'Another world of pain'-athlete and sport physiotherapist perspectives on the unique experience of pain in sport.

Our objective was to explore athlete's and sports physiotherapists' experiences of sports-related pain in the upper and lower limb. Using a constructivist and pragmatic perspective, we carried out focus groups comprising a deliberate criterion sample of athletes and sports physiotherapists. We used a topic guide that moved from open exploratory questions to questions focusing on the phenomena of sports-related pain in athletes. We coded, developed candidate themes and refined finalised themes using reflexive thematic analysis. A member of our research team acted as a critical friend adding additional perspectives. We followed the Consolidated Criteria for Reporting Qualitative Research (COREQ). We completed five focus groups comprising 12 athletes (n=5 female, n=7 male) and four sports physiotherapists (n=4 male) including one initial pilot (two athletes). We developed four final themes (1-4) and nine subthemes (1.1-4.3): (1) Athlete Pain Lens (1.1-pain is part of being an athlete and 1.2-pain shapes the life of an athlete), (2) Exploring And Navigating Pain (2.1-the sports-related pain spectrum and 2.2-making sense of pain), (3) The Emotional Toll of Pain (3.1-challenging emotions and 3.2-the impact of time) and (4) Coping, Community and Communication (4.1-coping with pain, 4.2-influence of community and support network and 4.3-communication, the broken key). We highlighted the distinct and challenging phenomenon of sports-related pain experienced by athletes and physiotherapists. Through effective communication, members of the athlete's community may recognise, and adjust to these challenges.

A Review of the Design of Multimedia Patient Educational Materials in Low Back Pain Research.

Low back pain guidelines recommend patient education as a component of management. Multimedia education materials to provide patient education are increasingly being used not only due to the convenience of digital services but also because this is an efficient way to deliver educational information to under-resourced or rural/remote regions without optimal healthcare services. To maximize the knowledge transfer of research findings and low back pain guidelines, scientifically backed information must evolve beyond journal prints, bland government websites, and the basic web design of budget-constrained advocacy groups. Materials must instead be engaging for the public and compete with the various sources of low back pain misinformation, which can appear attractive and eye-catching while being conveniently accessed. We discuss a data subset from a larger musculoskeletal healthcare review to highlight the educational materials used in low back pain randomized controlled trials found in the literature. While there is no standard way to appraise the effectiveness of such educational materials, potential options are discussed. Future research is needed to determine whether knowledge is being transferred and whether this is the avenue to improving patient outcomes.

An Evaluation of Patient Educational Multimedia Design in Musculoskeletal Healthcare: A Systematic Review.

BACKGROUND: Educational multimedia are cost-effective and straightforward ways to administer large-scale information interventions to patient populations in musculoskeletal (MSK) healthcare. While an abundance of health research informs the content of these interventions, less guidance exists about optimising their design. OBJECTIVE: To identify randomised controlled trials (RCTs) of patient populations with MSK conditions which used multimedia-based patient educational materials (PEMs), and examine how design was reported and impacted patients' knowledge and/or their rehabilitation outcomes. Design was evaluated using principles from the Cognitive Theory of Multimedia Learning (CTML). METHODS: PubMed, CINAHL, PsycINFO, and Embase were searched from inception to September 2023 for studies examining adult MSK patients receiving multimedia PEMs compared to any other intervention(s). The primary outcome was knowledge retention via test scores. Secondary outcomes were any patient-reported measures. Retrievability was noted and materials were sourced through search, purchase, and author communication. RESULTS: 160 RCTs were eligible for inclusion: 12 included their materials, 30 required online search, purchase, or direct requests for materials. Of these 42 (26%) studies, none fully optimised their design, particularly lacking in the CTML principles of coherence, redundancy, modality and generative activities for the learner. The remaining 118 (74%) contained interventions that could not be retrieved or appraised. Learning was evaluated in 5 3%) studies. CONCLUSIONS: MSK studies should employ open science principles and provide their PEMs wherever possible. The link between providing multimedia PEMs and patient learning is largely unexamined, but engagement potential may be maximised when considering design principles like the CTML. CLINICALTRIAL: Prospectively registered with the International Prospective Register of Systematic Reviews (PROSPERO) as CRD42022292134.

Designing multimedia patient education materials for adolescent idiopathic scoliosis: A protocol for a feasibility randomized controlled trial of patient education videos.

Triple-masked three-armed feasibility parallel randomized controlled trial. Multimedia patient education materials are increasingly used in healthcare. While much research focuses on optimising their scientific content, research is equally needed to optimise design and implementation. This study aims to determine the feasibility of a study examining how the implementation of scientific advice on design affects patient outcomes. Participants aged 10-18 with radiographically confirmed adolescent idiopathic scoliosis will be recruited from community settings in Ireland and randomized into usual care or receiving multimedia educational videos with or without evidence-informed design principles. Participants will be masked in the two video intervention arms, as will the therapist sending the educational videos. Outcomes will include the number of participants recruited and randomized, the number analysed post-intervention and at week eight, and the outcomes for baseline, post-intervention, and week 8. Adverse events will also be reported. This feasibility randomized controlled trial will offer insight into the feasibility of implementing advice from the literature in designing a trial of multimedia patient education materials for a population with adolescent idiopathic scoliosis. Trial registration: Clinical Trail: Trial is registered on ClinicalTrials.gov as NCT06090344.