Abstract Objective Accurate knowledge is central to effective self‐care of osteoarthritis (OA). This study aimed to assess the measurement properties of the Osteoarthritis Knowledge Scale (OAKS) with versions for the hip and knee. Methods Participants with hip OA ( n = 144), knee OA ( n = 327), and no OA ( n = 735) were recruited. Rasch analysis was conducted to assess psychometric properties using data from all participants with hip OA and 144 randomly selected participants with either knee OA or no OA. Test‐retest reliability and measurement error were estimated among those with hip ( n = 51) and knee ( n = 142) OA. Results Four items from the draft scales were deleted following Rasch analysis. The final 11‐item OAKS was unidimensional. Item functioning was not affected by gender, age, educational level, or scale version (hip or knee). Person separation index was 0.75. Test‐retest intraclass correlation coefficient was 0.81 (95% CI 0.74, 0.86; hip version 0.66 [0.47, 0.79]; knee version 0.85 (0.79, 0.90)). Smallest detectable change was 9 points (scale range 11–55; hip OA version 11 points; knee OA version 8 points). Conclusion The OAKS is a psychometrically adequate, unidimensional measure of important OA knowledge that can be used in populations with and without hip and knee OA. Caution is needed when using with populations with only hip OA as test‐retest reliability of the hip version did not surpass the acceptable range.
An Ashland Theological Seminary supplementary guide providing a list of ebook resources (both subscription and open access) for our students, faculty, and staff.
This study assessed the effects of eight weeks of military training on aerobic fitness indices, military skills and neuropsychological function. Thirty five (n = 35) male Irish Defence Forces personnel, divided into training (n = 20) and control (n = 15) subgroups, completed tests of military aptitude (Kim's games, judging distance, fire order, map reading, weapon assembly) and neuropsychological function (Symbol digit modalities test (SDMT), Trail making test, Stroop test and grooved pegboard test) pre- and post-intervention. The repeated measures study design sought to account for any learning effect. Participants also completed a 10km route march, a two mile run and three by 20m shuttle run tests at both time points to quantify changes in fitness variables. The training sub-group significantly (P < 0.001) improved mean 20m shuttle-run distance and consequently estimated VO2 max pre- to post-intervention (49.8 +/- 1.0 vs. 52.4 +/- 0.9 mL x kg x min(-1)). Two mile run time was not significantly improved. Mean %HRmax during the 10km route march was significantly higher in both training (P < 0.001) and control (P < 0.01) sub-groups post-intervention (71 +/- 1 and 83 +/- 1%) compared to pre-intervention (65 +/- 1 and 77 +/- 1%). However, the training sub-group conducted the route march at a significantly faster speed on the second occasion. Military training significantly improved performance in 3/18 neuropsychological test components and 2/12 military skills test components. Training significantly improved ability to estimate both short (error; 36 +/- 6 vs. 12 +/- 1%) and intermediate (error; 72 +/- 12 vs. 11 +/- 3%) distances post-intervention. The training sub-group significantly (P < 0.01) improved SDMT score and mean Trail 1 time pre- to post-intervention (58.0 +/- 2.8 vs. 69.5 +/- 3.4; 18.1 +/- 0.8 vs. 14.4 +/- 0.8s, respectively). In Part 3 of the Stroop test, time mediated a significant (P < 0.05) and selective improvement in the training sub-group (51.3 +/- 3.2 vs. 63.8 +/- 5.4). In conclusion, aerobic fitness and a minority of neuropsychological and military skills tests improved following 8 weeks of military training.
Abstract Background Conservative treatments for hip and knee joint osteoarthritis are underused despite the known benefits. Adherence to conservative treatments is poor and affected by people’s health, illness and treatment beliefs. Clinicians’ beliefs can also affect the advice and education given to patients. Few studies have explored general practitioners’ (GPs; primary care physicians) and physiotherapists’ osteoarthritis-related health, illness and treatment beliefs. In addition, limited questionnaires are available to explore this phenomenon. This study aimed to identify if GPs and physiotherapists had beliefs about osteoarthritis that fit better with biomedical or biopsychosocial models, and explore the utility of the Pain Attitudes and Beliefs Scale for Physiotherapists (PABS-PT) adapted for osteoarthritis. Methods This study used a cross-sectional observational design. Data were collected anonymously from GPs and physiotherapists using an online survey. The survey included a study-specific demographic and occupational characteristics questionnaire and the PABS-PT questionnaire adapted for osteoarthritis. All data were analysed using descriptive statistics. PABS-PT data also underwent principal factor analysis. Results In total, 295 clinicians (87 GPs, 208 physiotherapists) participated in this study. The principal factor analysis identified two factors or subscales (biomedical and behavioural), with Cronbach’s alphas of 0.84 and 0.44, respectively. Participants scored higher on the behavioural (3.85) than the biomedical (2.78) beliefs subscale. Conclusions The results suggest clinicians’ osteoarthritis beliefs are broadly more behavioural (biopsychosocial) than biomedical in orientation. However, the poor internal consistency of the behavioural subscale suggests the PABS-PT is not suitable for adaptation for osteoarthritis.
Abstract Background Hip joint osteoarthritis (OA) is a chronic condition that can significantly affect the energetic cost of walking. Exercise is a high-value method for the management and maintenance of function in people with hip joint OA. Walking economy is a measure of the energetic cost of steady-state walking and is associated with declines in physical activity. Previous research has highlighted the ability of exercise programs focusing on improving gait symmetry and reducing step-to-step variability to improve walking economy in older adults. It is unknown if walking economy can be influenced by neuromuscular exercise in those with hip joint OA. Therefore, this study aims to investigate the effects of a neuromuscular exercise program on walking economy in adults with hip joint OA. Methods Fifty individuals (25 per group) with hip joint OA will be recruited from the community. Following a baseline assessment, they will be randomly allocated to either 1) an exercise intervention or 2) a control group continuing usual care. The intervention group will undergo a 12-week neuromuscular exercise program focused on improving gait symmetry and reducing step-to-step variability in a group exercise setting. The primary outcome is walking economy at standard and preferred walking speeds. Secondary outcomes include spatiotemporal gait measures (step frequency, length, and width as well as stance and swing duration) and lower limb strength (handheld dynamometer, isometric mid-thigh pull, and wall sit test). Additional measures include self-reported pain, hip function, and physical activity, and body mass index (BMI). Discussion The findings from this study will assist practitioners in the prescription of exercises for individuals with hip joint OA. Specifically, we will determine whether a 12-week neuromuscular exercise program can improve walking economy and the likely mechanisms. Trial registration Australian New Zealand Clinical Trials Registry, registration number ACTRN12624000411549. Registered 4th April 2024.
To audit cardiopulmonary resuscitation (CPR) training and certification requirements of registered healthcare professionals in New Zealand.An enquiry-based policy audit of all regulatory bodies under the Health Practitioners Competence Assurance Act 2003 (HPCA Act 2003), and vocational medical training and recertification providers accredited by the Medical Council of New Zealand (MCNZ).All the organisations approached (n=37) responded to the audit. Six of the 17 health professional regulatory bodies have some form of mandatory CPR certification requirement for initial registration, ongoing registration, or continuing professional development. The Midwifery Council, Dentistry Council, Podiatrists Board, and Pharmacy Council have the most comprehensive requirements. Twelve of the 20 vocational medical colleges specify some form of CPR training. The Royal New Zealand College of Urgent Care is the only one to require annual re-certification.This audit revealed a wide variety of CPR training and certification requirements across health professions in New Zealand. Future studies should investigate whether mandating CPR training improves outcomes from cardiac arrest and consider patient, public, and whānau expectations regarding the ongoing certification of healthcare professionals in resuscitation and emergency care.
Anterior cruciate ligament (ACL) injury is a risk factor for developing post-traumatic osteoarthritis (PTOA). The burden of ACL injuries and PTOA is considerable and predicted to increase if there is no change in their management. The efficacy of different ACL rehabilitation interventions in reducing the incidence of PTOA is unknown. This systematic review aimed to identify, synthesise, and critique research findings that evaluated the effectiveness of anterior cruciate ligament reconstruction (ACLR) plus rehabilitation compared to rehabilitation alone on the incidence of PTOA following ACL injury. A quality critique of the selected studies was undertaken using a modified Downs and Black appraisal tool. Data were extracted and analysed to answer the research question: What is the effect of ACL reconstruction and rehabilitation compared to conservative management on the incidence of PTOA after ACL injury? Six good-quality articles were retained for final review. Five studies compared the effect of surgical and non-surgical management of ACL injuries on developing PTOA. One study investigated the impact of different ACL rehabilitation protocols on the development of PTOA. The incidence of PTOA following ACL injury was comparable regardless of the surgical or non-surgical intervention and rehabilitation compared in each study. Further high-quality studies are needed to inform ACL injury management to reduce the impact of PTOA following ACL injury.
Introduction: The transformative nature of collaborative interprofessional learning experiences, for both students and educators, signals the importance of learning opportunities that transcend professional or disciplinary boundaries. Specifically, real-time clinical practice experiences where students and educators from a number of health professions learn with, from and about eachother, while working with patients, enables authentic interprofessional learning opportunities.Methods: This paper reports the qualitative interpretive findings from a mixed methods study on the learning experiences of students and educators from several undergraduate health and allied health programmes engaged in collaborative interprofessional practice in a university context. Interpretive thematic analysis of student and educator focus group transcripts revealed a number of transformational learning thresholds that students and educators transitioned through, over time. Findings: Transformative learning occurred through cumulative collaborative learning experiences. Interprofessional thresholds were identified as: broadening perspectives on health practice; navigating collaborative roles through interprofessional practice (IPP); interprofessional team practice through active learning/learning by doing; integrative professional practice for actioning holistic, patient-centred healthcare. Conclusion: Threshold Concepts Theory (TCT) provided both an interpretive lens for viewing the experiential learning processes that occurred during the student-led interprofessional programme and a theoretical perspective into the transformative nature of knowledge and skills acquisition and integration during interprofessional learning opportunities.
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