Consensus on the exercise and dosage variables of an exercise training programme for chronic non-specific neck pain: protocol for an international e-Delphi study

Price, Jonathan; Rushton, Alison; Tyros, Vasileios; Heneghan, Nicola R

doi:10.1136/bmjopen-2020-037656

Cited by 11 publications

(10 citation statements)

References 58 publications

(66 reference statements)

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“… 40 43–45 Specifically, while consensus and agreement have been used interchangeably, 45 unique definitions have also been recommended. 46 Therefore, this study will use the following definitions and is consistent with earlier research 47 :…”

Section: Methodsmentioning

confidence: 99%

Expert consensus on a standardised definition and severity classification for adverse events associated with spinal and peripheral joint manipulation and mobilisation: protocol for an international e-Delphi study

et al. 2021

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IntroductionSpinal and peripheral joint manipulation (SMT) and mobilisation (MOB) are widely used and recommended in the best practice guidelines for managing musculoskeletal conditions. Although adverse events (AEs) have been reported following these interventions, a clear definition and classification system for AEs remains unsettled. With many professionals using SMT and MOB, establishing consensus on a definition and classification system is needed to assist with the assimilation of AEs data across professions and to inform research priorities to optimise safety in clinical practice.Methods and analysisThis international multidisciplinary electronic Delphi study protocol is informed by a scoping review and in accordance with the ‘Guidance on Conduction and Reporting Delphi Studies’. With oversight from an expert steering committee, the study comprises three rounds using online questionnaires. Experts in manual therapy and patient safety meeting strict eligibility criteria from the following fields will be invited to participate: clinical, medical and legal practice, health records, regulatory bodies, researchers and patients. Round 1 will include open-ended questions on participants’ working definition and/or understanding of AEs following SMT and MOB and their severity classification. In round 2, participants will rate their level of agreement with statements generated from round 1 and our scoping review. In round 3, participants will rerate their agreement with statements achieving consensus in round 2. Statements reaching consensus must meet the a priori criteria, as determined by descriptive analysis. Inferential statistics will be used to evaluate agreement between participants and stability of responses between rounds. Statements achieving consensus in round 3 will provide an expert-derived definition and classification system for AEs following SMT and MOB.Ethics and disseminationThis study was approved by the Canadian Memorial Chiropractic College Research Ethics Board and deemed exempt by Parker University’s Institutional Review Board. Results will be disseminated through scientific, professional and educational reports, publications and presentations.

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Section: Methodsmentioning

confidence: 99%

Expert consensus on a standardised definition and severity classification for adverse events associated with spinal and peripheral joint manipulation and mobilisation: protocol for an international e-Delphi study

et al. 2021

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“…To assess the convergence through the rounds, we examined the relationship between the level (system, organizational, and clinical) of interventions and the transition of the consensus state in rounds 1 and 3. We defined the consensus as being reached if IQR = < 1 following the previous studies using 5-point Likert scale [ 13 , 14 ]. The transitions of the consensus state were classified into four categories: 1) consistent consensus (consensus was achieved in both round 1 and round 3), 2) change to consensus (consensus was not achieved in round 1, but achieved in round 3), 3) change to dissensus (consensus was achieved in round 1, but not achieved in round 3), and 4) consistent dissensus (consensus was not achieved in round 1 or round 3).…”

Section: Methodsmentioning

confidence: 99%

Prioritization of patient safety health policies: Delphi survey using patient safety experts in Japan

et al. 2020

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Various patient safety interventions have been implemented since the late 1990s, but their evaluation has been lacking. To obtain basic information for prioritizing patient safety interventions, this study aimed to extract high-priority interventions in Japan and to identify the factors that influence the setting of priority. Six perspectives (contribution, dissemination, impact, cost, urgency, and priority) on 42 patient safety interventions classified into 3 levels (system, organizational, and clinical) were evaluated by Japanese experts using the Delphi technique. We examined the relationships of the levels and the perspectives on interventions with the transition of the consensus state in rounds 1 and 3. After extracting the high-priority interventions, a chi-squared test was used to examine the relationship of the levels and the impact/cost ratio with high priority. Regression models were used to examine the influence of each perspective on priority. There was a significant relationship between the level of interventions and the transition of the consensus state (p = 0.033). System-level interventions had a low probability of achieving consensus. “Human resources interventions,” “professional education and training,” “medication management/reconciliation protocols,” “pay-for performance (P4P) schemes and financing for safety,” “digital technology solutions to improve safety,” and “hand hygiene initiatives” were extracted as high-priority interventions. The level and the impact/cost ratio of interventions had no significant relationships with high priority. In the regression model, dissemination and impact had an influence on priority (β = -0.628 and 0.941, respectively; adjusted R-squared = 0.646). The influence of impact and dissemination on the priority of interventions suggests that it is important to examine the dissemination degree and impact of interventions in each country for prioritizing interventions.

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“…This international 3-round Delphi study was conducted between March-September 2020 according to an open-access protocol and is reported using Guidance on Conducting and REporting DElphi Studies (CREDES) [35,36]. The University of Birmingham Ethics Committee granted ethical approval (REF: ERN_19-1857).…”

Section: Designmentioning

confidence: 99%

“…Quantitative data analysis was completed by two researchers (J.P./V.T.) using IBM SPSS Statistics Version 25 using a priori criteria (see protocol for full details) [36,57]. Expert consensus (the extent to which the group of experts share the same opinion) was evaluated for each statement using median (�3), interquartile range (�1.5) and percentage agreement (the percentage of responses rated agree/strongly agree)(�60%) [42,58].…”

Section: Roundmentioning

confidence: 99%

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Expert consensus on the important chronic non-specific neck pain motor control and segmental exercise and dosage variables: An international e-Delphi study

et al. 2021

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Background Chronic non-specific neck pain is highly prevalent, resulting in significant disability. Despite exercise being a mainstay treatment, guidance on optimal exercise and dosage variables is lacking. Combining submaximal effort deep cervical muscles exercise (motor control) and superficial cervical muscles exercise (segmental) reduces chronic non-specific neck pain, but evaluation of optimal exercise and dosage variables is prevented by clinical heterogeneity. Objective To gain consensus on important motor control and segmental exercise and dosage variables for chronic non-specific neck pain. Methods An international 3-round e-Delphi study, was conducted with experts in neck pain management (academic and clinical). In round 1, exercise and dosage variables were obtained from expert opinion and clinical trial data, then analysed thematically (two independent researchers) to develop themes and statements. In rounds 2 and 3, participants rated their agreement with statements (1–5 Likert scale). Statement consensus was evaluated using progressively increased a priori criteria using descriptive statistics. Results Thirty-seven experts participated (10 countries). Twenty-nine responded to round 1 (79%), 26 round 2 (70%) and 24 round 3 (65%). Round 1 generated 79 statements outlining the interacting components of exercise prescription. Following rounds 2 and 3, consensus was achieved for 46 important components of exercise and dosage prescription across 5 themes (clinical reasoning, dosage variables, exercise variables, evaluation criteria and progression) and 2 subthemes (progression criteria and progression variables). Excellent agreement and qualitative data supports exercise prescription complexity and the need for individualised, acceptable, and feasible exercise. Only 37% of important exercise components were generated from clinical trial data. Agreement was highest (88%-96%) for 3 dosage variables: intensity of effort, frequency, and repetitions. Conclusion Multiple exercise and dosage variables are important, resulting in complex and individualised exercise prescription not found in clinical trials. Future research should use these important variables to prescribe an evidence-informed approach to exercise.

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Consensus on the exercise and dosage variables of an exercise training programme for chronic non-specific neck pain: protocol for an international e-Delphi study

Cited by 11 publications

References 58 publications

Expert consensus on a standardised definition and severity classification for adverse events associated with spinal and peripheral joint manipulation and mobilisation: protocol for an international e-Delphi study

Expert consensus on a standardised definition and severity classification for adverse events associated with spinal and peripheral joint manipulation and mobilisation: protocol for an international e-Delphi study

Prioritization of patient safety health policies: Delphi survey using patient safety experts in Japan

Expert consensus on the important chronic non-specific neck pain motor control and segmental exercise and dosage variables: An international e-Delphi study

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