This critical appraisal tool will aid both the health care practitioner to critically appraise the relevant literature and researchers to improve the quality of reporting of the validity and reliability of objective clinical tools.
BackgroundNon-specific neck pain is a common health problem of global concern for office workers. This systematic review ascertained the latest evidence for the effectiveness of therapeutic exercise versus no therapeutic exercise on reducing neck pain and improving quality of life (QoL) in office workers with non-specific neck pain.MethodSeven electronic databases using keywords, that is, ‘office workers’, ‘non-specific neck pain’, ‘exercise’ and/or ‘exercise therapy’, ‘QoL’, ‘strengthening’, ‘stretching’, ‘endurance’, ‘physiotherapy’ and/or ‘physical therapy’, were searched from inception until March 2017. Heterogeneous data were reported in narrative format and comparable homogenous data were pooled using Revman.ResultsEight randomised control trials were reviewed and scored on average 6.63/10 on the Physiotherapy Evidence Database (PEDro) scale. Five studies performed strengthening exercise, one study had a strengthening and an endurance exercise group, one study performed stretching exercise and one study had an endurance intervention group and a stretching intervention group. Five and four studies reported significant improvement in neck pain and QoL, respectively, when conducting strengthening exercise. When performing endurance exercises, one and two studies reported significant changes in neck pain and QoL, respectively. The one study incorporating stretching exercise reported significant improvement in neck pain. The meta-analysis revealed that there is a clinically significant difference favouring strengthening exercise over no exercise in pain reduction but not for QoL.ConclusionThere is level II evidence recommending that clinicians include strengthening exercise to improve neck pain and QoL. However, the effect of endurance and stretching exercise needs to be explored further.
BackgroundResearch training programmes are a knowledge translation (KT) intervention which aim to improve research evidence uptake by clinicians. Whilst KT training programmes have been reported to significantly improve evidence uptake by physiotherapists, it is unclear which aspects of training optimally assist KT into physiotherapy practice. The purpose of the review was to establish the body of evidence regarding KT training programmes to improve physiotherapists’ use of evidence-based practice (EBP) and clinical practice guidelines (CPG).MethodsA systematic scoping review was undertaken in line with the adapted Arksey and O’Malley framework. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PUBMED, OTseeker, Scopus, ERIC) were searched. Targeted keywords identified primary research articles of any hierarchy, that described the nature and impact of KT training programmes for physiotherapists. Where systematic reviews were identified, the component primary studies were considered individually for relevance. Critical appraisal was not undertaken due to the nature of a scoping review, and data was reported descriptively.ResultsTen systematic reviews were identified (yielding four relevant primary studies). Five additional primary studies were identified (two randomised controlled trials, two non-randomised controlled trials and one pre-post study) which were not included in the original systematic reviews. This provided nine eligible primary research studies for review. The KT strategies were all multi-faceted. Interactive sessions, didactic sessions, printed material and discussion and feedback were consistently associated with effective outcomes. When KT strategies addressed local barriers to EBP utilisation, there were better success rates for EBP and CPG uptake, irrespective of the outcome measures used. There were no consistent ways of measuring outcome.ConclusionMulti-faceted KT strategies designed to address local barriers to knowledge translation were most effective in improving EBP/ CPG uptake among physiotherapists.Electronic supplementary materialThe online version of this article (doi: 10.1186/s12909-018-1121-6) contains supplementary material, which is available to authorized users.
BackgroundUnderstanding students’ learning styles, and modifying teaching styles and material accordingly, is an essential to delivering quality education. Knowing more about the learning styles of physiotherapy learners will assist educators’ planning and delivering of learning activities. The purpose of this scoping review was to explore what is published about physiotherapy learning styles.MethodsAn adapted Arksey and O’Malley framework was applied to undertake this systematic scoping review. Nine electronic databases (CINAHL, BIOMED CENTRAL, Cochrane, Web of Science, PROQUEST, PubMed, OTseeker, Scopus, ERIC) were searched using the keywords: ‘learning styles’ and ‘physiotherapy’. English-language, primary research articles that investigated physiotherapy learners’ learning styles were sought.ResultsOf 396 potentially-relevant articles, 15 were included in this review. The studies mostly reflected undergraduate students (910 undergraduates, 361 postgraduates, 23 professionals), in developed countries. Nine articles used the Kolb’s experiential learning theory (ELT); one study applied Honey and Mumford’s approach; two studies used the Gregorc model of cognition and three studies did not specify an underlying theory. Outcome measures included different versions of Kolb’s Learning Style Inventory, the visual-aural-read/write-kinesthetic questionnaire, Gregorc style delineator, Felder Silverman’s Index of Learning Survey, and Honey and Mumford’s Learning Style Questionnaire.The preferred physiotherapy learning styles, according to the ELT, seem to be Converger (learns “hands-on” and applying previously attained knowledge) and Assimilator (gathers and organises information to make the most sense).ConclusionsBoth physiotherapy learners and physiotherapists have specific learning styles of active participation, underpinned with practical examples of theoretical concepts. More research is needed in developing countries, and on postgraduate and professional physiotherapy learners’ learning styles. Also, further research should focus on defining and describing physiotherapy learning styles in a way to be used as an industry standard; and developing valid and reliable learning style outcome measures applicable across physiotherapy learners and settings.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1434-5) contains supplementary material, which is available to authorized users.
Rationale: Clinical practice guidelines (CPGs) should provide busy health care professionals with easy-to-use tools that support efficient uptake of current best evidence in daily clinical practice. However, CPG uptake rarely occurs at the speed of evidence production. The aim of this study was to explore the factors influencing CPG uptake among South African (SA) physiotherapists (PTs).Method: An exploratory, descriptive qualitative study design was used, within an interpretative research paradigm. A phenomenological approach was taken, as the study aimed to explore the phenomenon of CPG uptake by SA PTs and how the themes and subthemes related to each other within this phenomenon.Semistructured interviews were undertaken via telephone calls that were audiotaped and independently transcribed. An inductive and deductive thematic content analysis approach was taken where the transcript content was analysed by hand.Findings: Thirty-one PTs from the private, public, and education sectors participated in the interviews. The main themes identified were resources, training, and organizational factors. The SA PT workforce, particularly that in the public sector, is limited and patient load and need is high. Time to implement and stay up-to-date with current evidence were barriers for many interviewees. Participants also perceived CPG uptake as not being financially rewarding. Training in CPG uptake was mostly perceived as a facilitator, and the PTs felt that they would be more inclined to implement CPGs if they felt more confident in how to source and use CPGs, particularly if they were incentivized to undertake such training. Roles, responsibilities, and power in the health care team were perceived as being both organizational barriers and, conversely, facilitators, depending on work environments. Conclusions:The findings of this study generally concur with previous studies about PT barriers to CPG uptake; however, it provides novel information on barrier contexts in one LMIC with complex PT service delivery.
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