Department of Physical Therapy, Duquesne University, Pittsburgh, Pennsylvania.
Department of Physical Therapy, Virginia Commonwealth University, Richmond, Virginia.
Phys Ther. 2020 May 18;100(5):757-765. doi: 10.1093/ptj/pzaa006.
A critical factor to move the field of physical therapy forward is the measurement of fidelity during comparisons of interventions. Fidelity translates as "faithfulness"; thus, fidelity of intervention means faithful and correct implementation of the key components of a defined intervention. Fidelity measurement guards against deviations from, or drift in, the delivery of a targeted intervention, a process necessary for evaluating the efficacy of rehabilitation approaches. Importantly, attention to fidelity measurement differentiates rehabilitation approaches from each other. However, earlier research comparing physical therapist interventions often reported findings without careful attention to fidelity measurement. The purpose of this paper is 2-fold: (1) to support the development of intervention-specific fidelity measures in physical therapy research as the gold standard for translating research findings to clinical practice, and (2) to describe the process of creating a multi-dimensional fidelity measurement instrument in rehabilitation intervention. Improved attention to fidelity measurement will allow the rehabilitation field to communicate interventions clearly with a direct link to outcomes and target the implementation of our improved intervention for the right patient problem with the right dose and the right ingredients at the right time.
推动物理治疗领域发展的一个关键因素是在干预措施比较过程中对保真度的测量。保真度的意思是“忠实”；因此，干预措施的保真度意味着对定义明确的干预措施的关键组成部分进行忠实和正确的实施。保真度测量可以防止针对特定干预措施的偏离或漂移，这是评估康复方法疗效的必要过程。重要的是，对保真度测量的关注将康复方法彼此区分开来。然而，早期比较物理治疗师干预措施的研究往往在没有仔细关注保真度测量的情况下报告发现。本文的目的有两个：（1）支持在物理治疗研究中开发特定于干预措施的保真度测量标准，作为将研究结果转化为临床实践的金标准，（2）描述在康复干预中创建多维保真度测量工具的过程。对保真度测量的重视程度提高，将使康复领域能够将干预措施与结果直接联系起来，并针对正确的患者问题以正确的剂量和正确的成分在正确的时间实施我们改进后的干预措施。
