Physiotherapy - Journal Articles
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Item Dual tasking interferes with dynamic balance in young and old healthy adults(IOS Press, 2021-01-11) Sulaiman, Amal Al-Shaikh; Kelly, Marie; O’Connor, Mairead; Bamiou, Doris-Eva; Pavlou, Marousa; Ménière’s Society, UKBACKGROUND: Functional mobility requires an ability to adapt to environmental factors together with an ability to execute a secondary task simultaneously while walking. A complex dual-tasking gait test may provide an indication of functional ability and falls risk among community-dwelling older adults. PURPOSE: The aim of this cross-sectional study is to investigate age-related differences in dual-tasking ability and to evaluate whether dual-tasking ability is related to executive function. METHODS: Forty-one community-dwelling healthy older and forty-one younger adults completed a dual-tasking assessment in which concurrent tasks were incorporated into the Functional Gait Assessment (FGA). The manual dual-task involved carrying a glass of water (FGA-M) while the cognitive dual-tasks involved numeracy (FGA-N) and literacy (FGA-L) related tasks. FGA scores under single (FGA-S) and dual-task conditions together with associated dual-task costs and response accuracy were determined. Executive function was assessed using The Behavioural Assessment of the Dysexecutive Syndrome (BADS). RESULTS: FGA-N and FGA-L scores were adversely affected in both groups compared to FGA-S (p≤0.001). However, score reductions and dual-task costs were significantly greater for older adults compared to younger adults on FGA-N (p≤0.05) and FGA-L (p≤0.001), with older adult performance on FGA-N associated with falls risk (p≤0.05). Executive function did not appear to be related to dual-tasking ability. CONCLUSION: Findings suggest that cognitively demanding tasks while walking, have a deleterious effect on dynamic balance and could place older adults at a greater risk of falls.Item A telephone assessment and advice service within an ED physiotherapy clinic: a single-site quality improvement cohort study(AboutScience Srl, 2021) Kelly, Marie; Higgins, Anna; Murphy, Adrian; McCreesh, KarenBackground: In response to issues with timely access and high non-attendance rates for Emergency Department(ED) physiotherapy, a telephone assessment and advice service was evaluated as part of a quality improvementproject. This telehealth option requires minimal resources, with the added benefit of allowing the healthcareprofessional streamline care. A primary aim was to investigate whether this service model can reduce wait timesand non-attendance rates, compared to usual care. A secondary aim was to evaluate service user acceptability.Methods: This was a single-site quality improvement cohort study that compares data on wait time to firstphysiotherapy contact, non-attendance rates and participant satisfaction between patients that opted for a servicebased on initial telephone assessment and advice, versus routine face-to-face appointments. 116 patients werereferred for ED physiotherapy over the 3-month pilot at the ED and out-patient physiotherapy department, XMercyUniversity Hospital, Cork, Ireland. 91 patients (78%) opted for the telephone assessment and advice service, with40% (n=36) contacting the service. 25 patients (22%) opted for the face-to-face service. Data on wait time and non-attendance rates was gathered using the hospital data reporting system. Satisfaction data was collected ondischarge using a satisfaction survey adapted from the General Practice Assessment Questionnaire. Independent-samples t-test or Mann Whitney U Test was utilised depending on the distribution of the data. For categorical data,Chi-Square tests were performed. A level of significance ofp≤0.05 was set for this study.Results: Those that contacted the telephone assessment and advice service had a significantly reduced wait time(median 6 days; 3–8 days) compared to those that opted for usual care (median 35 days; 19–39 days) (p≤0.05).There was no significant between-group differences for non-attendance rates or satisfaction.Conclusion: A telephone assessment and advice service may be useful in minimising delays for advice for thosereferred to ED Physiotherapy for musculoskeleltal problems. This telehealth option appears to be broadlyacceptable and since it can be introduced rapidly, it may be helpful in triaging referrals and minimising face-to-faceconsultations, in line with COVID-19 recommendations. However, a large scale randomised controlled trial iswarranted to confirm these findings.Item eHealth interventions to support self-management: Perceptions and experiences of people with musculoskeletal disorders and physiotherapists - ‘eHealth: It’s TIME’: A qualitative study(Taylor & Francis, 2022-11-25) Kelly, Marie; Fullen, Brona M.; Martin, Denis; Bradley, Colin; McVeigh, Joseph G.; Irish Society of Chartered PhysiotherapistsBackground: There is increasing interest in the potential role of eHealth interventions to support self-management in people with musculoskeletal disorders (MSDs). The COVID-19 pandemic appears to have been a significant catalyst for the implementation of eHealth modalities into routine practice, providing a unique opportunity for real-world evaluation of this underutilized method of delivering physiotherapy. Objective: To explore the perceptions of eHealth-mediated supported self-management from the perspective of people with MSDs and physiotherapists who work in this clinical area. Methods: A qualitative interpretive descriptive approach was used. Semi-structured telephone interviews with 13 musculoskeletal physiotherapists and 13 people with musculoskeletal disorders were undertaken. Transcripts were analyzed using reflexive thematic analysis. Results: Three main themes were identified: 1) Flexibility within a blended care model; 2) eHealth as a facilitator of self-management support; and 3) Technology: Getting it right. Participants expressed concerns about assessment and diagnosis, establishing a therapeutic relationship and felt eHealth should be reserved for follow-up purposes. There was a consistent view expressed that eHealth could facilitate aspects of self-management support. A lack of resources and suboptimal user experience remains a challenge. Conclusions: eHealth-mediated self-management support interventions were broadly acceptably, predominately as a follow-up option.Item Design and development of an eHealth intervention to support self-management in people with musculoskeletal disorders - ‘eHealth: It’s TIME’: a study protocol(HRB OPen Research, 2023-08-10) Kelly, Marie; Fullen, Brona; Martin, Denis; Bradley, Colin; O'Mahony, Billy; McVeigh, Joseph G.; Health Research BoardBackground: Musculoskeletal disorders (MSDs) are a leading cause of global morbidity, with the burden expected to increase in the near future. Self-management, with the support of healthcare professionals, is recommended for many MSDs. However, frequent clinical contact is not feasible. Previous research has highlighted the need for a co-designed eHealth-mediated self-management follow-up support intervention which integrates remote monitoring and behavioural change. Thus, the current study aims to develop and design a user-centred, eHealth-mediated self-management support prototype for people with MSDs. Methods: A three-step, iterative system development cycle will be utilised to develop and design the “eHealth: It’s TIME prototype”. The three-step process will include creating website features and content using two sequential focus groups with people with MSDs (n = 6 – 8); heuristic testing using the 10 heuristic principles of Nielsen (n = 5); and usability testing through in-person 60-minute interviews with people with MSDs (n = 3 – 5) and musculoskeletal physiotherapists (n = 3 – 5). Conclusion: The eHealth: It’s TIME prototype will be a systematically developed, follow-up self-management support intervention guided by behavioural change theory and the preferences of end users.Item eHealth interventions to support self-management in people with musculoskeletal disorders, “eHealth: It’s TIME”—A scoping review(Oxford University Press, 2022-01-13) Kelly, Marie; Fullen, Brona; Martin, Denis; McMahon, Sinéad; McVeigh, Joseph G.; Irish Society of Chartered PhysiotherapistsObjective: eHealth-mediated interventions have been proposed as one option to support self-management in those with musculoskeletal disorders (MSDs). This scoping review aimed to chart the evidence regarding eHealth modalities, musculoskeletal diagnosis, and outcomes of eHealth-mediated self-management support interventions in persons with MSDs and identify any gaps within the literature. Methods: Six electronic databases (MEDLINE, CINAHL, PsycINFO, Embase, Scopus, and the Cochrane Database of Systematic Reviews), 7 grey literature sources (eg, OpenGrey), and reference and citation lists of included studies were searched from database inception to July 2020. Published studies of adult participants with a MSD utilizing an eHealth intervention to support self-management were included. Studies were limited to those published in English. Two reviewers independently screened all studies. Data were extracted by 1 reviewer and reviewed by another reviewer. Results: After screening 3377 titles and abstracts followed by 176 full texts, 87 studies fulfilled the eligibility criteria. The majority were published in the last 5 years (n = 48; 55%), with almost one-third originating in the United States (n = 28; 32%). The most common eHealth modality type was internet based (n = 22; 35%), with almost one-half (n = 41; 47%) of the included studies involving participants with widespread musculoskeletal symptoms. The most commonly reported outcomes were related to body functions (ie, pain intensity) (n = 67; 45%), closely followed by activities and participation (ie, function) (n = 65; 44%), with environmental factors (ie, health care utilization) the least commonly reported (n = 17; 20%). Conclusions: There is considerable variation within the eHealth-mediated self-management support intervention literature. Research is needed on the role of eHealth-mediated self-management support interventions across a broad range of MSDs to guide clinical practice. Impact: This scoping review has identified gaps in the literature relating to specific eHealth modalities, musculoskeletal diagnoses, and health care utilization data, which should guide future research.