Physical Therapists' Adoption of the Lumbopelvic Manipulation

415 Pages·2013·2.46 MB·English

by  Jesse Ortel

PHYSICAL THERAPISTS’ ADOPTION OF THE LUMBOPELVIC MANIPULATION
CLINICAL PREDICTION RULE AND LUMBOPELVIC MANIPULATION
FOLLOWING A MULTI-COMPONENT TRAINING PROGRAM
by

Jesse Ortel
A Dissertation
Submitted to the
Graduate Faculty
of
George Mason University
in Partial Fulfillment of
The Requirements for the Degree
of
Doctor of Philosophy
Education

Committee:

Chair

Program Director

Dean, College of Education
and Human Development

Date: Summer Semester 2013
George Mason University
Fairfax, VA
Physical Therapists’ Adoption of the Lumbopelvic Manipulation Clinical Prediction Rule
and Lumbopelvic Manipulation Following a Multi-Component Training Program
A dissertation submitted in partial fulfillment of the requirements for the degree of
Doctor of Philosophy at George Mason University
by
Jesse Ortel
Doctorate of Physical Therapy
Temple University, 2006
Director: Brenda Bannan, Associate Professor
College of Education and Human Development
Summer Semester 2013
George Mason University
Fairfax, VA
THIS WORK IS LICENSED UNDER A CREATIVE COMMONS
ATTRIBUTION-NODERIVS 3.0 UNPORTED LICENSE.

ii
Dedication
This is dedicated to my loving wife Brittany, and my two wonderful children Elliott and
Austin. I could not have done it without your support and patience.
iii
Acknowledgements
I would like to thank the many friends, relatives, and supporters who have made this
happen. A special thanks to Brenda Bannan, Joseph Maxwell, Nada Dabbagh, Priscilla
Norton, and Jeff Thompson.

iv
Table of Contents
Page
List of Tables ..................................................................................................................... ix
List of Figures ..................................................................................................................... x
List of Abbreviations ......................................................................................................... xi
Abstract ............................................................................................................................. xii
Chapter One: Introduction .................................................................................................. 1
Chapter Two: Literature Review ........................................................................................ 4
The Innovations (LMCPR and LM) ................................................................................ 4
Low Adoption among Physical Therapy Students .......................................................... 7
Current Physical Therapy Studies ................................................................................... 8
Training Transfer Problem .............................................................................................. 9
Training Transfer Process and Relevant Theories ........................................................ 12
Training Transfer Solutions .......................................................................................... 17
Design Based Research ................................................................................................. 23
ILDF and Iteration of Intervention ................................................................................ 26
Chapter Three: Methods ................................................................................................... 32
Research Design ............................................................................................................ 34
Research Relationship ................................................................................................... 34
Intervention, Setting, and Participant Selection ............................................................ 36
Data Collection .............................................................................................................. 38
Data Analysis ................................................................................................................ 44
Validity .......................................................................................................................... 46
Chapter Four: Quantitative Results ................................................................................... 55
Tables ............................................................................................................................ 55
Chapter Five: Case Studies ............................................................................................. 104
Cases Overview ........................................................................................................... 104
Case #1 Susan.............................................................................................................. 105
v
Pre-Course ................................................................................................................... 105
Course.......................................................................................................................... 107
Post-course .................................................................................................................. 107
Case #2 Mary .............................................................................................................. 115
Pre-Course ................................................................................................................... 116
Course.......................................................................................................................... 117
Post-course .................................................................................................................. 118
Case #3 John................................................................................................................ 124
Pre-Course ................................................................................................................... 124
Course.......................................................................................................................... 126
Post-course .................................................................................................................. 126
Case #4 Todd ............................................................................................................... 131
Pre-Course ................................................................................................................... 131
Course.......................................................................................................................... 132
Post-course .................................................................................................................. 132
Case #5 Trisha ............................................................................................................. 141
Pre-Course ................................................................................................................... 141
Course.......................................................................................................................... 143
Post-course .................................................................................................................. 143
Case #6 Tim ................................................................................................................ 149
Pre-Course ................................................................................................................... 149
Course.......................................................................................................................... 150
Post-course .................................................................................................................. 151
Case #7 George ........................................................................................................... 155
Pre-Course ................................................................................................................... 155
Course.......................................................................................................................... 156
Post-course .................................................................................................................. 156
Case #8 Jeff ................................................................................................................. 162
Pre-Course ................................................................................................................... 162
Course.......................................................................................................................... 164
Post-course .................................................................................................................. 164
Case #9 Leslie ............................................................................................................. 168
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Pre-Course ................................................................................................................... 168
Course.......................................................................................................................... 170
Post-course .................................................................................................................. 170
Case #10 Keith ............................................................................................................ 175
Pre-Course ................................................................................................................... 175
Course.......................................................................................................................... 176
Post-course .................................................................................................................. 176
Cross Case analysis ..................................................................................................... 181
Chapter Six: Discussion and Conclusion ........................................................................ 188
Research Questions ..................................................................................................... 190
General Discussion ...................................................................................................... 299
Validity Threats ........................................................................................................... 321
Implications for Research............................................................................................ 326
Appendix A: Knowledge of LMCPR and LM Questionnaire ........................................ 328
Appendix B: Baseline Demographics, Perception and Intention of LMCPR & LM, and
Adoption Questionnaire .................................................................................................. 330
Appendix C: Follow-Up Perception, Intention of LMCPR & LM, Adoption, and Process
Questionnaire .................................................................................................................. 335
Appendix D: Baseline Reaction and Perception of Program Questionnaire .................. 339
Appendix E: Follow-Up Reaction and Perception of Program Questionnaire ............... 340
Appendix F: LMCPR and LM Competency Checklist ................................................... 342
Appendix G: Interview Guide ......................................................................................... 343
Appendix H: CPR Algorithm ......................................................................................... 346
Appendix I: Informed Consent ....................................................................................... 347
Appendix J: Pre-notification Letter 5th Week ................................................................. 349
Appendix K: Email Questionnaire Invitation 6th Week .................................................. 350
Appendix L: Reminder Email for Questionnaire Email ................................................. 351
Appendix M: Final Letter Reminder............................................................................... 352
Appendix N: Pre-notification Letter 11th Week ............................................................. 353
Appendix O: Email Questionnaire Invitation 12th Week ............................................... 354
Appendix P: Discrepancies between Questionnaire Data and Interview Data ............... 355
Appendix Q: Discussion Board Postings ........................................................................ 370
Appendix R: Table of Codes/Themes ............................................................................ 371
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Appendix S: Blog Postings ............................................................................................. 379
Appendix T: Design Based Research Plan .................................................................... 382
Appendix U: Phone Interview Dates ............................................................................. 386
Appendix V: LBP and the Lumbopelvic Manipulation Clinical Prediction Rule ......... 387
References ....................................................................................................................... 391

viii
List of Tables
Table Page
Table 1 .............................................................................................................................. 46
Table 2 .............................................................................................................................. 59
Table 3 .............................................................................................................................. 60
Table 4 .............................................................................................................................. 61
Table 5 .............................................................................................................................. 64
Table 6 .............................................................................................................................. 65
Table 7 .............................................................................................................................. 65
Table 8 .............................................................................................................................. 66
Table 9 .............................................................................................................................. 68
Table 10 ............................................................................................................................ 69
Table 11 ............................................................................................................................ 70
Table 12 ............................................................................................................................ 71
Table 13 ............................................................................................................................ 72
Table 14 ............................................................................................................................ 74
Table 15 ............................................................................................................................ 77
Table 16 ............................................................................................................................ 79
Table 17 ............................................................................................................................ 80
Table 18 ............................................................................................................................ 82
Table 19 ............................................................................................................................ 86
Table 20 ............................................................................................................................ 88
Table 21 ............................................................................................................................ 92
Table 22 ............................................................................................................................ 95
Table 23 ............................................................................................................................ 98
Table 24 .......................................................................................................................... 101
Table 25 .......................................................................................................................... 103
Table 26 .......................................................................................................................... 183
Table 27 .......................................................................................................................... 185
Table 28 .......................................................................................................................... 187

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