A carregar...
Publicação
Fiabilidade, barreiras e facilitadores para a implementação da bateria de testes funcionais Split.OA em pessoas com Osteoartrose: um estudo de métodos mistos
Orientador(es)
Resumo(s)
Introdução: Para uma prescrição de exercício adequada e personalizada em pessoas com
osteoartrose da anca ou joelho (OAAJ), é crucial avaliar a aptidão física, através de testes
funcionais objetivos fiáveis e adaptados ao contexto em que são implementadas.
Objetivos: Avaliar a fiabilidade de uma bateria de testes de desempenho físico para
pessoas com osteoartrose e explorar barreiras e facilitadores para a sua implementação na
prática clínica dos fisioterapeutas.
Metodologia: Realizou-se um estudo de métodos mistos convergente em duas fases
sequenciais. Na fase quantitativa foi aplicada a bateria de testes Split.OA a pessoas com
OAAJ (n=21) (30sec Chair Stand Test, 40 meter Fast Paced Walk Test, 6 Minute Walk
Test, Sit-and-Reach Test, Modified Thomas Test e o Star Excurssion Balance Test) em
dois momentos, um para testar a fiabilidade inter-observador, e 7 a 14 dias após, para
testar a fiabilidade intra-observador. Foi analisado o coeficiente de correlação intraclasse
(CCI). Na fase qualitativa realizaram-se 2 grupos focais com 11 fisioterapeutas. O guião
da entrevista e análise de dados dedutiva foram orientados pelo modelo Capacidade,
Oportunidade, Motivação – Comportamento (COM-B).
Resultados: Foram incluídos 21 participantes com OA. A análise de fiabilidade inter-
observador dos instrumentos revelou valores de CCIs moderados a excelentes (CCI1,1
entre 0,726 e 0,986; CCI1,k entre 0,925 e 0,966), assim como a intra-observador (CCI3,1
entre 0,699 e 0,995; CCI3,k entre 0,890 e 0,975). A análise dedutiva dos grupos focais
revelou 14 barreiras e 16 facilitadores, em 5 domínios do COM-B. Os participantes
consideraram que os seus contextos e equipas de trabalho, os recursos necessários, as
expectativas do utente e comunicação com o mesmo e o treino para a aplicação da bateria,
são fatores importantes para a sua implementação.
Conclusão: Os níveis de fiabilidade demonstrados, revelam que os fisioterapeutas podem
confiar nos resultados da bateria de testes Split.OA e as barreiras e facilitadores
identificadas, permitirão informar possíveis estratégias a adotar no treino de
competências do programa Split.OA, otimizando a implementação da bateria na prática
clínica dos fisioterapeutas.
Introduction: For an adequate and tailored exercise prescription in people with hip and/or knee osteoarthritis (HKOA), it is crucial to evaluate physical performance, through objective functional tests that are reliable and adapted to the context which they are implemented. Purpose: Assess the reliability of a battery of physical performance tests for people with osteoarthritis (OA) and explore barriers and enablers to implementing this battery in clinical practice. Methodology: A convergent mixed methods study was carried out in two sequential phases. In the quantitative phase, the Split.OA test battery was applied to people with HKOA (n=21) (6 Minute Walk Test, 40 meter Fast Paced Walk Test, 30sec Chair Stand Test, Sit-and-Reach Test, Modified Thomas Test e o Star Excursion Balance Test) in two moments, one for interrater reliability, and 7 to 14 days after, for intrarater reliability. This was analysed with Interclass Correlation Coefficient (CCI). For the qualitative phase, 2 focus groups were conducted with 11 physiotherapists. The interview guide and deductive content analysis were guided by the Capacity, Opportunity, Motivation – Behaviour (COM-B) model. Results: In total, 21 participants with OA were include. The interrater reliability analysis of the tests showed moderate to excellent CCI values (CCI1,1 between 0,726 e 0,986; CCI1,k between 0,925 e 0,966), like the intrarrater (CCI3,1 between 0,699 e 0,995; CCI3,k between 0,890 e 0,975). The deductive analysis revealed 14 barriers and 16 enablers, within 5 domains of COM-B. The physiotherapists considered that their contexts and work teams, necessary resources, patient’s expectations and communication with them, and the training for applying the battery were important factors for its implementation. Conclusion: The reliability levels showed that physiotherapist can trust the results of the Split.OA battery of tests. Additionally, the barriers and enablers identified will inform possible strategies to be adopted in the training of the Split.OA programme and optimise the implementation of the battery in physiotherapists’ clinical practice.
Introduction: For an adequate and tailored exercise prescription in people with hip and/or knee osteoarthritis (HKOA), it is crucial to evaluate physical performance, through objective functional tests that are reliable and adapted to the context which they are implemented. Purpose: Assess the reliability of a battery of physical performance tests for people with osteoarthritis (OA) and explore barriers and enablers to implementing this battery in clinical practice. Methodology: A convergent mixed methods study was carried out in two sequential phases. In the quantitative phase, the Split.OA test battery was applied to people with HKOA (n=21) (6 Minute Walk Test, 40 meter Fast Paced Walk Test, 30sec Chair Stand Test, Sit-and-Reach Test, Modified Thomas Test e o Star Excursion Balance Test) in two moments, one for interrater reliability, and 7 to 14 days after, for intrarater reliability. This was analysed with Interclass Correlation Coefficient (CCI). For the qualitative phase, 2 focus groups were conducted with 11 physiotherapists. The interview guide and deductive content analysis were guided by the Capacity, Opportunity, Motivation – Behaviour (COM-B) model. Results: In total, 21 participants with OA were include. The interrater reliability analysis of the tests showed moderate to excellent CCI values (CCI1,1 between 0,726 e 0,986; CCI1,k between 0,925 e 0,966), like the intrarrater (CCI3,1 between 0,699 e 0,995; CCI3,k between 0,890 e 0,975). The deductive analysis revealed 14 barriers and 16 enablers, within 5 domains of COM-B. The physiotherapists considered that their contexts and work teams, necessary resources, patient’s expectations and communication with them, and the training for applying the battery were important factors for its implementation. Conclusion: The reliability levels showed that physiotherapist can trust the results of the Split.OA battery of tests. Additionally, the barriers and enablers identified will inform possible strategies to be adopted in the training of the Split.OA programme and optimise the implementation of the battery in physiotherapists’ clinical practice.
Descrição
Palavras-chave
Fiabilidade Barreiras Facilitadores Testes funcionais Osteoartrose Reliability Barriers Enablers Functional tests Osteoarthritis