Physiotherapists’ experiences with a blended osteoarthritis intervention: a mixed methods study

Kloek, PT Corelien J.J.; Bossen, Daniël; Vries, Herman de; Bakker, D.H. de; Veenhof, Cindy; Dekker, Joost

doi:10.1080/09593985.2018.1489926

Cited by 26 publications

(21 citation statements)

References 16 publications

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“…An important operational issue is the physiotherapists' training in the e-Exercise LBP intervention. From previous studies we learned that implementing a blended intervention into daily routine is a complex process that changes existing routines [28]. Therefore, training of the participating physiotherapists in the e-Exercise LBP intervention has been expanded from a 4-h training session to two 4-h training sessions.…”

Section: Discussionmentioning

confidence: 99%

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Effectiveness and cost-effectiveness of stratified blended physiotherapy in patients with non-specific low back pain: study protocol of a cluster randomized controlled trial

Koppenaal

Arensman

Dongen³

et al. 2020

BMC Musculoskelet Disord

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Background: Patient education, advice on returning to normal activities and (home-based) exercise therapy are established treatment options for patients with non-specific low back pain (LBP). However, the effectiveness of physiotherapy interventions on physical functioning and prevention of recurrent events largely depends on patient self-management, adherence to prescribed (home-based) exercises and recommended physical activity behaviour. Therefore we have developed e-Exercise LBP, a blended intervention in which a smartphone application is integrated within face-to-face care. E-Exercise LBP aims to improve patient self-management skills and adherence to exercise and physical activity recommendations and consequently improve the effectiveness of physiotherapy on patients' physical functioning. The aim of this study is to investigate the short-(3 months) and long-term (12 and 24 months) effectiveness on physical functioning and cost-effectiveness of e-Exercise LBP in comparison to usual primary care physiotherapy in patients with LBP.

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Section: Discussionmentioning

confidence: 99%

“…Despite all these benefits, matching the appropriate blended treatment for the individual patient is reported as a challenge [28]. To resolve this challenge within traditional face-to-face guidance, stratification tools have gained more attention in the last decade.…”

Section: (Continued From Previous Page)mentioning

confidence: 99%

Effectiveness and cost-effectiveness of stratified blended physiotherapy in patients with non-specific low back pain: study protocol of a cluster randomized controlled trial

Koppenaal

Arensman

Dongen³

et al. 2020

BMC Musculoskelet Disord

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“…Recent studies showed the potential of a blended care delivery mode, in which physiotherapy sessions are integrated with a smartphone application to stimulate patients' ability to manage their musculoskeletal problems independently, outside of treatment sessions [17][18][19]. An example of a blended physiotherapy intervention is e-Exercise, which has been developed for patients with hip and knee osteoarthritis, low back pain, and recently for neck and/or shoulder complaints (van Tilburg M, Kloek CJJ, Pisters MF, Staal JB, Ostelo WJG, Foster NE, et al: Development & feasibility of a stratified approach integrated with eHealth in patients with neck and/or shoulder complaints, in preparation); [17][18][19][20][21]. E-Exercise is an integration of physiotherapy sessions with a smartphone application consisting of an information module, an exercise module, and a physical activity module.…”

Section: Introductionmentioning

confidence: 99%

“…Examples of such behavior change techniques are goal setting, assignments, tailored feedback, self-monitoring, visualization of treatment progress and content matching [22]. These behavior change techniques were found to enhance healthy behavior, such that recurrences of symptoms might be prevented, which might in turn lead to a reduction in healthcare and societal costs [21,23]. However, blended care may not be suitable for every patient and is not expected to be effective in this subgroup [16].…”

Section: Introductionmentioning

confidence: 99%

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints: protocol for a cluster randomized controlled trial

Tilburg

Kloek

Pisters

et al. 2021

BMC Musculoskelet Disord

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Background Neck and shoulder complaints are common in primary care physiotherapy. These patients experience pain and disability, resulting in high societal costs due to, for example, healthcare use and work absence. Content and intensity of physiotherapy care can be matched to a patient’s risk of persistent disabling pain. Mode of care delivery can be matched to the patient’s suitability for blended care (integrating eHealth with physiotherapy sessions). It is hypothesized that combining these two approaches to stratified care (referred to from this point as Stratified Blended Approach) will improve the effectiveness and cost-effectiveness of physiotherapy for patients with neck and/or shoulder complaints compared to usual physiotherapy. Methods This paper presents the protocol of a multicenter, pragmatic, two-arm, parallel-group, cluster randomized controlled trial. A total of 92 physiotherapists will be recruited from Dutch primary care physiotherapy practices. Physiotherapy practices will be randomized to the Stratified Blended Approach arm or usual physiotherapy arm by a computer-generated random sequence table using SPSS (1:1 allocation). Number of physiotherapists (1 or > 1) will be used as a stratification variable. A total of 238 adults consulting with neck and/or shoulder complaints will be recruited to the trial by the physiotherapy practices. In the Stratified Blended Approach arm, physiotherapists will match I) the content and intensity of physiotherapy care to the patient’s risk of persistent disabling pain, categorized as low, medium or high (using the Keele STarT MSK Tool) and II) the mode of care delivery to the patient’s suitability and willingness to receive blended care. The control arm will receive physiotherapy as usual. Neither physiotherapists nor patients in the control arm will be informed about the Stratified Blended Approach arm. The primary outcome is region-specific pain and disability (combined score of Shoulder Pain and Disability Index & Neck Pain and Disability Scale) over 9 months. Effectiveness will be compared using linear mixed models. An economic evaluation will be performed from the societal and healthcare perspective. Discussion The trial will be the first to provide evidence on the effectiveness and cost-effectiveness of the Stratified Blended Approach compared with usual physiotherapy in patients with neck and/or shoulder complaints. Trial registration Netherlands Trial Register: NL8249. Officially registered since 27 December 2019. Date of first enrollment: 30 September 2020. Study status: ongoing, data collection.

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“…[8] Choice of a specific method of physical therapy or physiotherapy exercises should always take into account both the clinical condition of the patient and the physiotherapist's experience. [9] The use of analgesics improves the quality of life of patients but their long-term application can lead to many side effects (toxic effects on the liver and kidneys, hematopoietic system, and gastrointestinal mucosa), and also involves the cost of medication. Thorlund et al [10] showed that chronic (over 1 year) use of analgesics in patients with osteoarthritis of knee and hip joints affected the exacerbation of symptoms of comorbidities in the treated group of patients.…”

Section: Introductionmentioning

confidence: 99%

Evaluation of β-endorphin concentration, mood, and pain intensity in men with idiopathic hip osteoarthritis treated with variable magnetic field

et al. 2019

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Osteoarthritis is the most frequently diagnosed disease of the musculoskeletal system. Growing number of patients waiting for surgical treatment and the possible negative consequences resulting from long-term pharmacological therapy lead to the search for non-pharmacological methods aimed at alleviating pain and reducing doses of analgesics, among them physical therapy with use of magnetic fields. The study involved 30 men aged 49 to 76 (mean age, 61.7 years) treated for idiopathic osteoarthritis of the hip joint. The subjects were divided into 2 groups (15 patients each) and underwent a cycle of magnetostimulation and magnetoledtherapy procedures, respectively. During the exposure cycle concentrations of β-endorphin were assessed 3 times and the mood was assessed 2 times. In addition, the assessment of pain intensity and the dose of analgesic drugs was performed before and after the end of therapy. Statistically significant increase in plasma β-endorphins concentration was observed in both groups of patients (magnetostimulation— P < .01 vs magnetoledtherapy— P < .001). In the assessment of mood of respondents, no statistically significant differences were found. Significant reduction in intensity of perceived pain was observed in both groups of patients ( P < .05). In the group of patients who underwent magnetoledtherapy cycle, the analgesic drug use was significantly lower by 13% ( P < .05) as compared with initial values, which was not noted in group of patients who underwent magnetostimulation procedures. The use of magnetic field therapy in the treatment of men with idiopathic osteoarthritis of hip joints causes a statistically significant increase in the concentration of plasma β-endorphins resulting in statistically significant analgesic effect in both magnetostimulation and magnetoledtherapy treated groups of patients, with accompanying decrease of need for analgetic drugs in magnetoledtherapy group, but without any significant changes regarding the patient's mood.

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Physiotherapists’ experiences with a blended osteoarthritis intervention: a mixed methods study

Cited by 26 publications

References 16 publications

Effectiveness and cost-effectiveness of stratified blended physiotherapy in patients with non-specific low back pain: study protocol of a cluster randomized controlled trial

Effectiveness and cost-effectiveness of stratified blended physiotherapy in patients with non-specific low back pain: study protocol of a cluster randomized controlled trial

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints: protocol for a cluster randomized controlled trial

Evaluation of β-endorphin concentration, mood, and pain intensity in men with idiopathic hip osteoarthritis treated with variable magnetic field

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