基于社区的康复实施框架，以解决资源匮乏社区跑步者的髌股疼痛问题：德尔菲共识
Community-based rehabilitation implementation framework to address patellofemoral pain amongst runners in under-resourced communities: Delphi consensus.
作者信息
Kunene Siyabonga, Taukobong Nomathemba, Ramklass Serela
机构信息
Department of Physiotherapy, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa.
School of Clinical Medicine, College of Health Sciences, University of KwaZulu-Natal, Durban, South Africa.
出版信息
S Afr J Physiother. 2021 Jun 22;77(1):1531. doi: 10.4102/sajp.v77i1.1531. eCollection 2021.
BACKGROUND
Runners in under-resourced communities in parts of South Africa present with a high prevalence of patellofemoral pain (PFP), which affects their level of participation in sporting activities. Therefore, a specific rehabilitation approach is necessary to manage the PFP-related needs of these runners within their means and reach.
OBJECTIVE
To develop a community-based rehabilitation (CBR) implementation framework for PFP amongst runners in under-resourced communities.
METHOD
Our study used the Delphi technique to develop an appropriate rehabilitation implementation framework for PFP in community-based settings. Sport medicine experts, involved in the treatment and rehabilitation of PFP, were recruited to participate. The Delphi process consisted of three rounds to attain consensus amongst the experts on the components and elements that could be contained in a rehabilitation implementation framework for the management of PFP. Experts rated the framework items using a five-point Likert scale.
RESULTS
A total of 19 experts participated in our study: 10 were females and 9 were males of whom 13 were aged between 36 and 55 years. Most were local experts (15) with 11-20 years of clinical experience. Four core rehabilitation implementation items were identified through the Delphi process. These were: (1) the establishment of transdisciplinary rehabilitation teams, (2) upskilling of available clinicians, their assistants and trainers, (3) implementation of a CBR programme at low-level or no-cost and (4) referral of cases to secondary or tertiary institutions for further management.
CONCLUSION
Consensus was reached for a comprehensive CBR implementation framework aimed at addressing the specific needs of runners with PFP in under-resourced communities.
CLINICAL IMPLICATIONS
A further study to test the feasibility of the agreed-upon intervention is recommended.
背景
在南非部分资源匮乏社区的跑步者中，髌股关节疼痛（PFP）的患病率很高，这影响了他们参与体育活动的水平。因此，需要一种特定的康复方法，以在这些跑步者力所能及的范围内满足他们与PFP相关的需求。
目的
为资源匮乏社区的跑步者开发一个基于社区的PFP康复（CBR）实施框架。
方法
我们的研究采用德尔菲技术，为基于社区的环境中PFP开发一个合适的康复实施框架。招募了参与PFP治疗和康复的运动医学专家参与。德尔菲过程包括三轮，以使专家们就PFP管理康复实施框架中可能包含的组成部分和要素达成共识。专家们使用五点李克特量表对框架项目进行评分。
结果
共有19名专家参与了我们的研究：10名女性和9名男性，其中13名年龄在36至55岁之间。大多数是当地专家（15名），有11至20年的临床经验。通过德尔菲过程确定了四个核心康复实施项目。这些项目是：（1）建立跨学科康复团队，（2）提高现有临床医生、他们的助手和培训师的技能，（3）以低成本或无成本实施CBR计划，（4）将病例转诊至二级或三级机构进行进一步管理。
结论
针对旨在满足资源匮乏社区中患有PFP的跑步者的特定需求的全面CBR实施框架达成了共识。
临床意义
建议进一步研究以测试商定干预措施的可行性。
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