Checklists to manage Pain Induced by Exercise and Mobilization (PIEM) during physical therapy programs: PIEM checklists for practitioners and physiotherapists

Objectives: Identify key informational and educational items (messages) to provide to physicians (general practitioners and specialists) and physiotherapists for the management of pain induced by exercise and mobilization (PIEM). Develop checklists to improve this management in daily practice. Material and methods: The Delphi method for consensus-building was used to identify informational and educational messages for health professionals who deal with PIEM. Informed by the results of an extensive qualitative study, a panel of experts from 5 medical and paramedical disciplines concerned with PIEM and a representative of a patients' association were interviewed individually and iteratively in order to obtain a single, convergent opinion. Results: Delphi consultation helped to determine 9 areas corresponding to 54 key messages of information and education for doctors and physiotherapists who deal with PIEM. These messages relate to: defining, characterizing, identifying, and evaluating PIEM; identifying factors that may cause or increase this pain; informing the patient in order to avoid misinterpretation of PIEM; preventing and treating PIEM; and dealing with it during physical therapy sessions. The method also enabled us to develop 2 synthetic instruments (checklists) -1 for physicians and 1 for physiotherapists - to help with the management of this pain. Conclusion: Consulting a panel of experts comprising different categories of actors dealing with PIEM on the basis of a thorough qualitative diagnosis in order to identify messages for a training program makes it possible to harmonize programs with the expectations of patients and the problems encountered by professionals. The formulation of this program and the institutionalization of two checklists should enable health professionals to identify, qualify, and deal more effectively with PIEM. (C) 2015 Elsevier Masson SAS. All rights reserved.