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Lechauve JB, Dobija L, Pereira B, Grolier M, Goldstein A, Lanhers C, Coudeyre E. Evaluation of the impact of a smartphone application on adherence to home exercise program for people with chronic low back pain: research protocol for a pilot randomised controlled trial. BMJ Open 2023; 13:e062290. [PMID: 36963800 PMCID: PMC10040032 DOI: 10.1136/bmjopen-2022-062290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/26/2023] Open
Abstract
INTRODUCTION Multidisciplinary rehabilitation programmes are highly recommended for individuals with the most disabling low back pain (LBP). However, the long-term adherence to regular home exercise is often poor. We aim to perform a prospective, controlled, pilot, randomised study that will evaluate the impact of a smartphone application on adherence to exercise programme for people with chronic LBP (CLBP). METHODS AND ANALYSIS 120 participants with non-specific CLBP aged 18-65 years will be recruited and randomised in two groups: an experimental group benefitting from education in the application's use in addition to a conventional multidisciplinary rehabilitation programme (exercises and self-management education) and a control group who will only participate in the multidisciplinary rehabilitation programme. Both groups will undergo the programme 5 days a week for 3 weeks. The primary outcome will be a change in patient's adherence to physical exercise (Exercise Adherence Rating Scale) at 6 months. Secondary outcomes will be function (Oswestry Disability Index), beliefs concerning physical activity (Evaluation of Physical Activity Perception), pain (Numeric Rating Scale), and physical capacity and qualitative adherence (video).Statistical analyses will be performed according to intention to treat. A linear mixed model will be used to compare the primary endpoint between groups at 6 months post-randomisation.The study could demonstrate the impact of using a smartphone application on adherence to exercise programme in people with CLBP. We hypothesise that the application's use will improve outcomes through improved exercise adherence. ETHICS AND DISSEMINATION The study was approved by the medical ethics committee of Ile de France 3. The results of this study will be disseminated in peer-reviewed publications and presentations at international scientific meetings and will also be disseminated to the participants. TRIAL REGISTRATION NUMBER NCT04264949.
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Affiliation(s)
- Jean-Baptiste Lechauve
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Lech Dobija
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Bruno Pereira
- Direction de la Recherche Clinique et de l'Innovation, Unité de Biostatistiques CHU Clermont-Ferrand, University Hospital CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Maxime Grolier
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Anna Goldstein
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Charlotte Lanhers
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
| | - Emmanuel Coudeyre
- Service de Médecine Physique et de Réadaptation, CHU Clermont-Ferrand, CHU Clermont-Ferrand, Clermont-Ferrand, France
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Halfpap J, Allen C, Rhon DI. A novel Home Exercise Assessment Tool (HEAT) to assess recall and performance: A reliability study. Physiother Theory Pract 2023; 39:423-432. [PMID: 35129064 DOI: 10.1080/09593985.2021.2017089] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
BACKGROUND A reliable and valid tool to measure short-term recall does not exist. OBJECTIVE The purpose of this study was o assess the reliability of a novel tool designed to evaluate the immediate recall and performance of prescribed exercises. This reliability study was secondary from a parent randomized controlled trial. METHODS Patients ages 18 to 65 with low back or unilateral knee pain longer than 6 weeks, reporting to a primary care or physical therapy clinic at one large military hospital. Participants were randomized into one of four groups based on number of exercises and type of instruction. The Home Exercise Assessment Tool (HEAT) is scored along an ordinal scale, (zero = low; three = high performance), with 2+ equal to meeting the intent of the exercise. Reliability of testing was assessed using a pool of four raters. RESULTS The interrater reliability of the HEAT performed on 30 participants (9 females, and 21males, mean age 36.7 (SD = 11.7)) and eight participants during pilot testing demonstrated moderate to good reliability (ICC = 0.66-0.77). Intrarater reliability during pilot testing was excellent (ICC = 0.93-0.96). CONCLUSION The HEAT demonstrated moderate to good interrater and excellent intrarater reliability. This tool is unique in that it assesses both recall and adherence, and merits further testing in other settings.
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Affiliation(s)
- Joshua Halfpap
- Bowling Green State University, College of Health and Human Services Doctor of Physical Therapy Program, Ohio Bowling Green U.S.A
| | - Christopher Allen
- Doctor of Physical Therapy Program University of Cincinnati, College of Allied Health Sciences, Cincinnati Ohio U.S.A
| | - Daniel I Rhon
- Department of Rehabilitation Medicine, Brooke Army Medical Center, San Antonio Texas U.S.A
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Rater agreement for assessment of equine back mobility at walk and trot compared to quantitative gait analysis. PLoS One 2021; 16:e0252536. [PMID: 34086765 PMCID: PMC8177646 DOI: 10.1371/journal.pone.0252536] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2020] [Accepted: 05/17/2021] [Indexed: 12/04/2022] Open
Abstract
Background Lameness assessment in horses is still predominantly performed using subjective methods. Visual assessment is known to have moderate to good intra-rater agreement but relatively poor inter-rater agreement. Little is known about inter- and intra-rater agreement on the evaluation of back motion, for which no objective measurement technique in a clinical setting is available thus far. Objectives To describe inter- and intra-rater agreement of visual evaluation of equine back mobility. Study design Rater reliability study using a fully crossed design in which all horses are rated by all observers. This data is compared with objective gait analysis. Methods Seventy equine professionals (veterinarians and physiotherapists) and veterinary students evaluated videos of 12 healthy horses at walk and trot on a hard, straight line. Nine parameters related to back mobility were scored: general mobility, thoracic, lumbar, lumbosacral flexion and extension and left and right thoracolumbar latero-flexion. All parameters were compared with simultaneously measured quantitative motion parameters. After 1 month, six randomly chosen horses were re-evaluated by 57 observers. Results For each parameter inter- and intra-rater agreements were calculated using intra-class correlation coefficients. For all parameters, inter-rater agreement was very poor (<0.2). The mean intra-rater agreement of all observers and for all parameters was poor (~0.4) but varied between 0.0 and 0.96 for individual observers. There was no correlation between the visual subjective scoring and objective gait analysis measurements. Main limitations Horses were scored from videos and by lack of any existing (semi-) quantitative system, a custom-made system had to be used. Conclusions The poor inter- and intra-rater agreements of visual scoring of mobility of the equine back and the disagreement between subjective and objective gait analysis data, demonstrate the need for the development and introduction of objective, quantitative and repeatable techniques to assess equine back motion.
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Arensman RM, Geelen RH, Koppenaal T, Veenhof C, Pisters MF. Measuring exercise adherence in patients with low back pain: development, validity, and reliability of the EXercise Adherence Scale (EXAS). Physiother Theory Pract 2020; 38:928-937. [PMID: 32933359 DOI: 10.1080/09593985.2020.1818337] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVES To develop an instrument to measure adherence to frequency, intensity, and quality of performance of home-based exercise (HBE) programs recommended by a physical therapist and to evaluate its construct validity and reliability in patients with low back pain. METHODS The Exercise Adherence Scale (EXAS) was developed following a literature search, an expert panel review, and a pilot test. The construct validity of the EXAS was determined based on data from 27 participants through an investigation of the convergent validity between adherence, lack of time to exercise, and lack of motivation to exercise. Associations between adherence, pain, and disability were determined to test divergent validity. The reliability of the EXAS quality of performance score was assessed using video recordings from 50 participants performing four exercises. RESULTS Correlations between the EXAS and lack of time to exercise, lack of motivation to exercise, pain, and disability were rho = 0.47, rho = 0.48, rho = 0.005, and rho = 0.24, respectively. The intrarater reliability of the quality of performance score was Kappa quadratic weights (Kqw) = 0.87 (95%-CI 0.83-0.92). The interrater reliability was Kqw = 0.36 (95%-CI 0.27-0.45). CONCLUSIONS The EXAS demonstrates acceptable construct validity for the measurement of adherence to HBE programs. Additionally, the EXAS shows excellent intrarater reliability and poor interrater reliability for the quality of performance score and is the first instrument to measure adherence to frequency, intensity, and quality of performance of HBE programs. The EXAS allows researchers and clinicians to better investigate the effects of adherence to HBE programs on the outcomes of interventions and treatments.
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Affiliation(s)
- Remco M Arensman
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Physiotherapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, Netherlands
| | - Rianne H Geelen
- Physiotherapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, Netherlands
| | - Tjarco Koppenaal
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Department of Health, Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands
| | - Cindy Veenhof
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Physiotherapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, Netherlands.,Research Group Innovation of Human Movement Care, University of Applied Sciences Utrecht, Utrecht, Netherlands
| | - Martijn F Pisters
- Department of Rehabilitation, Physiotherapy Science and Sport, UMC Utrecht Brain Center, University Medical Center Utrecht, Utrecht, Netherlands.,Physiotherapy Research, Program in Clinical Health Sciences, University Medical Center Utrecht, Utrecht, Netherlands.,Center for Physical Therapy Research and Innovation in Primary Care, Leidsche Rijn Julius Health Care Centers, Utrecht, Netherlands.,Department of Health, Innovations and Technology, Fontys University of Applied Sciences, Eindhoven, Netherlands
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