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针对患有膝关节疼痛的老年人的有效运动益处试验物理治疗师培训项目的内容与评估

Content and Evaluation of the Benefits of Effective Exercise for Older Adults With Knee Pain Trial Physiotherapist Training Program.

作者信息

Holden Melanie A, Whittle Rebecca, Healey Emma L, Hill Susan, Mullis Ricky, Roddy Edward, Sowden Gail, Tooth Stephanie, Foster Nadine E

机构信息

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire.

Arthritis Research UK Primary Care Centre, Research Institute for Primary Care and Health Sciences, Keele University, Keele, Staffordshire.

出版信息

Arch Phys Med Rehabil. 2017 May;98(5):866-873. doi: 10.1016/j.apmr.2016.10.017. Epub 2016 Nov 25.

Abstract

OBJECTIVE

To explore whether participating in the Benefits of Effective Exercise for knee Pain (BEEP) trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain in older adults.

DESIGN

Before/after training program evaluation. Physiotherapists were asked to complete a questionnaire before the BEEP trial training program, immediately after, and 12 to 18 months later (postintervention delivery in the BEEP trial). The questionnaire included a case vignette and associated clinical management questions. Questionnaire responses were compared over time and between physiotherapists trained to deliver each intervention within the BEEP trial.

SETTING

Primary care.

PARTICIPANTS

Physiotherapists (N=53) who completed the BEEP trial training program.

INTERVENTIONS

Not applicable.

MAIN OUTCOME MEASURES

Self-confidence in the diagnosis and management of knee pain in older adults; and intended clinical behavior measured by a case vignette and associated clinical management questions.

RESULTS

Fifty-two physiotherapists (98%) returned the pretraining questionnaire, and 44 (85%) and 39 (74%) returned the posttraining and postintervention questionnaires, respectively. Posttraining, self-confidence in managing older adults with knee pain increased, and intended clinical behavior regarding exercise for knee pain in older adults appeared more in line with clinical guidelines. However, not all positive changes were maintained in the longer-term.

CONCLUSIONS

Participating in the BEEP trial training program increased physiotherapists' self-confidence and changed their intended clinical behavior regarding exercise for knee pain, but by 12 to 18 months later, some of these positive changes were lost. This suggests that brief training programs are useful, but additional strategies are likely needed to successfully maintain changes in clinical behavior over time.

摘要

目的

探讨参与膝关节疼痛有效运动益处(BEEP)试验训练项目是否能增强物理治疗师的自信心,并改变他们针对老年人膝关节疼痛进行运动治疗的预期临床行为。

设计

训练项目前后评估。在BEEP试验训练项目前、训练项目刚结束后以及12至18个月后(BEEP试验干预实施后),要求物理治疗师完成一份问卷。问卷包括一个病例 vignette 和相关的临床管理问题。对问卷回复进行时间上的比较,以及在BEEP试验中接受不同干预训练的物理治疗师之间的比较。

地点

初级保健机构。

参与者

完成BEEP试验训练项目的物理治疗师(N = 53)。

干预措施

不适用。

主要观察指标

对老年人膝关节疼痛诊断和管理的自信心;以及通过病例 vignette 和相关临床管理问题测量的预期临床行为。

结果

52名物理治疗师(98%)返回了训练前问卷,44名(85%)和39名(74%)分别返回了训练后和干预后问卷。训练后,管理膝关节疼痛老年人的自信心增强,针对老年人膝关节疼痛运动治疗的预期临床行为似乎更符合临床指南。然而,并非所有积极变化都能长期维持。

结论

参与BEEP试验训练项目增强了物理治疗师的自信心,并改变了他们针对膝关节疼痛运动治疗的预期临床行为,但到12至18个月后,其中一些积极变化消失了。这表明简短的训练项目是有用的,但可能需要额外的策略来随着时间成功维持临床行为的变化。

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