Factors associated with physiotherapists' confidence during assessment of clinical cervical and lumbar spine instability
Factors associated with physiotherapists' confidence during assessment of clinical cervical and lumbar spine instability
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DOI：
10.1002/pri.27
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发表时间：
2005-06-01
影响因子：
1.7
通讯作者：
Sizer, Philip S.
中科院分区：
文献类型：
--
作者：
Cook, Chad;Brismee, Jean-Michel;Sizer, Philip S.
背景和目的。物理治疗师经常遇到的病人抱怨模糊，难以区分的颈部和背部疼痛，如临床脊柱不稳定。由于信心是专家临床实践的一个组成部分，我们对测量专家临床医生在诊断和评估临床脊柱不稳定方面的信心感兴趣。本研究的目的是找出与物理治疗师的目标、物理诊断和临床脊柱不稳定评估相关的常见“标识符”，并确定报告的诊断置信度与这些标识符的关联。方法。该研究使用德尔菲仪器进行因素分析，并对APTA委员会认证的骨科专家进行调查，以报告信心。使用逻辑回归分析，识别主题和临床背景特征与临床脊柱不稳定诊断的置信度相关。结果。只有临床颈椎不稳有显著的发现。“临床实践中运动评估过程中可观察到或可触摸到的运动异常”这一识别词与报告的诊断置信度呈正相关，手工治疗背景模型的影响也是如此：Cyriax、Maitland、McKenzie、NAIOMPT、Osteopathic、Paris等。男性性别与报告的自信呈负相关。没有与腰椎自信相关的因素。结论。多个物理治疗师的背景证明了使用可观察或可触摸的方法检测异常运动来检测临床脊柱不稳定的信心。
Background and Purpose. Physiotherapists commonly encounter patients with complaints of vague, indistinguishable neck and back pain, such as clinical spine instability. Since confidence is a component of expert clinical practice, we were interested in measuring expert clinicians' confidence in diagnosing and assessing clinical spine instability. The aims of the present study were to factor out the common 'identifiers' associated with physiotherapists' objective, physical diagnosis and assessment of clinical spine instability, and to determine the association of reported diagnostic confidence to these identifiers. Method. The study used data from a Delphi instrument for the factor analysis and a survey of APTA Board-certified orthopaedic specialists for report of confidence. Using an ologit regression analysis, the identifier themes and clinical background characteristics were associated with confidence in diagnosis of clinical spine instability. Results. Only clinical cervical spine instability obtained significant findings. The identifier 'observable or palpable abnormalities of motion during movement assessment in clinical practice' was positively associated with reported confidence in diagnosis, as was the influence of manual therapy background models: Cyriax, Maitland, McKenzie, NAIOMPT, Osteopathic, Paris and other. Male gender yielded negative association with reported confidence. No factors were associated with reported lumbar confidence. Conclusions. Multiple backgrounds of physiotherapists demonstrate confidence in detecting clinical spine instability using observable or palpable methods to detect abnormal movements.