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BackgroundNational strategies from North America call for substantive improvements in entry-level pain management education to help reduce the burden of chronic pain. Past work has generated a valuable set of interprofessional pain management competencies to guide the education of future health professionals. However, there has been very limited work that has explored the development of such competencies for individual professions in different regions. Developing profession-specific competencies tailored to the local context is a necessary first step to integrate them within local regulatory systems. Our group is working toward this goal within the context of entry-level physiotherapy (PT) programs across Canada.AimsThis study aimed to create a consensus-based competency profile for pain management, specific to the Canadian PT context.MethodsA modified Delphi design was used to achieve consensus across Canadian university-based and clinical pain educators.ResultsRepresentatives from 14 entry-level PT programs (93% of Canadian programs) and six clinical educators were recruited. After two rounds, a total of 15 competencies reached the predetermined endorsement threshold (75%). Most participants (85%) reported being "very satisfied" with the process.ConclusionsThis process achieved consensus on a novel pain management competency profile specific to the Canadian PT context. The resulting profile delineates the necessary abilities required by physiotherapists to manage pain upon entry to practice. Participants were very satisfied with the process. This study also contributes to the emerging literature on integrated research in pain management by profiling research methodology that can be used to inform related work in other health professions and regions.

Pain is a subjective experience. Gaining insight from persons in pain into what it is to live with pain is important for clinicians, teachers and researchers. Being exposed to art created by persons in pain is one way to help understand these lived experiences.

BACKGROUND: Since the beginning of the COVID-19 pandemic, protection and isolation measures established by the Canadian and Quebec governments have directly affected the work of health and social professionals (HSPs). These measures have added pressure on HSPs, complexified their work and added tasks to their already busy workload. However, few studies have explored in depth the impacts of the pandemic on HSPs working with people with disabilities. OBJECTIVE: The objective of this study was to qualitatively explore the experiences of HSPs working among people with disabilities in the province of Quebec, Canada, during the COVID-19 pandemic (January and February 2021), including the impact on their work, the relationships with their colleagues, and on their immediate social and familial environment. METHODS: HSPs participated in a semi-structured interview. A mixed thematic analysis approach, combining inductive and deductive coding, was carried out using N'Vivo 12. RESULTS: Fifty-five HSPs participated in the interviews (mean [SD] age, 42 [9]). They mostly identified as women (91%). Three main themes representing the impacts of the pandemic were identified, including 1) Health and Well-being; 2) Family and social networks including the subthemes; 2.1) Fear of being a vector of contamination for their loved ones; 2.2) Work-family balance; 2.3) Social Network, and finally 3) Work, highlighting, including 3.1) Workload and adaptative strategies developed; 3.2) Relationship with colleagues; 3.3) Perceived support received at work, and 3.4) Services offered to patients. CONCLUSIONS: These findings highlight the importance of closely tracking and supporting the well-being of HSPs. [ABSTRACT FROM AUTHOR]

* OBJECTIVE: To assess the effectiveness of a single session of education and exercise compared with multiple sessions of a multimodal physiotherapy intervention for adults with spinal disorders in an advanced practice physiotherapy specialized spine model of care. * DESIGN: Pragmatic randomized controlled trial. * METHODS: We randomized patients with spinal disorders, who were referred for a spinal surgery consultation and triaged as nonsurgical cases by an advanced practice physiotherapist, to a single session of education and prescription of an exercise program (n = 52) or multiple sessions (6 in total) of a multimodal physiotherapy intervention (n = 54). The primary outcomes were the short form Brief Pain Inventory pain severity scale (BPI-S) and the Brief Pain Inventory pain interference scale (BPI-I), and secondary outcomes included disability, quality of life, catastrophization, and satisfaction. Linear mixed models were used to assess differences between groups across time points at 6, 12, and 26 weeks. * RESULTS: There were no significant between-group differences on the BPI-S and only a significant improvement at 6 weeks on the BPI-I in the multiple-session group (mean difference: -0.96/10; 95% CI, -1.87 to -0.05). There were no other statistically significant differences between groups, except for satisfaction where participants in the multiple-session group reported statistically significantly greater satisfaction on the 9-item Visit-Specific Satisfaction Questionnaire and the MedRisk questionnaire. Both groups saw significant improvements over time on all outcomes except for the BPI-S. * CONCLUSION: Adding supervised multimodal physiotherapy sessions did not result in better clinical outcomes when compared to a single session of education and exercise. Patients were more satisfied with the multiple-session approach. J Orthop Sports Phys [ABSTRACT FROM AUTHOR]

tOBJECTIVE: To compare the effects of personalized, supervised group-based programs (ie, group physical therapy programs) and usual oneon- one physical therapy care (ie, usual physical therapy care) on disability for military personnel suffering from low back pain, rotator cuff--related shoulder pain, patellofemoral pain syndrome, or lateral ankle sprain. Secondary outcomes were pain severity, pain-related fear, health-related quality of life, and patients' satisfaction with their condition and care. tDESIGN: Non-inferiority pragmatic randomized clinical trial. tMETHODS: One hundred twenty military personnel from the Canadian Armed Forces, experiencing 1 of 4 targeted musculoskeletal disorders, were consecutively recruited and randomly assigned to group physical therapy programs or usual physical therapy care. Disability, pain severity, pain-related fear, and health-related quality-of-life outcomes were measured at 6, 12, and 26 weeks after baseline. Satisfaction with treatment was evaluated at the end of the intervention. Intention-to-treat analyses using linear mixed models with random effects were used to compare the effects of interventions. Chi-square tests were used to compare satisfaction. tRESULTS: There were no significant Time - Group interactions for any of the primary and secondary outcomes (Time - Group: P>.67). Satisfaction with treatment also did not differ between groups (P>.05). Statistically significant and clinically important improvements were observed in both groups for all outcomes after 12 weeks (Time effect: P<.01), except for health-related quality of life (P = .13). tCONCLUSION: Group physical therapy programs were not inferior to usual physical therapy care for managing pain, functional capacity, and patients' satisfaction with care of military personnel presenting with various musculoskeletal disorders. Both interventions led to clinical and statistical improvement in pain and function in the mid and long term. Group physical therapy could be an effective strategy to enhance access to care. [ABSTRACT FROM AUTHOR]

Background: Low back pain (LBP) is a common and disabling musculoskeletal disorder. LBP experiences and expectations can vary from one person to another and influence their clinical outcomes. Despite the existence of numerous evidence‐based treatment recommendations, LBP management in primary care remains challenging. This study aims to investigate the experiences and expectations of patients with LPB in primary care settings. Methods: A qualitative study with an inductive thematic analysis was conducted. Semi‐structured interviews were performed using individuals who had experienced LBP in the past year and had consulted a family physician (FP) or a physiotherapist (PT). Results: Ten participants with LBP were interviewed (5 women, 5 men, mean age 49 ± 17). Five themes were identified: (1) I am always upset because I can't do anything; (2) I waited to consult; I thought it would go away; (3) I want to see what is going on with my LBP; (4) I want to see the person that will provide the right treatment; (5) I needsupportto get over it. Participants consulted when their pain was severe and disabling. They expected an imaging test to explain the cause of their LBP and placed more importance on the imaging test results than the FP's or PT's evaluation. Their opinions on care selection and being listened to were important for the participants. Conclusion: This study has highlighted the importance of the patient's point of view in their care. This consideration is important to ensure a comprehensive and collaborative approach with evidence‐based practice care. [ABSTRACT FROM AUTHOR]

Physical therapists (PTs) should know how to best treat patients with inflammatory arthritis. To document interventions chosen by PTs for patients with rheumatoid arthritis (RA) and ankylosing spondylitis (AS) and whether choices follow evidence-based practice. Licensed musculoskeletal PTs in Quebec, Canada responded to an online survey. Descriptive statistics illustrated proportions for each treatment choice and inferential statistics explored associations with demographic and practice-related factors. There were 298 PTs who responded to the survey. For both RA and AS respectively, most common interventions were mobility exercises (91.0%; 98.3%) and patient education (90.1%; 92.8%). For both cases, slightly >60% selected strengthening exercises. Passive forms of therapy were chosen by 36% of PTs for RA and 58% for AS. Aerobic exercise was rarely selected. PTs working in the public sector were less likely to use manual therapy for both RA (Odds Ratio (OR) 0.43, 95% confidence interval (CI) 0.22,0.86) and AS (OR 0.46, 95% CI 0.22,0.97). Most PTs chose mobility exercises and patient education, representing evidence-based approaches. Despite current recommendations, strengthening and especially aerobic exercises were not used as much. There is a need to increase awareness regarding the benefits of strengthening and aerobic exercise for these patients. [ABSTRACT FROM AUTHOR]

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Purpose: Work‐related musculoskeletal disorders (WRMD) are the most common causes of disability worldwide and are associated with significant use of healthcare. One way to optimize the clinical outcomes of injured workers receiving rehabilitation is to identify and address individual prognostic factors (PF), which can facilitate the personalization of the treatment plan. As there is no pragmatic and systematic method to collect prognostic‐related data, the purpose of the study was to develop and assess the acceptability of a set of questionnaires to establish the "prognostic profile" of workers with WRMD. Methods: We utilized a multistep process to inform the acceptability of the Measures Associated to PrognoStic (MAPS) questionnaire. During STEP‐1, a preliminary version of the was developed through a literature search followed by an expert consensus including a patient‐advisor. During STEP‐2, future users (rehabilitation professionals, healthcare administrators and compensation officers) were consulted through an online survey and were asked to rate the relevance of each content item; items that obtained ≥80% of "totally agree" answers were included. They were also asked to prioritize PF according to their usefulness for clinical decision‐making, as well as perceived efficacy to enhance the treatment plan. Results: The questionnaire was developed with three categories: the outcome predicted, the unique PF, and prognostic tools. Personal PF (i.e.: coping strategies, fear‐avoidance beliefs), pain related PF (i.e.: pain intensity/severity, duration of pain), and work‐related PF (i.e.: work physical demands, work accommodations) were identified to be totally relevant and included in the questionnaire. 84% of the respondents agreed that their patients could complete the MAPS questionnaire in their clinical setting, while 75% totally agreed that the questionnaire is useful to personalize rehabilitation interventions. Conclusion: The MAPS questionnaire was deemed acceptable to establish the "prognostic profile" of injured workers and help the clinicians in the treatment decision‐making process. [ABSTRACT FROM AUTHOR]