Building the Rationale and Structure for a Complex Physical Therapy Intervention Within the Context of a Clinical Trial: A Multimodal Individualized Treatment for Patients With Hip Osteoarthritis

Bennell, Kim L.; Egerton, Thorlene; Pua, Yong-Hao; Abbott, J. Haxby; Sims, Kevin; Buchbinder, Rachelle

doi:10.2522/ptj.20100430

Cited by 31Musculoskeletal pain and rehabilitationHealth Policy Implementation ScienceHip disorders and treatments

Building the Rationale and Structure for a Complex Physical Therapy Intervention Within the Context of a Clinical Trial: A Multimodal Individualized Treatment for Patients With Hip Osteoarthritis

Bennell, Kim L., Egerton, Thorlene, Pua, Yong-Hao, Abbott, J. Haxby, Sims, Kevin, Buchbinder, Rachelle·2011·Physical Therapy

DOI 10.2522/ptj.20100430

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Abstract

Evaluating the efficacy of complex interventions such as multimodal, impairment-based physical therapy treatments in randomized controlled trials is essential to inform practice and compare relative benefits of available treatment options. Studies of physical therapy interventions using highly standardized intervention protocols, although methodologically rigorous, do not necessarily reflect “real-world” clinical practice, and in many cases results have been disappointing. Development of a complex intervention that includes multiple treatment modalities and individualized treatment technique selection requires a systematic approach to designing all aspects of the intervention based on theory, evidence, and practical constraints. This perspective article outlines the development of the rationale and structure of a multimodal physical therapy program for painful hip osteoarthritis to be assessed in a clinical trial. The resulting intervention protocol comprises a semi-structured program of exercises and manual therapy, advice, physical activity, and optional prescription of a gait aid that is standardized, yet can be individualized according to physical assessment and radiographic findings. The program is evidence based and reflects contemporary physical therapist practice, while also being reproducible and reportable. This perspective article aims to encourage physical therapy researchers involved in evaluation of complex interventions to better document their own intervention development, as well as the outcomes, thus generating a body of knowledge about the development processes and protocols that is generalizable to the real-world complexity of providing physical therapy to individual patients.

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The structure and specific ingredients of HOCOS were based on recommendations by Bennell et al: impact of psychosocial factors on pain and disability in hand injuries, evidence base for CBT on MSK conditions, importance of a biopsychosocial framework, and practical delivery issues.
“The structure and specific ingredients of HOCOS were based on the following recommendations suggested by Bennell et al [57]: (1) impact of psychosocial factors on pain and disability in hand injuries, (2) evidence base for the effects of CBT on MSK conditions, (3) the importance of incorporating the management of hand injuries into a biopsychosocial framework, and (4) practical issues related to”
From Development and usability testing of a web-based and therapist-assisted coping skills program for managing psychosocial problems in individuals with hand and upper limb injuries: Mixed methods study (2020) · cites this paper as [57]

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Building the Rationale and Structure for a Complex Physical Therapy Intervention Within the Context of a Clinical Trial: A Multimodal Individualized Treatment for Patients
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Authors: Bennell, K. L., Egerton, T., Pua, Y.-H., Abbott, J. H., Sims, K., & Buchbinder, R.
Affiliations: The University of Melbourne (AU)
Singapore General Hospital (SG)
University of Otago (NZ)
K. Sims, DipPhty, MPhty, PhD, FACP, Cricket Australia Centre of Excellence, Brisbane, Queensland, Australia.
Cabrini Hospital (AU)
Corresponding author: Bennell, Kim L.
ORCID: Bennell, Kim L.
Egerton, Thorlene
Pua, Yong-Hao
Abbott, J. Haxby
Sims, Kevin
Buchbinder, Rachelle
Venue: Physical Therapy
Publisher: Oxford University Press (OUP)
Published: 2011-10-01
Volume: 91
Issue: 10
Pages: 1525-1541
ISSN: 0031-9023 (ISSN-L)
1538-6724
DOI: 10.2522/ptj.20100430
OpenAlex: W2113696036
Cited by: 31
References: 93
Citations by year: 2024: 1 · 2023: 1 · 2022: 2 · 2021: 1 · 2020: 2 · 2019: 1 · 2018: 1 · 2017: 1 · 2016: 6 · 2015: 4 · 2014: 7 · 2013: 2 · 2012: 2
FWCI: 2.58
Type: journal article
Language: en
Open access: closed
Locations: Physical Therapy (publishedVersion)
PubMed (publishedVersion)
Topics: Health Sciences › Medicine › Pharmacology › Musculoskeletal pain and rehabilitation
Health Sciences › Health Professions › General Health Professions › Health Policy Implementation Science
Health Sciences › Medicine › Surgery › Hip disorders and treatments
Keywords: hip osteoarthritis, complex interventions, multimodal therapy, personalized treatment, manual therapy, exercise therapy, physical activity guidelines, randomized controlled trials, real-world clinical practice
MeSH terms: Clinical Trials as Topic, Combined Modality Therapy, Humans, Research Design, Osteoarthritis, Hip, Program Development, Treatment Outcome, Physical Therapy Modalities, Precision Medicine

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Building the Rationale and Structure for a Complex Physical Therapy Intervention Within the Context of a Clinical Trial: A Multimodal Individualized Treatment for Patients With Hip Osteoarthritis

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