The MedRisk instrument for measuring patient satisfaction with physical therapy care: validation in the Singapore outpatient physiotherapy setting.

BACKGROUND: Patient satisfaction (PS) serves an important role in physiotherapy. Being able to measure PS is important for improving service delivery. The MedRisk has not been validated in the Singapore population. OBJECTIVE: To validate the use of the MedRisk instrument for measuring PS in a local outpatient clinic, and to explore if PS was affected by continuity of care or individual items in the MedRisk. METHODS: Three hundred and one participants who underwent physiotherapy in the clinic completed the MedRisk instrument. Factor analysis was adopted to group the individual items in the MedRisk questionnaire into components and multiple regression was conducted to explore items predicting the two global ratings. RESULTS: Factors affecting PS can be grouped into two distinct components, therapist-related attributes and organizational factors (47.7% and 11.8% of variance explained, respectively). All questionnaire items were retained. Giving patients a home exercise program (overall satisfaction [OS] r = 0.691 and willingness to return to the same clinic [WR] r = 0.578) and listening to the patients' concerns (OS r = 0.685, WR r = 0.569) correlated with both overall satisfaction and willingness to return. Continuity of care was not correlated to overall satisfaction (r = 0.001, p = .988) or willingness to return for treatment (r = 0.069, p = .234). CONCLUSION: The MedRisk instrument is applicable to the local population. Patient satisfaction with outpatient physiotherapy services was predominantly influenced by therapist-related attributes.

Telerehabilitation in the Treatment of Frozen Shoulder: A Case Report.

Background and objectives: Frozen shoulder is a common musculoskeletal condition. Telerehabilitation has seen emerging use in a variety of conditions. This case report aims to investigate the feasibility of adopting telerehabilitation in treating frozen shoulder. Case presentation: A 43-year old female presented with frozen shoulder of insidious onset. She underwent four sessions of physiotherapy. Sessions two and three were telerehabilitation sessions; the initial and final sessions were conducted in-person. Results: The subject was compliant with all exercises prescribed during her rehabilitation and achieved all rehabilitation goals in four sessions. She was then discharged from physiotherapy. Conclusion: Telerehabilitation is feasible in treating frozen shoulder. One barrier to implementation of telerehabilitation includes the lack of technical skills and knowledge despite the high prevalence of technology in today's society. Telerehabilitation increases accessibility and ease of rehabilitation. Telerehabilitation can be considered for segments of the population that are most inclined to use technology.

Shuttle walk tests in people with COPD who demonstrate exercise-induced oxygen desaturation: An analysis of test repeatability and cardiorespiratory responses.

Exercise-induced oxygen desaturation (EID) is prevalent in people with chronic obstructive pulmonary disease (COPD). This article reports a sub-analysis from a randomized controlled trial (RCT) in people with COPD and EID (COPD/EID). The primary aim, in people with COPD/ EID, was to determine the repeatability of the distance and time walked in the incremental shuttle walk test (ISWT) and endurance shuttle walk test (ESWT), respectively. A secondary aim was to determine whether any participant characteristics predicted those who did not demonstrate improvements on a repeat ISWT or ESWT. Participants with nadir oxygen saturation (SpO2) < 90% on the 6-minute walk test were recruited to the RCT. Two ISWTs and two ESWTs were then performed as part of the baseline assessments, and participants were included in this sub-analysis if their nadir SpO2 was <90% during the better of two ISWTs. Repeatability of the tests was analysed using Bland-Altman plots and paired t-tests. Participant characteristics of age, lung function, level of nadir SpO2 and end-test dyspnoea were used to predict those who were not likely to demonstrate improvements on a repeat test using receiver operating curves. Eighty-seven participants (mean age (standard deviation, SD) 70 (7) years; forced expiratory volume in one second (FEV1) 47 (17)% predicted) were included. The mean differences (coefficient of repeatability) for the ISWTs and ESWTs were 9 m (55 m) and 19 seconds (142 seconds) respectively ( p < 0.05). No participant characteristic predicted the absence of improvement on the second ISWT (area under the curve (AUC) ranged from 0.49 to 0.58, all p > 0.2) or the second ESWT (AUC ranged from 0.43 to 0.52, all p > 0.3). Although repeating the tests showed only small improvements in distance (ISWT) and time (ESWT) walked in people with COPD/EID, the variability was large making definite conclusions about test repeatability in these individuals difficult.