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Dissertation
A modified Delphi Study Establishing Consensus in the Therapeutic Management of Posttraumatic Elbow Stiffness
Doctor of Health Science (D.H.Sc.), Drexel University
Dec 2020
DOI:
https://doi.org/10.17918/00001408
Abstract
Loss of range of motion at the elbow is difficult to prevent after elbow trauma. Early implementation of therapy is strongly supported as the first choice of treatment for posttraumatic stiffness of the elbow. Currently there is high variability in therapy practice for the management of the posttraumatic elbow outlined in the literature. This lack of consensus impedes further research into effectiveness of treatment and the development of clinical practice guidelines. The purpose of this study is to identify the current therapeutic management of posttraumatic elbow stiffness using expert consensus. Methods: This study used a survey methodology to identify expert opinion using a web-based modified Delphi method using three rounds. Quantitative data and comments were collected during the first round. Questions with Likert scaling were used to identify consensus (defined as 75% agreement) with each statement, multiple choice formats were used to gather expert opinion, and comment boxes enabled open-ended responses. Lack of consensus and data from comments guided the second-round of the survey. This process was repeated after Round 2 to develop the Round 3 survey. Consensus was achieved at Round 3 and no further rounds were needed. Results: Round 1 included 34 experts (response rate 20%), not all experts were able to continue through all rounds. Round 2 included 18 experts and Round 3 included 15 experts. Survey items were categorized as follows: examination procedures, therapeutic interventions, orthotic intervention considerations, contributing patient factors, and clinical decisions and rehabilitation challenges. 25% of items achieved consensus after Round 1, 30% after Round 2 and 52% after Round 3. Although most participants agreed that orthotic intervention is critical to patient outcomes, there were conflicting thoughts about the orthotic dosage and design. Conclusions: The results of this web-based modified Delphi study help to establish consensus and contribute to the current body of knowledge on the therapeutic management of posttraumatic elbow stiffness. The findings of this study help to can be used to help guide practice and identify gaps in clinical practice that can be studied in future studies on posttraumatic elbow stiffness.
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Details
- Title
- A modified Delphi Study Establishing Consensus in the Therapeutic Management of Posttraumatic Elbow Stiffness
- Creators
- Mary Whitten
- Contributors
- Jane Fedorczyk (Advisor)
- Awarding Institution
- Drexel University
- Degree Awarded
- Doctor of Health Science (D.H.Sc.)
- Publisher
- Drexel University; Philadelphia, Pennsylvania
- Number of pages
- x, 140 pages
- Resource Type
- Dissertation
- Language
- English
- Academic Unit
- College of Nursing and Health Professions; Drexel University; Physical Therapy (and Rehabilitation Sciences)
- Other Identifier
- 991014833149304721