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Physical Therapy

Guide to locating research evidence and tools for Physical Therapy students and faculty.

Defining the Question: Background and Foreground Questions

Background questions can help you develop foundational knowledge about whatever topic interests you.

Topic example: mindfulness training and chronic pain management in patients with fibromyalgia

Here are some examples of background questions related to the topic:

  • What populations of people are most impacted by fibromyalgia?
  • What types of therapies are most commonly used to treat pain in fibromyalgia patients?
  • How is mindfulness defined? Are there different types of mindfulness training? If so, what are they?
  • What are the core principles underlying mindfulness and mindfulness training?
  • How does one measure chronic pain?

The Find Background Information section of this guide lists useful sources for answering background questions.

Foreground questions are specific. They often deal with a particular therapy or intervention of interest.

A research question framework can help you organize the concepts in your foreground question. There are a number of different frameworks. The one you choose should correspond to the type of question you are asking.

  • PICO (Problem/Population, Intervention, Comparison, Outcome): The most common clinical question framework. Useful for clinical questions addressing the effect of an intervention, therapy, or treatment. 
  • ECLIPSe (Expectation, Client Group, Location, Impact, Professionals, Service): Useful for questions about policy and services.
  • PCC (Population/Problem, Concept, Context): Useful for broad scoping questions.
  • PEO (Population, Exposure, Outcome): Useful for describing association between exposures/risk factors and outcomes.
  • SPICE (Setting, Perspective, Intervention/phenomenon of Interest, Comparison, Evaluation): Useful for evaluating the outcomes of a service, project, or intervention.
  • SPIDER (Sample, Phenomenon of Interest, Design, Evaluation, Research Type): Useful for questions of experience or perspectives (questions that may be addressed by qualitative or mixed methods research).

PICO Framework Example

P (Population/Problem of Interest) = People with fibromyalgia

I (Intervention) = Aquatic therapy

C (Comparison Intervention) = No aquatic therapy

O (Outcome) = Reduction in pain

How effective is aquatic therapy for pain management (pain reduction) in people with fibromyalgia? 

ECLIPSe Framework Example

E (Expectation) = To increase access to physical therapy services

(Client Group) = People with osteoarthritis living in rural communities

(Location of service or policy) = Hospitals

(Impact of service or policy) = Increased utilization of physical therapy services by people with osteoarthritis living in rural areas

(Professionals involved in offering the service or policy) = Physical therapists, Hospital administrators

Se (Service) = Physical therapy services

How can physical therapists and hospital administrators work together to increase utilization of hospital-based physical therapy services by people with osteoarthritis who live in rural areas?

PCC Framework Example

(Population characteristics or Problem focus) = Graduate students

(Concept being examined) = Technological literacy

(Context for the question - could include geographic location, setting of interest, etc.) = Physical therapy programs

How do physical therapy programs teach and measure the technological literacy of their graduate students throughout their educational programs?

PEO Example

(Population) = Novice physical therapists

(Exposure)=Mentoring programs

(Outcome)=Professional confidence

What impact do mentoring programs have on the professional confidence of novice physical therapists?

SPICE Example

(Setting) = Physical therapy graduate programs

(Perspective) = New physical therapy graduate students

(Intervention/Interest/Exposure) = Mindfulness training

(Comparison) = No mindfulness training

(Evaluation) = Reduced stress levels

What is the impact of mindfulness training on the stress levels of new physical therapy graduate students?

SPIDER Example

(Sample, i.e. the group being studied) = Physical therapy interns

PI Phenomenon of Interest, i.e., the reason for the behavior or decisions) = Clinical placements in extended care facilities

(Design, i.e. how the research was collected) = Surveys and interviews

(Evaluation, i.e. the outcome being impacted) = Experiences and attitudes

(Research type) = Qualitative, quantitative, or mixed methods

What are the experiences of physical therapy interns in clinical placements at extended care facilities?