Browsing by Person "Williamson, Julia"

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Classifying Outcome Measures According to the International Classification of Functioning, Disability and Health: a Pilot Study.
(2009-11-25) Williamson, Julia; Bulley, Catherine; Coutts, Fiona; Macmillan, Fiona
at which level of the World Health Organisation International Classification of Functioning, Disability and Health (WHO ICF) (WHO 2001) a selection of low back pain outcome tools measure. The ICF describes several categories of impact, those on body systems, activity, participation in life roles as well as environmental and personal factors. These categories can be used to relate an outcome measure to the level of the intervention. The results of a study may be compromisedif the outcome measure does not correspond to the level of intervention. For example, a treatment designed to reduce pain should be measured by a tool that measures at a body systems level while an intervention designed to improve return to work needs to measure at the participation level. In order to conduct a trial examining the effects of rehabilitation strategies after lumbar surgery it has been necessary to examine the qualities of commonly used low back pain outcome measures in light of the ICF. Confusion exists as to whether the entities of activity and participation are separate (Dahl 2002). Several attempts have been made to distinguish between the two but as yet, no consensus exists (Granlund2004). It was therefore necessary to define activity and participation and to validate this with a group of qualified health practitioners. J Williamson, C Bulley, F. Coutts, F. MacMillan
What do patients feel they can do following lumbar microdiscectomy? A qualitative study
(2008) Williamson, Julia; Bulley, Catherine; Coutts, Fiona
Purpose. Lumbar microdiscectomy is becoming increasingly popular in the management of prolapsed intervertebral disc. The early stage of rehabilitation has been under-researched, with little documented about optimal activity levels during the initial six weeks. This study aimed to gain insight into patients' experiences of physiotherapy and activity choices during this period. Method. Eight participants were chosen purposively. All had undergone an uncomplicated lumbar microdiscectomy in the preceding six weeks in an acute neurosurgical unit in the Northeast of England. One-to-one semi-structured interviews were conducted in the participants' homes and transcribed. Data were thematically analysed within a constructionist framework. Mechanisms to ensure analytical rigour were implemented. Results. Three major themes were derived inductively from the data. The first, 'wish for precise movement boundaries,' described participants reduced levels of activity postoperatively as being related to high levels of anxiety about the surgery and fear of re-injury. The second theme suggested that physiotherapy failed to help participants explore their potential for activity. The final theme described post-operative fatigue. Conclusions. High levels of postoperative anxiety about movement and activity were not addressed postoperatively. This has significant clinical implications and highlights the need for further research.