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Perceptions of best practice, pain science and structure-focused education for rotator cuff-related shoulder pain: a content analysis of qualitative data from a randomised experiment

Por: Zhang · Z. · Ferreira · G. E. · Muller · R. · Sousa · F. · Malliaras · P. · West · C. A. · OKeeffe · M. · Maher · C. · Zadro · J.
Objectives

To explore how people perceive different forms of education for rotator cuff-related shoulder pain in terms of words or feelings evoked by the education and treatments they feel are needed.

Setting

We performed a content analysis of qualitative data collected in a randomised experiment.

Participants

2237 participants with rotator cuff-related shoulder pain were randomly assigned to receive three forms of education: best practice education, best practice education plus pain science messages and structure-focused education.

Primary and secondary outcomes

After receiving the education, participants answered two questions regarding (1) words or feelings evoked by the education and (2) treatments they felt were needed.

Results

2232 responses for each question were analysed (99.7% response rate). Participants who received best practice education more frequently expressed feelings of unhappiness/frustration. The addition of pain science messages to best practice education resulted in slightly more emotional responses and a greater sense of being validated or cared for. In contrast, participants who received structure-focused education more frequently expressed trust in the clinician’s expertise and the need for medication, activity modification, rest, diagnostic imaging, injections and surgery. These participants also less frequently considered exercise as a viable treatment option.

Conclusion

Participants with rotator cuff-related shoulder pain expressed generally similar emotional responses across groups, with small differences in treatment preferences favouring self-management in the best practice education groups compared with those who received structure-focused education. Those in the best practice education also less frequently reported needing potentially unnecessary treatments (eg, imaging, injections and surgery).

Trial registration number

Australia New Zealand Clinical Trials Registry (ACTRN12623000197639).

PhyCARE reporting guidelines for physiotherapy case reports: a consensus-based development

Por: Naqvi · W. M. · Mishra · G. V. · Shaikh · S. Z. · Pashine · A. A. · Sanchez Romero · E. A. · Swaminathan · N. · Jiandani · M. P. · Herrero · P. · Zazulak · B. · Macpherson · C. E. · Goyal · C. · Zadro · J. R. · Sahni · P. · Innocenti · T. · Quazi Syed · Z. · Hoogeboom · T. · Kiekens · C
Objectives

Case reports (CRs) are essential in physiotherapy, yet reporting remains heterogeneous and insufficiently standardised. The 2013 CAse REport (CARE) guideline improves transparency but lacks physiotherapy-specific detail. This study aimed to develop a consensus-driven extension of the CARE reporting guideline to support structured reporting of physiotherapy CRs, encompassing physiotherapy-specific assessments and interventions.

Design

An e-Delphi consensus process study following the ACcurate COnsensus Reporting Document (ACCORD) guidelines.

Setting

Online.

Participants

Forty-four international experts in physiotherapy practice, research and education, along with six core committee members.

Methods

Experts objectively scored items for relevance (5-point Likert scale) and provided open-ended responses for each item of the drafts. Scores and responses were analysed to facilitate iterative refinement of the Physiotherapy CAse REport (PhyCARE) reporting guidelines. Consensus was predetermined at over 70% agreement.

Results

Round 1 had the majority of items achieving ≥70% agreement, except two items that did not meet the threshold were revised and replaced with an alternative. Five new items addressing physiotherapy-specific reporting needs were added, and 10 items were relocated. In round 2, all 35 items across 13 domains achieved 84%–100% agreement. The nomenclature of one domain was revised to ‘Outcomes and Follow-up’. Following two e-Delphi rounds, consensus was achieved, and suggestions from online meeting, piloting led to item rephrasing, after which the PhyCARE guidelines were finalised.

Conclusion

The PhyCARE guidelines have the potential to provide a physiotherapy-specific extension of CARE to support structured, transparent and reproducible reporting of physiotherapy CRs.

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