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The percept study

In this thesis, a Dutch version of the Brief IPQ is presented to assess IPs in daily physiotherapy practice in The Netherlands. Further, a literature overview of the existing associations and prognosis of IPs on MSP and functioning is presented, and these associations in primary physiotherapy care in The Netherlands are explored. The impact of a matched care physiotherapy package, matched to dysfunctional IPs, and MSP and physical functioning is studied. In this thesis, three themes (ie. measurement, association / prediction and treatment) are explored for their contribution to physiotherapy management of MSP in general, and especially for low back pain

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Feasibility of a stratified blended physiotherapy intervention for patients with non-specific low back pain: a mixed methods study

Introduction: Integrating web-based or mobile components and face-to-face components within a treatment process is called blended care. As part of the participatory development of a blended physiotherapeutic intervention for patients with low back pain (e-Exercise LBP), a proof of concept study was carried out and showed promising results.Objective: To investigate the feasibility of the e-Exercise LBP prototype for patients and physiotherapists to improve the intervention.Methods: A mixed methods study was executed, embedded in the development phase of e-Exercise LBP. 21 physiotherapists treated 41 patients with e-Exercise LBP. Quantitative data consisted of: patients’ satisfaction on a five-point Likert Scale; patients’ and physiotherapists’ experienced usability of the web-based application (System Usability Scale) and; patients’ experiences with e-Exercise LBP (closed-ended questions and statements related to the elements and goals of e-Exercise LBP). Semi-structured interviews about experiences with e-Exercise LBP were conducted with seven patients and seven physiotherapists. Qualitative data were analyzed by a phenomenological approach. Quantitative data were analyzed with descriptive statistics.Results: Patients were satisfied with e-Exercise LBP (mean: 4.0; SD:0.8; range: extreme dissatisfaction (1)-extreme satisfaction (5)). Usability of the web-based application was acceptable (patients: mean: 73.2 (SD:16.3); physiotherapists: mean: 63.3 (SD:12.0); range: 0–100). Interviews revealed that physiotherapists’ training is essential to successfully integrate the web-based application and face-to-face sessions within physiotherapy treatment. Also, patients addressed the need of reminder messages to support long-term (exercise) adherence.Conclusion: e-Exercise LBP appeared to be feasible. However, various prerequisites and points of improvement were mentioned to improve physiotherapists’ training and the prototype.

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Promoting explicit instruction of strategies for self-regulated learning

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Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints

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.

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Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints

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Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study

Background Providing individualized care based on the context and preferences of the patient is important. Knowledge on both prognostic risk stratification and blended eHealth care in musculoskeletal conditions is increasing and seems promising. Stratification can be used to match patients to the most optimal content and intensity of treatment as well as mode of treatment delivery (i.e. face-to-face or blended with eHealth). However, research on the integration of stratified and blended eHealth care with corresponding matched treatment options for patients with neck and/or shoulder complaints is lacking. Methods This study was a mixed methods study comprising the development of matched treatment options, followed by an evaluation of the feasibility of the developed Stratified Blended Physiotherapy approach. In the first phase, three focus groups with physiotherapists and physiotherapy experts were conducted. The second phase investigated the feasibility (i.e. satisfaction, usability and experiences) of the Stratified Blended Physiotherapy approach for both physiotherapists and patients in a multicenter single-arm convergent parallel mixed methods feasibility study. Results In the first phase, matched treatment options were developed for six patient subgroups. Recommendations for content and intensity of physiotherapy were matched to the patient’s risk of persistent disabling pain (using the Keele STarT MSK Tool: low/medium/high risk). In addition, selection of mode of treatment delivery was matched to the patient’s suitability for blended care (using the Dutch Blended Physiotherapy Checklist: yes/no). A paperbased workbook and e-Exercise app modules were developed as two different mode of treatment delivery options, to support physiotherapists. Feasibility was evaluated in the second phase. Physiotherapists and patients were mildly satisfied with the new approach. Usability of the physiotherapist dashboard to set up the e-Exercise app was considered ‘OK’ by physiotherapists. Patients considered the e-Exercise app to be of ‘best imaginable’ usability. The paper-based workbook was not used. Conclusion Results of the focus groups led to the development of matched treatment options. Results of the feasibility study showed experiences with integrating stratified and blended eHealth care and have informed amendments to the Stratified Blended Physiotherapy approach for patients with neck and/or shoulder complaints ready to use within a future cluster randomized trial.

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Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study

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Validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy

Objective To evaluate the validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy. Methods Physiotherapists included patients with musculoskeletal pain, aged 18 years or older. Patients completed a questionnaire at baseline and follow-up at 5 days and 3 months, respectively. Construct validity was assessed by comparing scores of STarT MSK items with reference questionnaires. Pearson’s correlation coefficients were calculated to test predefined hypotheses. Test-retest reliability was evaluated by calculating quadratic-weighted kappa coefficients for overall STarT MSK tool scores (range 0–12) and prognostic subgroups (low, medium and high risk). Predictive validity was assessed by calculating relative risk ratios for moderate risk and high risk, both compared with low risk, in their ability to predict persisting disability at 3 months. Results In total, 142 patients were included in the analysis. At baseline, 74 patients (52.1%) were categorised as low risk, 64 (45.1%) as medium risk and 4 (2.8%) as high risk. For construct validity, nine of the eleven predefined hypotheses were confirmed. For test-retest reliability, kappa coefficients for the overall tool scores and prognostic subgroups were 0.71 and 0.65, respectively. For predictive validity, relative risk ratios for persisting disability were 2.19 (95% CI: 1.10–4.38) for the medium-risk group and 7.30 (95% CI: 4.11–12.98) for the highrisk group. Conclusion The Dutch STarT MSK tool showed a sufficient to good validity and reliability in patients with musculoskeletal pain in primary care physiotherapy. The sample size for high-risk patients was small (n = 4), which may limit the generalisability of findings for this group. An external validation study with a larger sample of high-risk patients (�50) is recommended.

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Validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy

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Implementatie van de Keele STarT MSK Tool Nederlandse versie

De Keele STarT MSK Tool heeft als doel om patiënten met veelvoorkomende musculoskeletale klachten in een zo vroeg mogelijk stadium een passende behandeling aan te bieden. De tool bestaat uit 10 vragen, op basis waarvan de patiënt wordt ingedeeld in één van de drie prognostische categorieën: een laag, midden of hoog risico op aanhoudende klachten.Doel Patiënten met veelvoorkomende musculoskeletale klachten (pijn aan de rug, knie, schouder, nek of een combinatie hiervan) in een zo vroeg mogelijk stadium een passende behandeling aanbieden. In opdracht van Keele University houdt de onderzoeksgroep uit Utrecht bij voor welke doeleinden de tool in Nederland wordt ingezet. Resultaten Onderzoeksresultaten (validiteit en betrouwbaarheid van de Keele STarT MSK Tool) worden naar verwachting in 2020 gepubliceerd. Looptijd 01 januari 2020 - 01 januari 2025 Aanpak De tool is ontwikkeld door onderzoekers van Keele University, Engeland. Onderzoekers van de Academische Werkplaats eerstelijns Fysiotherapie (AWF Utrecht) hebben de tool recent vertaald naar het Nederlands. De tool is vrij te gebruiken in de praktijk of onderzoeksetting. In opdracht van Keele University houdt de onderzoeksgroep uit Utrecht bij voor welke doeleinden de tool in Nederland wordt ingezet. Bent u geïnteresseerd in de Nederlandse versie van de Keele STarT MSK Tool? Dan kunt u zich hier registreren door onderstaande gegevens te mailen naar lectoraat.beweegzorg@hu.nl Voornaam: Achternaam: E-mail adres: Naam praktijk / organisatie: Wat is uw rol binnen deze praktijk / organisatie: Waar heeft u gehoord over de Keele STarT MSK Tool: Voor welk doel wilt u de Keele STarT MSK Tool gebruiken: a) Binnen de patiëntenzorg b) Onderzoek c) Commercieel gebruik Dan ontvangt u vervolgens gratis en zonder andere voorwaarden de Nederlandse vertaling van de Keele STarT MSK Tool. U ontvangt een versie met scoringsinstructie en een versie zonder scoringsinstructie (die u voor de patiënt kunt gebruiken). Uw contactgegevens worden niet voor andere doeleinden gebruikt. Engelse versie StarT MSK Tool Academische Werkplaats Fysiotherapie

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Producten 7

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The percept study

PDF

product

Feasibility of a stratified blended physiotherapy intervention for patients with non-specific low back pain: a mixed methods study

MULTIFILE

product

Promoting explicit instruction of strategies for self-regulated learning

MULTIFILE

product

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints

PDF

product

Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study

PDF

product

Validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy

PDF

Projecten 1

project

Implementatie van de Keele STarT MSK Tool Nederlandse versie

Afgerond

Zoekresultaten

Producten 7

The percept study

Feasibility of a stratified blended physiotherapy intervention for patients with non-specific low back pain: a mixed methods study

Promoting explicit instruction of strategies for self-regulated learning

Development and internal validation of a machine learning prediction model for low back pain non-recovery in patients with an acute episode consulting a physiotherapist in primary care

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints

Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study

Validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy

Projecten 1

Implementatie van de Keele STarT MSK Tool Nederlandse versie

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Producten 7

The percept study

Feasibility of a stratified blended physiotherapy intervention for patients with non-specific low back pain: a mixed methods study

Promoting explicit instruction of strategies for self-regulated learning

Development and internal validation of a machine learning prediction model for low back pain non-recovery in patients with an acute episode consulting a physiotherapist in primary care

Stratified care integrated with eHealth versus usual primary care physiotherapy in patients with neck and/or shoulder complaints

Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study

Validity and reliability of the Dutch STarT MSK tool in patients with musculoskeletal pain in primary care physiotherapy

Projecten 1

Implementatie van de Keele STarT MSK Tool Nederlandse versie