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Support for PEDro comes from Physiotherapy New Zealand, Norsk Fysioterapeutforbund, and Suomen FysioterapeutitRead More
Another word on low back pain
Back in April we highlighted a major Lancet series on non-specific low back pain. The series described the burden and global impact of back pain, gave an overview of causes and course, reviewed the evidence for the effectiveness of current treatments, and made a worldwide call to action to change policy and practice. The series received significant media attention, including being featured on Australia’s ABC Radio National Health Report. This radio program (now available as a podcast) emphasised how expensive treatments like surgery and cortisone injections are overused to treat back pain; that cheap, effective care is under-used; and some of the latest neuroscience research that may change our understandings of how best to deal with back pain. The program followed a group of researchers, educators and clinicians who cycled 750 km as part of the 2018 Pain Revolution to change how people understand pain in rural and regional communities in Australia. Mark Hancock, one of 30 international authors of the Lancet series, highlighted the need for legislative and funding changes plus called for clinicians to rethink how they're managing back pain.
Read the Lancet series on non-specific low back pain.
Listen to the ABC Radio National Health Report on rethinking what’s best for low back pain.
Find out more about the Pain Revolution.
#PhysicalTherapy #physio #LowBackPain
PEDro update (2 July 2018)
PEDro contains 40,552 records. In the 2 July 2018 update you will find:
- 31,924 reports of randomised controlled trials (31,030 of these trials have confirmed ratings of methodological quality using the PEDro scale)
- 7,970 reports of systematic reviews, and
- 658 reports of evidence-based clinical practice guidelines
PEDro update (July 2018)
PEDro was updated on 2 July 2018. For latest guidelines, reviews and trials in physiotherapy visit Evidence in your inbox.
Next PEDro update (July 2018)
The next PEDro update is on Monday 2 July 2018.
“This Girl Can” campaign inspires women to engage in physical activity
Do you know that women (particularly teenagers and young adults) play less regular sport than men? Do you know that a key factor driving this gender-gap is the fear of being judged?
Back in 2015, Sport England initiated a great public health campaign to encourage women to become more active. Called This Girl Can, the campaign uses videos and case studies to inspire women to beat their barriers and get involved.
This Girl Can is becoming an international phenomenon, with localised versions of the campaign being launched in Australia (Girls make your move) and the Australian state of Victoria (This Girl Can – Victoria). If you are aware of initiatives in other countries we’d like to hear from you.
This Girl Can is a great resource for physiotherapists to share with their patients.
#PhysicalTherapy #physio #girlsmove #thisgirlcan
The Template for Intervention Description and Replication (TIDieR) checklist can be summed to create a score
The Template for Intervention Description and Replication (TIDieR; http://www.equator-network.org/reporting-guidelines/tidier/) checklist is a tool designed to improve the reporting of interventions in randomised controlled trials that has been promoted widely in physiotherapy. Until now, TIDieR items have been reported individually. A recent study has examined whether it is reasonable to calculate a summary score from the TIDieR checklist. TIDieR summary scores (range 0-24) were calculated for 200 reports of physiotherapy trials published in 2013 and randomly selected from PEDro. Rasch analysis was used to investigate the item hierarchy, category function and reliability of the TIDieR checklist and determine the extent to which the summary score can be considered an interval-level measure. The data fit the Rasch model suggesting the summary score is able to assess the completeness of reporting. The items appeared to target the study sample well (average report measure was 0.48 (0.87) compared to the average item measure of 0.0 (1.82)), and progressed in a logical manner, suggesting the summary score can be used as a single variable. The low internal consistency (0.62) suggests the summary score may only be able to discriminate between the least and most detailed reports. These results support use of the TIDieR summary score, but replication in an independent data set is required.
Yamato TP et al. Rasch analysis suggested that items from the Template for Intervention Description and Replication (TIDieR) checklist can be summed to create a score. J Clin Epidemiol 2018 May 21;Epub ahead of print
Systematic review found that supervised exercise therapy improves walking distance compared to home-based exercises or walking advice in people with intermittent claudication
This recent systematic review evaluates the effects of supervised exercise therapy compared to home-based exercise therapy and walking advice in people with intermittent claudication. This is an update of a Cochrane systematic review, which was first published in 2006. The primary outcome was maximal treadmill walking distance or time. Secondary outcomes were pain-free treadmill walking distance or time, quality of life, functional impairment, mortality and adherence to exercise program. Supervised exercise therapy was defined as a treatment program lasting at least 6 weeks with more than 50% of total exercise spent on walking or training the lower limbs and conducted under supervision of a physiotherapist or trained medical professional either as a hospital-based or community-based program. Home-based exercise therapy was defined as structured walking advice supplemented with an observation component (e.g., exercise log-book). Walking advice was defined as “go home and walk” advice provided with or without a predefined exercise scheme. The review identified 21 randomised controlled trials (1,400 participants), among which 635 received supervised exercise therapy, 320 home-based exercise therapy and 445 received walking advice. 17 trials (81%) were considered to be low risk of bias. There is moderate quality evidence showing that structured exercise therapy is superior to home-based exercise therapy (standardised mean difference 0.37; 95% confidence interval 0.12 to 0.62) and high quality evidence showing that supervised exercise therapy is superior to walking advice (standardised mean difference 0.80; 95% confidence interval 0.53 to 1.07) in improving maximal treadmill walking distance at three months. These effect sizes represent that participants treated with structured exercise therapy were able to walk 120 metres further than those treated with home-based exercise therapy and 210 meters more than those treated walking advice, on average. There is moderate quality evidence showing that home-based exercise therapy did not improve walking distance compared to those treated with walking advice (standardised mean difference 0.30; 95% confidence interval -0.45 to 1.05). There is moderate quality evidence that supervised exercise therapy was more effective than home-based exercise therapy in increasing pain-free walking distance at 3 months (standardised mean difference 0.51; 95% confidence interval 0.21 to 0.81), and low quality evidence that it was not more effective in improving quality of life at 3 months (standardised mean difference 0.00; 95% confidence interval -4.79 to 4.79). This review showed moderate and high evidence that supervised exercise therapy provides an important benefit in improving walking distance compared to home-based exercise therapy and walking advice, respectively.
Hageman D, et al. Supervised exercise therapy versus home-based exercise therapy versus walking advice for intermittent claudication. Cochrane Database Syst Rev 2018;Issue 4
Read more on PEDro.
Support for PEDro comes from the American Physical Therapy Association, physioswiss, Physio Austria, Fysioterapeuterna, Associação Espanola de Fisioterapeutas, Taiwan Physical Therapy Association, Association Luxembourgeoise Des Kinésithérapeutes, Hong Kong Physiotherapy Association, Lietuvos Kineziterapeutų Draugija, and Ghana Physiotherapy Association
We thank the American Physical Therapy Association, physioswiss, Physio Austria, Fysioterapeuterna, Associação Espanola de Fisioterapeutas, Taiwan Physical Therapy Association, Association Luxembourgeoise Des Kinésithérapeutes, Hong Kong Physiotherapy Association, Lietuvos Kineziterapeutų Draugija, and Ghana Physiotherapy Association who have just renewed their partnerships with PEDro for another year.
PEDro indexes 40,000+ reports
We are pleased to announce that PEDro has just achieved two new milestones for the amount of evidence. There are now 40,000+ reports of trials, reviews and guidelines indexed on PEDro.