Development of a preliminary questionnaire to investigate the attitudes of NZ osteopaths regarding the use of exercise in osteopathy

Abstract

Background: In the healthcare context, exercise may be conveniently considered in two categories: physical activity and therapeutic exercise. Physical activity has demonstrated benefits for the maintenance of physical and psychological health and wellbeing. Therapeutic exercise is typically considered in a preventative or rehabilitation context and is usually associated with clinical management of any of a wide range of target disorders. Therapeutic exercise has been demonstrated to be beneficial for decreasing pain levels and increasing functional capability in chronic pain as well as helping encourage an active coping style. There are two distinct ways of delivering information about physical activity and therapeutic exercise: advice and prescription. Prescription includes providing information regarding four key elements; frequency, intensity, type, and time. Providing advice includes instructions about any less than all four of these elements. To date there is little research available regarding the use of physical activity or therapeutic exercise within osteopathy.

Aims: The study aimed to develop a questionnaire which could be used as a tool to investigate the attitudes of NZ osteopaths regarding the use of exercise within osteopathy.

Objectives: The objectives were to i) Conduct a qualitative research project to identify key issues/themes about the study topic ; ii) To draft items based on the themes identified in part i; and iii) Pilot the draft items in the format of a preliminary questionnaire to review face validity, and usability.

Methods: This was a two part study. Part 1 used the method interpretive description using face-to face interviews to collect data involving five registered osteopaths and one osteopathic student. Data analysis using interpretive description identified four theme clusters. Part 2 used quantitative survey research in order to draft, format and pilot items formatted into a 45 item questionnaire structured into three sections; ‘Demographics’, ‘Physical activity’, and ‘Therapeutic exercise’. Piloting involved two rounds; Round 1 (usability) and Round 2 (expert review).

Results: Four theme clusters were identified from Part 1: ‘Exercise and osteopathy: A perfect match?’, ‘Experiences with exercise’, ‘Exercise choice’, and ‘Barriers to providing exercise’. Part 2 resulted in the addition of seventeen items, the deletion of two items, and the further differentiation of the ‘physical activity’ and ‘therapeutic exercise’ sections into ‘advice’, and ‘prescription’ leading to the addition of a further 39 items. The final questionnaire was structured into five sections: ‘demographics’, ‘physical activity advice’, ‘physical activity prescription’, ‘therapeutic activity advice’, and ‘therapeutic exercise prescription’.

Conclusion: The preliminary questionnaire is ready for further development using factor analysis as a means of exploring internal and external validity. The questionnaire can then be used to investigate the attitudes of NZ osteopaths regarding exercise within osteopathy.