Evidence map›Paper›PMID 36890570›Full record

Trial reportBMC musculoskeletal disorders2023

Development and feasibility of stratified primary care physiotherapy integrated with eHealth in patients with neck and/or shoulder complaints: results of a mixed methods study.

Mark L van Tilburg, Corelien J J Kloek, Nadine E Foster, Raymond W J G Ostelo, Cindy Veenhof, J Bart Staal, Martijn F Pisters

Open access · goldAbstract readRandomized Controlled TrialMulticenter Study
In one paragraph

Trial report in BMC musculoskeletal disorders, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 2 pooled it
1.2field-weighted citation impact, top 23% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 2 syntheses or guidelines pooled it, 4 citations in OpenAlex.

  1. Telerehabilitation for neck pain.The Cochrane database of systematic reviews · 2025
    Pooled it
  2. Pooled it
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 5 institutions in 3 countries.

Mark L van TilburgExpertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS, Utrecht, The Netherlands. mark.vantilburg@hu.nl.
Corelien J J KloekExpertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS, Utrecht, The Netherlands.
Nadine E FosterPrimary Care Centre Versus Arthritis, School of Medicine, Keele University, Keele, UK.
Raymond W J G OsteloDepartment of Health Sciences, Faculty of Science, VU University, Amsterdam Movement Sciences Research Institute, Amsterdam, The Netherlands.
Cindy VeenhofExpertise Center Healthy Urban Living, Research Group Innovation of Human Movement Care, HU University of Applied Sciences Utrecht, Heidelberglaan 7, 3584 CS, Utrecht, The Netherlands.
J Bart StaalMusculoskeletal Rehabilitation Research Group, HAN University of Applied Sciences, Radboud University Medical Centre, Nijmegen, The Netherlands.
Martijn F PistersCenter for Physical Therapy Research and Innovation in Primary Care, Julius Health Care Centers, Utrecht, The Netherlands.
University of Applied Sciences Utrecht · NLAmsterdam University Medical Centers · NLRadboud University Medical Center · NLUtrecht University · NLVersus Arthritis · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundProviding individualized care based on the context and preferences of the patient is important. Knowledge on both prognostic risk stratification and blended eHealth care in musculoskeletal conditions is increasing and seems promising. Stratification can be used to match patients to the most optimal content and intensity of treatment as well as mode of treatment delivery (i.e. face-to-face or blended with eHealth). However, research on the integration of stratified and blended eHealth care with corresponding matched treatment options for patients with neck and/or shoulder complaints is lacking.

methodsThis study was a mixed methods study comprising the development of matched treatment options, followed by an evaluation of the feasibility of the developed Stratified Blended Physiotherapy approach. In the first phase, three focus groups with physiotherapists and physiotherapy experts were conducted. The second phase investigated the feasibility (i.e. satisfaction, usability and experiences) of the Stratified Blended Physiotherapy approach for both physiotherapists and patients in a multicenter single-arm convergent parallel mixed methods feasibility study.

resultsIn the first phase, matched treatment options were developed for six patient subgroups. Recommendations for content and intensity of physiotherapy were matched to the patient's risk of persistent disabling pain (using the Keele STarT MSK Tool: low/medium/high risk). In addition, selection of mode of treatment delivery was matched to the patient's suitability for blended care (using the Dutch Blended Physiotherapy Checklist: yes/no). A paper-based workbook and e-Exercise app modules were developed as two different mode of treatment delivery options, to support physiotherapists. Feasibility was evaluated in the second phase. Physiotherapists and patients were mildly satisfied with the new approach. Usability of the physiotherapist dashboard to set up the e-Exercise app was considered 'OK' by physiotherapists. Patients considered the e-Exercise app to be of 'best imaginable' usability. The paper-based workbook was not used.

conclusionResults of the focus groups led to the development of matched treatment options. Results of the feasibility study showed experiences with integrating stratified and blended eHealth care and have informed amendments to the Stratified Blended Physiotherapy approach for patients with neck and/or shoulder complaints ready to use within a future cluster randomized trial.

Indexed as

ShoulderTelemedicineFeasibility StudiesHumansPhysical Therapy ModalitiesPrimary Health CareBlended careeHealthFeasibilityMixed methodsNeck painPhysiotherapyShoulder painStratified careTelehealth

Identifiers

PMID36890570
PMCPMC9996840
OpenAlexW4323652217

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.