■为了确定因素和障碍,这会影响婴儿对脊柱操纵和动员的利用,孩子们,和青少年。
■邀请了26名手动治疗和儿科的国际物理治疗师专家参加使用Qualtrics的Delphi调查。在第1轮物理治疗师中,从影响他们决定在儿科人群中使用脊柱操纵和动员的因素和障碍列表中选择,并有机会添加到列表中。第二轮要求受访者选择他们同意的尽可能多的因素和障碍,导致频率计数。围绕障碍和促进者的问题的回答子集是本研究的重点。
■12名物理治疗师完成了两轮调查。医学诊断,损伤机制,患者介绍,对处理的容忍度,和治疗师的技术知识是在婴儿中使用脊柱操纵和动员的主要决定因素,孩子们,和青少年跨越脊髓水平。超过90%的受访者选择在婴儿中不适当的操纵作为他们的最高障碍。75%以上的受访者认为,在婴儿和儿童中使用脊柱操纵的其他主要障碍包括害怕伤害患者,害怕诉讼,缺乏沟通,缺乏证据,缺乏监护人的同意,以及检查的准确性,以告知临床推理。
这项国际调查提供了有关物理治疗师在考虑在儿科人群中使用脊柱动员和操纵时应考虑的因素和障碍的急需的见解。
UNASSIGNED: To identify factors and barriers, which affect the utilisation of spinal manipulation and mobilisation among infants, children, and adolescents.
UNASSIGNED: Twenty-six international expert physiotherapists in manual therapy and
paediatrics were invited to participate in a Delphi investigation using QualtricsⓇ. In Round-1 physiotherapists selected from a list of factors and barriers affecting their decision to use spinal manipulation and mobilisation in the paediatric population and had opportunity to add to the list. Round-2 asked respondents to select as many factors and barriers that they agreed with, resulting in a frequency count. The subset of responses to questions around barriers and facilitators are the focus of this study.
UNASSIGNED: Twelve physiotherapists completed both rounds of the survey. Medical diagnosis, mechanism of injury, patient presentation, tolerance to handling, and therapist\'s knowledge of techniques were the dominant deciding factors to use spinal manipulation and mobilisation among infants, children, and adolescents across spinal levels. More than 90% of the respondents selected manipulation as inappropriate among infants as their top barrier. Additional dominant barriers to using spinal manipulation among infants and children identified by ≥ 75% of the respondents included fear of injuring the patient, fear of litigation, lack of communication, lack of evidence, lack of guardian consent, and precision of the examination to inform clinical reasoning.
UNASSIGNED: This international survey provides much needed insight regarding the factors and barriers physiotherapists should consider when contemplating the utilisation of spinal mobilisation and manipulation in the paediatric population.