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Orthopaedic Proceedings
Vol. 106-B, Issue SUPP_15 | Pages 43 - 43
7 Aug 2024
Johnson K Pavlova A Swinton P Cooper K
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Purpose and background. Work-related musculoskeletal disorders, particularly back pain, are a significant issue for healthcare workers, with patient handling being the most frequently reported risk factor. Patient handling is often performed without assistive devices or equipment, which can cause healthcare staff to maintain awkward postures or experience high loads. This review aimed to comprehensively map the literature surrounding manual patient handling (without assistive devices) by healthcare practitioners to identify the current evidence-base on moving and handling of patients and explore what primary research had been conducted. Methods and results. JBI methodology for scoping reviews and an a priori registered protocol (DOI 10.17605/OSF.IO/8PR7A) was followed and AMED, CINAHL, MEDLINE, SPORTDiscus and EMBASE databases were searched. Literature published in English between 2002 and 2021 was included. Forty-nine records were included: 36 primary research studies, 1 systematic review and 12 ‘other’ including narrative and government reports. Primary research predominantly used observational cross-sectional designs (n = 21 studies). Most studies took place in hospitals (n = 13) and laboratories (n = 12). Nurses formed the largest population group (n = 13), with very little research on physiotherapists and other allied health professionals. Conclusion. This scoping review comprehensively reviewed the available literature in the area. Most of the included primary research was observational. Nurses were often investigated in hospitals and laboratories. Qualitative research investigating moving and handling and further biomechanical investigation into therapeutic handling by healthcare staff were identified as areas for further research. Conflicts of interest. None. Sources of funding. None. This work has been published in Physiotherapy: Johnson, K., Swinton, P., Pavlova, A. and Cooper, K., 2023. Manual patient handling in the healthcare setting: a scoping review. Physiotherapy. (120) 60–77 . https://doi.org/10.1016/j.physio.2023.06.003


Orthopaedic Proceedings
Vol. 101-B, Issue SUPP_9 | Pages 53 - 53
1 Sep 2019
Delion T Draper-Rodi J
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Purpose of the study and background. The biopsychosocial (BPS) model is now widely implemented in clinical practice. Most research on manual therapists' attitudes regarding psychosocial (PS) factors and NSLBP is from the physiotherapy profession. There is currently no literature available to understand how osteopaths integrate those factors with patients presenting with NSLBP. The University College of Osteopathy students being the future of the profession and receiving an accredited BPS teaching warranted the need for an investigation about their attitudes towards PS factors and NSLBP. Methods and results. A qualitative research design with elements of grounded theory was used. Nine final year UCO students were recruited and interviewed at the UCO teaching centre. Data collection and analysis occurred simultaneously through the constant comparative method of analysis. Three main themes emerged from the data analysis: 1) Definition and interpretation of PS factors towards LBP; 2) Assessment and management of PS factors; 3) Competence and difficulties towards PS factors. Conclusion. The level of understanding was homogeneous amongst the participants on the understanding of PS factors and their role in a NSLBP presentation. They assessed for PS factors throughout the case history and tend to rely on their instincts. Two types of strategies towards the PS factors management were identified. However, lack of clinical experience and lack of training on the management of PS factors were identified as the main barriers encountered by students when treating patient with NSLBP. No conflict of interest. No funding


Orthopaedic Proceedings
Vol. 100-B, Issue SUPP_2 | Pages 11 - 11
1 Feb 2018
Savergnini G Vogel S
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Purpose and background. Pain related distress is associated with poor low back pain outcomes, and is challenging for practitioners to address. This study investigated osteopaths' beliefs about the relationship between chronic pain (CP) and distress (D). The research aimed to explore how patient's distress is understood and managed by osteopath educator clinicians with an interest in the field. Methods and results. A qualitative research design using a constructivist grounded theory analytical approach was used to analyse semi-structured interviews. A purposive sample of seven osteopaths working at the British School of Osteopathy (BSO) with experience with CP-D was recruited. Data collection and analysis were carried out simultaneously. Audio-recording, verbatim-transcriptions, memos-writing and diary-keeping were used to develop themes and theory. Three main themes were identified: osteopaths understanding of the CP-D presentation, evaluation and assessment of the CP-D patient, the role of the osteopath and therapist-patient interaction in CP-D treatment. Three sub-themes were developed for each theme. Conclusions. Osteopaths recognized the relationship between CP-D. They considered the management of this presentation complex and challenging due to extensive clinical uncertainty. Osteopaths considered the therapist-patient interaction as a crucial vehicle for evaluating the individual patient presentation along with understanding patient's biopsychosocial factors and readiness to change, however a lack of rigor was identified with this process. Challenges related to evaluation were mainly related to patient characteristics and osteopath's lack of training. Further work is required to develop better evaluation and intervention strategies as well as understanding patient's attitudes to the relationship between CP and D. Conflict of interest: None. Sources of funding: None


Background. Psychosocial (PS) factors have been described as the combination of the individual's cognitive, emotional and social status and they play an important role in the development and recovery from chronic low back pain (CLBP). The aims of the study where to explore/describe physiotherapists' personal beliefs and knowledge in relation to the assessment of PS factors in patients with CLBP in Italy. Methods and results. A qualitative research design with a constructivist grounded theory approach was used for semi-structured interviews and data collection/analysis. A purposive sample of eight physiotherapists practicing in Italy and having experience with patients presenting chronic musculoskeletal problems were recruited from private clinics. Three main categories were constructed:. 1). Conceptions of the biopsychosocial model and its role in CLBP;. 2). Evaluation and management of PS factors;. 3). Barriers in the assessment and treatment. The study revealed partial identification of these factors, limited understanding of the role they play in CLBP and lack of standardization in this area within the manipulative physiotherapy profession. Conclusions. Physiotherapists showed basic knowledge of the biopsychosocial model and partially recognized social, emotional, cognitive and psychological factors and their contribution in patients' pain and disability. Physiotherapists highlighted the presence of barriers in the evaluation and treatment of people with CLBP, and some participants displayed lack of skills to overcome these barriers. Physiotherapists perceived limited education and training to successfully address PS factors in the management of patients with CLBP, indicating the need to incorporate the biopsychosocial model in the daily practice and improve the training and education of the psychosocial assessment and management. Conflicts of interest: None. Source of funding: None


Bone & Joint Open
Vol. 4, Issue 11 | Pages 873 - 880
17 Nov 2023
Swaby L Perry DC Walker K Hind D Mills A Jayasuriya R Totton N Desoysa L Chatters R Young B Sherratt F Latimer N Keetharuth A Kenison L Walters S Gardner A Ahuja S Campbell L Greenwood S Cole A

Aims

Scoliosis is a lateral curvature of the spine with associated rotation, often causing distress due to appearance. For some curves, there is good evidence to support the use of a spinal brace, worn for 20 to 24 hours a day to minimize the curve, making it as straight as possible during growth, preventing progression. Compliance can be poor due to appearance and comfort. A night-time brace, worn for eight to 12 hours, can achieve higher levels of curve correction while patients are supine, and could be preferable for patients, but evidence of efficacy is limited. This is the protocol for a randomized controlled trial of ‘full-time bracing’ versus ‘night-time bracing’ in adolescent idiopathic scoliosis (AIS).

Methods

UK paediatric spine clinics will recruit 780 participants aged ten to 15 years-old with AIS, Risser stage 0, 1, or 2, and curve size (Cobb angle) 20° to 40° with apex at or below T7. Patients are randomly allocated 1:1, to either full-time or night-time bracing. A qualitative sub-study will explore communication and experiences of families in terms of bracing and research. Patient and Public Involvement & Engagement informed study design and will assist with aspects of trial delivery and dissemination.