ORCID Profile
0000-0002-2322-7692
Current Organisations
University of Notre Dame Australia
,
Fiona Stanley Hospital
,
Rockingham Peel Group
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Publisher: Wiley
Date: 23-10-2021
DOI: 10.1002/NOP2.667
Publisher: Wiley
Date: 06-05-2021
Abstract: To investigate factors contributing to the decision for a working age adult experiencing non‐specific low back pain (NSLBP) to seek care at an Australian metropolitan tertiary ED. Participants triaged with NSLBP were recruited from one metropolitan tertiary Australian ED. We employed a qualitative descriptive methodology using semi‐structured interviews to collect data. The short‐form Orebro musculoskeletal pain screening questionnaire was administered pre‐interview and used to inform discussion of psychosocial factors in the interview. Patient perception and interpretation of their low back pain symptoms was the most important participant decision‐making factor. This was part of the care‐seeking decision for all participants. Convenience of care accessed in the ED was also important with many participants aiming to avoid multiple appointments in primary care settings while in pain or attending ED because it was close to home. Participants expected high‐quality care in the ED and often did not identify an alternative in primary care they believed could provide an equivalent standard of care. Few participants were advised to attend ED by a GP or physiotherapist, but when given, this advice was a critical factor. Patient beliefs about NSLBP are important drivers of ED care seeking. Evidence‐based guidelines recommend screening for red flags and then addressing pain and disability through engagement with patient concerns and providing a management plan athway. In the ED setting, addressing the anxieties of these patients and re‐interpreting the significance of their pain may be a path to providing time efficient high‐value care.
Publisher: Wiley
Date: 10-07-2023
Abstract: This study aimed to establish the demographic profile of adult patients presenting with constipation and constipation‐related issues to an Australian tertiary hospital ED, investigate ED management and referral pathways in this cohort and determine satisfaction of these aspects of care from a patient's perspective. This is a single‐centre study conducted in an Australian tertiary hospital ED which sees 115 000 presentations annually. ED presentations of adults aged 18–80 years with symptoms of constipation were evaluated through retrospective electronic medical record audit and follow‐up by survey 3–6 months after their ED presentation. The patients presenting to the ED with constipation had a median age of 48 years (IQR 33.5–63.5) and arrived self‐referred by private transport. Median length of stay was 292 min. 22% of patients reported they had previously attended the ED for the same issue within the previous year. Diagnosis of chronic constipation was inconsistent, with limited supporting documentation. Constipation was largely managed with aperients. Four in five patients were satisfied with ED care however, 3–6 months post‐ED visit, 92% of patients reported ongoing bowel‐related issues, reflecting the chronic course of functional constipation. This is the first study to investigate the management of constipation in adult patients in an Australian ED setting. It is important that ED clinicians recognise that functional constipation is a chronic condition and many patients have persistent symptoms. There are opportunities for quality‐of‐care improvements including diagnostics, treatment, and referral post‐discharge to allied health, nursing and medical specialist services.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Mary Ann Liebert Inc
Date: 02-2014
Abstract: Back pain is a common and disabling condition for people in rural and remote areas. In these areas, access to rehabilitation services is limited by service availability. Telerehabilitation is suggested as a solution for providing physical therapy services however, the validity of clinical assessment is largely unproven. The aim of this study was to establish the validity of clinically pragmatic remote assessment of spinal posture, active movements of the lumbar spine, and the passive straight leg raise (SLR) test. Face-to-face physical therapist assessment was compared with telerehabilitation assessment of spinal posture, active movements of the lumbar spine, and the SLR test. Twenty-six participants recruited from a rural population with current or recent low back pain (LBP) were assessed by a face-to-face physical therapist and a remote physical therapist. Pain, disability, and clinical measurements were assessed. Outcomes were compared to establish agreement. High levels of agreement were found with detecting pain with specific lumbar movements, eliciting symptoms, and sensitizing the SLR test. Moderate agreement occurred with identifying the worst lumbar spine movement direction, SLR range of motion, and active lumbar spine range of motion. Poor agreement occurred with postural analysis and identifying reasons for limitations to lumbar movements. Conducted in a rural clinical setting, this study validates elements of the physical assessment of the lumbar spine and identifies technical and clinical issues to be addressed by future research. Important components of the standard musculoskeletal assessment of LBP are valid via telerehabilitation in a clinical setting.
Publisher: Elsevier BV
Date: 11-2023
Publisher: Wiley
Date: 17-05-2010
DOI: 10.1002/PRI.471
Abstract: Musculoskeletal injuries are the most common source of chronic pain and disability. The ankle joint is the most common of these injuries and without adequate rehabilitation function can be severely impaired. Access to physiotherapy rehabilitation services can be limited due to geographical remoteness and a shortage of services in rural and remote areas. Telerehabilitation is a potential solution to bridge this service delivery gap. The aim of this study was to determine the criterion validity and reliability of conducting a remote musculoskeletal assessment of the ankle joint complex using telerehabilitation technologies compared with a face-to-face assessment. This study utilized a repeated measures design to assess 15 subjects (mean age 24.5, SD 10.8 years) presenting with ankle pain. Conventional face-to-face assessments were compared with assessments performed via a telerehabilitation system. A similar agreement of 93.3% in patho-anatomical diagnosis and an 80% exact agreement (chi(2) = 4.267 p < 0.04) in primary systems diagnosis was found between face-to-face and telerehabilitation assessments. Clinical observations were found to have very strong agreement (k = 0.92) for categorical data and significant agreement (93.3% agreement chi(2) = 234.4 p < 0.001) for binary data. A high level of inter- and intrarater reliability was found for the telerehabilitation assessments. This study demonstrates the criterion validity and reliability of remote musculoskeletal assessments of the ankle joint complex using telerehabilitation.
Publisher: SAGE Publications
Date: 08-07-2017
Abstract: Lower limb musculoskeletal disorders place a heavy burden on healthcare systems. Appropriate management of these conditions is critical, however access to appropriate physiotherapy services is difficult for those in geographically remote areas or those with mobility or transport difficulties. The aim of this study was to evaluate the accuracy and reliability of an online musculoskeletal physiotherapy assessment of the knee complex using telerehabilitation compared to traditional face-to-face assessment. In a repeated-measures design, 18 subjects who sought treatment for knee pain underwent a traditional face-to-face assessment and a remote telerehabilitation assessment. Telerehabilitation assessments were conducted with participants performing facilitated self-palpation, self-applied modified orthopaedic tests, active movements and functional tasks. Primary pathoanatomical diagnoses were in exact agreement in 67% of cases and were similar in 89% of cases. The system of pathology was found to be in agreement in 17 out of 18 cases (94%). Comparisons of objective findings from the two physical assessments demonstrated substantial agreement (kappa = 0.635) for categorical data and binary data (chi-squared = 400.36 p 0.001). A high level of intra-rater (89%) and moderate level of inter-rater (67%) reliability was evident for telerehabilitation assessments. Telerehabilitation assessment of the knee complex appears to be feasible and reliable. This study has implications for clinical practice and the development of physiotherapy services to address the burden of lower limb musculoskeletal pain and disability.
Publisher: Scientific Scholar
Date: 20-01-2021
Location: Australia
No related grants have been discovered for Piers Truter.