Physiotherapy (PHYSIOTHERAPY )

Publisher: Chartered Society of Physiotherapy (Great Britain), Elsevier

Description

Physiotherapy aims to publish original research and facilitate continuing professional development for physiotherapists and other health professions worldwide. Dedicated to the advancement of physiotherapy through publication of research and scholarly work concerned with, but not limited to, its scientific basis and clinical application, education of practitioners, management of services and policy. We are pleased to receive articles reporting original scientific research, systematic or narrative reviews, educational, theoretical or debate articles, brief reports, case histories or single case studies. All papers should demonstrate methodological rigour. Physiotherapy is peer reviewed by an international panel.

  • Impact factor
    1.57
  • 5-year impact
    1.49
  • Cited half-life
    0.00
  • Immediacy index
    0.19
  • Eigenfactor
    0.00
  • Article influence
    0.41
  • Website
    Physiotherapy website
  • Other titles
    Physiotherapy (Online)
  • ISSN
    1873-1465
  • OCLC
    60630130
  • Material type
    Document, Periodical, Internet resource
  • Document type
    Internet Resource, Computer File, Journal / Magazine / Newspaper

Publisher details

Elsevier

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  • Post-print
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    • Publisher's version/PDF cannot be used
    • Articles in some journals can be made Open Access on payment of additional charge
    • NIH Authors articles will be submitted to PubMed Central after 12 months
    • Publisher last contacted on 18/10/2013
  • Classification
    ​ green

Publications in this journal

  • [Show abstract] [Hide abstract]
    ABSTRACT: Objective The purpose of this study was to determine if there is an association between admission interview score and subsequent academic and clinical performance, in a four-year undergraduate physiotherapy course. Design Retrospective observational study. Participants 141 physiotherapy students enrolled in two entry year groups. Outcome measures Individual student performance in all course units, practical examinations, clinical placements as well as year level and overall Grade Point Average. Predictor variables included admission interview scores, admission academic scores and demographic data (gender, age and entry level). Results Interview score demonstrated a significant association with performance in three of six clinical placements through the course. This association was stronger than for any other admission criterion although effect sizes were small to moderate. Further, it was the only admission score to have a significant association with overall Clinical Grade Point Average for the two year groups analysed (r = 0.322). By contrast, academic scores on entry showed significant associations with all year level Grade Point Averages except Year 4, the clinical year. Conclusions This is the first study to review the predictive validity of an admission interview for entry into a physiotherapy course in Australia. The results show that performance in this admission interview is associated with overall performance in clinical placements through the course, while academic admission scoring is not. These findings suggest that there is a role for both academic and non-academic selection processes for entry into physiotherapy.
    Physiotherapy 12/2014;
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    ABSTRACT: Background Clinicians commonly assess cervical range of motion (ROM), but it has rarely been critically evaluated for its ability to contribute to patient diagnosis or prognosis, or whether it is affected by mobilisation/manipulation. Objectives This review summarises the methods used to measure cervical ROM in research involving patients with cervical spine disorders, reviews the evidence for using cervical ROM in patient diagnosis, prognosis, and evaluation of the effects of mobilisation/manipulation on cervical ROM. Data sources and study selection: A systematic search of MEDLINE, EMBASE, CINAHL, AMED and ICL databases was conducted, addressing one of four constructs related to cervical ROM: measurement, diagnosis, prognosis, and the effects of mobilisation/manipulation on cervical ROM. Study appraisal and synthesis: Two independent raters appraised methodological quality using the QUADAS-2 tool for diagnostic studies, the QUIPS tool for prognostic studies and the PEDro scale for interventional studies. Heterogeneity of studies prevented meta-analysis. Results Thirty-six studies met the criteria and findings showed there is limited evidence for the diagnostic value of cervical ROM in cervicogenic headache, cervical radiculopathy and cervical spine injury. There is conflicting evidence for the prognostic value of cervical ROM, though restricted ROM appears associated with negative outcomes while greater ROM is associated with positive outcomes. There is conflicting evidence as to whether cervical ROM increases or decreases following mobilisation/manipulation. Conclusion and Implications of Key Findings Cervical ROM has value as one component of assessment, but clinicians should be cautious about making clinical judgments primarily on the basis of cervical ROM. Funding This collaboration was supported by an internal grant from the Faculty of Health, The University of Newcastle.
    Physiotherapy 12/2014; 100(4):290-304.
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    ABSTRACT: The use of Patient-Reported Outcome Measures (PROMs) is set to rise in physiotherapy. PROMs provide additional ‘patient-centred’ data which is unique in capturing the patient's own opinion on the impact of their disease or disorder, and its treatment, on their life. Thus, PROMs are increasingly used by clinicians to guide routine patient care, or for the purposes of audit, and are already firmly embedded in clinical research. This article seeks to summarize the key aspects of PROM use for physiotherapists, both in routine clinical practice and in the research setting, and highlights recent developments in the field. Generic and condition-specific PROMs are defined and examples of commonly used measures are provided. The selection of appropriate PROMs, and their effective use in the clinical and research settings is discussed. Finally, existing barriers to PROM use in practice are identified and recent physiotherapy PROM initiatives, led by the Royal Dutch Society for Physical Therapy are explored.
    Physiotherapy 11/2014;
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    ABSTRACT: Research has demonstrated that incorporating psychological interventions within physiotherapy practice has numerous potential benefits. Despite this physiotherapists have reported feeling inadequately trained to confidently use such interventions in their day-to-day practice. To systematically review musculoskeletal physiotherapists' perceptions regarding the use of psychological interventions within physiotherapy practice. Eligible studies were identified through a rigorous search of AMED, CINAHL, EMBASE, MEDLINE and PsychINFO from January 2002 until August 2013. Full text qualitative, quantitative and mixed methodology studies published in English language investigating musculoskeletal physiotherapists' perceptions regarding their use of psychological interventions within physiotherapy practice. Included studies were appraised for risk of bias using the Critical Appraisal Skills Programme qualitative checklist. Meta-analysis was not possible due to study heterogeneity. Six studies, all with a low risk of bias, met the inclusion criteria. These studies highlighted that physiotherapists appreciate the importance of using psychological interventions within their practice, but report inadequate understanding and consequent underutilisation of these interventions. These results should be noted with some degree of caution due to various limitations associated with the included studies and with this review, including the use of a qualitative appraisal tool for mixed methodology/quantitative studies. These findings suggest that musculoskeletal physiotherapists are aware of the potential benefits of incorporating psychological interventions within their practice but feel insufficiently trained to optimise their use of such interventions; hence highlighting a need for further research in this area and a review of physiotherapist training. Copyright © 2014 Chartered Society of Physiotherapy. Published by Elsevier Ltd. All rights reserved.
    Physiotherapy 11/2014;
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    ABSTRACT: Objective To evaluate if the incremental shuttle walking test (ISWT) requires maximal effort in healthy subjects of different ages.Design Cross-sectional.Setting University-based research laboratory.Participants 331 healthy subjects separated into six groups according to age: G1, 18-28 yrs; G2, 29-39 yrs; G3, 40-50 yrs; G4, 51-61 yrs; G5, 62-72 yrs and; G6, 73-83 yrs.Main outcome measures Two ISWTs were performed and participants were permitted to run and to exceed 12 levels during the test, if necessary. Heart rate (HR) and symptoms of dyspnea and fatigue were recorded before and after the test, and the percentage of age-predicted maximal HR (HRmax) was calculated. Maximal effort was defined as HRmax >90% of age-predicted HRmax.Results Almost 31% of the subjects exceeded 12 levels in the ISWT. At the end of the test, all groups presented a median [interquartile range] HR greater than 90% of HRmax (G1: 100 [95–104]; G2: 100 [96–105]; G3: 103 [97–108]; G4: 99 [91–106]; G5: 96 [87–106] and G6: 96 [91–109] %HRmax). Regarding symptoms, all groups showed higher values after the test (P < 0.05). A multiple logistic regression analysis identified female gender, older age and a lower HR before the test as determinants of not achieving 90% of HRmax at the end of the test.Conclusions The ISWT requires maximal effort in healthy individuals, but for that it is necessary to extend the test beyond twelve levels. Female gender, older age and lower heart rate before the test are the determinants of not reaching maximal effort.
    Physiotherapy 11/2014;
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    ABSTRACT: Musculoskeletal condition assessment and management is increasingly delivered at the primary to secondary care interface, by inter-disciplinary triage and treat services.Objectives This review aimed to describe Intermediate Care pathways, evaluate effectiveness, describe outcomes and identify gaps in the evidence.Data sourcesPubMed, ISI Web of Science, EMBASE, Ovid Medline, PEDro, Google Scholar to October 2013.Study selection/eligibility criteriaStudies in English that evaluated relevant services were considered for inclusion. Studies evaluating paediatric or emergency medicine and self-referral were excluded.ResultsTwenty-three studies were identified. Between 72% and 97% of patients could be managed entirely within Intermediate Care with a 20% to 60% resultant reduction in orthopaedic referral rate. Patient reported outcome measures typically showed significant symptom improvements. Knee conditions were most commonly referred on to secondary care (35% to 56%), with plain films (5% to 23%) and MRI (10% to 18%) the commonest investigations. Physiotherapists’ clinical decision making and referral accuracy were comparable to medical doctors in 68% to 96% of cases. Intermediate Care consistently leads to significantly reduced orthopaedic waiting times and high patient satisfaction.LimitationsThese findings are not based on strong evidence and there is an urgent need for high-quality, prospective, comprehensive evaluation of Intermediate Care provision, including cost-effectiveness and impact on other services.FundingPart funded by EPSRC and AXA-PPP.Conclusion Intermediate Care consistently improves patient outcome, typically results in appropriate referral and management, reduces waiting times and increases patient satisfaction. There is a case for wider provision of Intermediate Care services to effectively manage non-surgical musculoskeletal patients.
    Physiotherapy 11/2014;
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    ABSTRACT: Background Cortical change, in the manner of cortical remapping is a common feature of and potential driver for chronic low back pain (CLBP). Novel interventions such as graded motor imagery (GMI) and mirror visual feedback (MVF) have been shown to facilitate correction of cortical changes and improve symptoms in other chronic pain states. However, little is known regarding the effectiveness of these treatment approaches in CLBP. Objective To identify and assess the current evidence regarding the effectiveness of interventions which target cortical remapping in the management of CLBP. Data Sources The electronic databases Medline, Embase, CINAHL, AMED, OVID, PEDro, BNI, PsycINFO, HMIC, and Cochrane library were systematically searched. Study Selection Of 11 potential citations identified, 5 articles were identified for inclusion and critiqued. These comprised 3 randomised controlled trials (RCTs), 1 randomised cross-over study, and 1 multiple case study design. Results Visualisation of lumbar movement may significantly improve movement-related pain severity and duration. A combined sensorimotor retraining approach has been shown to produce short-term improvements in both pain and disability outcomes in CLBP. The relative effectiveness of individual interventions and their long-term efficacy have yet to be established. Conclusions There is a paucity of robust literature which has examined the application and efficacy of these novel treatments in the management of CLBP. Results from the few CLBP studies which are available are encouraging. Further, robust research is needed to optimise treatment protocols and establish their long-term effectiveness in CLBP.
    Physiotherapy 10/2014;
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    ABSTRACT: Many clinical mobility tests have been used for individuals who have suffered a stroke; however, the ceiling effect has been identified as a limitation for relatively high functioning individuals. The L test, a variation of the timed up and go test (TUG), was developed as a mobility test for patients after amputation. The objective of this study was to examine the reliability and validity of the L test among patients following a stroke.
    Physiotherapy 10/2014;
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    ABSTRACT: Background Ventilator hyperinflation (VHI) and manual hyperinflation (MHI) are thought to improve secretion clearance, atelectasis and oxygenation in adults receiving mechanical ventilation. However, to the authors’ knowledge, a systematic review of their relative effectiveness has not been undertaken previously. Objective To determine whether VHI is more effective than MHI for the improvement of clinical outcomes in adults receiving mechanical ventilation. Data sources The electronic databases PubMed, Cochrane Library, CINHAL Plus, Wiley Online Library, ScienceDirect and PEDro were searched from January 1993 until August 2013. OpenGrey, the metaRegister of Controlled Trials (mRCT) and the reference lists of all potentially relevant studies were also searched. Study eligibility criteria Full English reports of randomised clinical trials comparing at least one effect of VHI and MHI in adults receiving mechanical ventilation. Study synthesis and appraisal Included studies were appraised using the Cochrane risk of bias tool. The findings were synthesised using a purely qualitative approach. Results All four included studies reported no significant differences in sputum wet weight, dynamic and static pulmonary compliance, oxygenation and cardiovascular stability between VHI and MHI. Limitations All the included studies had considerable limitations related to the protocols, equipment, participants and outcome measures. Furthermore, the overall risk of bias was judged to be high for three studies and unclear for one study. Conclusion Only four studies, all of which had a high or unclear risk of bias and significant additional limitations, have compared the effects of VHI and MHI in adults receiving mechanical ventilation. As such, further research in this area is clearly warranted.
    Physiotherapy 10/2014;
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    ABSTRACT: Objectives The International Physical Activity Questionnaire Short Form (IPAQ-SF) is a self-report questionnaire commonly used in patients with rheumatoid arthritis (RA) to measure physical activity. However, despite its frequent use in patients with RA, its validity has not been ascertained in this population. The aim of this study was to examine the criterion validity of energy expenditure from physical activity recorded with the IPAQ-SF in patients with RA compared with the objective criterion measure, the SenseWear Armband (SWA) which has been validated previously in this population. Design Cross-sectional criterion validation study. Setting Regional hospital outpatient setting. Participants Twenty-two patients with RA attending outpatient rheumatology clinics.Interventions Subjects wore an SWA for 7 full consecutive days and completed the IPAQ-SF.Main outcome measures Energy expenditure from physical activity recorded by the SWA and the IPAQ-SF. Results Energy expenditure from physical activity recorded by the IPAQ-SF and the SWA showed a small, non-significant correlation (r = 0.407, P = 0.60). The IPAQ-SF underestimated energy expenditure from physical activity by 41% compared with the SWA. This was corroborated using Bland and Altman plots, as the IPAQ-SF was found to overestimate energy expenditure from physical activity in nine of the 22 individuals, and underestimate energy expenditure from physical activity in the remaining 13 individuals. Conclusion The IPAQ-SF has limited use as an accurate and absolute measure for estimating energy expenditure from physical activity in patients with RA.
    Physiotherapy 09/2014;
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    ABSTRACT: Objective To assess the immediate effect of conventional and burst transcutaneous electrical nerve stimulation (TENS) in combination with cryotherapy on pain threshold and tolerance in healthy individuals. Design Randomised, controlled trial. Setting University laboratory. Participants One hundred and twelve healthy women. Interventions Volunteers were allocated at random to seven groups (n = 16): (1) control; (2) placebo TENS; (3) conventional TENS; (4) burst TENS; (5) cryotherapy; (6) cryotherapy in combination with burst TENS; and (7) cryotherapy in combination with conventional TENS. Pain threshold and tolerance were measured by applying a pressure algometer at the lateral epicondyle of the humerus, before and after each intervention. Main outcome measures The primary outcome measure was pressure pain threshold. Results A significant increase in pain threshold and tolerance at the 5% level of significance was recorded as follows: burst TENS {pain threshold: mean difference 1.3 (95% CI 1.4 to 1.2); pain tolerance: mean difference 3.8 (95% CI 3.9 to 3.7)}, cryotherapy [pain threshold: mean difference 1.3 (95% CI 1.4 to 1.2); pain tolerance: mean difference 1.9 (95% CI 1.8 to 2.0)] and cryotherapy in combination with burst TENS [pain threshold: mean difference 2.6 (95% CI 2.4 to 2.8); pain tolerance: mean difference 4.9 (95% CI 5.0 to 4.8)]. Cryotherapy in combination with burst TENS provided greater analgesia compared with the other groups (P < 0.001). Conclusion These results support the use of cryotherapy in combination with burst TENS to reduce induced pain, and suggest a potentiating effect when these techniques are combined. No such association was found between cryotherapy and conventional TENS.
    Physiotherapy 09/2014;
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    ABSTRACT: Objectives To explore the potential relationship between ethnicity and achievement within undergraduate physiotherapy education. Design A retrospective analysis of assessment marks awarded for academic and clinical modules. Setting A London university offering undergraduate physiotherapy education. Participants: 448 undergraduate students enrolled onto the Physiotherapy honours degree programme between 2005-2009. Main Outcome Measures: Marks awarded following academic or clinical assessment. These were modelled through multivariable regression analysis to evaluate the relationship between marks awarded and ethnicity. Results Differences were noted between ethnic categories in final programme success and across academic and clinical modules. Our multivariable analysis demonstrated students from Asian backgrounds had decreased odds of succeeding compared with white British students (adjusted OR 0.43 95%CI 0.24, 0.79 p = 0.006), as had Black students (adjusted OR 0.42 95%CI 0.19, 0.95 p = 0.036) and students from Other ethnic backgrounds (adjusted OR 0.41 95%CI 0.20, 0.87 p = 0.020). Conclusions This analysis of undergraduate physiotherapy students illustrated a persistent difference in attainment between students from white British and those from BME backgrounds. Heterogeneity in academic outcomes both within and between minority ethnic groups was illustrated. This study not only reinforces the need to consider ethnicity within physiotherapy education but also raises further questions about why physiotherapy students from BME groups perform less well than their white British peers.
    Physiotherapy 09/2014;
  • Physiotherapy 09/2014;
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    ABSTRACT: Objective The purpose of this study was to determine the effects of body position on respiratory muscle strength of young healthy subjects. Methods Sixty-three (50 female, mean age 19.7 ± 1.5 years) healthy subjects participated in the study. Maximal inspiratory and expiratory mouth pressures (PImax, PEmax) and lung function were measured in the sitting position, semi-upright sitting position, and in the supine position. The order of the three conditions was randomly determined. Results A significant effect of body position was observed on PEmax values, controlling for gender. PImax in the sitting position (92.8 ± 20.05 cm H2O) was significantly higher than in the supine (84.1 ± 15.1 cm H2O; mean difference: 8.70, 95% CI [5.95, 12.45], p < 0.001) and semi-upright sitting positions (84.4 ± 17.5 cm H2O; mean difference: 8.43, 95% CI [5.78, 11.07], p < 0.001). PEmax was also significantly higher in the sitting position (125.4 ± 34.2 cm H2O) than in the supine (115.8 ± 29.0 cm H2O; mean difference: 9.59, 95% CI [4.86, 14.32], p < 0.001) and semi-upright sitting positions (120.2 ± 33.9 cm H2O; mean difference: 5.21, 95% CI [0.87, 9.54], p = 0.013). Conclusions Body position influences respiratory muscle strength of young healthy subjects. PImax and PEmax are higher in the sitting position than in the supine or semi-upright sitting positions.
    Physiotherapy 08/2014;
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    ABSTRACT: Background Physiotherapeutic management of patients immediately following lumbar spinal surgery is common. However, there is considerable variability in the interventions provided. Objectives To assess the effect of peri-operative physiotherapeutic intervention in adults undergoing surgery for the management of degenerative lumbar conditions. Data sources The Cochrane Library, Medline, Embase, CINAHL and PEDro were searched from inception to August 2012. Study selection Randomised controlled trials investigating physiotherapeutic interventions prior to and immediately following surgery for degenerative lumbar conditions were included. Data extraction and synthesis Two reviewers extracted data independently using a standardised form. Risk of bias was assessed using a modified version of the Cochrane Collaboration tool. The quality of evidence was assessed using the GRADE approach, and the treatment effect size was calculated where comparable outcome measures were used across multiple trials. Results Four studies were included. There is very-low-quality evidence that pre- and post-operative exercise in addition to standard physiotherapeutic care may reduce pain, time taken to achieve post-operative functional milestones, and post-operative time off work. Results from one study indicated that there is no clear benefit or risk of harm from performing either prone or side-lying transfers. Conclusion and implications of key findings Very-low-quality evidence suggests that physiotherapy may improve pain and function following lumbar surgery. Due to low numbers of included studies and variation in the interventions assessed, the current evidence provides limited guidance for physiotherapeutic practice. Further research is required to determine the effectiveness of physiotherapeutic interventions in this population.
    Physiotherapy 08/2014;
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    ABSTRACT: Objectives Although exercise therapy is effective for reducing pain and activity limitations in patients with knee osteoarthritis (OA), the underlying mechanisms are unclear. This study aimed to evaluate if improvements in neuromuscular factors (i.e. upper leg muscle strength and knee proprioception) underlie the beneficial effects of exercise therapy in patients with knee OA. Design Secondary analyses from a randomised controlled trial, with measurements at baseline, 6 weeks, 12 weeks and 38 weeks. Setting Rehabilitation centre. Participants One hundred and fifty-nine patients diagnosed with knee OA. Intervention Exercise therapy. Main outcome measures Changes in pain [numeric rating scale (NRS)] and activity limitations [Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) physical function subscale and get-up-and-go test] during the study period. Independent variables were changes in upper leg muscle strength and knee joint proprioception (i.e. motion sense) during the study period. Longitudinal regression analyses (generalised estimating equation) were performed to analyse associations between changes in upper leg muscle strength and knee proprioception with changes in pain and activity limitations. Results Improved muscle strength was significantly associated with reductions in NRS pain {B coefficient -2.5 [95% confidence interval (CI) -3.7 to -1.4], meaning that every change of 1 unit of strength was linked to a change of -2.5 units of pain}, WOMAC physical function (- 8.8, 95% CI -13.4 to -4.2) and get-up-and-go test (-1.7, 95% CI -2.4 to -1.0). Improved proprioception was not significantly associated with better outcomes of exercise therapy (P > 0.05). Conclusions Upper leg muscle strengthening is one of the mechanisms underlying the beneficial effects of exercise therapy in patients with knee OA.
    Physiotherapy 08/2014;
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    ABSTRACT: To investigate the perceptions of physiotherapists about their role in health promotion in an acute inpatient setting.
    Physiotherapy 08/2014;
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    ABSTRACT: Background Patients’ subjective impression of change is an important construct to measure following physiotherapy, but little evidence exists about the best type of measure to use. Objective To compare the construct validity and utility of two forms of a global subjective outcome scale (GSOS) in patients with back pain: Likert and visual analogue scale (VAS) GSOS. Design Two samples of patients attending physiotherapy for back pain completed a questionnaire battery at discharge from physiotherapy including either a Likert or VAS GSOS. Participants One hundred and eighty-seven {79 males, mean age 52.1 [standard deviation (SD) 15.5] years} patients completed the Likert GSOS and a separate sample of 144 patients [62 males, mean age 55.7 (SD 15.9) years] completed the VAS GSOS upon discharge from physiotherapy. Main comparisons The two versions of the GSOS were compared using pre- and post-treatment changes in scores using a VAS (pain), Roland–Morris Disability Questionnaire (18-item version) and catastrophising subscale of the Coping Strategies Questionnaire 24. Results Both versions of the GSOS showed significant (P < 0.01) moderate correlations (r between 0.30 and 0.46) with changes in pain and disability. The correlations between the two types of GSOS and changes in catastrophising were trivial and not significant (Likert GSOS: r = 0.07, P = 0.372; VAS GSOS: r = 0.10, P = 0.267). There were fewer missing values in the Likert GSOS (1%) compared with the VAS GSOS (8%). Conclusions The two versions of the GSOS showed similar validity; however, use of the Likert GSOS is recommended because of its greater utility.
    Physiotherapy 07/2014;