Hebda-Boon Anna, Shortland Adam P, Birn-Jeffery Aleksandra, Morrissey Dylan
Sport and Exercise Medicine, Barts and the London School of Medicine and Dentistry, Queen Mary University of London, London, UK.
School of Biomedical Engineering and Imaging Science, King's College London, London, UK.
Pilot Feasibility Stud. 2024 May 14;10(1):76. doi: 10.1186/s40814-024-01477-5.
Instrumented gait analysis (IGA) is an assessment and research tool with proven impacts on clinical decision-making for the management of ambulant children and young people with cerebral palsy (CYPwCP) but is underused and variably understood by relevant clinicians. Clinicians' difficulties in gaining expertise and confidence in using IGA are multifactorial and related to access for clinical decision-making, limited training opportunities and inability to translate this training into clinical practice.
The primary aim of this study is to test the feasibility of an educational intervention to advance clinicians' application of gait analysis in CYPwCP, to inform a definitive trial. The secondary aim is to measure the effect that appropriate IGA training has on physiotherapists' knowledge, skills, confidence and behaviours. This will be a two-arm feasibility randomised controlled trial with an experimental and control group. The 6-week on-line intervention uses a multicomponent approach grounded in behavioural change techniques. A repeated measures design will be adopted, whereby participants will complete outcome measures at baseline, immediately after the intervention and at 4 months. The primary outcome measures (trial feasibility-related outcomes) are recruitment and engagement. The secondary outcome measures (trial research-related outcomes) are knowledge, skills, confidence and practice change. Outcome measures will be collected via online questionnaires and during observed skill assessments. Analysis of data will use descriptive statistics, two-way mixed ANOVA model and qualitative content analysis.
This study will determine feasibility of the definitive randomised control trial of educational intervention delivered to advance clinicians' application of gait analysis in CYPwCP. This study offers the shift in emphasis from regarding IGA as a tool to a focus on clinicians' requirements for access, training and a well-defined role to optimise utilisation of IGA. The impact of this should be better engagement with IGA and clinical practice change. This study will contribute to a body of educational research into clinical education of healthcare professionals and IGA training offering insight into high levels of evaluation evidence including clinical behaviour change.
Protocol has been registered with the Open Science Framework (osf.io/nweq6) in June 2023.
仪器化步态分析（IGA）是一种评估和研究工具，已被证明对行走的脑瘫儿童和青少年（CYPwCP）的临床决策有影响，但相关临床医生对其使用不足且理解不一。临床医生在获取使用IGA的专业知识和信心方面存在困难，这是多方面因素造成的，与临床决策的获取途径、有限的培训机会以及无法将这种培训转化为临床实践有关。
本研究的主要目的是测试一种教育干预措施的可行性，以促进临床医生在CYPwCP中应用步态分析，为确定性试验提供信息。次要目的是衡量适当的IGA培训对物理治疗师的知识、技能、信心和行为的影响。这将是一项双臂可行性随机对照试验，分为实验组和对照组。为期6周的在线干预采用基于行为改变技术的多组分方法。将采用重复测量设计，参与者将在基线、干预后立即以及4个月时完成结局测量。主要结局测量指标（与试验可行性相关的结局）是招募和参与情况。次要结局测量指标（与试验研究相关的结局）是知识、技能、信心和实践变化。结局测量指标将通过在线问卷和观察到的技能评估来收集。数据分析将使用描述性统计、双向混合方差分析模型和定性内容分析。
本研究将确定为促进临床医生在CYPwCP中应用步态分析而进行的教育干预确定性随机对照试验的可行性。本研究提供了重点的转变，从将IGA视为一种工具，转变为关注临床医生在获取途径、培训和明确角色方面的要求，以优化IGA的使用。其影响应该是更好地参与IGA和临床实践变革。本研究将为医疗保健专业人员临床教育和IGA培训的教育研究做出贡献，深入了解包括临床行为改变在内的高水平评估证据。
方案已于2023年6月在开放科学框架（osf.io/nweq6）注册。
