Physical therapy
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Randomized Controlled Trial
Does teaching physical therapists to deliver a biopsychosocial treatment program result in better patient outcomes? A randomized controlled trial.
Psychosocial prognostic factors are important in the development of chronic pain, but treatment providers often lack knowledge and skills to assess and address these risk factors. ⋯ An 8-day university course for physical therapists did not improve outcomes in a group of patients as a whole or in patients with a risk of developing long-term disability. However, patients who had a risk of developing long-term disability and had higher levels of catastrophizing or depression may have shown greater reductions in disability if the attitudes and beliefs of their physical therapists changed during the course.
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Randomized Controlled Trial Comparative Study
Relationship among pain catastrophizing, depressed mood, and outcomes across physical therapy treatments.
Pain catastrophizing and emotional distress can act as prognostic factors for pain and disability. Research on how these variables interact within individuals and over time is in an early stage. Understanding various patterns of prognostic factors and how these factors change during treatment is important for developing treatments targeting important factors. ⋯ The results stress the importance of assessing and targeting prognostic factors. Moreover, the results suggest the need to tailor treatments to match patterns of prognostic factors and the need to target depressed mood and pain catastrophizing in physical therapy interventions.
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Randomized Controlled Trial
Cost-effectiveness of acupuncture care as an adjunct to exercise-based physical therapy for osteoarthritis of the knee.
The delivery of acupuncture alongside mainstream interventions and the cost-effectiveness of "alternative" treatments remain areas of controversy. ⋯ A package of AE+TA delivered by NHS physical therapists provided a cost-effective use of health care resources despite an associated increase in costs. However, the economic benefits could not be attributed to the penetrating nature of conventional acupuncture; therefore, further research regarding the mechanisms of acupuncture is needed. An analysis of alternative cost perspectives suggested that the results are generalizable to other health care settings.
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Multicenter Study
Relationship between categorization with the STarT Back Screening Tool and prognosis for people receiving physical therapy for low back pain.
The STarT Back Screening Tool (SBT) was recently developed for primary care providers to use as a screening tool for subgrouping people with low back pain (LBP) on the basis of modifiable prognostic factors. The use of the SBT in physical therapy has not been described. ⋯ The SBT may provide important prognostic information for physical therapists.
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This article reviews the role of psychological factors in the development of persistent pain and disability, with a focus on how basic psychological processes have been incorporated into theoretical models that have implications for physical therapy. To this end, the key psychological factors associated with the experience of pain are summarized, and an overview of how they have been integrated into the major models of pain and disability in the scientific literature is presented. ⋯ Based on a review of the scientific evidence, a set of 10 principles that have likely implications for clinical practice is offered. Because psychological processes have an influence on both the experience of pain and the treatment outcome, the integration of psychological principles into physical therapy treatment would seem to have potential to enhance outcomes.