van Dijk Margriet, Smorenburg Nienke, Visser Bart, Heerkens Yvonne F, Nijhuis-van der Sanden Maria W G
HU University of Applied Sciences, Institute for Human Movement Studies, Utrecht, the Netherlands.
Faculty of Health, ACHIEVE Centre of Expertise, Amsterdam University of Applied Sciences, Amsterdam, the Netherlands.
BMC Musculoskelet Disord. 2017 Jul 4;18(1):288. doi: 10.1186/s12891-017-1649-3.
Observation of movement quality (MQ) is an indelible element in the process of clinical reasoning for patients with non-specific low back pain (NS-LBP). However, the observation and evaluation of MQ in common daily activities are not standardized within allied health care. This study aims to describe how Dutch allied health care professionals (AHCPs) observe and assess MQ in patients with NS-LBP and whether AHCPs feel the need to have a specific outcome measure for assessing MQ in patients with NS-LBP.
In this cross-sectional digital survey study, Dutch primary care AHCPs (n = 114) answered one open and three closed questions about MQ in NS-LBP management. Qualitative and quantitative analyses were applied.
Qualitative analyses of the answers to the open questions revealed four main themes: 1) movement pattern features, 2) motor control features, 3) environmental influences and 4) non-verbal expressions of pain and exertion. Quantitative analyses clearly indicated that AHCPs observe MQ in the diagnostic (92%), therapeutic (91%) and evaluation phases (86%), that they do not apply any objective measurement of MQ and that 63% of the AHCPs consider it important to have a specific outcome measure to assess MQ. The AHCPs expressed added benefits and critical notes regarding clinical reasoning and quality of care.
AHCPs recognize the importance of observing MQ in the assessment and management of LBP in a standardized way. However, there is no consensus amongst AHCPs how MQ should be standardized. Prior to standardization, it will be important to develop a theoretical framework to determine which observable and measurable dimensions of MQ are most valid and relevant for patients with NS-LBP to include in the assessment.
对于非特异性下腰痛（NS-LBP）患者，运动质量（MQ）观察是临床推理过程中不可或缺的要素。然而，在联合医疗保健领域，日常活动中MQ的观察和评估尚未标准化。本研究旨在描述荷兰联合医疗保健专业人员（AHCPs）如何观察和评估NS-LBP患者的MQ，以及AHCPs是否认为需要有特定的结局指标来评估NS-LBP患者的MQ。
在这项横断面数字调查研究中，荷兰初级保健AHCPs（n = 114）回答了关于NS-LBP管理中MQ的一个开放性问题和三个封闭式问题。采用了定性和定量分析方法。
对开放性问题答案的定性分析揭示了四个主要主题：1）运动模式特征，2）运动控制特征，3）环境影响，4）疼痛和用力的非语言表达。定量分析清楚地表明，AHCPs在诊断阶段（92%）、治疗阶段（91%）和评估阶段（86%）观察MQ，他们没有应用任何MQ的客观测量方法，并且63%的AHCPs认为有一个特定的结局指标来评估MQ很重要。AHCPs表达了关于临床推理和护理质量的额外益处和关键意见。
AHCPs认识到以标准化方式观察MQ在LBP评估和管理中的重要性。然而，AHCPs对于如何标准化MQ尚未达成共识。在标准化之前，制定一个理论框架以确定MQ的哪些可观察和可测量维度对于NS-LBP患者的评估最有效和相关将很重要。
