理治疗效果有价值,该量表所需时间少,因此可能是临床环境中的理想选择。患者和治疗师对变化的感知受患者教育水平和问题数量的显著影响,这在选择适当的治疗策略时可能具有相关性。