ORCID Profile
0000-0001-6071-7060
Current Organisation
La Trobe University
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Publisher: BMJ
Date: 21-11-2007
Abstract: To identify psychosocial predictors of failure to return to work in non-chronic (lasting less than 3 months) non-specific low back pain (NSLBP). A systematic review of prognostic studies was carried out. Medline, Embase, PsychINFO, CINAHL and PEDro electronic bibliographic databases up to April 2006 were searched. Included studies took baseline measures in the non-chronic phase of NSLBP (ie, within 3 months of onset), included at least one psychosocial variable and studied a s le in which at least 75% of participants had NSLBP. Baseline measures had to be used to predict at least one work-specific outcome. The search identified 24 studies meeting the inclusion criteria. From these studies there is strong evidence that recovery expectation is predictive of work outcome and that depression, job satisfaction and stress sychological strain are not predictive of work outcome. There is moderate evidence that fear avoidance beliefs are predictive of work outcome and that anxiety is not predictive of work outcome. There is insufficient evidence to determine whether compensation or locus of control are predictive of work outcome. To predict work outcome in non-chronic NSLBP, psychosocial assessment should focus on recovery expectation and fear avoidance. More research is needed to determine the best method of measuring these constructs and to determine how to intervene when a worker has low recovery expectations.
Publisher: BMJ
Date: 20-12-2012
DOI: 10.1136/BJSPORTS-2012-091704
Abstract: This paper will help clinicians and researchers to understand studies on the validity, responsiveness and reliability of patient-reported outcome measures (PROMs) and to interpret the scores and change scores derived from these and other types of outcome measures. Validity studies provide a method for assessing whether the underlying construct of interest is adequately assessed. Responsiveness studies explore the longitudinal validity of a test and provide evidence that an instrument can detect change in the construct of interest. Reliability is commonly assessed with correlation indices, which indicate the stability of repeated measurements and the 'noise' or error in the measurement. Proposed indicators for clinical interpretation of test scores are the minimum clinically important difference, the standard error of measurement and the minimum detectable change. Studies of the Victorian Institute of Sports Assessment questionnaire for patellar tendinopathy and other PROMs are used to illustrate concepts.
Publisher: SAGE Publications
Date: 02-2007
Abstract: Objective: To review the measurement properties (reliability, validity, responsiveness) of the Human Activity Profile (HAP), a self-report measure of energy expenditure or physical fitness. Data sources: MEDLINE, CINAHL and EMBASE were searched up to September 2005 and the reference lists of included studies were checked for additional relevant studies. Review method: Studies were included that reported Human Activity Profile scores, test-retest reliability, correlations with other measures, or responsiveness (sensitivity to change). Of 83 potentially relevant articles, 39 articles were included plus the test manual. Two independent reviewers extracted data from the included studies. Results: The Human Activity Profile has been used to evaluate physical activity in a wide variety of clinical populations and in healthy in iduals. The change in score required to be 90% confident that change is beyond measurement error was estimated to be 7.8 for the Maximum Activity Score and 6.8 for the Adjusted Activity Score. The construct validity of the Human Activity Profile was supported by a large number of studies, although evidence for criterion validity was limited to four studies. No studies have investigated a priori the responsiveness or minimum clinically important difference of the Human Activity Profile. Conclusion: The Human Activity Profile appears to be a useful indicator of physical activity levels in people with chronic pain, arthritis, renal failure, various neurological and cardiorespiratory conditions, as well as in healthy older people.
Publisher: The Haworth Press
Date: 09-06-2005
Publisher: Wiley
Date: 19-05-2006
DOI: 10.1002/PRI.328
Abstract: [corrected] Evidence-based practice is the explicit use of current best evidence in making decisions about the care of in idual patients and is a concept of growing importance for physiotherapy. The aim of the present study was to investigate Australian physiotherapists' self-reported practice, skills and knowledge of evidence-based practice and to examine differences between recent and experienced graduates, physiotherapists with low and high levels of training and physiotherapists working in private practice and hospital settings. A survey was sent to 230 physiotherapists working in hospitals and in private practice. One hundred and twenty-four were completed and returned. Although 69.4% of respondents said they frequently (at least monthly) read research literature, only 10.6%, 15.3% and 26.6% of respondents, respectively, searched PEDro, Cochrane and Medline or Cinahl databases frequently, and only 25.8% of respondents reported critically appraising research reports. Recent graduates rated their evidence-based practice skills more highly than more experienced graduates, but did not perform evidence-based practice tasks more often. Physiotherapists with higher levels of training rated their evidence-based practice skills more highly, were more likely to search databases and to understand a range of evidence-based practice terminology than those with lower levels of training. Private practice and hospital physiotherapists rated their evidence-based practice skills equally and performed most evidence-based practice activities with equal frequency. Respondents had a positive attitude toward evidence-based practice and the main barriers to evidence-based practice were time required to keep up to date, access to easily understandable summaries of evidence, journal access and lack of personal skills in searching and evaluating research evidence. Efforts to advance evidence-based practice in physiotherapy should focus on reducing these barriers.
Publisher: Springer Science and Business Media LLC
Date: 30-09-2010
Publisher: Elsevier BV
Date: 2011
Publisher: Elsevier
Date: 2005
Publisher: Elsevier BV
Date: 02-2013
DOI: 10.1016/J.MATH.2012.06.005
Abstract: The effectiveness of multidisciplinary treatment for post-acute (>6 weeks) low back pain (LBP) has been established. Physiotherapists have sufficient training to conduct less intensive functional restoration. The effectiveness of physiotherapy functional restoration (PFR) has not been evaluated using current systematic review methodology. To determine the effects of PFR for post-acute LBP. Electronic databases searched include: MEDLINE, EMBASE, CINAHL, PsycINFO, PEDro and Cochrane CENTRAL. TRIAL ELIGIBILITY CRITERIA: Randomised controlled trials of physiotherapy treatment for post-acute LBP combining exercise and cognitive-behavioural intervention compared with other intervention, no intervention or placebo. TRIAL APPRAISAL AND SYNTHESIS METHODS: Two authors independently extracted data. Risk of bias was assessed using the PEDro scale and overall quality of the body of evidence was assessed using GRADE (Grading of Recommendations, Assessment, Development and Evaluation). Treatment effect sizes and 95% confidence intervals were calculated for pain, function and sick leave. Sixteen trials were included. Heterogeneity prevented meta-analysis for most comparisons. Meta-analyses showed moderate to high quality evidence of significant but small effects favouring PFR compared with advice for intermediate term function and intermediate and long term pain. There was however low to moderate quality evidence that PFR was no more effective than a range of other treatment types. Heterogeneous trials frequently contributed to very low quality evidence. Moderate to high quality evidence was found of small effects favouring PFR compared with advice. Preliminary evidence suggested PFR is not different to other treatment types. Further high quality research is required replicating existing trial protocols.
Publisher: Elsevier BV
Date: 02-2006
DOI: 10.1016/J.MATH.2005.02.003
Abstract: Physiotherapists have traditionally relied on impairment measures such as range of motion and muscle strength to monitor patient progress. The impact of treatment on patients' daily activities can be assessed with valid and reliable questionnaires, but the use of standardized questionnaires by physiotherapists appeared to be limited. A range of strategies were implemented that aimed to increase physiotherapists' use of standardized measures of functional activities. A simple random s le of 300 was drawn from a database of physiotherapy providers to a transport accident scheme, and was surveyed in March and September 2003, with response rates of 51% and 55%, respectively. There was a statistically significant (P<.05) increase in reported use of seven questionnaires and a significant reduction in the perception of barriers that were targeted by the interventions The most frequently utilized tests were a pain rating scale and questionnaires for lumbar and cervical problems. Physiotherapists' attitudes to outcome measurement were generally positive although there was a small but statistically significant (P=.02) reduction in mean attitude score over the re-test period. Physiotherapists in the population s led significantly increased their reported use of a range of standardized outcome measures over the re-test period. The trend towards greater objectivity in measuring the progress of rehabilitation can enable physiotherapists to develop improved treatment plans with the patients' needs at the centre of the equation.
Publisher: Elsevier BV
Date: 2011
Publisher: Wiley
Date: 27-07-2012
DOI: 10.1002/PRI.1533
Abstract: To evaluate the return to work and health outcomes of a physiotherapy network provider programme. A prospective case-control study was conducted with 21 clients of network occupational physiotherapy (OP) providers and 21 matched clients of non-network providers. Health outcomes and return to work were recorded 3 and 6 months following the commencement of physiotherapy. Health outcomes included the Short Form (SF)-12, return to usual activities and the global perceived effect of treatment. Within-group changes and between-group differences were analysed. Within-group changes showed the OP group improved significantly in physical functioning (p = 0.006), and the control group deteriorated in mental health status (p = 0.016) as measured by the SF-12. Mean change over time between groups from the 3-month to 6-month follow-ups showed a significant difference favouring the OP group for return to usual activities (p = 0.027) and the physical component of the SF-12 (p = 0.009). All job-attached participants returned to work following their accident, so there was no difference between the groups. The OP clients demonstrated a greater change in physical functioning health outcomes over time. This study provides preliminary support for the implementation of the OP scheme.
Publisher: Informa UK Limited
Date: 03-09-2013
DOI: 10.3109/09638288.2013.829529
Abstract: Investigate test--retest reliability and validity of five shoulder outcome measures in people during their active rehabilitation after a shoulder fracture. This prospective longitudinal study assessed shoulder function in 20 people (16 women, mean age 68.1 years) with surgical or conservative management at 6, 12 and 13 weeks post proximal humeral fracture using three patient-reported (Disabilities of Arm, Shoulder and Hand Oxford Shoulder Score Subjective Shoulder Value) and two clinician-administered (Constant Score UCLA Shoulder score) outcome measures. Content analysis categorised items into multiple domains of functioning for each outcome measure. Construct validity testing between measures found moderate to strong correlations (r=0.43-0.92). Longitudinal validity (responsiveness), represented by correlations between change scores, was moderate to strong (r=0.44-0.83). Although ICCs2,1 for test-retest reliability ranged from 0.75 to 0.93, Limits of Agreement between measurements were relatively wide (10-23% of available range of scores). Minimal clinically important difference estimates varied between anchor- and distribution-based methods. The five outcome measures assessing shoulder function provided values for reliability and validity that meet measurement requirements for use in groups of people after a proximal humeral fracture. However, the use of these outcome measures might be limited by low absolute agreement between measurements and their content covering multiple domains of functioning. Implications for Rehabilitation Linking the International Classification of Functioning, Disability and Health (ICF) to the content of common shoulder function outcome measures showed that multiple domains of functioning are combined into a single score. This might not be preferred for measurement of the single construct of "shoulder function". Currently available shoulder function outcome measures may not be sufficiently reliable to monitor change in an in idual after a proximal humeral fracture during the rehabilitation phase.
Publisher: Medical Journals Sweden AB
Date: 2012
Abstract: Low recovery expectations have been identified as a strong and consistent predictor of poor outcome in non-chronic non-specific low back pain (NSLBP). The aim of this study was to explore how people determine their own recovery expectation during an episode of non-chronic NSLBP. In-depth interviews were conducted with a purposive s le of people with non-chronic NSLBP and low recovery expectations. Interviews were audio--recorded and transcribed verbatim. Two researchers independently applied open coding, followed by axial coding to allow themes to emerge from the data using a constant comparison method. The central theme of the person and 4 subthemes of pain, progress, performance, and treatment emerged from the data. The formation of recovery expectations was dependent on the person's unique apprasial of their pain, how the condition had progressed, the limitation of their performance of activities, and the impact of different aspects of treatment. Recovery expectation is a person's appraisal of several factors to determine when they are likely to return to their usual activities during an episode of non-chronic NSLBP. Health professionals should explore the person's perception of these factors as part of a tailored intervention to prevent non-chronic NSLBP progressing to chronic NSLBP.
Publisher: Hindawi Limited
Date: 22-04-2014
DOI: 10.1111/IJCP.12444
Abstract: To systematically review the evidence for health coaching for patients with low back pain and describe the ersity of health coach training and interventions. Electronic databases Medline, CINAHL, EMBASE, PsycINFO, AMED and the Cochrane Central Register of Controlled Trials were searched to 24 June 2013 using in idually devised strategies. Randomised or quasi randomised controlled trials (RCTs) of health coaching for adults with low back pain of any duration were considered. The overall quality of the body of evidence was assessed using the GRADE approach. Treatment effects were presented as the difference in mean scores with 95% confidence intervals and standardised mean difference at follow-up between health coaching and control groups. Health coaching interventions were compared narratively by their theoretical principles and the training and assessment of heath coaches. Five publications describing three RCTs and one cluster RCT met the criteria for review. A rating of very low was assigned to the body of evidence using the GRADE approach. One RCT found significant improvements in lifting capacity and exercise compliance in favour of the health coaching group at both follow-up points with a large and moderate standardised mean difference. All included studies based health coaching interventions on the transtheoretical model of change however, the content of counselling programmes varied between studies and measures of treatment fidelity were inconclusive. Variability in health coaching interventions and a lack of assessment of treatment fidelity in addition to the very low rating of the overall body of evidence identified in the current review renders any estimates of the effect of health coaching on low back pain uncertain. Well-designed RCTs of patients with sub-acute low back pain are required that incorporate clearly described protocols for health coaching interventions and include standardised measures of treatment fidelity.
Publisher: Elsevier BV
Date: 03-2012
Publisher: Springer Science and Business Media LLC
Date: 06-01-2009
DOI: 10.1007/S10926-008-9161-0
Abstract: The aim of the current review was to determine the predictive strength of low recovery expectations for activity limitation outcomes in people with non-chronic NSLBP. A systematic review of prognostic studies was performed. Included studies took baseline measures in the non-chronic phase of NSLBP, included at least one baseline measure of recovery expectation, defined as a prediction or judgement made by the person with NSLBP regarding any aspect of prognosis, and studied a s le with at least 75% of participants with NSLBP. Recovery expectations measured using a time-based, specific single-item tool produced a strong prediction of work outcome. Recovery expectations measured within 3 weeks of NSLBP onset provide a strong prediction of outcome. It is not clear whether predictive strength of recovery expectations is affected by the length of time between the expectation measure and outcome measure. Recovery expectations when measured using a specific, time-based measure within the first 3 weeks of NSLBP can identify people at risk of poor outcome.
Publisher: Elsevier BV
Date: 06-2008
DOI: 10.1016/J.MATH.2007.01.008
Abstract: The purpose of the study was to explore the construct validity of three versions of the Oswestry Disability Questionnaire for low back pain using Rasch analysis. The three versions of the ODQ share 9 items and differ on one other. About 100 patients with non-specific low back pain seeking physiotherapy treatment at hospital outpatient departments and physiotherapy private practices completed the 12 Oswestry items as part of a battery of questionnaires. Rasch analysis revealed that four items (Personal Care, Standing, Sex Life and Social Life) had disordered response thresholds and one item (Walking) showed differential item functioning by age. The 10 standard Oswestry items and a modified version in which Sex Life is replaced by Work/Housework showed adequate overall fit to the Rasch model (chi(2)P>.01). The third version, in which Sex Life is replaced by Changing Degree of Pain, did not fit the model (chi(2)P=.006) and the Changing Degree of Pain item was misfitting (residual 2.34, P=.007). These findings suggest that either of the first two of the three versions of this widely used low back pain outcome measure should be selected over the third. Users should also be aware that for some items the rating scale steps do not perform as intended.
Publisher: Springer Science and Business Media LLC
Date: 24-02-2009
DOI: 10.1007/S11136-009-9456-4
Abstract: The aim of this study was to examine fit of the original 24-item Roland-Morris Disability Questionnaire and three short-form versions to a Rasch model with particular attention to targeting of item difficulty and to differential item functioning. Cross-sectional survey of 140 people with low back pain seeking physiotherapy treatment. Data were analysed using a dichotomous Rasch model. All versions showed adequate overall data fit to the Rasch model, with few misfitting items. Person separation was around 0.85 for all versions. Item 5 (use a handrail to get upstairs) showed differential item functioning by age. Targeting of persons of high ability was poor and short-form versions also had poor targeting of persons of low ability. Items of similar difficulty clustered in the centre of the logit scale. Although the Roland data fit the Rasch model, there were insufficient items of higher difficulty to sufficiently evaluate disability in persons with mild disability. Short-form versions also lacked items of lower difficulty.
Publisher: Springer Science and Business Media LLC
Date: 2008
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2004
DOI: 10.1097/01.BRS.0000103346.38557.73
Abstract: A prospective repeated measures design was used to produce a back-specific version of the Short Form-36 Physical Functioning scale (SF-36 PF) by Rasch analysis of a pool of items from the SF-36 PF, Oswestry Disability Questionnaire, and the Quebec Back Pain Disability Scale. To identify items for a back-specific version of the SF-36 PF scale and to compare the psychometric properties of the new version with the original 10-item scale. Adequate assessment of patient function requires the administration of a generic and a condition-specific questionnaire. A back-specific version of the SF-36 PF would facilitate comprehensive patient assessment in the clinical setting. Consecutive patients with low back pain presenting for physiotherapy treatment were recruited at three public hospitals, three community health services, and four private practices. Patients completed questionnaires on two occasions 6 weeks apart. A scale of 18 items showed a better fit to the Rasch model than the original SF-36 PF scale. Items in the original scale that had a poor fit (INFIT/OUTFIT statistics outside the range 0.7-1.3) showed an acceptable fit in the new scale. The augmented scale had comparable reliability and improved responsiveness to the original 10-item SF-36 PF scale. The minimum detectable change (90% confidence) and the minimum clinically important difference were 12 points. Floor and ceiling effects were practically eliminated. The psychometric properties of the new scale were comparable to those of the Oswestry Disability Questionnaire. The Low-Back SF-36 PF18 comprises the 10-item SF-36 PF scale and four items each from the Oswestry and Quebec back pain questionnaires. The possible total score ranges from 0 to 100, with a higher score indicating better function. The new scale appears to offer advantages over the use of the original scale for the assessment of functioning in patients with low back pain.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 03-2011
Publisher: Elsevier BV
Date: 04-2008
DOI: 10.1016/J.APMR.2007.10.021
Abstract: To investigate the validity of item score summation for the original and modified versions of the Barthel Index. Rasch analysis of Barthel Index data. General medical wards at 2 acute care hospitals in Australia. Consecutive older medical patients (N=396). Not applicable. Activity limitation was assessed by using the Barthel Index at hospital admission and discharge. At 1 hospital site, the original Barthel Index was used, and at the other hospital site the Modified Barthel Index (MBI) was used. More than half of the items showed misfit to the Rasch model for both versions of the Barthel Index. The continence items appear to measure a different construct to the other items. After the removal of the continence items, data for the remaining items still did not fit the Rasch model. Neither the original nor the MBI are unidimensional scales. An exception to this occurred when the original Barthel Index was rescored and only then for discharge and not for admission Barthel Index data. Because clinicians do not typically rescore outcomes obtained by using the Barthel Index, these findings, combined with unacceptable ceiling effects, render the Barthel Index an assessment tool with limited validity for measuring and monitoring the health of older medical patients.
Publisher: Wiley
Date: 2010
DOI: 10.1002/PRI.493
Abstract: The de Morton Mobility Index (DEMMI) is an instrument that accurately measures the mobility of older people across clinical settings. To report the multiple reliability studies conducted during the development and validation of the DEMMI. Intra-rater and inter-rater reliability studies were conducted for the DEMMI in two independent s les (development and validation s les) of older acute medical patients (aged 65 years or older). Inter-rater reliability studies were conducted between the test developer (a physiotherapist) and another experienced physiotherapist. Order of assessor administration was randomized by a coin toss. Patients who were fatigued after the first assessment were excluded from the inter-rater reliability study. Intra-rater reliability studies included participants with 'unchanged' mobility status between hospital admission and discharge. Scale reliability estimates were expressed as the minimal detectable change with 90% confidence (MDC90 ). Item reliability was calculated using Kappa statistics and absolute percentage agreement. The MDC90 for the DEMMI development s le was 9.51 points (95% confidence interval [95% CI], 5.04-13.32 n=21) and 7.84 (95% CI, 4.34-11.65 n=16) on the 100-point interval DEMMI scale for the inter-rater and intra-rater reliability studies, respectively. Similar estimates were obtained for the DEMMI validation s les of 8.90 (95% CI, 6.34-12.69 n=35) and 13.28 points (95% CI, 8.08-20.87 n=19). Items were not excluded from the DEMMI based on the results of item reliability. Reliability estimates for the DEMMI were consistent across independent s les of older acute medical patients using different reliability study methodology. Error represents approximately 9% of the DEMMI scale width.
No related grants have been discovered for Megan Davidson.