The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: A rapid review Part I

Toomey, Elaine; Currie-Murphy, Laura; Matthews, James; Hurley, Deirdre A.

doi:10.1016/j.math.2014.10.013

Cited by 46 publications

(32 citation statements)

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“…Our review extends previous findings14 54 55 that show no superiority for one type of exercise over another in the management of MSK conditions. Our findings are also consistent with those of a recent review,33 where self-management that included group physiotherapy was as effective as individual physiotherapy and medical management in those with LBP and osteoarthritis.…”

Section: Discussionsupporting

confidence: 92%

“…A recent rapid review33 of five databases investigated the effectiveness of group education and exercise interventions in people with osteoarthritis and chronic LBP. Interventions that included group education were as effective as individual physiotherapy and medical management.…”

Section: Introductionmentioning

confidence: 99%

“…Interventions that included group education were as effective as individual physiotherapy and medical management. In that review,33 group interventions were not required to be delivered by a physiotherapist and the authors included group education interventions that contained some individual sessions. The group interventions were compared with several different treatments (individual physiotherapy, usual medical management, booklets and no intervention), while the control interventions were not required to have an exercise component.…”

Section: Introductionmentioning

confidence: 99%

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Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis

et al. 2016

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Only small, clinically irrelevant differences in pain or disability outcomes were found between group and individual physiotherapy incorporating exercise. Since all but one study included other interventions together with exercise in either the group or individual arm, deciphering the unique effect of the way in which exercise is delivered is difficult. Group interventions may need to be considered more often, given their similar effectiveness and potentially lower healthcare costs.

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis

et al. 2016

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“…Recent reviews of the effectiveness of group self-management programmes for low back pain which included a wide range of physiotherapy only and multi-disciplinary programmes concluded that such interventions are as effective as individual physiotherapy or medical management, however limitations reported in the studies included too much focus on pain scores perhaps resulting in inadequate assessment of behaviour change [35]. Treatment fidelity has also been described as poor, although it is unclear whether this is due to lack of consistency between delivery and prescribed models or limited reporting of fidelity checks in published research [36].…”

Section: Implications For Practicementioning

confidence: 99%

Combining a psychological intervention with physiotherapy: A systematic review to determine the effect on physical function and quality of life for adults with chronic pain

Wilson

Cramp

2018

Physical Therapy Reviews

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Combining a psychological intervention with physiotherapy. A systematic review to determine the effect on physical function and quality of life for adults with chronic pain. Background Chronic pain affects approximately 28 million people in the UK. It does not always respond to conventional curative treatments and can have a devastating impact on an individual's ability to function and perform life roles in the way they would like. Psychological approaches to pain management have been advocated for over 40 years, but it is unclear whether the addition of such approaches to physiotherapy increases treatment effectiveness. Objectives To systematically review the literature to determine whether the addition of psychological approaches to physiotherapy is more effective in improving physical functioning and quality of life than physiotherapy alone. Methods An electronic database search focused on randomised controlled trials comparing a physiotherapy intervention for chronic pain with a matched intervention with an additional psychological therapy component. All eligible studies were independently reviewed by two researchers and the strength of evidence and results evaluated. A meta-analysis was conducted on post-test mean data for physical functioning. Results Eight studies were identified for inclusion. Meta-analysis of the data showed combined treatments to be superior in modifying functional outcomes (standardised mean difference-1.12 95% confidence intervals-1.94 to-0.31). This was echoed in the narrative review of the quality of life evidence. Study quality was variable and thus the findings should be interpreted with caution. Conclusions There is evidence that combining physiotherapy and psychological approaches improves physical function in chronic pain in comparison to physiotherapy alone. Further examination of this field is required to inform changes in practice and to develop treatment methods.

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“…International clinical guidelines for osteoarthritis (OA) and low back pain (LBP) endorse selfmanagement (SM), exercise and physical activity as key components of healthcare interventions [1][2][3][4][5], but the evidence for their effectiveness is weak and low quality [6][7][8]. The Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) intervention is an evidencesupported group treatment approach, developed through the intervention mapping process [9], and evaluated for its acceptability and feasibility compared to individual physiotherapy in the SOLAS feasibility trial [10].…”

Section: Introductionmentioning

confidence: 99%

Evaluation of an E-Learning Training Program to Support Implementation of a Group-Based, Theory-Driven, Self-Management Intervention For Osteoarthritis and Low-Back Pain: Pre-Post Study (Preprint)

Hurley¹,

Keogh²,

Ardle³

et al. 2018

Preprint

Self Cite

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Background: The Self-management of Osteoarthritis and Low back pain through Activity and Skills (SOLAS) (ISRCTN49875385) feasibility trial included physical therapists (PTs) completing two days small group face-to-face training to deliver the six week group-based intervention. While the effectiveness of this training program has been established, potential upscaling to a definitive national trial and future implementation is limited by travel, time, and cost constraints for PTs. Therefore, an asynchronous, interactive, web-based E-learning training program (E-SOLAS) underpinned by behavior and learning theories was developed.Objective: This study investigated the effectiveness of the E-SOLAS training program on relevant outcomes for effective training and implementation.Methods: Thirteen PT's from across Ireland were trained via E-SOLAS using mixed methods and seven PTs progressed to intervention implementation. The effectiveness of E-SOLAS was evaluated using the Kirkpatrick model at the levels of (1) Reaction: PTs engagement and satisfaction with E-SOLAS training methods and content, (2) Learning: pre to post-training changes in PTs a) confidence and b) knowledge in delivering SOLAS content and self-determination theory (SDT)-based communication strategies, administered via a SurveyMonkey questionnaire and (3) Behavior: Fidelity to delivery of SOLAS content using PT-completed weekly checklists. During implementation, five PTs audio-recorded delivery of one class and the communication between PTs and clients was assessed using the Health Care Climate Questionnaire (HCCQ), the Controlling Coach Behavior Scale (CCBS), and an intervention specific measure (ISM; 7-point Likert scales). A range of implementation outcomes were evaluated during training and delivery (i.e. acceptability, appropriateness, feasibility, fidelity and sustainability of E-SOLAS) using a post-training feedback questionnaire and individual semi-structured telephone interviews. median CCBS = 6.6 (1.0); 5.6-7.0; median ISM = 4.5 (1.2); 2.8-4.8). Fidelity scores were high for SOLAS content delivery (total % mean (SD) fidelity score = 93.5% (4.9)). The post-training questionnaire and post-delivery qualitative interviews showed PTs found E-SOLAS acceptable, appropriate, feasible and sustainable within primary care services to support the implementation of the SOLAS intervention. Conclusions:This study provides preliminary evidence of the effectiveness, acceptability and 2 feasibility of an e-learning program to train PTs to deliver a group-based self-management complex intervention in primary care settings that is equivalent to face to face training outcomes and would support inclusion of PTs in a definitive trial of SOLAS.Keywords: technology-enhanced learning; evaluation; e-learning; digital learning; program evaluation; effectiveness; physical therapy; implementation; osteoarthritis; low back pain. 3 IntroductionInternational clinical guidelines for osteoarthritis (OA) and low back pain (LBP) endorse selfmanagement (SM), exercise and phy...

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The effectiveness of physiotherapist-delivered group education and exercise interventions to promote self-management for people with osteoarthritis and chronic low back pain: A rapid review Part I

Cited by 46 publications

References 47 publications

Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis

Are group-based and individual physiotherapy exercise programmes equally effective for musculoskeletal conditions? A systematic review and meta-analysis

Combining a psychological intervention with physiotherapy: A systematic review to determine the effect on physical function and quality of life for adults with chronic pain

Evaluation of an E-Learning Training Program to Support Implementation of a Group-Based, Theory-Driven, Self-Management Intervention For Osteoarthritis and Low-Back Pain: Pre-Post Study (Preprint)

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