Department of Implementation Science, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Department of Internal Medicine, Section of Gerontology and Geriatric Medicine, Wake Forest University School of Medicine, Winston-Salem, NC, USA.
Physiother Theory Pract. 2024 Nov;40(11):2540-2549. doi: 10.1080/09593985.2023.2274385. Epub 2023 Oct 30.
Despite physical activity being a major component of managing chronic low back pain, < 50% of patients receive physical activity interventions. Electronic Health Records can deepen our understanding about this clinical gap.
We aimed to: 1) develop and test a data abstraction form that captures physical activity documentation; and 2) explore physical therapists' documentation of physical activity assessments and interventions.
We developed a data abstraction form using previously published practice guidelines. After identifying the forms' inter-rater reliability, we used it to explore physical therapists' documentation related to physical activity assessments and interventions for patients with chronic low back pain.
The final data abstraction form included information about physical activity history, assessments, interventions, general movement discussion, and plan. Our inter-rater reliability was high. Of the 18 patients, 66.7% had documentation about their PA history. Across the 56 encounters, 14 (25.0%) included an assessment, 18 (32.1%) an intervention, 18 (32.1%) a general movement discussion, and 12 (21.4%) included a plan.
Using our reliable data abstraction form we identified a lack of documentation about physical activity assessments and interventions among patients with chronic low back pain. A larger study is needed to examine the generalizability of these results.
尽管身体活动是管理慢性下腰痛的主要组成部分，但<50%的患者接受身体活动干预。电子健康记录可以加深我们对这一临床差距的理解。
我们旨在：1）开发和测试一种数据提取表格，以捕获身体活动记录；2）探索物理治疗师对身体活动评估和干预的记录。
我们使用先前发表的实践指南开发了一种数据提取表格。在确定表格的组内可靠性后，我们使用它来探索与慢性下腰痛患者的身体活动评估和干预相关的物理治疗师的记录。
最终的数据提取表格包括身体活动史、评估、干预、一般运动讨论和计划的信息。我们的组内可靠性很高。在 18 名患者中，有 66.7%的患者有关于他们 PA 历史的记录。在 56 次就诊中，有 14 次（25.0%）包括评估，18 次（32.1%）包括干预，18 次（32.1%）包括一般运动讨论，12 次（21.4%）包括计划。
使用我们可靠的数据提取表格，我们发现慢性下腰痛患者的身体活动评估和干预记录不足。需要进行更大规模的研究来检验这些结果的普遍性。
