A service evaluation and improvement project: a three year systematic audit cycle of the physiotherapy treatment for Lateral Epicondylalgia

Barratt, Paul; Selfe, James

doi:10.1016/j.physio.2017.09.001

Cited by 7 publications

(12 citation statements)

References 50 publications

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“… 32 The agreed dose for isometric exercises was maximal resistance, held for 60 s and repeated five times, as used by Barratt and Selfe. 35 Two other dosing regimes were considered but the dose prescribed by Park et al , 36 of 50 repetitions of 10 s holds, four times a day was considered too burdensome, and contractions based on percentage of maximum voluntary contraction from 20% increasing up to 35%, used by Vuvan et al , 8 too complicated.…”

Section: Discussionmentioning

confidence: 99%

Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy: a consensus study using an online nominal group technique

et al. 2021

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ObjectivesThere are a wide range of physiotherapy treatment options for people with lateral elbow tendinopathy (LET); however, previous studies have reported inconsistent approaches to treatment and a lack of evidence demonstrating clinical effectiveness. This study aimed to combine the best available research evidence with stakeholder perspectives to develop key components of an optimised physiotherapist-led treatment protocol for testing in a future randomised controlled trial (RCT).DesignOnline consensus groups using nominal group technique (NGT), a systematic approach to building consensus using structured multistage meetings.SettingUK National Health Service (NHS).Participants10 physiotherapists with special interest in LET, 2 physiotherapy service managers and 3 patients who had experienced LET.InterventionsTwo consensus groups were conducted; the first meeting focused on agreeing the types of interventions to be included in the optimised treatment protocol; the second meeting focused on specific details of intervention delivery. Participants were sent an evidence summary of available treatments for LET prior to the first meeting. All treatment options were discussed before anonymous voting and ranking of priority. Consensus for inclusion of each treatment option was set at ≥70% based on OMERACT guidelines. Options with 30%–69% agreement were discussed again, and a second vote was held, allowing for a change of opinion.ResultsThe optimised physiotherapist-led treatment package included: advice and education, exercise therapy and orthotics. Specific components for each of these interventions were also agreed such as: condition-specific advice, health-promotion advice, exercise types, exercise into ‘acceptable’ levels of pain, exercise dosage and type of orthoses. Other treatment options including electrotherapy, acupuncture and manual therapy were excluded.ConclusionAn optimised physiotherapist-led treatment protocol for people with LET was successfully developed using an online NGT consensus approach. This intervention is now ready for testing in a future pilot/feasibility RCT to contribute much needed evidence about the treatment of LET.Trial registration numberThis is the pre-cursor to the OPTimisE Pilot and Feasibility Randomised Controlled Trial. Registration: https://www.isrctn.com/ISRCTN64444585

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Section: Discussionmentioning

confidence: 99%

Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy: a consensus study using an online nominal group technique

et al. 2021

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“…In addition, there were incomplete data, including those related to treatment outcome and the specifics of exercise dose prescription. A recent service improvement study at another, similar‐sized, UK teaching hospital comprised similar patient numbers and found lower rates of treatment completion, highlighting the difficulties in studying this patient group (Barratt & Selfe, ). However, our study was able to highlight significant gaps in the research evidence, and a lack of concordance in relation to the most appropriate treatment used in physiotherapy for tennis elbow.…”

Section: Discussionmentioning

confidence: 97%

Current physiotherapy practice in the management of tennis elbow: A service evaluation

Bateman¹,

Whitby²,

Kacha³

et al. 2018

Musculoskeletal Care

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Wide variations in treatment approaches were identified. There was no consistency in the choice of modality used, the type of exercise or the dose of exercise prescribed. The use of passive modalities and corticosteroid injections was found to remain commonplace, despite a lack of supporting research evidence. There is a clear need for evidence-based guidance for physiotherapists treating patients with tennis elbow.

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“…The second most common service level involved QI efforts in orthopedics (n 5 11, 15.7%). 30,31,50,60,61,64,69,70,79,89,99 The service level described as "system" comprised seven studies (10%), 36,37,48,58,81,88,105 and included QI projects related to system processes or outcomes in PT practice that were not specific to a given service level.…”

Section: Service Levelmentioning

confidence: 99%

“…Of the 70 total included studies in this review, 18 (26%) 28,37,39,40,[43][44][45]48,52,60,68,70,73,74,77,79,96,102 were approved by local ethics boards, 19 (27%) [32][33][34]36,41,46,47,49,50,53,55,56,58,63,64,67,81,97,100 sought approval but were considered exempt, 15 (21%) 19,35,38,42,57,59,61,62,65,71,72,75,78,80,…”

Section: Qi Models or Toolsmentioning

confidence: 99%

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

Crick¹,

Rethorn²,

Beauregard³

et al. 2023

J Healthc Qual

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Introduction: Quality improvement (QI) is a useful methodology for improving healthcare, often through iterative changes. There is no prior review on the application of QI in physical therapy (PT). Purpose and Relevance: To characterize and evaluate the quality of the QI literature in PT. Methods: We searched four electronic databases from inception through September 1, 2022. Included publications focused on QI and included the practice of PT. Quality was assessed using the 16-point QI Minimum Quality Criteria Set (QI-MQCS) appraisal tool. Results: Seventy studies were included in the review, 60 of which were published since 2014 with most (n = 47) from the United States. Acute care (n = 41) was the most prevalent practice setting. Twenty-two studies (31%) did not use QI models or approaches and only nine studies referenced Revised Standards for QI Reporting Excellence guidelines. The median QI-MQCS score was 12 (range 7–15). Conclusions/Implications: Quality improvement publications in the PT literature are increasing, yet there is a paucity of QI studies pertaining to most practice settings and a lack of rigor in project design and reporting. Many studies were of low-to-moderate quality and did not meet minimum reporting standards. We recommend use of models, frameworks, and reporting guidelines to improve methodologic rigor and reporting.

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A service evaluation and improvement project: a three year systematic audit cycle of the physiotherapy treatment for Lateral Epicondylalgia

Cited by 7 publications

References 50 publications

Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy: a consensus study using an online nominal group technique

Development of an optimised physiotherapist-led treatment protocol for lateral elbow tendinopathy: a consensus study using an online nominal group technique

Current physiotherapy practice in the management of tennis elbow: A service evaluation

The Use of Quality Improvement in the Physical Therapy Literature: A Scoping Review

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