ABSTRACT
OBJECTIVES: Physical therapists have used continuing education as a method of improving their skills in conducting clinical examination of patients with low back pain (LBP). The purpose of this study was to evaluate how well the pathoanatomical classification of patients in acute or subacute LBP can be learned and applied through a continuing education format. The patients were seen in a direct access setting. METHODS: The study was carried out in a large health-care center in Finland. The analysis included a total of 57 patient evaluations generated by six physical therapists on patients with LBP. We analyzed the consistency and level of agreement of the six physiotherapists' (PTs) diagnostic decisions, who participated in a 5-day, intensive continuing education session and also compared those with the diagnostic opinions of two expert physical therapists, who were blind to the original diagnostic decisions. Evaluation of the physical therapists' clinical examination of the patients was conducted by the two experts, in order to determine the accuracy and percentage agreement of the pathoanatomical diagnoses. RESULTS: The percentage of agreement between the experts and PTs was 72-77%. The overall inter-examiner reliability (kappa coefficient) for the subgroup classification between the six PTs and two experts was 0.63 [95% confidence interval (CI): 0.47-0.77], indicating good agreement between the PTs and the two experts. The overall inter-examiner reliability between the two experts was 0.63 (0.49-0.77) indicating good level of agreement. DISCUSSION: Our results indicate that PTs' were able to apply their continuing education training to clinical reasoning and make consistently accurate pathoanatomic based diagnostic decisions for patients with LBP. This would suggest that continuing education short-courses provide a reasonable format for knowledge translation (KT) by which physical therapists can learn and apply new information related to the examination and differential diagnosis of patients in acute or subacute LBP.
ABSTRACT
BACKGROUND: There is a lack of knowledge of the motor abilities required in different exercise modes which are needed when counseling sedentary middle-aged people to start a physically active lifestyle. METHODS: Nominal group technique was used to establish the consensus statement concerning motor abilities and physical fitness in 31 exercise modes. RESULTS: Walking, running, jogging, and calisthenics were regarded as the most suitable exercise modes for most people with no specific requirements. The most demanding exercise modes of evaluated exercise modes were roller skating, downhill skiing, and martial arts, requiring all five motor abilities. Four abilities were necessary in skating, jazz dance, and ice hockey. When exercising is target-oriented, endurance is trained evidently in 27 out of 31 and muscle strength in 22 out of 31 exercise modes. CONCLUSIONS: The consensus statement gives theoretical basis for the components of motor abilities and physical fitness components in different exercise modes. The statement is instructive in order to promote health-enhancing physical activity among sedentary people. This study completes the selection of the exercise modes more detailed than current PA recommendation and guidelines for public health. A variety of exercise modes with one or none motor requirements is available to start. When amount and intensity of exercise is increased the training effects can be found in most components of motor ability and physical fitness.
