- •Web based modified Delphi study identifying expert consensus during 3 rounds.
- •Consensus was found in the following categories: examination procedures, therapeutic interventions, orthotic intervention considerations, contributing patient factors, and clinical decisions and rehabilitation challenges.
- •Findings of this study support the need for future high-level studies looking at effectiveness of recommended therapeutic interventions.
: Web-based modified Delphi study.
: Therapy is widely considered the first choice of treatment for posttraumatic stiffness of the elbow since loss of motion is a common sequela following traumatic elbow injuries. There is high variability in practice patterns for the management of the posttraumtic elbow.
: The aim of this study is to identify the current therapeutic management of posttraumatic elbow stiffness using expert consensus.
: This study surveyed experts using a web-based 3 round modified Delphi method. 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 and comment boxes enabled open-ended responses to gather expert opinion. 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.
: 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. Twenty-five percent 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 design and wearing schedule.
: The findings of this web-based modified Delphi study helped to establish a current body of knowledge using expert consensus to guide practice and identify specific questions that can be studied in future clinical studies on posttraumatic elbow stiffness.
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JHT Read for Credit
Quiz: # 846
Record your answers on the Return Answer Form found on the tear-out coupon at the back of this issue or to complete online and use a credit card, go to JHTReadforCredit.com. There is only one best answer for each question.
- # 1.How many rounds were needed to reach consensus?
- # 2.To be included as a so-called expert, a therapist had to treat a minimum of ______ traumatic elbow patients in a year
- # 3.Commonly encountered clinical issues included
- a.reactive flares to interventions
- b.reluctance to wearing splints
- c.altered esthetics secondary to limited ROM
- d.insurance company's declining reimbursement for therapy
- # 4.The experts agreed that the chief intervention was
- a.manual therapy
- b.orthotic wearing
- c.physical agent modalities
- d.therapeutic exercise
- # 5.The Modified Weeks Test was the most commonly identified tool for assessing orthotic intervention
When submitting to the HTCC for re-certification, please batch your JHT RFC certificates in groups of 3 or more to get full credit.
Published online: January 12, 2022
Accepted: November 13, 2021
Received in revised form: October 30, 2021
Received: February 17, 2021
Published by Elsevier Inc.