Illness Beliefs and Treatment Beliefs as Predictors of Short-Term and Medium-Term Outcome in Chronic Back Pain.

Illness beliefs and treatment beliefs as predictors of short-term and medium-term outcome in chronic back pain.

J Rehabil Med. 2013 Feb 18;
Glattacker M, Heyduck K, Meffert C

Objective: Patients’ illness beliefs were shown to be more relevant than other psychosocial factors of influence for predicting outcome in back pain in primary care. The aim of this study was to determine whether illness beliefs and beliefs about rehabilitation are predictors of functioning, pain intensity, and coping with pain after rehabilitation in a population with longstanding chronic back pain. Design and patients: The study included 110 patients with longstanding chronic back pain in a longitudinal study design with 3 measurement points (before rehabilitation, end of rehabilitation, and 6 months follow-up). Methods: Hierarchical multiple regression analyses were conducted to test the relative contribution of illness beliefs and beliefs about rehabilitation to the rehabilitation outcomes while adjusting for baseline values of outcome measures, mental health, sociodemographic, and illness-related variables. Results: Illness beliefs and beliefs about rehabilitation made a significant contribution to the prediction of rehabilitation outcomes. In the short and medium term, incremental variance for coping with pain was as much as 13%, for functioning up to 14%, and for pain intensity between 6% and 9%. Conclusion: Further studies should be conducted as a confirmatory test of our preliminary results and to test the relative relevance of these constructs compared with other yellow flags for chronic patient samples. HubMed – rehab

What’s in the black box of arthritis rehabilitation? A comparison of rehabilitation practice for patients with inflammatory arthritis in Northern Europe.

J Rehabil Med. 2013 Feb 28;
Grotle M, Klokkerud M, Kjeken I, Bremander A, Hagel S, Strömbeck B, Hørslev-Petersen K, Meesters J, Vlieland TP, Hagen KB

Background: In evaluating complex interventions, it is a challenge for researchers to provide transparent reporting of the intervention content with sufficient detail and clarity such that effects can be compared across studies or countries. Objective: To describe and compare the content of current rehabilitation for patients with inflammatory arthritis across 4 northern European countries. Patients and methods: A total of 731 patients with inflammatory rheumatic diseases participated in a multicentre, longitudinal observational study carried out in Sweden, The Netherlands, Denmark and Norway. Data on context, structure and process were reported by patients and teams at the different participating study sites according to the Scandinavian Team Arthritis Register – European Team Intiative for Care Research (STAR-ETIC) framework. Results: Although large similarities were found in the context, there were important differences between the Netherlands and the Scandinavian countries. Regarding structure, there were considerable differences in the length of the rehabilitation period across settings and countries. The most evident differences concerned process variables, especially the type and dosage of individual treatment modalities. Conclusion: The variation in important aspects of arthritis rehabilitation found in the present study underline the need for transparent and standardized description of these variables when comparing effects across settings and countries. A standardized description of current practice can be achieved by the STAR-ETIC framework. HubMed – rehab

Static progressive orthoses for the upper extremity: a comprehensive literature review.

Hand (N Y). 2012 Mar; 7(1): 10-7
Schwartz DA

Static progressive orthoses are commonly used in the treatment of stiff joints or joint contractures of the upper extremity, but there are few high-quality studies to support this intervention. In addition, there has not been a recently published review of the current literature describing this treatment technique and the outcomes achieved. The specific purpose of this comprehensive literature review is to investigate the current levels of evidence supporting the use of static progressive orthoses in the treatment of joint stiffness or contracture in clients with orthopedic conditions of the upper extremity. This review will also discuss common diagnoses of patients and outcomes achieved, as well as provide recommendations for future hand therapy practice.A computerized database search of publications incorporating the use of static progressive orthoses for the upper extremity was conducted, dating from January 1979 through January of 2011. The search was limited to studies in English of adults with orthopedic conditions.A total of 65 publications were located. However, only 16 of these studies met this review’s inclusion criteria of level 4 evidence or above. Each of the articles was critically appraised using the Structured Effectiveness for Quality Evaluation of Study (SEQES) and the Oxford Center for Evidence-Based Medicine 2011 Level of Evidence. Total SEQES scores ranged from 17 to 39. The majority of the studies are level 4 evidence.Although the overall level of evidence is low, the inclusion of static progressive orthoses as an intervention appears to result in positive outcomes, including increased active range of motion, increased grip strength, improved DASH scores, and improved patient satisfaction as well as reduced pain medications during orthotic intervention. The current evidence supports static progressive orthoses as an intervention for patients with upper extremity joint stiffness or contractures due to orthopedic conditions. HubMed – rehab

Physiotherapists’ perceptions of their role in the rehabilitation management of individuals with obesity.

Physiother Can. 2012; 64(2): 168-75
You L, Sadler G, Majumdar S, Burnett D, Evans C

To examine physiotherapists’ perceptions of their role in the rehabilitation management of individuals with obesity. A Web-based survey was conducted in 2008. Participants were recruited through the Canadian Physiotherapy Association (CPA) via electronic communication and were eligible if they had entry level to practice qualifications and were residents of Canada. The online questionnaire consisted of 61 statements pertaining to potential PT roles, barriers, and learning needs, developed using the framework of CPA’s position statement on obesity. Frequencies were computed for all Likert-scale response items on the questionnaire. A total of 851 physiotherapists, representative of CPA membership, participated in the study. There was strong agreement that physiotherapists have a role to play in the management of clients who are obese through exercise interventions (96%), mobility training (97%), and cardiorespiratory programmes for impairments associated with obesity (95%). Respondents were less clear about their role in the assessment of body fat or patients’ weight loss. Lack of client motivation was identified as a barrier to treatment. Physiotherapists were clear that they see their role as largely focused on exercise and education to treat conditions associated with obesity. These are important components but do not by themselves constitute an overall management plan. HubMed – rehab