BACKGROUND AND OBJECTIVE: High-velocity low-amplitude thrust spinal manipulation (SM) is a recommended and commonly used manual therapy intervention in physiotherapy. Beliefs surrounding the safety and effectiveness of SM have challenged its use, and even advocated for its abandonment. Our study aimed to investigate the knowledge and beliefs surrounding SM by Italian physiotherapists compared with similar practitioners in other countries.METHODS: An online survey with 41 questions was adapted from previous surveys and was distributed via a mailing list of the Italian Physiotherapists Association (March 22-26, 2020). The questionnaire was divided into 4 sections to capture information on participant demographics, utilization, potential barriers, and knowledge about SM. Questions were differentiated between spinal regions. Attitudes towards different spinal regions, attributes associated with beliefs, and the influence of previous educational background were each evaluated.RESULTS: Of the 7398 registered physiotherapists, 575 (7.8%) completed the survey and were included for analysis. The majority of respondents perceived SM as safe and effective when applied to the thoracic (74.1%) and lumbar (72.2%) spines; whereas, a smaller proportion viewed SM to the upper cervical spine (56.8%) as safe and effective. Respondents reported they were less likely to provide and feel comfortable with upper cervical SM (respectively, 27.5% and 48.5%) compared to the thoracic (respectively, 52.2% and 74.8%) and lumbar spines (respectively, 46.3% and 74.3%). Most physiotherapists (70.4%) agreed they would perform additional screening prior to upper cervical SM compared to other spinal regions. Respondents who were aware of clinical prediction rules were more likely to report being comfortable with SM (OR 2.38-3.69) and to perceive it as safe (OR 1.75-3.12). Finally, physiotherapists without musculoskeletal specialization, especially those with a traditional manual therapy background, were more likely to perform additional screening prior to SM, use SM less frequently, report being less comfortable performing SM, and report upper cervical SM as less safe (p < 0.001).DISCUSSION: The beliefs and attitudes of physiotherapists surrounding the use of SM are significantly different when comparing the upper cervical spine to other spinal regions. An educational background in traditional manual therapy significantly influences beliefs and attitudes. We propose an updated framework on evidence-based SM.
BACKGROUND AND OBJECTIVE: High-velocity low-amplitude thrust spinal manipulation (SM) is a recommended and commonly used manual therapy intervention in physiotherapy. Beliefs surrounding the safety and effectiveness of SM have challenged its use, and even advocated for its abandonment. Our study aimed to investigate the knowledge and beliefs surrounding SM by Italian physiotherapists compared with similar practitioners in other countries.METHODS: An online survey with 41 questions was adapted from previous surveys and was distributed via a mailing list of the Italian Physiotherapists Association (March 22-26, 2020). The questionnaire was divided into 4 sections to capture information on participant demographics, utilization, potential barriers, and knowledge about SM. Questions were differentiated between spinal regions. Attitudes towards different spinal regions, attributes associated with beliefs, and the influence of previous educational background were each evaluated.RESULTS: Of the 7398 registered physiotherapists, 575 (7.8%) completed the survey and were included for analysis. The majority of respondents perceived SM as safe and effective when applied to the thoracic (74.1%) and lumbar (72.2%) spines; whereas, a smaller proportion viewed SM to the upper cervical spine (56.8%) as safe and effective. Respondents reported they were less likely to provide and feel comfortable with upper cervical SM (respectively, 27.5% and 48.5%) compared to the thoracic (respectively, 52.2% and 74.8%) and lumbar spines (respectively, 46.3% and 74.3%). Most physiotherapists (70.4%) agreed they would perform additional screening prior to upper cervical SM compared to other spinal regions. Respondents who were aware of clinical prediction rules were more likely to report being comfortable with SM (OR 2.38-3.69) and to perceive it as safe (OR 1.75-3.12). Finally, physiotherapists without musculoskeletal specialization, especially those with a traditional manual therapy background, were more likely to perform additional screening prior to SM, use SM less frequently, report being less comfortable performing SM, and report upper cervical SM as less safe (p < 0.001).DISCUSSION: The beliefs and attitudes of physiotherapists surrounding the use of SM are significantly different when comparing the upper cervical spine to other spinal regions. An educational background in traditional manual therapy significantly influences beliefs and attitudes. We propose an updated framework on evidence-based SM.
Background. The Treatment Beliefs Questionnaire has been developed to measure patients’ beliefs of necessity of and concerns about rehabilitation. Preliminary evidence suggests that these beliefs may be associated with attendance of rehabilitation. The aim of this study was to translate and adapt the Treatment Beliefs Questionnaire for interdisciplinary pain rehabilitation and to examine the measurement properties of the Dutch translation including the predictive validity for dropout. Methods. The questionnaire was translated in 4 steps: forward translation from English into Dutch, achieving consensus, back translation into English, and pretesting on providers and patients. In order to establish structural validity, internal consistency, construct validity, and predictive validity of the questionnaire, 188 participants referred to a rehabilitation centre for outpatient interdisciplinary pain rehabilitation completed the questionnaire at the baseline. Dropout was measured as the number of patients starting, but not completing the programme. For reproducibility, 51 participants were recruited at another rehabilitation centre to complete the questionnaire at the baseline and one week later. Results. We confirmed the structural validity of the Treatment beliefs Questionnaire in the Dutch translation with three subscales, necessity, concerns, and perceived barriers. internal consistency was acceptable with ordinal alphas ranging from 0.66–0.87. Reproducibility was acceptable with ICC2,1 agreement ranging from 0.67–0.81. Hypotheses testing confirmed construct validity, similar to the original questionnaire. Predictive validity showed the questionnaire was unable to predict dropouts. Conclusion. Cross-cultural translation was successfully completed, and the Dutch Treatment Beliefs Questionnaire demonstrates similar psychometric properties as the original English version.
The project is a field study for several diverse hotel chains, including individual properties operated under the Marriott brand, Postillion Hotels. Each brand has unique values, missions, and visions. Therefore, this integration will lead to the development of company-specific sustainability strategies and processes. The study will use the model of levers of control to provide such tailor-made solutions and determine if a generic approach can be developed to match a corporate sustainability strategy with a corporate strategy and develop a supporting management control system for operationalizing the sustainability strategy. Research question: How can a hotel brand formulate and implement a sustainability strategy with a supporting management control system that not only complies with the new CSRD (Corporate Sustainability Reporting Directive) legislation but also emphasizes the creation of substantial value in financial and ESG (Environmental, Social, and Governance) aspects, based on double materiality, in line with the organization's corporate values and beliefs? Objective The aim is to develop a validated method, including tools, that hotels can use to create a sustainability strategy in line with the CSRD guidelines. This strategy should create value for the organization, the environment, and society, while aligning with the hotel's values and beliefs. Merely being compliant with the CSRD is not enough for hotels. Instead, they should view the implementation of the CSRD as an opportunity to stand out in terms of sustainability. By creating value in areas such as environment, safety, and governance, or through the six capitals (financial, manufactured, intellectual, human, social and relationship, and natural) that align with the UN-SDGs, and explicitly taking both an inside-out and an outside in perspective (double materiality), hotels can significantly enhance their sustainability reputation.
Kinderfysiotherapeuten begeleiden baby's waarbij er zorgen zijn over de motorische ontwikkeling. Een goed ontwikkelde motoriek is belangrijk voor o.a. de cognitieve en de taalontwikkeling, en maakt het gemakkelijker om een fysiek actieve leefstijl te ontwikkelen die voorwaardelijk is voor een lang gezond leven. Interventies van kinderfysiotherapeuten bij baby’s met een bewegingsprobleem richten zich op het ondersteunen van ouders in een gelijkwaardige samenwerking. Kinderfysiotherapeuten zien daarbij een diversiteit in ideeën en overtuigingen die ouders hebben over ontwikkeling. Deze ideeën en overtuigingen, ook wel Parental Beliefs genoemd, vormen de basis van hun doen en laten in het zorgen voor hun baby (Parental Practices). Om een interventie goed te laten aansluiten bij het gezin, is het belangrijk dat kinderfysiotherapeuten zicht hebben op de Parental Beliefs. Kinderfysiotherapeuten ervaren echter belemmeringen om dit uit te vragen en werken hierin nu vaak intuïtief, omdat goede instrumenten ontbreken. In het project PEBBLES (ParEntal Beliefs concerning their Baby, Lifestyle and Experience Study) staat daarom de volgende onderzoeksvraag centraal: Hoe kunnen we samen met ouders en kinderfysiotherapeuten tools voor het in kaart brengen van Parental Beliefs & Practices ten aanzien van de motorische ontwikkeling van kinderen van 0-2 jaar ontwikkelen, die ingezet kunnen worden in de kinderfysiotherapeutische beroepspraktijk en in interventiestudies? In het PEBBLES-project ontwerpen we een toolbox om kinderfysiotherapeuten te ondersteunen bij het in kaart brengen van het denken en doen van ouders. In een iteratief proces ontwikkelen we dit samen met co-designers, Living Labs van zes MKB-kinderfysiotherapiepraktijken, ouders en onderzoekers. Een co-design-aanpak met aandacht voor de menselijke waarden borgt dat er tijdens het ontwerpproces voldoende aandacht is voor de impact van deze innovaties op de ouders en kinderfysiotherapeuten. Ook doen kinderfysiotherapeuten ervaring op met ontwerpprocessen en ontwikkelen daarbij ontwerpend vermogen.
Kinderfysiotherapeuten begeleiden baby's waarbij zorgen zijn over de motorische ontwikkeling. Interventies richten zich op ondersteuning van ouders in gelijkwaardige samenwerking. Kinderfysiotherapeuten zien een diversiteit aan ideeën en overtuigingen over de ontwikkeling (Parental Beliefs) die de basis vormen van de zorg (Parental Practices). Het is belangrijk dat kinderfysiotherapeuten zicht hebben op de Parental Beliefs.
