Sleep disturbance influences human health. To examine sleep patterns, it is advisable to utilize valid subjective and objective measures. Laboratory-based polysomnography (PSG) is deemed the gold standard to measure sleep objectively, but is impractical for long-term and home utilization (e.g. resource-demanding, difficult to use). Hence, alternative devices have been developed. This study aimed to review the literature systematically, providing an overview of available objective sleep measures in non-laboratory settings as an alternative to PSG. To identify relevant articles, a specific search strategy was run in EMBASE, PubMed, CINAHL, PsycInfo and Compendex (Engineering Village 2). In addition, reference lists of retrieved articles were screened and experts within this research field were contacted. Two researchers, using specified in/exclusion criteria, screened identified citations independently in three stages: on title, abstract and full text. Data from included articles were extracted and inserted into summarizing tables outlining the results. Of the 2217 electronically identified citations, 35 studies met the inclusion criteria. Additional searches revealed eight papers. Psychometric characteristics of nine different objective measures of sleep pattern alternatives to PSG [(bed) actigraphy, observation, bed sensors, eyelid movement- and non-invasive arm sensors, a sleep switch and a remote device] were evaluated. Actigraphy is used widely and has been validated in several populations. Alternative devices to measure sleep patterns are becoming available, but most remain at prototype stage and are validated insufficiently. Future research should concentrate on the development and further validation of non-invasive, inexpensive and user-friendly sleep measures for non-laboratory settings.

While approximately 70% of chronic low back pain (CLBP) sufferers complain of sleep disturbance, current literature is based on self report measures which can be prone to bias and no objective data of sleep quality, based exclusively on CLBP are available. In accordance with the recommendations of The American Sleep Academy, when measuring sleep, both subjective and objective assessments should be considered as the two are only modestly correlated, suggesting that each modality assesses different aspects of an individual's sleep experience. Therefore, the purpose of this study was to expand previous research into sleep disturbance in CLBP by comparing objective and subjective sleep quality in participants with CLBP and healthy age and gender matched controls, to identify correlates of poor sleep and to test logistics and gather information prior to a larger study.

The Medical Research Council framework provides a useful general approach to designing and evaluating complex interventions, but does not provide detailed guidance on how to do this and there is little evidence of how this framework is applied in practice. This study describes the use of intervention mapping (IM) in the design of a theory-driven, group-based complex intervention to support self-management (SM) of patients with osteoarthritis (OA) and chronic low back pain (CLBP) in Ireland’s primary care health system. The six steps of the IM protocol were systematically applied to develop the self-management of osteoarthritis and low back pain through activity and skills (SOLAS) intervention through adaptation of the Facilitating Activity and Self-management in Arthritis (FASA) intervention. A needs assessment including literature reviews, interviews with patients and physiotherapists and resource evaluation was completed to identify the programme goals, determinants of SM behaviour, consolidated definition of SM and required adaptations to FASA to meet health service and patient needs and the evidence. The resultant SOLAS intervention behavioural outcomes, performance and change objectives were specified and practical application methods selected, followed by organised programme, adoption, implementation and evaluation plans underpinned by behaviour change theory. The SOLAS intervention consists of six weekly sessions of 90-min education and exercise designed to increase participants’ physical activity level and use of evidence-based SM strategies (i.e. pain self-management, pain coping, healthy eating for weight management and specific exercise) through targeting of individual determinants of SM behaviour (knowledge, skills, self-efficacy, fear, catastrophizing, motivation, behavioural regulation), delivered by a trained physiotherapist to groups of up to eight individuals using a needs supportive interpersonal style based on self-determination theory. Strategies to support SOLAS intervention adoption and implementation included a consensus building workshop with physiotherapy stakeholders, development of a physiotherapist training programme and a pilot trial with physiotherapist and patient feedback. The SOLAS intervention is currently being evaluated in a cluster randomised controlled feasibility trial. IM is a time-intensive collaborative process, but the range of methods and resultant high level of transparency is invaluable and allows replication by future complex intervention and trial developers.

A multicenter assessor-blinded randomized clinical trial was conducted. To investigate the difference in effectiveness of manipulative therapy and interferential therapy for patients with acute low back pain when used as sole treatments and in combination. Both manipulative therapy and interferential therapy are commonly used treatments for low back pain. Evidence for the effectiveness of manipulative therapy is available only for the short-term. There is limited evidence for interferential therapy, and no study has investigated the effectiveness of manipulative therapy combined with interferential therapy. Consenting subjects (n = 240) recruited following referral by physicians to physiotherapy departments in the (government-funded) National Health Service in Northern Ireland were randomly assigned to receive a copy of the Back Book and either manipulative therapy (MT; n = 80), interferential therapy (IFT; n = 80), or a combination of manipulative therapy and interferential therapy (CT; n = 80). The primary outcome was a change in functional disability on the Roland Morris Disability Questionnaire. Follow-up questionnaires were posted at discharge and at 6 and 12 months. The groups were balanced at baseline for low back pain and demographic characteristics. At discharge all interventions significantly reduced functional disability (Roland Morris scale, MT: −4.53; 95% CI, −5.7 to −3.3 vs. IFT: −3.56; 95% CI, −4.8 to −2.4 vs. CT: −4.65; 95% CI, −5.8 to −3.5; P = 0.38) and pain (McGill questionnaire, MT: −5.12; 95% CI, −7.7 to −2.5 vs. IFT: −5.87; 95% CI, −8.5 to −3.3 vs. CT: −6.64; 95% CI, −9.2 to −4.1; P = 0.72) and increased quality of life (SF-36 Role-Physical, MT: 28.6; 95% CI, 18.3 to 38.9 vs. IFT: 31.4; 95% CI, 21.2 to 41.5 vs. CT: 30; 95% CI, 19.9 to 40; P = 0.93) to the same degree and maintained these improvements at 6 and 12 months. No significant differences were found between groups for reported LBP recurrence, work absenteeism, medication consumption, exercise participation, or healthcare use at 12 months (P > 0.05). For acute low back pain, there was no difference between the effects of a combined manipulative therapy and interferential therapy package and either manipulative therapy or interferential therapy alone.

Despite emphasis on patient centred healthcare, healthcare professionals have been slow to use validated measurements of patient satisfaction in physiotherapy practice. The aim of this cross sectional survey was to measure patient satisfaction with private physiotherapy in Ireland, for patients with musculoskeletal pain, using a previously validated survey instrument.