Diagnostic Classification of Patients with Low Back Pain: Report on a Survey of Physical Therapy Experts

Binkley, Jill; Finch, Elspeth; Hall, J; Black, T.; Gowland, Carolyn

doi:10.1093/ptj/73.3.138

Cited by 77 publications

(47 citation statements)

References 7 publications

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“…Consensus regarding a factor was operationally defined as when 75% or more of the respondents scored a factor as a No or Yes 26 . To complete the decision between Near-consensus and Undecided, a logic analysis was conducted.…”

Section: Data Analysis-delphi Methodsmentioning

confidence: 99%

“…Learners must constantly assess and adapt how they are thinking and responding with respect to what they see and experience. This reflective process can guide them toward making effective clinical and evidencebased decisions regarding implementation and modification of testing and treatment procedures 26 . In a similar way, a learner's Application of knowledge to skill and skill to patient care (ranked 4 th ) reflects the link of theory to practice, which is essential for effective clinical learning to occur 39 .…”

Section: Motivationmentioning

confidence: 99%

See 1 more Smart Citation

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

Sizer

Sawyer²,

Felstehausen³

et al. 2008

Journal of Manual & Manipulative Therapy

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A learner's development of orthopaedic manual physical therapy (OMPT) psychomotor skills may be influenced by selected intrinsic and extrinsic factors. The purposes of this study were to identify the factors that influence learners' development of manual physical therapy competencies and to define each factor as intrinsic or extrinsic. A 3-round Delphi method survey and a retrospective review of the data were used to develop composite scores and rankings. Eighty manual physical therapy educators participated in the 3 rounds. Thirty-six factor descriptor statements associated with manual physical therapy competency were established and further categorized as intrinsic (19 total), extrinsic (10 total), or conceptual outliers (7 total). Cognitive Processing ranked as the most important factor influencing manual physical therapy competency development. Adaptation ranked second, followed by Science Knowledge. This study is the first to establish manual physical therapy educational factors associated with attainment of competency. The majority of the factors distill into the theory of extrinsic and intrinsic factors identified by Schmidt and Lee. The outcomes of this study identify the factors to which OMPT educators should give particular attention when developing and executing the learning experiences for their learners. Keywords:Competency-Based Education, Curriculum, Delphi Technique, Factors, Motor Learning, Musculoskeletal Manipulations, Psychomotor Performance. S pecific manual and/or movement-based competencies are emphasized by physical therapy educators during learners' development of psychomotor skills. Psychomotor skill acquisition is a product of psychomotor learning, which is a set of processes associated with practice or experience leading to relatively permanent changes in the capability for responding to stimuli 1 . As a consequence of psychomotor learning, individuals gain greater movement efficiency, develop more complex movement control strategies, optimize movement behaviors, and develop movement expertise 2 . Schmidt and Lee identified five extrinsic and four intrinsic factors that influence psychomotor learning factors are 1) practice, 2) feedback, 3) task classification, 4) instruction format, and 5) movement context. Factors such as practice, which involves cognitive processing 3,4 , accentuate learned abilities through the processing of sensory information 5 . The use of quantitative feedback and concurrent feedback in manual physical therapy learning has provided both favorable [6][7][8] and unfavorable results 9 . Visual instructional formats incorporate observation to facilitate psychomotor skill acquisition 10 , while kinesthetic instruction uses the learner's sensory system by physically moving the learner through the task 11 . Finally, movement context appears to influence psychomotor skill acquisition 12 . The intrinsic factors include 1) attention, 2) memory, 3) motivation, and 4) psychomotor learning stage 13 . These factors are less tangible and more difficult to measure t...

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Section: Data Analysis-delphi Methodsmentioning

confidence: 99%

Section: Motivationmentioning

confidence: 99%

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

Sizer

Sawyer²,

Felstehausen³

et al. 2008

Journal of Manual & Manipulative Therapy

View full text Add to dashboard Cite

show abstract

“…J Orthop Sports Phys Ther 2007;37 (6):290-302. doi: 10.2519/jospt.2007.2498 A good deal of work, both theoretical and experimental, has been performed by Physical Therapists describing subgroups of patients based on clusters of signs and symptoms and proposing a particular intervention strategy as most effective. 13,91,105,115 One approach to classifying patients with LBP based on signs and symptoms was described by Delitto and colleagues in 1995. 35 Research has supported that decision making based on this classification structure results in better outcomes for physical therapy than decision making based on alternative procedures.…”

mentioning

confidence: 99%

Subgrouping Patients With Low Back Pain: Evolution of a Classification Approach to Physical Therapy

Fritz¹,

Cleland²,

Childs³

2007

J Orthop Sports Phys Ther

299

219

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“…Canadian studies have all used a biomedical approach and have classified all LBP patients (acute, subacute and chronic). In one study [10] one cultural factor (language) was considered. All but one study [87] were developed by physiotherapists, and all studies, except one [68], were developed by a judgmental approach from the proposed authors; thus, methodological quality has been low in most of them.…”

Section: Discussionmentioning

confidence: 99%

Subclassification of low back pain: a cross-country comparison

2007

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Various health professionals have attempted to classify low back pain (LBP) subgroups and have developed several LBP classification systems. Knowing that culture has an effect on LBP symptomatology, assessment findings and clinical decision making, the aim of this review is to perform a cross-country comparative review amongst the published classification systems, addressing each country's similarities and differences as well as exploring whether cultural factors have been incorporated into the subclassification process. A systematic search of databases limited to human adults was undertaken by Medline, Cinahl, AMED and PEDro databases between January 1980 and October 2005. Classification systems from nine countries were identified. Most studies were classified according to pathoanatomic and/or clinical features, whereas fewer studies utilized a psychosocial and even less, a biopsychosocial approach. Most studies were limited in use to the country of the system's developer. Very few studies addressed cultural issues, highlighting the lack of information on the impact of specific cultural factors on LBP classification procedures. However, there seem to be certain 'cultural trends' in classification systems within each country, which are discussed. Despite the plethora of classification studies, there is still no system which is internationally established, effective, reliable and valid. Future research should aim to develop a LBP classification system within a well identified cultural setting, addressing the multi-dimensional features of the LBP presentation.

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Diagnostic Classification of Patients with Low Back Pain: Report on a Survey of Physical Therapy Experts

Abstract: The importance of developing homogeneous subgroups of patients with LBP based on constellations of reliable clinical findings is emphasized.

Cited by 77 publications

References 7 publications

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

Intrinsic and Extrinsic Factors Important to Manual Therapy Competency Development: A Delphi Investigation

Subgrouping Patients With Low Back Pain: Evolution of a Classification Approach to Physical Therapy

Subclassification of low back pain: a cross-country comparison

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