ICF linked Dutch physiotherapy guidelines concerning initial assessment, treatment and evaluation in hip and knee osteoarthritis.
Bibliographic record
Abstract
Purpose: In 2001 the Royal Dutch Society for Physical Therapy (KNGF) Guideline for hip and knee osteoarthritis (HKOA) was developed. Since then, many scientific papers on physical therapy interventions as well as national and international guidelines were published. Relevance: An update of the physical therapy guideline was needed to support the physical therapy practice in performing the best clinical practice based on current evidence inHKOA. Participants: This guideline is developed by a guideline development committee consisting 10 expert physical therapists working in different centers specialized in care for HKOA patients. Methods: Topics concerning the three guideline chapters: initial assessment, treatment and evaluation were selected by the guideline development committee. With respect to treatment a systematic literature search (up to June 2009) within various databases was performed aiming to identify reviews and randomized controlled trials (RCTs) on the effectiveness of physical therapy interventions and the evidencewas graded (1–4). For initial assessment and evaluation mainly review papers and textbooks were used. Based on evidence and expert opinion, recommendations were formulated (5 consensus meetings and 8 feedback rounds) and graded (A–D). For the initial assessment, a description of relevant health related topics in HKOA was made according to the International Classification of Functioning, disability and health (ICF) core set for osteoarthritis (OA). Concerning treatment, 22 systematic reviews and 74 RCTs were reviewed. Analysis: A first draft of the guideline was reviewed by 17 experts from different professional backgrounds (2 feedback rounds). A second draft was field-tested by 45 physical therapists working in daily practice. The comments of both groups have been processed in the definite guideline. Results: Recommended were: exercise therapy, education and self management interventions, a combination of exercise and manual therapy, and postoperative exercise therapy in HKOA, and taping of the patella in knee OA. Neither recommended nor advised against were: balneotherapy, hydrotherapy, and preoperative physical therapy in HKOA; thermotherapy, TENS, and Continuous Passive Motion in knee OA. Not recommended were: massage, ultrasound, electrotherapy, electromagnetic field and Low Level Laser Therapy. For the evaluation of treatment goals the use of one or more of the following measurement instruments was recommended: daily activities and participation: Lequesne index,Western Ontario and McMaster Universities osteoarthritis index questionnaire, Hip disability and Knee injury and Osteoarthritis Outcome Scores, 6 Minute Walk test, Timed Stand Up and Go test and Patient Specific Complaint list; body functions and structures: Visual Analogue Scale for pain, Intermittent and Constant OsteoArthritis Pain questionnaire, goniometry, Medical Research Council for strength, Handheld Dynamometer. Conclusions: This update of the Dutch physical therapy guideline concerning HKOA included recommendations on the initial assessment, treatment and evaluation. The revised guideline has been launched in April 2010 and published on www.fysionet.nl (including an English translation). Implications: This guideline is helpful in physical therapy practice to perform the best practice based on current evidence. Working according guidelines is a requirement to stand registered in the Dutch physical therapy quality register.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.020 | 0.072 |
| Meta-epidemiology (narrow) | 0.002 | 0.001 |
| Meta-epidemiology (broad) | 0.004 | 0.004 |
| Bibliometrics | 0.012 | 0.016 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.004 | 0.004 |
| Research integrity | 0.007 | 0.004 |
| Insufficient payload (model declined to judge) | 0.030 | 0.011 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".