ORCID Profile
0000-0002-4556-9159
Current Organisation
James Cook University
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Publisher: Wiley
Date: 30-05-2012
DOI: 10.1111/J.1365-2923.2012.04295.X
Abstract: Education in simulated learning environments (SLEs) has grown rapidly across health care professions, yet no substantive randomised controlled trial (RCT) has investigated whether SLEs can, in part, substitute for traditional clinical education. Participants were physiotherapy students (RCT 1, n = 192 RCT 2, n = 178) from six Australian universities undertaking clinical education in an ambulatory care setting with patients with musculoskeletal disorders. A simulated learning programme was developed as a replica for clinical education in musculoskeletal practice to replace 1 week of a 4-week clinical education placement. Two SLE models were designed. Model 1 provided 1 week in the SLE, followed by 3 weeks in clinical immersion Model 2 offered training in the SLE in parallel with clinical immersion during the first 2 weeks of the 4-week placement. Two single-blind, multicentre RCTs (RCT 1, Model 1 RCT 2, Model 2) were conducted using a non-inferiority design to determine if the clinical competencies of students part-educated in SLEs would be any worse than those of students educated fully in traditional clinical immersion. The RCTs were conducted simultaneously, but independently. Within each RCT, students were stratified on academic score and randomised to either the SLE group or the control ('Traditional') group, which undertook 4 weeks of traditional clinical immersion. The primary outcome measure was a blinded assessment of student competency conducted over two clinical examinations at week 4 using the Assessment of Physiotherapy Practice (APP) tool. Students' achievement of clinical competencies was no worse in the SLE groups than in the Traditional groups in either RCT (Margin [Δ] ≥ 0.4 difference on APP score RCT 1: 95% CI - 0.07 to 0.17 RCT 2: 95% CI - 0.11 to 0.16). These RCTs provide evidence that clinical education in an SLE can in part (25%) replace clinical time with real patients without compromising students' attainment of the professional competencies required to practise.
Publisher: CSIRO Publishing
Date: 2020
DOI: 10.1071/PY20148
Abstract: Effective interprofessional collaboration (IPC) contributes to superior patient outcomes, facilitates cost-efficient health care, and increases patient and practitioner satisfaction. However, there is concern that IPC may be difficult to implement in clinical settings that do not conform to formal team-based processes, such as mono-professional physiotherapy private practice facilities. The aim of this study was to describe the characteristics of private physiotherapy practitioners’ interprofessional interactions, including their experiences and perceptions regarding IPC. A custom developed cross-sectional online survey instrument was used to collect data from physiotherapists employed in private practice facilities in Queensland, Australia. In all, 49 (20% response rate) physiotherapists completed the survey. Only a small proportion (14%) indicated that their interprofessional interactions were a daily occurrence, and less than one-third of all respondents (31%) participated in formal, multi-professional face-to-face planned meetings. Most participants (76%) reported a moderate-to-high level of satisfaction regarding their interprofessional interactions. Despite low self-reported levels of interprofessional activity and other data indicating that IPC is necessary for holistic patient care, this study shows that physiotherapists were predominately satisfied when interacting with health practitioners from various professional backgrounds. Further research is required to inform the implementation of robust strategies that will support sustainable models of IPC in physiotherapy private practice.
Publisher: Elsevier BV
Date: 12-2023
Publisher: Nova Southeastern University
Date: 2015
DOI: 10.46743/1540-580X/2015.1525
Abstract: Introduction: Decisions about physiotherapy service provision occur within the context of organisations, locations, and settings. The uniqueness of rural communities means it is important to consider contextual factors when making decisions about rural health services. As literature describing decision making about rural physiotherapy services is limited, this study sought perspectives on service level decision making (SLDM) from a range of stakeholders. The research approach needed to support consideration of both location and the broader health system. Method: A sequential mixed methods approach within a systems theory-case study heuristic provided the framework to explore rural physiotherapy SLDM. The investigation site, a large area of one Australian state, contained a mix of regional, rural, and remote communities. Perspectives on SLDM were obtained through surveys of physiotherapists, colleagues, and managers, with follow up interviews of a purposeful s le of participants. Results: Responses from physiotherapists, colleagues, manager surveys (n=34), and in-depth interviews (n=19) revealed commonalities and differences between sites and sectors. Available skill and expertise were common considerations across sites. Decisions about prioritisation of services occurred in both public and private settings however, organisational priorities were a greater influence in the public sector and financial viability in the private sector. Service size influenced the perceived degree of autonomy of physiotherapists in SLDM, with physiotherapists in smaller sites having more independence. Directions from health facility management and the increasing need to prioritise services were reflected in physiotherapy responses from larger facilities. National health reforms and state level priorities were noted as influencing factors, as were connection to community, rurality, and the distance from decision makers. Conclusion: This study provides insight into decisions informing rural physiotherapy service provision. Understanding context and ersity is important to understanding local health service decisions. System level influences from macro and meso level decision makers provide the framework within which micro level physiotherapy SLDM occurs. Service sector, size and rurality then further qualify local service options and influence SLDM. Decisions about service provision need to take into consideration the current availability of services, the context of each location and skill mix required.
Publisher: Nova Southeastern University
Date: 29-06-2022
DOI: 10.46743/1540-580X/2022.2130
Abstract: Purpose: Extended scope physiotherapists (ESPs) are an innovative approach to service delivery that have emerged in response to increasing pressures on emergency departments (EDs). While previous systematic reviews have suggested that ESPs have a positive impact on ED outcomes, clinical practice recommendations based on limited evidence highlight a pressing need for evaluation studies to truly determine their effectiveness and safety in this setting. Therefore, the objective of this systematic review and meta-analysis was to evaluate the clinical effectiveness and safety of ESPs when delivering services in EDs. Method: Systematic literature searches were conducted using the online databases: Medline (Ovid), CINAHL (EBSCOhost), Scopus, PEDro, Cochrane Library and Informit in October, 2019. Randomised controlled trials (RCTs) or cohort studies investigating the clinical effectiveness and safety of ESPs in EDs in comparison with usual ED medical care providers were eligible for inclusion. Data extraction was completed using a form specifically developed for the study. The quality of each study was assessed using the Crowe Critical Appraisal Tool (CCAT) as well as a subjective assessment of bias, and the level of evidence was graded using the National Health and Medical Research Council (NHMRC) evidence hierarchy. Random-effects model meta-analyses were conducted using Stata (version 16.1). Results: Eleven studies met the inclusion criteria for the systematic review. These studies provided III-1 to III-3 evidence, with quality scores ranging from 50% to 93%. Consistent positive results were found regarding ESP clinical effectiveness and safety with meta-analyses demonstrating significant reductions in wait time (Cohen’s d effect size: -0.54 95% confidence interval [CI]: -0.64 to -0.45) and length of stay (Cohen’s d effect size: -0.79 95% CI: -0.86 to -0.72) for patients managed by ESPs. Although, confounding of results by treatment urgency made it difficult to establish a clear causal link between ESP services and outcomes. Conclusion: Although it was not able to be suggested that ESPs are an appropriate substitute for usual ED medical care due to the presence of bias and confounding, the results highlighted that ESPs, as an additional staff member in EDs, improve throughput and access to care for patients in lower urgency triage categories.
Publisher: Ovid Technologies (Wolters Kluwer Health)
Date: 02-2013
Publisher: Informa UK Limited
Date: 18-03-2011
Publisher: Nova Southeastern University
Date: 2020
DOI: 10.46743/1540-580X/2020.1919
Abstract: Background: Interprofessional collaboration is a complex process defined by the relationships and interactions between health practitioners from erse professional backgrounds. Although the benefits of a collaborative health workforce are widely acknowledged, it is currently poorly understood to what extent private physiotherapy practitioners engage in interprofessional collaboration as a part of their clinical practice, and whether they consider to be adequately trained in this area. Information regarding the frequency, modes of communication, and perceived level of satisfaction associated with private physiotherapy practitioners’ interprofessional interactions is also limited. Purpose: The aim of this paper is to describe the development of a survey instrument that can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Methods: A multiphase process was used to develop the survey instrument. The research team conducted a literature search which resulted in the generation of 34 in idual survey items. After the initial pool of survey items was developed, three experienced physiotherapists were invited to review the items. The draft survey instrument was then subject to online testing with private physiotherapy practitioners to evaluate the utility of the instrument. Results: All three physiotherapists invited to review the initial pool of survey items provided written feedback to the research team. Following revision, five private physiotherapy practitioners participated in pilot testing the survey instrument. Pilot testing revealed that approximately 10 minutes was required to complete the online survey. Conclusions: The final survey instrument has 29 questions in six sections with categorical, Likert and free text response options and can be used to explore the characteristics of Australian private physiotherapy practitioners’ interprofessional interactions. Information obtained from future research projects utilising this survey may guide the development of effective interventions aimed at enhancing the nature and quality of clinical interactions between private physiotherapy practitioners and other health practitioners working in Australia.
Publisher: Elsevier BV
Date: 09-2018
DOI: 10.1016/J.PHYSIO.2017.08.011
Abstract: Chest physiotherapy (CPT) is implemented before and after congenital heart disease (CHD) surgery in paediatrics to prevent and treat postoperative pulmonary complications (PPC). Currently, there are no systematic reviews or meta-analyses on the efficacy of CPT in this population. To conduct a systematic review and meta-analysis to determine whether peri-operative CPT is safe and effective for paediatric patients with CHD. A literature search was conducted on PEDro, MEDLINE, CINAHL, Informit, The Cochrane Library and Scopus in March and April 2016. English peer-reviewed articles that utilised CPT before or after cardiac surgery for paediatric CHD. Systematic reviews were excluded. Completed by two independent researchers using the Crowe Critical Appraisal Tool. Data were collated using a piloted data extraction tool. Mix Version 2.0.1.4 was used for meta-analysis, and data were extracted using an odds ratio (with a random effects model). Eleven studies met the inclusion criteria for the systematic review. Variable results were found regarding the effect of CPT on peripheral oxygen saturation and pain. Meta-analysis showed that CPT did not prevent pneumonia (odds ratio (OR) 2.01 95% confidence interval (CI) 0.80 to 5.05 P=0.13), and did not prevent or treat atelectasis (OR 1.27 95% CI 0.18 to 8.87 P=0.81). There was a lack of high-quality studies. The included studies were comprised of heterogeneous treatment, limiting external validity. Active therapies such as mobilisation, deep breathing and incentive spirometry were more effective than passive treatment. Percussion led to oxygen desaturation, and percussion, vibration and suctioning increased the risk of developing atelectasis. Systematic review registration number CRD42015024768.
Publisher: Wiley
Date: 06-2014
DOI: 10.1111/AJR.12110
Abstract: To obtain stakeholder perspectives on factors influencing rural physiotherapy service provision and insights into decision making about service provision. Purposive s ling, open-ended survey questions and semi-structured interviews were used in this exploratory, qualitative study. A rural centre and its regional referral centre formed the pilot sites. Nine participant perspectives were obtained on rural physiotherapy services. Stakeholder perspectives on factors influencing rural physiotherapy service provision and service level decision making. Workforce capacity and capability, decision maker's knowledge of the role and scope of physiotherapy, consideration of physiotherapy within resource allocation decisions and proof of practice emerged as key issues. The latter three were particularly reflected in public sector participant comments. Business models and market size were identified factors in influencing private practice. Influencing factors described by participants both align and extend our understanding of issues described in the rural physiotherapy literature. Participant insights add depth and meaning to quantitative data by revealing impacts on local service provision. Available funding and facility priorities were key determinants of public sector physiotherapy service provision, with market size and business model appearing more influential in private practice. The level of self direction or choice about which services to provide, emerged as a point of difference between public and private providers. Decisions by public sector physiotherapists about service provision appear constrained by existing capacity and workload. Further research into service level decision making might provide valuable insights into rural health service delivery.
Publisher: Informa UK Limited
Date: 2008
Publisher: Informa UK Limited
Date: 16-04-2020
Publisher: Public Library of Science (PLoS)
Date: 23-02-2022
DOI: 10.1371/JOURNAL.PONE.0263683
Abstract: Handgrip strength (HGS), lung function and health-related quality of life (HRQoL) are relevant indicators of future cardiovascular risk and mortality. The impact of cardiac surgery on these predictive variables has been under-explored. The aim of this study was to determine the acute (within hospital) changes in HGS, lung function and HRQoL, and their relationships, in adults undergoing elective cardiac surgery. Further, the study examined the relationship between these variables and the predictors for lung function and HRQoL in these patients. The study was a prospective cohort study that involved 101 patients who completed pre-operative (1–2 days before surgery) and physiotherapy discharge (5–7 days after surgery) assessments. Handgrip strength, lung function and HRQoL were assessed using JAMAR dynamometers, Vitalograph-Alpha or EasyOne spirometer, and Short-Form 36 questionnaire, respectively. Changes in these variables and their relationships were analysed using paired t-test and Pearson correlation coefficients, respectively. Prediction of lung function and HRQoL using HGS and other co-variates was conducted using regression analysis. At the time of physiotherapy discharge, lung function, HGS and the physical component of HRQoL were significantly ( .001) reduced compared to their pre-operative values. Significant ( .001) and moderate correlations were identified between HGS and lung function at pre-operation and physiotherapy discharge. Handgrip strength was a significant predictor of lung function pre-operatively but not at physiotherapy discharge. Pre-operative lung function and HRQoL, as well as other variables, were significant predictors of lung function and HRQoL during physiotherapy discharge. Undergoing cardiac surgery acutely and significantly reduced lung function, HGS and physical component of HRQoL in adults with cardiac disease. Assessment of HGS at physiotherapy discharge may be a poor indicator of operative changes in lung function and HRQoL. Clinicians may consider HGS as an inadequate tool in predicting lung function and HRQoL following cardiac surgery.
Publisher: Wiley
Date: 14-02-2022
DOI: 10.1111/AJR.12843
Abstract: To identify the attitudes and perspectives of speech pathologists, occupational therapists and physiotherapists on using telehealth videoconferencing for service delivery to children with developmental delays. Systematic Literature Review. An electronic search of databases Scopus, CINAHL, MEDLINE, PEDro, Speechbite, OTseeker and ScienceDirect was undertaken in October 2020. Articles were compared with eligibility criteria by 2 authors. All articles were appraised for quality and level of evidence. Fourteen studies were deemed to be eligible. Results were synthesised using a narrative analysis. The themes identified were technology, self‐efficacy, replacement of face‐to‐face services, time management, relationships, access and family‐centred care. Each of these themes was seen as both a potential barrier and a facilitator when trying to provide services via telehealth. The results in this review cannot be generalised due to small s ling size, low response rates, lack of maximum variation s ling and under‐representation of occupational therapists and physiotherapists. Study design was either mixed‐methods survey or interview or only survey or interview. Risk of bias in studies was high. Further research is required including comparison studies and cost‐benefit analysis.
Publisher: Elsevier BV
Date: 2011
DOI: 10.1016/J.ARCHGER.2009.11.005
Abstract: What effect does body position have on cardio-respiratory variables in active older people? An experimental laboratory study was undertaken measuring heart rate, systolic and diastolic blood pressure and oxygen saturation when 26 active people aged 60 years and over adopted five standardized body positions. Measurements were taken every 2 min over a 10-min period in sitting, right side lying, left side lying, supine and supine with the head 20° below the level of the body. Rate pressure product and mean arterial pressure were calculated. Smoking history, medication use, health conditions and activity level were recorded. Height, weight and body fat were measured. Left and right side lying produced significantly lower diastolic and systolic blood pressure, rate pressure product and mean arterial pressure than supine with the head down. Excluding oxygen saturation mean values for all variables remained within recommended normal limits in all positions. Significant differences in cardio-respiratory variables occur when active older people change body position. Positioning as a treatment intervention appears safe in supine, side lying and sitting for this population. Head down supine position should be adopted with caution.
Publisher: Hindawi Limited
Date: 09-2015
DOI: 10.1111/HSC.12121
Abstract: Children with cerebral palsy have complex healthcare needs and often require complex multidisciplinary care. It is important for clinicians to understand which approaches to healthcare service delivery for this population are supported in the literature and how these should be applied in clinical practice. This narrative review aims to identify and review the evidence for current approaches to healthcare service delivery for children with cerebral palsy. Databases were searched using key terms to identify relevant research articles and grey literature from December 2011 to September 2013. Search results were screened and sorted according to inclusion and exclusion criteria. Thirty-two documents were included for evaluation and their content was analysed thematically. Three current approaches to healthcare service delivery for children with cerebral palsy identified in this narrative review were family-centred care, the World Health Organisation's International Classification of Functioning, Disability and Health, and collaborative community-based primary care. However, healthcare services for children with cerebral palsy and their families are inconsistently delivered according to these approaches and the identified guidelines or standards of care for children with cerebral palsy have limited incorporation of these approaches. Future research is required to investigate how these approaches to healthcare service delivery can be integrated into clinical practices to enable clinicians to improve services for this population.
Publisher: Nova Southeastern University
Date: 04-2023
DOI: 10.46743/1540-580X/2023.2304
Abstract: Purpose: Assessment of recovery in post-cardiac surgical patients is commonly conducted using lung function, dominant handgrip strength (DHGS), and health-related quality of life (HRQoL). The aim of this study was to determine the recovery of lung function, DHGS and HRQoL in cardiac surgical patients at six-weeks and six-months after hospital discharge. Further, this study investigated the association between these parameters and the predictive ability of DHGS for lung function and HRQoL. Methods: This was a prospective observational study that involved 58 cardiac surgical patients who completed lung function, DHGS, and HRQoL assessments pre-operatively, at six-weeks, and six-months after hospital discharge. Lung function was assessed using three different calibrated spirometers, while DHGS was measured using three different calibrated handgrip dynamometers. The Short-Form 36 questionnaire was utilized for HRQoL assessment. Results: At six-weeks after hospital discharge, lung function and DHGS were significantly (pConclusion:Variable changes were identified in lung function, DHGS, and HRQoL in cardiac surgical patients at six-weeks and six-months after hospital discharge. Dominant hand grip strength may have limited or no value in predicting lung function and HRQoL in cardiac surgical patients during the intermediate recovery period.
Publisher: Informa UK Limited
Date: 08-06-2023
Publisher: Nova Southeastern University
Date: 2017
DOI: 10.46743/1540-580X/2017.1650
Abstract: Purpose: Simulation in physiotherapy education is increasing, but a standardised assessment tool for student performance in simulation has not been developed. The Assessment of Physiotherapy Practice (APP) is a validated tool for student performance in the clinical workplace, and has been used recently for simulation despite its relevance for this context being unknown. The purpose of the study was to gain consensus about which APP items should be included in a tool to assess physiotherapy students’ performance in simulation. The relevance of items was considered for both single patient encounters, and longitudinal (multiple) encounters. Methods: An online Delphi approach used a custom designed survey. A purposive s le of physiotherapists with simulation experience was recruited via email. Two rounds were undertaken with consensus being reached when at least 80% of the panel agreed on inclusion or exclusion of an item. Results: Twenty participants responded in the first round and fourteen in the second (70% retention). For longitudinal simulations, all APP items reached consensus in the first round. For single patient simulation encounters, consensus was not reached in the first round for the following items: commitment to learning (61%), teamwork (76%) and discharge planning (72%). In the second round, consensus for ‘teamwork’ remained the only item below eighty percent agreement (78.6%). Conclusions: The APP was deemed to be an appropriate measure for longitudinal clinical simulations, and with the exclusion of teamwork, for a single patient simulation encounter.
Publisher: Informa UK Limited
Date: 25-03-2014
DOI: 10.3109/09593985.2014.900835
Abstract: The aim of this study was to assess the concurrent validity and reliability of the Simple Goniometer (SG) iPhone® app compared to the Universal Goniometer (UG). Within subject comparison design comparing the UG with the SG app. James Cook University, Townsville, Queensland, Australia. Thirty-six volunteer participants, with a mean age of 60.6 years (SD 6.2). Not applicable. Thirty-six participants performed three standing lunges during which the knee joint angle was measured with the SG app and the UG. There were no significant differences in the measures of in idual knee joint angles between the UG and the SG app. Pearson correlations of 0.96-0.98 and intraclass correlation coefficients of 0.97-0.99 (95% confidence interval: 0.95-1.00) were recorded for all measures. Using the Bland-Altman method, the standard error of the mean of the differences and the standard deviation of the mean of the differences were low. The measurements from the SG iPhone® app were reliable and possessed concurrent validity for this s le and protocol when compared to the UG.
Publisher: Elsevier BV
Date: 05-2015
Publisher: Elsevier BV
Date: 08-2018
Publisher: Springer Science and Business Media LLC
Date: 12-2017
Publisher: Nova Southeastern University
Date: 29-06-2022
DOI: 10.46743/1540-580X/2022.2165
Abstract: Background: Spirometry via telehealth (telespirometry) involves remote monitoring of lung function, which is useful to detect pulmonary changes and increase continuity of care for patients with cystic fibrosis (CF). Purpose: This systematic review aims to evaluate the feasibility and efficacy of telespirometry assessments for paediatric and adult CF patients. Method: A comprehensive search of health-related databases (CINAHL, Emcare (Ovid), Medline (Ovid), PEDRo and Scopus) was conducted. For inclusion, patients had to be clinically diagnosed with CF and studies could be of any study design or level according to the National Health and Medical Research Council (NHMRC) evidence hierarchy, had to use telespirometry devices for lung function tests, and be written or translated into English. The Crowe Critical Appraisal Tool (CCAT) was used to assess study quality, while also accounting for potential sources of bias encountered during the review process. Data was exported and summarised using the population, intervention, comparators, and outcomes (PICO) framework in Microsoft excel, to provide clinical recommendations. Results: Fourteen studies were included, with participants ranging from 5 to 44-years-old. Thirteen trials were performed domestically, while s le sizes and baseline patient characteristics varied. Nine studies analysed a control and intervention group. All studies varied in the intervention regime and clinical support provided. Collectively, the literature indicated poor patient adherence to telespirometry, which acted as a barrier to gauging its efficacy. Although appearing to be effective in detecting pulmonary deterioration, inconsistencies in pulmonary exacerbation (PEx) criteria were identified and lack of significant improvements in pulmonary outcomes were observed. Conclusion: Poor quality literature and small s le sizes increased risk of bias and restricted the application of the results to clinical practice. The current evidence base is limited by minimal experimental studies, lack of standardised telespirometry protocols, and criteria for PExs and poor patient compliance. Recommendations: At this stage, telespirometry for CF monitoring should be used by motivated and rurally/remotely located patients to complement in-person consults until its uptake is improved and accuracy and clinically efficacy can be ascertained.
Publisher: Springer Science and Business Media LLC
Date: 27-03-2015
Publisher: Nova Southeastern University
Date: 31-03-2022
DOI: 10.46743/1540-580X/2022.2124
Abstract: Purpose: The purposes of the study are to (1) determine what barriers and facilitators physiotherapists perceive to using telehealth, (2) to determine willingness to use and (3) to determine perspectives on training in the use of telehealth. Method: This is a qualitative semi structured interview and focus group design. Participants were recruited from the first stage of the larger research process using purposive s ling. A semi structured guide was used to facilitate discussion of shared experiences and to allow themes to emerge from the discussion. Results: Thematic analysis was used to synthesise frequent and important themes. Ten participants took part in either a focus group (n=7) or interview (n=3). Nine main themes identified were split into barriers and facilitators. Facilitators were the right family, right child, adequate technology and space, and collaboration. Barriers were technology, time management, lack of physical touch, lack of organisational support, and work environment. Conclusion: Results suggest that physiotherapists working with children with developmental delay consider telehealth to be unsuitable to replace face-to-face therapy entirely but are willing to use it to provide follow up services to the right family and the right child. Physiotherapists in the study were positive about telehealth’s potential to improve services to children in rural areas. Physiotherapists said that specific physiotherapy training in telehealth was currently lacking.
Publisher: Nova Southeastern University
Date: 30-09-2022
DOI: 10.46743/1540-580X/2022.2147
Abstract: Purpose: The aim of this study was to determine the inter-instrument reliability of different dynamometers and spirometers commonly used in clinical practice. Methods: The study involved 113 healthy volunteers across three facility sites. At each site, dominant handgrip strength (DHGS), and lung function (forced expiratory volume in one second [FEV1], forced vital capacity [FVC] and peak expiratory flow rate [PEFR]), were compared using a local and reference device. Assessments were randomized with five minutes rest between measurements. Significant differences between devices were assessed using paired t-test while relative reliability between devices was determined via intra-class correlations (ICC). Accuracy index and variability between measurements were assessed using the technical error of measurement (TEM%) and coefficient of variation (CV), respectively. Agreement between devices was determined using the Bland Altman’s plot with limits of agreement (LOA). Results: The local devices recorded significantly (p1 (3.1%-8.4%), FVC (3.1%-13%) compared to the reference devices. Good-excellent correlations (ICC=0.89-0.96), unacceptable CV (5.8-9.9%) and TEM% (6.6-9.9%), and large mean biases (3-9kg) and LOA (3-23kg) were identified between the local and reference dynamometers. Excellent correlations (ICC=0.91-0.99), and mostly unacceptable CV and TEM% were identified between the local and reference spirometers for FVC and PEFR. Compared to the reference device, all local spirometers showed unacceptable (-0.134 to -0.536 liters) and acceptable (-0.12 to 0.05 liters/second) mean biases for FVC and PEFR, respectively. Conclusion: Unacceptable inter-instrument reliability was identified between local and reference dynamometers and spirometers for measuring DHGS and all lung function indices, respectively. Across clinical settings, comparing DHGS and lung function between different brands of devices may lead to the reporting of erroneous results with corrective adjustments required for clinical practice.
Publisher: CSIRO Publishing
Date: 2010
DOI: 10.1071/AH08681
Abstract: The experience of returning to physiotherapy practice needs to be understood from the perspective of those who have returned to practice, those thinking of returning, and clinical supervisors who have worked with people that have returned to practice. A qualitative methodology using an interpretivist theoretical framework was utilised. Participants were selected using a combination of purposive and snowballing s ling techniques. Semi-structured interviews were conducted to determine the opinions of participants on returning to physiotherapy. Maternity and child-care were the main reason returners and potential returners took a break from physiotherapy. The main reason for returning to physiotherapy was because the returner wanted to rather than external factors such as financial hardship. Overall, the experience of returning to physiotherapy has been rewarding for returners and clinical supervisors. Returners and potential returners were highly motivated, keen to learn, and are willing to undertake a period of training to help them return to practice. However, there is only one programme available for returners to re-register as a physiotherapist and no refresher programmes are available. Returners, potential returners, and clinical supervisors thought that a structured re-registration or re-entry programme would need to be flexible to allow for returners’ current needs, commitments, and career directions. What is known about the topic?In nursing, reasons for returning to the profession are change in family circumstance, financial necessity or wishing to use their skills again. Little is known of the circumstances for other health professionals. What does this paper add?Return to physiotherapy was driven by personal motivation rather than financial hardship. Returners are highly motivated, keen to learn, and are willing to undertake a period of training to help them return to practice. What are the implications for practitioners?Flexible methods to enable return to practice are needed. Time away from practice needs to be managed to enable seamless returns, facilitating workforce strategies.
Publisher: Wiley
Date: 21-04-2015
DOI: 10.1002/PRI.1627
Abstract: Understanding decision-making about health service provision is increasingly important in an environment of increasing demand and constrained resources. Multiple factors are likely to influence decisions about which services will be provided, yet workforce is the most noted factor in the rural physiotherapy literature. This paper draws together results obtained from exploration of service level decision-making (SLDM) to propose 'conceptual' models of rural physiotherapy SLDM. A prioritized qualitative approach enabled exploration of participant perspectives about rural physiotherapy decision-making. Stakeholder perspectives were obtained through surveys and in-depth interviews. Interviews were transcribed verbatim and reviewed by participants. Participant confidentiality was maintained by coding both participants and sites. A system theory-case study heuristic provided a framework for exploration across sites within the investigation area: a large area of one Australian state with a mix of regional, rural and remote communities. Thirty-nine surveys were received from participants in 11 communities. Nineteen in-depth interviews were conducted with physiotherapists and key decision-makers. Results reveal the complexity of factors influencing rural physiotherapy service provision and the value of a systems approach when exploring decision-making about rural physiotherapy service provision. Six key features were identified that formed the rural physiotherapy SLDM system: capacity and capability contextual influences layered decision-making access issues value and beliefs and tensions and conflict. Rural physiotherapy SLDM is not a one-dimensional process but results from the complex interaction of clusters of systems issues. Decision-making about physiotherapy service provision is influenced by both internal and external factors. Similarities in influencing factors and the iterative nature of decision-making emerged, which enabled linking physiotherapy SLDM with clinical decision-making and placing both within the broader healthcare context. The conceptual models provide a way of thinking about decisions informing rural physiotherapy service provision. Copyright © 2015 John Wiley & Sons, Ltd.
Publisher: Informa UK Limited
Date: 15-03-2011
Publisher: Elsevier BV
Date: 12-2015
DOI: 10.1016/J.PHYSIO.2015.04.001
Abstract: Physiotherapy in intensive care units (ICU) has traditionally focussed on the respiratory management of mechanically ventilated patients. Gradually, focus has shifted to include rehabilitation in adult ICUs, though evidence of a similar shift in the paediatric ICU (PICU) is limited. Review the evidence to determine the role of physiotherapists in the management of mechanically ventilated patients in PICU. A search was conducted of: PEDro, CINAHL, Medline, PubMed and the Cochrane Library. Studies involving PICU patients who received physiotherapy while invasively ventilated were included in this review. Those involving neonatal or adult ICU patients, or patients on non-invasive or long-term ventilation, were not included in the study. All articles were critically appraised by two reviewers and results were analysed descriptively. Six studies on chest physiotherapy (CPT) met the selection criteria. Results support the use of the expiratory flow increase technique and CPT, especially manual hyperinflation and vibrations, for secretion clearance. Evidence does not support the routine use of either CPT or suction alone. No studies investigating rehabilitation in PICU met selection criteria. A lack of high level evidence was available to inform this review. Evidence indicates that CPT is still the focus of physiotherapy intervention in PICU for mechanically ventilated patients, and supports its use for secretion clearance in this setting. PROSPERO register for systematic reviews (registration no. CRD42014009582).
Publisher: SAGE Publications
Date: 23-02-2015
Abstract: Although current health care service delivery approaches for children with cerebral palsy recognize the importance of including parents in the health care of their child, we do not yet understand how parents experience this phenomenon. In this study, we used grounded theory methodology to explore parents’ experiences of health care for their children with cerebral palsy living in a regional area of Australia. Our findings indicate that parents experience health care for their child as a cyclical process of “making the most of their body and their life.” Important aspects of care include “learning as you go,” “navigating the systems,” “meeting needs through partnership,” “being empowered or disempowered,” and “finding a balance.” We suggest modifications to health care service delivery practices that might contribute to improved experiences of health care for this population.
Publisher: Springer Science and Business Media LLC
Date: 11-0007
Publisher: Informa UK Limited
Date: 18-04-2022
DOI: 10.1080/09593985.2021.1901323
Abstract: Handgrip strength (HGS) is a functional test that has been directly associated with lung function in some healthy populations however, inconsistent findings have been reported for populations with chronic diseases. The aim of this study was to identify the relationship between HGS and lung function in both healthy and unhealthy adults. A systematic search was conducted using six databases from their earliest inception to February 29, 2020. Two authors reviewed and assessed methodological quality of eligible studies using the Crowe Critical Appraisal Tool (CCAT). Twenty-five studies met the inclusion criteria with 8 and 17 studies examining healthy and unhealthy populations, respectively. Reported average methodological quality of all included studies using the CCAT was 38-85% with most rated as Good to Excellent. Despite the use of heterogeneous equipment and protocols during HGS and lung function assessments, significant positive and moderate correlations and/or regression coefficients were reported for healthy populations consistently. Conversely, the reported relationships between HGS and lung function for unhealthy counterparts were variable. Handgrip strength was significantly associated with lung function in most healthy adults. Future robust studies are needed to confirm the suitability of HGS to assess lung function for healthy and unhealthy adults.
No related grants have been discovered for Anne Jones.