- ItemBehaviour change interventions for physical activity in adults with chronic obstructive pulmonary disease; a systematic review and meta-analysis(Elsevier B.V., 2023-11-14) Hanrahan, Ciara; Broderick, Julie; O'Connor, Terence M.; McVeigh, Joseph G.; University College CorkBackground: Physical activity in adults with COPD is poor, but behaviour change interventions could help improve activity. This systematic review aims to examine behaviour change interventions to promote physical activity and health outcomes for adults with COPD. Methods: Eight databases were searched from inception until February 2022: Web of Science, CENTRAL, MEDLINE, EMBASE, APA PsychINFO, CINAHL, PROSPERO, Cochrane Airways Trials Register. Relevant studies were appraised to determine the impact of behaviour change interventions on physical activity outcomes. Interventions were mapped to Michie's Theoretical Domains Framework (TDF) and a meta-analysis and narrative synthesis conducted. The Cochrane risk of bias tool and the GRADE criteria evaluated bias and the quality and certainty of the evidence. Results: Twelve randomized controlled trials (RCTs) were included in the review (n= 1211). The most frequently utilized behaviour change interventions included counselling, stepcount monitoring, social support and goal setting. The most commonly measured outcomes across studies were steps-per-day, physical activity levels, exercise capacity and quality of life. A meta-analysis of comparable studies demonstrated there was no difference in stepcount in favour of behaviour change interventions with respect to steps-per-day (SMD 0.16, 95% CI -0.03, 0.36; p=0.10). There was some evidence of short-term improvement in physical activity and quality of life, with behaviour change interventions related to goals, behaviour regulation and social influences. Conclusions: People with COPD may benefit from behaviour change interventions to increase physical activity and quality of life in the short-term. The overall certainty and quality of the evidence is low however.
- ItemEducation and training interventions for physiotherapists working in dementia care: a scoping review(Elsevier Inc., 2022-11-10) O'Sullivan, Trish; McVeigh, Joseph G.; Timmons, Suzanne; Foley, TonyObjectives: Physiotherapy plays a key role in many aspects of dementia care, most notably in maintaining mobility. However, there is a lack of dementia care training at undergraduate and postgraduate level, and more importantly, a paucity of evidence as to what constitutes effective dementia education and training for physiotherapists. The aim of this scoping review was to explore and map the evidence, both quantitative and qualitative, relating to education and training for physiotherapists. Design: This scoping review followed the Joanna Briggs Institute methodology for scoping reviews. A chronological narrative synthesis of the data outlined how the results relate to the objectives of this study. Setting: All studies, both quantitative and qualitative on dementia education and training conducted in any setting, including acute, community care, residential or any educational setting in any geographical area were included. Participants: Studies that included dementia education and training for both qualified and student physiotherapists were considered. Results: A total of 11 papers were included in this review. The principal learning outcomes evaluated were knowledge, confidence, and attitudes. Immediate post- intervention scores showed an improvement in all three outcomes. The Kirkpatrick four level model was used to evaluate the level of outcome achieved. Most educational interventions reached Kirkpatrick level 2, which evaluates learning. A multi-modal approach, with active participation and direct patient involvement seems to enhance learning. Conclusions: Allowing for the heterogeneity of intervention design and evaluation, some common components of educational interventions were identified that led to positive outcomes. This review highlights the need for more robust studies in this area. Further research is needed to develop bespoke dementia curricula specific to physiotherapy.
- ItemAirway clearance techniques for patients experiencing acute exacerbations of chronic obstructive pulmonary disease in the Republic of Ireland(IOS Press, 2021-12-10) Hanrahan, Ciara; Pedlow, Katy; Osadnik, ChristianBackground and Objectives: Airway clearance techniques (ACTs) are used by physiotherapists with the purpose of clearing sputum from bronchial airways. They are commonly prescribed for patients experiencing acute exacerbations of chronic obstructive pulmonary disease (AECOPD), however large variability in practice is commonly observed. This study aimed to explore current physiotherapy practice regarding ACTs for people with AECOPD in the Republic of Ireland. Method: An online survey was distributed to physiotherapy clinicians via direct email and the Irish Society of Chartered Physiotherapists. Main survey themes, identified from previous studies using the same survey tool, included current practice in relation to use of ACTs, perception of their effectiveness, clinical reasoning and awareness of the literature and guidelines. For the purpose of this study, ACTs were defined as techniques used by a physiotherapist for the purpose of clearing sputum from patients’ airways. Results: 202 surveys were distributed and seventy responses (35%) were received. The majority of respondents (n = 56, 80%) reported prescribing ACTs for more than 60% of patients with AECOPD, the most common techniques being physical activity (n = 65, 93%) and active cycle of breathing techniques (n = 53, 90%). Sputum management (n = 66, 94%) was the most commonly reported indicator for use of ACTs. The majority of physiotherapists (n = 42, 60%) reported being unsure of the literature regarding ACTs in AECOPD. Conclusion: The response rate to this survey was low, however results show that physiotherapists in the Republic of Ireland regularly prescribe ACTs for patients with AECOPD. Physical activity and active cycle of breathing techniques were the most commonly used ACTs and perceived to be the most effective techniques in AECOPD, with sputum management the most commonly reported indicator for use. Further research is required to explore not only physiotherapists clinical reasoning in relation to the use of ACTs for AECOPD and the perceptions of their effectiveness, but also the lack of awareness of the literature and guidelines.