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Combined Shuttle-Box Training with Electrophysiological Cortex Recording and Stimulation as a Tool to Study Perception and Learning

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Physiotherapist-delivered Stress Inoculation Training for acute whiplash-associated disorders: A qualitative study of

Joan M Kelly¹, Samantha Bunzli², Carrie Ritchie³

¹Menzies Health Institute Queensland, Griffith University, Gold Coast, Queensland Australia.

Musculoskeletal Science & Practice

|September 16, 2018

Abstract

Background:

Formally trained and accredited physiotherapists delivered Stress Inoculation Training (SIT) integrated with guideline-based physiotherapy management to individuals with acute whiplash associated disorders (WAD) as part of a randomised controlled trial. The delivery of SIT by physiotherapists is new.

Objectives:

To investigate physiotherapists' perspectives on delivering SIT as part of the trial and in routine practice.

Design:

Qualitative descriptive.

Method:

Physiotherapists (n = 11) participated in semi-structured interviews. Interviews were audio-recorded, transcribed verbatim, and analysed thematically. Findings were triangulated against an audit of physiotherapists' adherence to the SIT protocol.

Results:

Three themes were identified: perceived value; capacity to deliver; and adaptation and implementation. Physiotherapists' saw value in SIT in that they perceived the program to have improved patient outcomes, enhanced their therapeutic alliance, and provided new skills to manage psychological contributors to WAD. Physiotherapists' capacity to deliver the program was facilitated through the development of confidence in their ability to deliver sessions, viewing SIT as falling within their current professional identity, and having confidence in their ability to manage mismatches in patients' expectations of care. All physiotherapists reported having used SIT to some extent in routine practice, by selectively delivering sessions and/or integrating the content with other management. Physiotherapists were able to deliver SIT as was intended (94.6% adherence).

Conclusions:

Physiotherapists' supported adding SIT to usual management of individuals with acute WAD. Education on SIT principles is recommended during pre-professional training to facilitate future implementation.

Keywords:

Physical therapists Psychologically informed practice Qualitative research Whiplash associated disorders

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