Patient perspectives on using a smartphone application to support home-based exercise during physical therapy treatment: a qualitative study. (Preprint)

2021 ◽  
Author(s):  
Remco Arensman ◽  
Corelien Kloek ◽  
Martijn Pisters ◽  
Tjarco Koppenaal ◽  
Raymond Ostelo ◽  
...  
Keyword(s):  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Smartphone Application ◽  
Patient Perspectives ◽  
Low Back ◽  
Home Based ◽  
Physical Therapy Treatment ◽  
And Performance ◽  
Therapy Treatment

BACKGROUND Home-based exercise is an important part of physical therapy treatment for patients with low back pain. However, treatment effectiveness depends heavily on patient adherence to home-based exercise recommendations. Smartphone applications designed to support home-based exercise have the potential to support adherence to exercise recommendations and potentially improve treatment effects. A better understanding of patient perspectives on the use of smartphone applications to support home-based exercise during physical therapy treatment can assist physical therapists with optimal use and implementation of these applications in clinical practice. OBJECTIVE The aim of this study is to investigate patient perspectives on the acceptability, satisfaction, and performance of a smartphone application to support home-based exercise following recommendations from a physical therapist. METHODS Using a interpretivist phenomenology approach, nine patients with non-specific low back pain recruited from two primary care physical therapy practices were interviewed within two weeks after treatment ended. The Physitrack® smartphone application was used to support home-based exercise as part of treatment for all patients. Data was analyzed using a framework approach to assist with interpretation of the data. RESULTS Data-analysis revealed eleven categories distributed among the three themes “acceptability”, “satisfaction”, and “performance”. Patients are willing to accept the application as part of treatment when it is easy to use, benefits the patient, and when the physical therapist instructs the patient in its use. Satisfaction with the app is determined by the perceived support from the application when exercising at home and the perceived increase in adherence. The video and text instructions, reminder functions, and self-monitor functions are considered most important for performance during treatment. The patients did not view the Physitrack® app as a replacement for the physical therapist and relied on their therapist for instruction and support when needed. CONCLUSIONS Patients who used an app to support home-based exercise as part of treatment are accepting of the app when it is easy to use, benefits the patient, and the therapist instructs the patient in its use. Physical therapists using an app to support home-based exercise can use the findings from this study to more effectively support their patients when exercising at home during treatment.

scholarly journals Internal and External Focus of Attention During Gait Re-Education: An Observational Study of Physical Therapist Practice in Stroke Rehabilitation

2013 ◽  
Vol 93 (7) ◽  
pp. 957-966 ◽  
Author(s):  
Louise Johnson ◽  
Jane H. Burridge ◽  
Sara H. Demain
Keyword(s):  
Physical Therapy ◽  
Stroke Rehabilitation ◽  
Physical Therapists ◽  
Focus Of Attention ◽  
Small Sample ◽  
Gait Rehabilitation ◽  
External Focus ◽  
Physical Therapy Treatment ◽  
The Impact ◽  
Therapy Treatment

BackgroundFocus of attention is known to play an important role in motor skill learning, yet little is known about how attention is directed within the context of stroke rehabilitation.ObjectiveThe aims of this study were: (1) to identify physical therapists' use of internal and external focus of attention during gait rehabilitation for individuals with hemiplegia following stroke and (2) to use the findings to design an experimental study examining the impact of focus of attention on learning poststroke.DesignThe study design involved direct nonparticipation observation of physical therapy treatment sessions.MethodsEight physical therapy treatment sessions, in which gait rehabilitation was taking place, were video recorded. Patients were aged between 36 and 85 years, and ranged from 7 to 216 days poststroke; physical therapists had between 3 and 12 years of experience in stroke rehabilitation. Data analysis took 2 forms: (1) clear definitions of internal and external focus of attention were agreed on via a consensus group and used to develop an analysis matrix through which incidences of instruction and feedback were identified, categorized, and counted; and (2) verbal dialogue was transcribed verbatim and transcripts were thematically analyzed to provide a detailed description of how instructions and feedback were used, illustrated by examples.ResultsThe use of instructions and feedback (internal and external focus) was high; an average of one verbal instruction or feedback statement was delivered every 14 seconds. Sixty-seven percent of the statements were internally focused, 22% were externally focused, and 11% were of mixed focus. Unfocused statements (eg, “good”) also were used regularly. Patients were frequently encouraged to “think about” their performance.LimitationsObservational data collection methods may result in changes in the behavior of those observed, which is a potential source of bias. The small sample size also was a limitation of the study.ConclusionPhysical therapists frequently encouraged patients to be aware of their movements and their performance (internal focus). This approach may reduce automaticity and hinder learning and retention.

Longitudinal Monitoring of Patients With Chronic Low Back Pain During Physical Therapy Treatment Using the STarT Back Screening Tool

2017 ◽  
Vol 47 (5) ◽  
pp. 314-323 ◽  
Author(s):  
Flávia Cordeiro Medeiros ◽  
Leonardo Oliveira Pena Costa ◽  
Marco Aurélio Nemitalla Added ◽  
Evelyn Cassia Salomão ◽  
Lucíola da Cunha Menezes Costa
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Chronic Low Back Pain ◽  
Screening Tool ◽  
Low Back ◽  
Start Back Screening Tool ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

scholarly journals Emergence of Delayed Posttraumatic Stress Disorder Symptoms Related to Sexual Trauma: Patient-Centered and Trauma-Cognizant Management by Physical Therapists

2012 ◽  
Vol 92 (2) ◽  
pp. 339-351 ◽  
Author(s):  
Kim Dunleavy ◽  
Amy Kubo Slowik
Keyword(s):  
Physical Therapy ◽  
Sexual Trauma ◽  
Stress Disorder ◽  
Physical Therapists ◽  
Ptsd Symptoms ◽  
Behavioral Strategies ◽  
Patient Centered ◽  
Physical Therapy Treatment ◽  
History Of ◽  
Therapy Treatment

Background and PurposeSexual violence has been identified as one of the most common predictors of posttraumatic stress disorder (PTSD). This case report describes the emergence of delayed PTSD symptoms, disclosure of history of sexual trauma, and the influence of re-experiencing, avoidance, and hyperarousal symptoms on physical therapy treatment.Case DescriptionA 60-year-old woman was seen for treatment of low back pain. Discussion of a discord between fear of falling and no balance impairments led to disclosure of sexual assault by a physician at 19 years of age. The patient's PTSD symptoms emerged after 10 weeks of physical therapy. The physical therapists monitored somatic responses and body language closely and modified and planned treatment techniques to avoid PTSD triggers and limit hyperarousal. Collaborative communication approaches included reinforcement of cognitive-behavioral strategies introduced by her psychotherapists.OutcomesTrauma-cognizant approaches supported the patient's efforts to manage PTSD symptoms sufficiently to tolerate physical therapy and participate in a back care class. Nonlinear psychological healing is illustrated.DiscussionSymptoms of PTSD may emerge during physical therapy treatment, and patient-sensitive responses to disclosure are important. The trauma-cognizant approach (2-way communication, patient-centered management, and integration of psychological elements into clinical decision making) helped identify and respond to triggers. The physical therapists reinforced cognitive-behavioral strategies introduced by psychotherapists to manage PTSD symptoms. Patient-centered care with further refinement to a trauma-cognizant approach may play an important role in assisting patients with PTSD or a history of sexual trauma to manage symptoms while addressing rehabilitation needs.

scholarly journals Predictors of Physical Therapy Clinic Performance in the Treatment of Patients With Low Back Pain Syndromes

2008 ◽  
Vol 88 (9) ◽  
pp. 989-1004 ◽  
Author(s):  
Linda Resnik ◽  
Dawei Liu ◽  
Vince Mor ◽  
Dennis L Hart
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Physical Therapist ◽  
Low Back ◽  
Therapist Experience ◽  
Performance Group ◽  
Pain Syndromes ◽  
Physical Therapist Assistants

Background and Purpose Little is known about organizational and service delivery factors related to quality of care in physical therapy. This study sought to identify characteristics related to differences in practice outcomes and service utilization. Subjects The sample comprised 114 outpatient clinics and 1,058 therapists who treated 16,281 patients with low back pain syndromes during the period 2000–2001. Clinics participated with the Focus on Therapeutic Outcomes, Inc (FOTO) database. Methods Hierarchical linear models were used to risk adjust treatment outcomes and number of visits per treatment episode. Aggregated residual scores from these models were used to classify each clinic into 1 of 3 categories in each of 3 types of performance groups: (1) effectiveness, (2) utilization, and (3) overall performance (ie, composite measure of effectiveness and utilization). Relationships between clinic classification and the following independent variables were examined by multinomial logistic regression: years of therapist experience, number of physical therapists, ratio of physical therapists to physical therapist assistants, proportion of patients with low back pain syndromes, number of new patients per physical therapist per month, utilization of physical therapist assistants, and setting. Results Clinics that were lower utilizers of physical therapist assistants were 6.6 times more likely to be classified into the high effectiveness group compared with the low effectiveness group, 6.7 times more likely to be classified in the low utilization group compared with the high utilization group, and 12.4 times more likely to be classified in the best performance group compared with the worst performance group. Serving a higher proportion of patients with low back pain syndromes was associated with an increased likelihood of being classified in the lowest or middle group. Years of physical therapist experience was inversely associated with being classified in the middle utilization group compared with the highest utilization group. Discussion and Conclusion These findings suggest that, in the treatment of patients with low back pain syndromes, clinics that are low utilizers of physical therapist assistants are more likely to provide superior care (ie, better patient outcomes and lower service use).

scholarly journals PREVALENCE OF LOW BACK PAIN IN HOME-BASED PHYSICAL THERAPISTS

2013 ◽  
Vol 2 (1) ◽  
pp. 15-20
Author(s):  
Ghazala Noor Nizami ◽  
Muhammad Sarfaraz ◽  
Dr. Shazia Noor Nizami
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Physical Therapists ◽  
Sampling Technique ◽  
Survey Study ◽  
Low Back ◽  
Work Related ◽  
Home Based ◽  
Significant Difference

BACKGROUND To find out the prevalence and to highlight the risk factors of low back pain in home-based physical therapist. STUDY DESIGN AND SAMPLING TECHNIQUE A cross-sectional survey study with non-probability convenience sampling technique STUDY SETTING AND PARTICIPANTS 200 physical therapists that were doing home patients in Karachi, either without or with their jobs were the part of this study. They were either self-employed or affiliated to different hospitals. DATA COLLECTING TOOL AND DATA ANALYSIS A questionnaire was used to collect data, which was adopted from Nordic questionnaire and other researches. The collected data was analyzed on SPSS 20. RESULTS 93 % home-based physical therapists had experienced the work-related pain or discomfort in the last 12 months. Among them the low back is the highly affected site with prevalence of 81.5%. Their working status of job in physical therapy department or academics with home-based physical therapy had a significant difference in presence or absence of work related pain or discomfort. CONCLUSION This study shows that home-based physical therapists are more prone to develop work-related problems and had higher prevalence of work-related LBP. This may be due to more work load, lower bed height of home patients, poor ergonomics at homes of patients and poor posture of physical therapists.

scholarly journals What factors explain the number of physical therapy treatment sessions in patients referred with low back pain; a multilevel analysis

2005 ◽  
Vol 5 (1) ◽  
Author(s):  
Ilse CS Swinkels ◽  
Raymond H Wimmers ◽  
Peter P Groenewegen ◽  
Wil JH van den Bosch ◽  
Joost Dekker ◽  
...  
Keyword(s):  
Low Back Pain ◽  
Back Pain ◽  
Physical Therapy ◽  
Multilevel Analysis ◽  
Low Back ◽  
Physical Therapy Treatment ◽  
Therapy Treatment

scholarly journals Primary Care Physical Therapy in People With Fibromyalgia: Opportunities and Boundaries Within a Monodisciplinary Setting

2010 ◽  
Vol 90 (12) ◽  
pp. 1815-1822 ◽  
Author(s):  
Jo Nijs ◽  
Kaisa Mannerkorpi ◽  
Filip Descheemaeker ◽  
Boudewijn Van Houdenhove
Keyword(s):  
Primary Care ◽  
Physical Therapy ◽  
Aerobic Exercise ◽  
Physical Therapists ◽  
Tertiary Care ◽  
Strengthening Exercise ◽  
Physical Therapy Treatment ◽  
Few Data ◽  
Evidence Based Guidelines ◽  
Therapy Treatment

Despite the fact that people with fibromyalgia syndrome (FMS) frequently are seen by primary care physical therapists, guidelines for the management of FMS are based primarily on outcomes from multidisciplinary and tertiary care treatment studies. Few data addressing the treatment of patients with FMS in primary care currently are available. The evidence-based guidelines on the management of FMS are based, in part, on evidence from studies examining physical therapy treatment components alone (eg, aerobic exercise, education). Thus, the recommendations can be applied to primary care physical therapy. Primary care physical therapy for patients with FMS should include education, aerobic exercise, and strengthening exercise. For other treatment components such as passive treatments, activity management, and relaxation, less evidence currently is available to advocate their use in primary care physical therapy. Superior results are to be expected when various treatment components are combined.

EVALUATING IMPEDIMENTS LEADING TO NON-ADHERENCE OF PHYSICAL THERAPY TREATMENT AMONGST INHABITANTS OF ROHTAK DISTRICT

2021 ◽  
pp. 19-21
Author(s):  
Meetu Nagpal
Keyword(s):  
Physical Therapy ◽  
Rural Areas ◽  
Urban Areas ◽  
Treatment Programme ◽  
Geriatric Population ◽  
Home Based ◽  
Urban Males ◽  
Physical Therapy Treatment ◽  
Rate Of Success ◽  
Therapy Treatment

Background:The rate of success of a physiotherapy treatment programme is strongly inuenced by the adherence of the patient with prescribed treatment programme. Non-adherence with the therapy given to the patient is often overlooked and is one of the reasons for failure to achieve desired results aimed for a given disease/condition. Methods:Atotal of 40 geriatric subjects (20 urban and 20 rural) were surveyed for information using self-questionnaire from Rohtak district. Results: Out of 40 subjects (10 urban males and 10 urban females and 10 rural males and 10 rural females) 70% of urban (30% females and 40% males) and 30% of rural (10% females and 20% males) population was found to be adherent to physical therapy treatment. Impediments identied in the current study that were statistically signicantly associated with non-adherence to physical therapy treatment among the geriatric population included residential locality (p=0.02), accessibility to physiotherapy clinics (p=0.001), paying capacity (p=0.003), compliance to unsupervised home based exercise treatment (p=0.01) and cooperation by family members (p= 0.01). A non-signicant relationship was found with ability of doing ADLs (p=0.06). Conclusion: The study shows that geriatric population of Rohtak district residing in urban areas are more adherent to physical therapy treatment programme as compared to those residing in rural areas.

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