Article

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.

Langue : ANGLAIS