Physiother Can
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In this study, we characterized physiotherapists' attitudes and beliefs about the bio-psychosocial problem of low back pain (LBP), their use of clinical practice guidelines (CPGs), and the extent to which their advice and treatment is in line with best-evidence CPGs. ⋯ The results suggest limited awareness by physiotherapists of best-evidence CPGs and contemporary understandings of LBP that support early activation and self-management. Research to better understand and facilitate the implementation of best-evidence professional education and clinical practice is an urgent priority.
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To describe the development of a contextually relevant multidisciplinary clinical practice guideline (CPG) for non-specific low back pain (LBP) and to discuss its value to the management of LBP and the practice of physiotherapy. ⋯ The Ambassador Program on Low Back Pain worked with front-line clinicians from across Alberta to review the best available evidence in developing a CPG responsive to the Alberta context. This CPG is intervention specific and provides a wide range of primary-care practitioners with the best available evidence to inform their clinical decisions in managing non-specific LBP.
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To compare the original and reduced versions of the Berg Balance Scale (BBS) and the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC), as completed by patients following total hip arthroplasty (THA) or total knee arthroplasty (TKA), with respect to their potential utility in clinical and research settings. ⋯ The reduced versions of the BBS and the WOMAC provided similar information to the original versions and were equally responsive. These reduced versions comprise fewer questions and may be completed in considerably less time, which suggests that they may be advantageous for clinical and research use.
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Chronic post-surgical pain (CPSP) is a frequent outcome of musculoskeletal surgery. Physiotherapists often treat patients with pain before and after musculoskeletal surgery. The purposes of this paper are (1) to raise awareness of the nature, mechanisms, and significance of CPSP; and (2) to highlight the necessity for an inter-professional team to understand and address its complexity. Using total joint replacement surgeries as a model, we provide a review of pain mechanisms and pain management strategies. ⋯ The roles of biological, surgical, psychosocial, and patient-related risk factors in the transition to pain chronicity require further investigation if we are to better understand their relationships with pain. Measuring pain intensity and analgesic use is not sufficient. Proper evaluation and management of risk factors for CPSP require inter-professional teams to characterize a patient's experience of postoperative pain and to examine pain arising during functional activities.
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To describe the performance of the pillow that participants usually slept on with respect to retiring and waking cervico-thoracic symptoms, pillow comfort, and sleep quality. ⋯ Many participants appear to have made poor pillow choices, as poor sleep quality, low pillow comfort, and waking symptoms were common. Further research is required to understand why people choose particular pillows to sleep on, as well as to identify the best fit between person and pillow to optimize sleep quality and reduce waking symptoms.