The New York Times published the news with links to the BMJ report and to an accompanying editorial by Brent R Collett an investigator at Seattle Children’s Research Institute As therapists, what are your thoughts to this research? Please share any of your experiences.]]>
Physician Screening Tool, PT Referral for Low Back Pain May Be Effective Approach for Treatment
We would like to share this article from PT Products
Published on April 4, 2014 by “PT PRODUCTS”
“An editorial in The Annals of Family Medicine suggests that the British screening approach for physicians with patients with low back pain (LBP) may help in creating a US-based approach that more often involves physical therapists (PTs) early on and lowers the financial costs of the condition. In the editorial, authors Timothy S. Carey, MD, MPH, and Janet Freburger, PT, PhD, comment on a new study of physical therapy management of patients with LBP, saying the results are an important step in validating an approach that involves early physical therapy.
According to a news release from the American Physical Therapy Association (APTA), the approach described in the study involves physician use of a British screening tool known as the STarT, which is designed to help a physician assess LBP. Once the assessment is made, a medium- or high-risk patient can be referred to a PT for effective treatment. The editorial answers the question as to whether or not this approach should be used in the US, with the authors saying yes.
The editorial authors point to logistical and regulatory wrinkles that would need to be worked out, but do note that similar screening approaches, such as those used for depression or alcohol use, were implemented fairly simply. The editorial states, “These advances don’t solve our problems with the large disability burden and high cost of low back pain, but they represent a promising start.”
[Sources: APTA, The Annals of Family Medicine]
]]>Evidence Based Practice: How Are You Measuring Outcomes; PART 2
SPEAKER BLOG SERIES:
[caption id="attachment_1847" align="alignleft" width="160" caption="Suzanne Davis"]
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Considering the three components of EBP, therapy has been particularly lacking in the area of research. Conducting high-level research is difficult for many reasons. One of the issues is finding outcome measures that are sensitive enough to measure the changes that the children with neuromotor and sensory dysfunction make.
A format that is sensitive to individual change is coming to the forefront. Goal Attainment Scaling (GAS) has been found to be responsive to this need and is now being recommended for use in clinical practice and in treatment outcomes research (Palisano, 1993; Steenbeck, et al, 2005; Ekstrom, et al, 2005). GAS is an individualized criterion-referenced measure that has been applied in a number of settings. Because goals are criterion-referenced versus norm-referenced it is a tool that is responsive to small but clinically significant change (McDougall & King, 2007). It can be used to determine the effectiveness of interventions with individuals as well as programs.
In the next entry of this blog, I will provide details on the GAS as well as compare and contrast GAS to SMART goals.
What tools are you using to show measurable change in the children’s outcomes? Share them here.
]]>PT Seeks Input Helping a Child with Torticollis
Jill Posts:
DEAR ERI COMMUNITY:
Hello, I am working with a child with Goldenhar Syndrome and significant right torticollis. I have been working with him for almost a year, and we have had phases of the neck alignment improving, but seems to have plateaued more recently. He is now 16 months old, and quite resistant to any stretching, and most handling. His family is great and tries to incorporate what they can into the daily routine, but of course his tolerance for this is poor, as he’d prefer to be up walking. His passive range of motion is pretty good, with his primary limitation being rotation. But he consistently maintains a 45 degree head tilt during play. He has a TOT collar which helps quite a bit, but limits his rotation, and encourages him to rotate to the left. In addition, once it’s removed, his tilt becomes even worse. We have tried kinesiotaping, but his skin is very sensitive and he did not tolerate it.
I would love any suggestions/treatment ideas people may have for working with a child of this age with torticollis. In the past, I have been able to discharge most of my kids with torticollis around a year. I feel like we have tried everything with this little guy, but we just aren’t having a lot of success.
Thank you!!!
]]>Evidence Based Practice: How Are You Measuring Outcomes
SPEAKER BLOG SERIES:
[caption id="attachment_1838" align="alignleft" width="160" caption="Suzanne Davis"]
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As therapists we are constantly challenged to use evidence-based practice (EBP) to provide services to our clients. The definition of EBP is threefold, including (Sackett, et al, 2000):
- Best research evidence
- Clinical expertise
- Patient and family values
Considering the three components of EBP, therapy has been particularly lacking in the area of research. Conducting high-level research is difficult for many reasons. One of the issues is finding outcome measures that are sensitive enough to measure the changes that the children with neuromotor and sensory dysfunction make.
What tools are you using to show measurable change in the children’s outcomes? Share them here
The next entry from Suzanne will discuss new research.
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