Bullock Laurna, Holden Melanie A, Jinks Clare, Atiah Asamane Evans, Herron Dan, Borrelli Belinda, Callaghan Michael J, Birrell Fraser, Halliday Nicola, Marshall Michelle, Sowden Gail, Ingram Carol, McBeth John, Dziedzic Krysia, Foster Nadine E, Jowett Sue, Lawton Sarah, Mallen Christian D, Peat George
School of Medicine, Primary Care Centre Versus Arthritis, Keele University, Keele, UK.
Centre for Musculoskeletal Research, Keele University, Keele, UK.
Musculoskeletal Care. 2024 Dec;22(4):e70021. doi: 10.1002/msc.70021.
To explore physiotherapists' experiences and perceived acceptability of delivering a bracing intervention for knee osteoarthritis (OA) in the 'PROvision of braces for Patients with knee OA' (PROP OA) randomised controlled trial.
Semi-structured telephone interviews with consenting physiotherapists who received the PROP OA training programme and delivered the knee bracing intervention (advice, information and exercise instruction plus knee brace matched to patients' clinical and radiographic presentation and with adherence support). Interviews were recorded and transcribed verbatim. Two-stage analytic framework: inductive thematic analysis preceded mapping to constructs of the Theoretical Framework of Acceptability.
Eight physiotherapists were interviewed and six key themes were developed. Perceptions of the training programme were generally positive, but additional formal training and experiential learning consolidated confidence and skills in novel intervention components. Advice, information, and exercise instruction reflected usual physiotherapy care for knee OA. Physiotherapists were confident in delivering the knee brace, but determining the pattern of knee OA to inform brace type selection was challenging. Physiotherapists valued brace adherence enhancing strategies and the follow-up appointment to facilitate adherence. Perceived impact of the bracing intervention for people with OA was positive. The bracing intervention was perceived as acceptable, although improving self-efficacy to deliver novel intervention components (e.g., reading x-rays) would enhance acceptability.
The complex knee bracing intervention was broadly perceived as acceptable by physiotherapists. If implemented within clinical practice beyond the trial, physiotherapists might benefit from not only initial training in brace selection but also ongoing support and mentoring to increase self-efficacy in delivery.
在“为膝骨关节炎患者提供支具”（PROP OA）随机对照试验中，探讨物理治疗师在提供膝骨关节炎（OA）支具干预方面的经验和感知到的可接受性。
对同意参与的物理治疗师进行半结构化电话访谈，这些治疗师接受了PROP OA培训计划并实施了膝关节支具干预（提供建议、信息和运动指导，加上根据患者的临床和影像学表现匹配的膝关节支具，并提供依从性支持）。访谈进行录音并逐字转录。采用两阶段分析框架：先进行归纳主题分析，然后映射到可接受性理论框架的结构。
对8名物理治疗师进行了访谈，并形成了6个关键主题。对培训计划的看法总体上是积极的，但额外的正规培训和体验式学习巩固了在新干预内容方面的信心和技能。建议、信息和运动指导反映了对膝骨关节炎的常规物理治疗。物理治疗师对提供膝关节支具很有信心，但确定膝骨关节炎的模式以指导支具类型选择具有挑战性。物理治疗师重视增强支具依从性的策略以及有助于依从性的随访预约。支具干预对骨关节炎患者的感知影响是积极的。支具干预被认为是可接受的，尽管提高实施新干预内容（如阅读X光片）的自我效能会增强可接受性。
物理治疗师普遍认为复杂的膝关节支具干预是可接受的。如果在试验之外的临床实践中实施，物理治疗师可能不仅会从支具选择的初始培训中受益，还会从持续的支持和指导中受益，以提高实施过程中的自我效能。
